iA Financial Group is backing a more integrated approach, including research and program design, as employers shift from coverage debates to measurable outcomes
Employers have more influence over obesity-related outcomes than many realize, but not in the way they often assume. The biggest lever is not a single benefit enhancement or a one-time wellness program. It is whether employees can access structured, sustained support early enough to prevent productivity loss from turning into disability risk.
Obesity is increasingly recognized as a chronic disease shaped by a range of medical, pharmacological, biological, psychological, environmental and social drivers, and its prevalence continues to climb. Statistics Canada reported that 68% of Canadian adults aged 18 to 79 were classified as overweight or having obesity between 2022 and 2024, up from 60% in 2016 to 2019.
New evidence and a widening set of treatment options are reshaping how obesity is understood and managed. Employers are moving the conversation beyond coverage questions and toward a more operational challenge: what does effective care look like inside a workplace benefits plan, and what happens when support remains partial?
Eveline Keable, Strategic Leader, Health, Wellness and Disability at iA Financial Group’s Group Benefits and Retirement Solutions, has spent more than 25 years in group benefits. Her view is that obesity has become harder to separate from the core outcomes employers already care about: productivity, disability risk, and workforce stability.
When presenteeism becomes a disability problem
The most obvious workplace costs associated with obesity tend to be the ones employers already track: drug claims, equipment expenses tied to sleep apnea, or rising utilization connected to diabetes and cardiovascular disease.
But Keable argues the bigger impact often appears earlier, in productivity.
“We realize that the more the level of obesity is high, the more there is an increase in absenteeism and presenteeism,” she said. “And at some point… the presenteeism becomes absenteeism.”
Presenteeism is harder to measure than absenteeism because the employee is still at work. Yet the operational consequences are real. Keable notes, “Presenteeism among employees with obesity is largely driven by sleep problems, as obstructive sleep apnea affects an estimated 40% to 90% of individuals with obesity, depending on severity.”
A worker who is fatigued, cognitively foggy, or physically limited may still attend every shift while producing less, or needing more support. In many workplaces, those performance issues are addressed as behavioural or managerial concerns rather than health risks.
They may not see it labelled explicitly, but it is often present underneath the conditions that are already driving cost and disability outcomes: hypertension, type 2 diabetes, osteoarthritis, cardiovascular disease, musculoskeletal issues and mood disorders. That overlap also means obesity may not appear as the stated cause of disability, even when it influences the trajectory of a claim.
From an employer’s perspective, that point is more than clinical nuance. It explains why obesity can affect disability duration and recovery outcomes without being visible in the initial diagnosis.
It also helps explain why many plan sponsors are beginning to treat obesity as a long-term risk exposure. iA Financial Group internal data from 2025 estimates that, for a typical group of 500 employees, obesity is associated with roughly $457,000 annually in disability and premature mortality costs, in addition to broader comorbidity-related expenses.
Those downstream costs often accumulate quietly. Disability cases become longer or more complex. Return-to-work pathways require additional supports. And the productivity impact builds long before any formal claim is triggered.
Why employee demand is forcing the benefits conversation forward
The rapid growth of anti-obesity medications has brought obesity into sharper focus for plan sponsors. Employees are asking about access. Employers are assessing affordability and utilization risk. In many organizations, the question is no longer whether weight management belongs in the workplace, but what effective support should look like.
That shift is being reinforced by plan member expectations. National survey findings cited by iA show that 55% of Canadians believe group insurance should include obesity management services, and 74% say they would participate in an employer-supported program if it were accessible, personalized, evidence-based, and affordable (iA Financial Group-Leger 2025 Survey). In Benefits Canada’s 2025 Health Care Survey, 65% of plan members say they want access to weight loss medications as part of their benefits.
Keable noted, “With more anti-obesity drugs entering the market, many plan sponsors focus on the added spend,” she said. “But they often underestimate the longer-term return.”
At the same time, she is cautious about treating medication coverage as a complete strategy. “Without broader support, people may stop treatment and lose the progress they’ve made.”
Her point is that obesity care tends to break down when it is episodic. Sustainable progress depends on adherence and the ability to address factors that sit beyond nutrition or willpower. That includes psychological drivers, social barriers, and practical limitations that affect engagement.
Keable also emphasizes sequencing, “For many plan members, the hardest part is knowing where to start,” she said. “Assessment early on helps establish a clear starting point and a path forward.”
Without that, employees may tackle obesity through one step at a time, such as visiting a dietitian, without addressing comorbidities or behavioural barriers that influence relapse and disengagement. Employers may see initial uptake, but weak sustained outcomes.
When evaluating success, adherence is just as important as participation. That includes adherence to medication and engagement with the broader support system required for lasting change.
Employers should set realistic success thresholds. Evidence suggests that even moderate improvement can be clinically meaningful. A 5% to 10% reduction in weight can improve health outcomes and reduce risk, supporting a more practical definition of progress for plan sponsors and plan members.
What employers can do without turning HR into clinicians
Obesity management raises a concern for HR leaders: how involved should employers be, and what is the appropriate role for managers?
Keable draws a clear boundary. Employers do not need HR teams and managers to become clinical specialists. Their role is to reduce friction and connect employees to resources.
That typically means clearer communication, stronger education, and less stigma. It also means improving navigation so employees understand what services exist, how they fit together, and what the first step should be.
One challenge for employers is that obesity care is still evolving. Weight management programs are newer than many other benefit categories, and the evidence base continues to develop, particularly in Canada. That is partly why some insurers have begun investing directly in research tied to obesity care pathways and long-term outcomes.
Employers can take a more evidence-based approach by using available data. Keable noted that insurers can provide anonymized insights on disability causes, drug utilization, and practitioner usage patterns. Employers can pair that with internal workforce signals, including absenteeism trends by role or department, to identify where risks may be building and where targeted support is likely to have the most impact.
iA Financial Group has committed $200,000 to the Quebec-based IUCPQ Foundation to support HARMONY, a research project evaluating a holistic obesity care model that combines medical treatment, nutrition, and personalized physical activity. The goal is to strengthen understanding of care pathways over time. The project is also intended to address unanswered questions about the real-world effects of weight-loss medications.
For employers deciding how to approach obesity support, those research efforts underscore a broader point: this is not a static category. Treatment options, clinical evidence, and best practices are moving quickly, and benefits strategies that remain episodic or piecemeal may struggle to keep pace.
Access iA Financial’s Obesity White Paper practical guidance: Managing Obesity: A Shared Commitment
Learn more about iA’s weight‑management offer or contact our team for support: Weight management: Leveraging group insurance plans to support wellbeing
This article was produced in partnership with iA Financial Group
