leaders in health: dr. sean wharton and compassion in obesity medicine

self-reported weight and height data from the  2022 canadian community health survey suggest that close to one in three canadians aged 18 and older (30 per cent) were obese in 2022, up from just over one in five (21 per cent) in 2003.

why, exactly? society is steeped in diet culture. thinness is a marker of success and health, and while you could say that getting thin for celebrities is part of the job, for the rest of us, it can lead to obsessive deprivation or cosmetic surgery to find the “best” version of ourselves that we can present to the world. eating disorders are now on the rise worldwide, with prevalence between 2000 and 2018 more than doubling from 3.4 per cent to 7.8 per cent of the population, the center for women’s health reports .

people with larger bodies are marginalized, bullied and made to feel ashamed. studies have demonstrated that heavier employees face systemic discrimination in the workplace, and a widely publicized 2006 survey by the rudd center for food and obesity at yale revealed that of 4,000 respondents, nearly half said they would give up a year of their life rather than be fat.

while he’s clearly dedicated to his work, sean didn’t grow up planning to be a doctor who would lead projects like canada’s new guidelines for treating obesity , published in 2020 in the canadian medical association journal, that call for a shift in focus to the root causes rather than weight loss alone (and many other notable achievements). his dad was a physiotherapist who wanted him to study medicine and sean had the grades and ability to go that path. he started with pharmacy at the university of toronto where he went on to get a doctorate degree. he became a pediatric pharmacist at toronto east general hospital, now the michael garron hospital. while he loved the work and the profession, he decided to go medical school at the university of toronto where he founded the black medical students association in 2000, now a recognized mentorship organization.

obesity treatment at his clinic and in the field has come a long way, with lifestyle and dietary interventions based on research, such as the canada food guide , that are now complemented by the promising effectiveness of prescription medications like wegovy and ozempic as an alternative to bariatric surgery. these two medications are glp-1 agonists, the “winners” in the pharmacological space for weight loss treatment, sean says. the first generation delivered between eight to 10 per cent weight loss, and now generation three is coming out within a couple years, showing up to 25 to 30 weight loss, which is well into the surgical levels achieved by a bariatric procedure.

many people with obesity will likely need to remain on medication permanently, as the bbc reports , but clinical trials are planned to see whether higher doses of glp-1 drugs can be used in the acute phase to help patients shed pounds, followed by lower maintenance doses. they come with fewer side effects (like the nausea, stomach pain and heartburn that can happen with wegovy) and are prescribed long-term. the coming wave of lower-cost generic alternatives could make this scenario more viable.