He started his clinic in 2008 to put weight and its associated risks of type 2 diabetes, fatty liver disease and osteoarthritis, among others, at the forefront because people with obesity deserve medical treatment. “Just like someone with high cholesterol, we don’t turn them away and make them pay for high cholesterol care. I absolutely insisted that it have an OHIP funded platform. There was a lot of emotion connected to that because somebody was finally trying and listening.”
Obesity treatment at his clinic and in the field has come a long way, with lifestyle and dietary interventions based on research,
, 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.
For weight loss, these medications pump the brakes on appetite and the rate food exits the stomach, so people eat less and are satisfied with smaller portions. It doesn’t work for everyone and like many chronic illnesses, from asthma to rheumatoid arthritis to high blood pressure, patients usually relapse as soon as their treatment stops.
Many people with obesity will likely need to remain on medication permanently,
, 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.