3 Takeaway Points

By Jamie Bussin and Dr. Sean Wharton

Dr. Sean Wharton has a doctorate in pharmacy and medicine from the University of Toronto. He’s the medical director of the Wharton Medical Clinic, a community based internal medicine, weight management and diabetes clinic. Dr. Wharton’s research focuses on bariatric medicine and type 2 diabetes. He’s the co-lead author of the Canadian obesity guidelines. In late 2022, researchers and clinicians gathered at ObesityWeek® – an international conference to review the latest developments in evidence-based obesity science and clinical research. Dr Wharton attended the ObesityWeek conference and reported on those findings on Episode #263 of The Tonic Talk Show/Podcast. This is an excerpted digest of that interview.

Obesity and Racial Disparities: According to Dr. Wharton, there’s a lot of bias, stigma and discrimination in the field of weight management and obesity medicine which is the reason he focused his practice on this issue. There is a higher percentage of obesity and complications associated with obesity amongst specific ethnic groups (specifically in Indiginous and Black groups). But is the cause genetic or systemic racism? It turns out that the answer is primarily structural racism and not biological. There are ethnic variations in body composition. But those differences don’t specifically account for morbidity, mortality or medical problems;  or issues such as ‘food deserts’ and disparity in care, access to medications. 

Historically there are adjustments to medical calculations that are because of ethnicity – which current research suggests is invalid. Just basing those adjustments on the colour of one’s skin is incorrect. There are so many genetic factors in individuals which must be taken into account. The research shows that grouping people racially does not lead to good outcomes medically vis a vis obesity. Rather look at the individual’s comorbidities (ie. risk factors such as blood sugar levels, blood pressure and family history). Even the measure of BMI for an individual can be misleading. The BMI cut offs were designed for white European males. They weren’t designed for women or Black or Asian people and therefore don’t pertain to the majority of the world.  

Obesity and Our Children: We tend to focus on obesity in adults because that is where all the marketing for drugs is done and there is research to support it. But the real problem is that there is an obesity epidemic and pandemic among our children. We’ve had very little success in managing children’s weight. Dr. Wharton says that the epidemic has nothing to do with a lack of activity. The research shows that childhood obesity has more to do with genetics and the current environment of genetically engineered and unhealthy foods and comfortable surroundings which don’t require us to lose weight. However, at ObesityWeek a new paper was presented showing that a new drug STEP TEENS (in phase 3 testing) for adolescents is effective in bringing weight down significantly for obese teenagers. 

Obesity and the Elderly: The elderly population is at greater risk of comorbidities (ie. Type 2 Diabetes, high blood pressure, etc.). As we get older our metabolic rate goes down. As a result it gets harder to keep weight off over the long term. However, research shows that older people do better in lifestyle modifications studies; lowering food intake, becoming more active. This is because the elderly have more time, more capacity to make change, and also a better understanding of their bodies. We also know that tools like cognitive therapy and even bariatric surgery can be used without adverse effects. 

For more information about Dr. Sean Wharton visit www.whartonmedicalclinic.com