Obesity Assessment Beyond BMI: The 4Ms Framework with Dr. Kristin Terenzi

Screening for Complications Related to Obesity with Dr. James Kim

🎙️This episode is supported by an unrestricted educational grant from Eli Lilly Canada What happens when a symptom is explained away too quickly? For people living with obesity, concerns like fatigue, shortness of breath, poor sleep, or pain are too often viewed through the lens of weight first. That can delay the right questions, the right tests, and the right care. In this episode, Dr. James Kim joins the podcast for a practical conversation about screening for obesity-related complications without letting weight bias narrow the clinical picture. We explore how healthcare professionals can recognize diagnostic overshadowing, build more consistent screening workflows, and make care safer, more respectful, and more evidence-based for people living with obesity. In this episode * Why diagnostic overshadowing can lead to missed or delayed diagnoses for people living with obesity * How to build practical screening workflows for obesity complications in primary care * What clinicians should know about MASLD, sleep apnea, insomnia, and cardiometabolic risk * How equipment and testing limitations can affect the reliability of screening results * How to talk about obesity complications without blame, shame, or stigma Additional resources * Canadian Adult Obesity Clinical Practice Guideline: https://utm.guru/uq74A [https://utm.guru/uq74A]  * Chapter: Assessment of People Living With Obesity: https://utm.guru/uq74B [https://utm.guru/uq74B]  * Free course: Obesity Assessment Essentials: https://utm.guru/uq74C [https://utm.guru/uq74C]  Calibre: Practical Clinical Strategies for Obesity Management If this episode leaves you thinking about how to strengthen your own approach to obesity care, Obesity Canada’s Calibre course is designed to help. Calibre is an accredited course for healthcare professionals who want practical, evidence-based tools they can apply in real clinical settings. The course combines self-paced learning with live, interactive sessions, helping learners build confidence in obesity assessment, treatment, communication, and patient-centred care. The next cohort runs September 3 through October 7 . Learn more & register: https://utm.guru/upbeo [https://utm.guru/upbeo]  Learning objectives * Apply evidence-based resources from the Canadian Adult Obesity Clinical Practice Guidelines to select and interpret appropriate screening tests for obesity-related complications. * Analyze cardiovascular, metabolic, and mechanical diagnostic results to address knowledge gaps and guide individualized obesity management. * Evaluate how diagnostic overshadowing and systemic weight bias lead to under-screening or the misinterpretation of symptoms in patients living with obesity. Enjoying the podcast? Support Scale Up Your Practice by: * Sharing this episode with a colleague or team member * Subscribing on your favourite podcast platform * Leaving a review to help more listeners find the show Have a question or a topic you’d like us to cover? Email us at scaleuppod@obesitycanada.ca Disclosures This episode script was developed using NotebookLM to synthesize complex source materials into a structured educational format. The tool was used to analyze the Canadian Obesity Education Competencies (COECs), the Obesity Canada Strategic Plan, and guest-specific research. Specific prompts were utilized to extract relevant learning objectives, map them to CanMEDS roles, and generate competency-based interview questions. While NotebookLM assisted in drafting the narrative arc and educational framework, all content has been reviewed, fact-checked, and refined by the podcast hosts and Obesity Canada's clinical experts. This ensures the script aligns with current Clinical Practice Guidelines and authentically represents the lived experience perspective.

Using EOSS and the 5As to Assess Obesity with Dr. Denise Campbell-Scherer

🎙️This episode is sponsored by an unrestricted education grant from Eli Lilly Canada. When obesity assessment starts and ends with BMI, important parts of the patient story can disappear. In this episode, Dr. Roshan Abraham and Michelle McMillan speak with Dr. Denise Campbell-Scherer about what it takes to assess obesity with more clarity, more context, and more respect for the person seeking care using the Edmonton Obesity Staging System  and the 5A’s Framework. In this episode * Why BMI can be part of the clinical assessment, but should never stand in for the whole person * How the Edmonton Obesity Staging System (EOSS) helps clinicians understand clinical severity, not just body size * What the 4Ms can reveal about mental, mechanical, metabolic, and monetary drivers of obesity * How a patient’s story can uncover barriers that a checklist may miss * Why strength-based counselling can change the experience of care for both patients and clinicians * How the 5As Team Tools can make obesity assessment more practical in primary care * What it sounds like to speak with patients about weight concerns without blame, assumptions, or shame Additional resources * Free course: Obesity Assessment Essentials https://utm.guru/uqG2K [https://utm.guru/uqG2K]  * Canadian Adult Obesity Clinical Practice Guidelines https://utm.guru/uqG2M [https://utm.guru/uqG2M]   * Chapter: Primary Care and Primary Healthcare in Obesity Management https://utm.guru/uqG2N [https://utm.guru/uqG2N]  * Edmonton Obesity Staging System https://utm.guru/uqG27 [https://utm.guru/uqG27]  * Dr. Campbell-Scherer’s 5As Team Tools https://utm.guru/uqG3j [https://utm.guru/uqG3j]  Calibre: Practical Clinical Strategies for Obesity Management If this episode leaves you thinking about how to strengthen your own approach to obesity care, Obesity Canada’s Calibre course is designed to help. Calibre is an accredited course for healthcare professionals who want practical, evidence-based tools they can apply in real clinical settings. The course combines self-paced learning with live, interactive sessions, helping learners build confidence in obesity assessment, treatment, communication, and patient-centred care. The next cohort runs September 3 through October 7. Learn more & register: https://utm.guru/uqG4F [https://utm.guru/uqG4F]  Learning Objectives * Apply the Edmonton Obesity Staging System (EOSS) to determine the clinical severity of obesity and prioritize individualized management strategies. * Analyze the mental, mechanical, metabolic, and monetary (4Ms) drivers of a patient's obesity to move beyond BMI-centric assessments. * Evaluate how utilizing the EOSS framework reduces systemic weight bias by shifting clinical focus from weight loss to meaningful health outcomes and functional stewardship. * Apply a patient-centered approach to establish values-based goals and assess obesity classification (BMI/waist circumference), while respecting patient readiness and comfort during the initial clinical encounter. * Analyze the mental, mechanical, metabolic, and monetary (4Ms) framework to comprehensively evaluate adiposity-related complications and root causes of weight gain. * Evaluate disease severity using the Edmonton Obesity Staging System (EOSS) to prioritize patient-centered management for patients living with obesity Have a topic you’d like us to cover? Email us at scaleuppod@obesitycanada.ca Disclosures: This episode script was developed using NotebookLM to synthesize complex source materials into a structured educational format. The tool was used to analyze the Canadian Obesity Education Competencies (COECs), the Obesity Canada Strategic Plan, and guest-specific research. Specific prompts were utilized to extract relevant learning objectives, map them to CanMEDS roles, and generate competency-based interview questions. While NotebookLM assisted in drafting the narrative arc and educational framework, all content has been reviewed, fact-checked, and refined by the podcast hosts and Obesity Canada's clinical experts. This ensures the script aligns with current Clinical Practice Guidelines and authentically represents the lived experience perspective.

Starting with the basics: Common obesity cases in practice with Drs. Rishi Handa & Taniya Nagpal

This special live episode of Scale Up Your Practice was recorded at the 2026 Canadian Obesity Summit in Montreal this past March. Dr. Roshan Abraham is joined by guest host Dr. Taniya Nagpal and special guest Dr. Rishi Handa for a case-based conversation about what obesity care can look like when healthcare professionals move beyond standardized answers and build care around the person in front of them. Through three common clinical cases, the episode explores how culture, patient goals, medication side effects, language used in referrals, weight bias, and clinical humility can shape the care experience. The conversation also asks a deeper question: what happens when standard practice stops being helpful and starts becoming a barrier? In this episode - Why evidence-based obesity assessment must look beyond standard BMI cut-offs, especially when caring for diverse populations - How weight bias and anticipatory stigma can shape clinical encounters before the appointment even begins - What healthcare professionals can include in referrals to make obesity care more specific, respectful, and collaborative - Why patient goals, function, culture, heritage, and lived experience need to be part of the care plan - How interprofessional care can support people starting obesity pharmacotherapy, including side effect management and nutrition support - Why culturally safe care means asking better questions instead of relying on one-size-fits-all advice Additional resources Canadian Adult Obesity Clinical Practice Guidelines: https://utm.guru/up0gz [https://utm.guru/up0gz]  Free course: Obesity Assessment Essentials: https://utm.guru/up0gA [https://utm.guru/up0gA]   Free course: Words Matter: The Consequences of Weight Bias & Stigmatizing Language: https://utm.guru/up0gB [https://utm.guru/up0gB]   Weight bias and stigma research from Dr. Nagpal - Widespread misconceptions about pregnancy for women living with obesity https://utm.guru/up0gG [https://utm.guru/up0gG]  - Women’s Suggestions for How to Reduce Weight Stigma in Prenatal Clinical Settings: https://utm.guru/up0gH [https://utm.guru/up0gH]  Calibre: Practical Clinical Strategies for Obesity Management If this episode leaves you thinking about how to strengthen your own approach to obesity care, Obesity Canada’s Calibre course is designed to help. Calibre is an accredited course for healthcare professionals who want practical, evidence-based tools they can apply in real clinical settings. The course combines self-paced learning with live, interactive sessions, helping learners build confidence in obesity assessment, treatment, communication, and patient-centred care. The next cohort runs September 3 through October 7. Learn more & register: https://utm.guru/up0gC [https://utm.guru/up0gC]  Learning objectives * Apply evidence-based obesity assessment principles to common patient presentations in clinical practice (Medical Expert). * Develop an individualized, guideline-informed obesity management plan using case-based scenarios, incorporating behavioural, surgical, pharmacological, and referral-based interventions as appropriate (Medical Expert, Leader). * Identify and address common clinical barriers in order to support patient-centred, collaborative obesity care (Communicator, Collaborator, Professional). Disclosures This episode script was developed using NotebookLM to synthesize complex source materials into a structured educational format. The tool was used to analyze the Canadian Obesity Education Competencies (COECs), the Obesity Canada Strategic Plan, and guest-specific research. Specific prompts were utilized to extract relevant learning objectives, map them to CanMEDS roles, and generate competency-based interview questions. While NotebookLM assisted in drafting the narrative arc and educational framework, all content has been reviewed, fact-checked, and refined by the podcast hosts and Obesity Canada's clinical experts. This ensures the script aligns with current Clinical Practice Guidelines and authentically represents the lived experience perspective.

Obesity Assessment Beyond BMI: The 4Ms Framework with Dr. Kristin Terenzi

🎙️This episode is sponsored by an unrestricted education grant from Eli Lilly Canada What happens when obesity assessment stops at BMI? In this episode of Scale Up Your Practice, we speak with Dr. Kristin Terenzi, family physician based in Ontario, about what it really means to assess obesity well in primary care. Drawing on both clinical experience and lived experience, Dr. Terenzi discusses how the 4Ms framework can help clinicians move beyond weight alone to better understand the mental, mechanical, metabolic, and social factors affecting a person’s health. The conversation explores how stigma and self-blame can shape the care experience, why trust matters, and how thoughtful, realistic assessment can open the door to care that feels more supportive, more practical, and more effective over time. In this episode * Why obesity assessment needs to go beyond BMI to explore the mental, mechanical, metabolic, and social factors shaping a person’s health. * How the 4Ms framework can help clinicians uncover root causes, understand barriers, and build more realistic care plans. * What internalized weight bias and self-blame can sound like in practice, and how clinicians can respond in ways that build trust and reduce shame. * Why follow-up, shared decision-making, and focusing on function rather than weight can help patients stay engaged in long-term care. Additional resources * Free course: Obesity Assessment Essentials https://utm.guru/upqGa [https://utm.guru/upqGa]  * Assessment of People Living with Obesity chapter of the Canadian Adult Obesity Clinical Practice Guidelines https://utm.guru/upqGv [https://utm.guru/upqGv]  * PDF download: 5As Framework for Obesity Management in Adults https://utm.guru/upqGQ [https://utm.guru/upqGQ]   * PDF download: The Edmonton Obesity Staging System https://utm.guru/upqHa [https://utm.guru/upqHa]  Learning objectives * Apply the 4Ms framework (Mental, Mechanical, Metabolic, Monetary/Milieu) to obtain a comprehensive, obesity-focused patient history that identifies the root causes of weight gain. * Analyze the biological and psychosocial drivers of obesity—including life transitions like menopause and mechanical barriers like osteoarthritis—to co-construct individualized, evidence-based management plans. * Evaluate how systemic weight bias and internalized shame prevent patients from seeking care, and implement stigma-free communication to build therapeutic trust. Enjoying the podcast? Support Scale Up Your Practice by: * Sharing this episode with a colleague or team member * Subscribing on your favourite podcast platform * Leaving a review to help more listeners find the show Have a question or a topic you’d like us to cover? Email us at scaleuppod@obesitycanada.ca Disclosures This episode script was developed using NotebookLM to synthesize complex source materials into a structured educational format. The tool was used to analyze the Canadian Obesity Education Competencies (COECs), the Obesity Canada Strategic Plan, and guest-specific research. Specific prompts were utilized to extract relevant learning objectives, map them to CanMEDS roles, and generate competency-based interview questions. While NotebookLM assisted in drafting the narrative arc and educational framework, all content has been reviewed, fact-checked, and refined by the podcast hosts and Obesity Canada's clinical experts. This ensures the script aligns with current Clinical Practice Guidelines and authentically represents the lived experience perspective.

How to start the conversation about weight with Dr. Shahebina Walji

🎙️This episode is supported by an unrestricted education grant from Eli Lilly Canada What happens in the first few moments of a conversation about weight with a patient can shape everything that follows. Dr. Shahebina Walji joins us for a thoughtful conversation about how to start discussions about weight in a way that feels respectful, collaborative, and actually helpful. We explore the power of asking permission, the harm weight bias can cause in clinical care, and the small but meaningful language shifts that can help patients feel heard instead of judged. If you’ve ever wondered how to approach this topic with patients more thoughtfully in practice, this conversation offers practical guidance you can use right away. In this episode * Why asking permission to talk about weight can reduce anxiety, build trust, and help patients feel safe enough to be honest and engaged in care. * How to move beyond generic advice by taking a more tailored, longitudinal history that reflects a person’s health, context, barriers, and goals. * Practical, patient-centred language clinicians can use to open conversations with respect, avoid over-attributing symptoms to weight, and strengthen therapeutic relationships over time. Additional resources * Primary Care Chapter of the Canadian Adult Obesity Clinical Practice Guidelines: https://utm.guru/uoKEu [https://utm.guru/uoKEu] * The 5As Framework for Obesity Management in Adults: https://utm.guru/uoKFh [https://utm.guru/uoKFh] * Edmonton Obesity Staging System: https://utm.guru/uoKFk [https://utm.guru/uoKFk] * Canadian Obesity Education Competencies: https://utm.guru/uoKFl [https://utm.guru/uoKFl] Take the next step in evidence-based obesity care Obesity Canada’s Calibre program is an accredited, expert-led course designed to help healthcare professionals strengthen their skills in obesity care. Grounded in Canada’s Adult Obesity Clinical Practice Guideline, it blends self-paced learning with live, interactive sessions on communication, bias, collaborative care, and evidence-based treatment.  Learn more and register for the September 2026 cohort here: https://utm.guru/uoKFo [https://utm.guru/uoKFo]  Learning objectives * Apply a patient-centered approach to initiate compassionate, stigma-free conversations about obesity management during clinical encounters. * Analyze how personal and systemic weight bias act as barriers to obtaining an accurate, tailored patient history, and adjust clinical communication to build trust. * Evaluate practical strategies for asking permission and using the 5As framework to establish personalized, supportive therapeutic relationships with patients. Enjoying the podcast? Support Scale Up Your Practice by: * Sharing this episode with a colleague or team member * Subscribing on your favourite podcast platform * Leaving a review to help more listeners find the show Have a question or a topic you’d like us to cover? Email us at scaleuppod@obesitycanada.ca Disclosures This episode script was developed using NotebookLM to synthesize complex source materials into a structured educational format. The tool was used to analyze the Canadian Obesity Education Competencies (COECs), the Obesity Canada Strategic Plan, and guest-specific research. Specific prompts were utilized to extract relevant learning objectives, map them to CanMEDS roles, and generate competency-based interview questions. While NotebookLM assisted in drafting the narrative arc and educational framework, all content has been reviewed, fact-checked, and refined by the podcast hosts and Obesity Canada's clinical experts. This ensures the script aligns with current Clinical Practice Guidelines and authentically represents the lived experience perspective.