Ethics, equity, and relational care in obesity medicine with Dr. Jerry Maniate

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.

Ethics, equity, and relational care in obesity medicine with Dr. Jerry Maniate

🎙️This episode is supported by an unrestricted education grant from Eli Lilly Canada What does ethical obesity care look like when the system itself can make good care harder to deliver? In this episode, we speak with Dr. Jerry Maniate about trust, language, weight bias, and the kind of reflective practice that helps healthcare professionals move beyond transactional and into relational care.  In this episode * A closer look at the trust gap many people living with obesity experience in healthcare * How language can either open the door to better care or reinforce harm and disconnection * Why ethical obesity care must account for real-world barriers like access, affordability, and food insecurity * Practical reflections on how clinicians can unlearn outdated thinking and stay open to feedback Additional resources * Equity in Health Systems Lab: https://utm.guru/un7Sv [https://utm.guru/un7Sv]  * Carefully Chosen Words: Language for Inclusive Care: https://utm.guru/un7Sw [https://utm.guru/un7Sw]  * Free course: Words matter: the Consequences of Weight Bias & Stigmatizing Language: https://utm.guru/un7Sx [https://utm.guru/un7Sx]  * Canadian Adult Obesity Clinical Practice Guidelines: https://utm.guru/un7Sy [https://utm.guru/un7Sy]  * Canadian Obesity Education Competencies: https://utm.guru/un7Sz [https://utm.guru/un7Sz]  Learning objectives * Apply ethical frameworks and evidence-based best practices to navigate the rapidly evolving clinical science of obesity care. * Analyze how receiving and acting upon interprofessional feedback fosters the learning necessary to maintain clinical competence. * Evaluate how systemic weight bias compromises ethical standards of care, and identify collaborative strategies to dismantle these barriers in daily practice. 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 science and best practices and authentically represents the lived experience perspective.

Navigating obesity pharmacotherapy in clinical practice with Dr. Sean Wharton

What changes when obesity care stops being about willpower and starts with biology? In this episode, Dr. Roshan Abraham speaks with Dr. Sean Wharton about how pharmacotherapy is reshaping obesity care, why “food noise” matters, and how clinicians can support patients with more empathy, less stigma, and a better understanding of obesity as a chronic disease. In this episode * Why obesity medications need to be understood as treatment for a chronic disease, not an “easy way out”  * How Dr. Wharton explains “food noise” and why naming it can help reduce self-blame * What it looks like to pair pharmacotherapy with compassionate, person-centred care  * Why long-term obesity care requires flexibility, compassion, and the willingness to try a different path when needed Additional resources * Accredited course: Pharmacotherapy in Obesity Management: https://utm.guru/unvDk [https://utm.guru/unvDk]   * 2025 Update: Pharmacotherapy chapter of the Canadian Adult Obesity Clinical Practice Guidelines: https://utm.guru/unvDm [https://utm.guru/unvDm]  Learning objectives * Apply evidence from the 2025 GLP-1/GIP pharmacotherapy landscape to co-construct patient-centric management plans. * Analyze how obesity medications regulate neurohormonal pathways to quiet "food noise" and reinforce obesity as a complex chronic disease. * Evaluate how systemic weight bias and the framing of medications as an easy fix create barriers to equitable pharmacotherapy access. 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.