The Obesity Doctor Podcast

Bariatric surgery is one of the most effective tools we have in obesity medicine—and also one of the most misunderstood.

In this episode, I’m diving into where surgery truly fits in the treatment of obesity and metabolic health. While we often focus on medical therapies like GLP-1s, it’s important to understand the role bariatric surgery can play—and why it continues to be underutilized or dismissed by many patients.

I’m joined by Toronto-based bariatric surgeon Dr. Lazar Klein, who shares his expertise on what bariatric surgery actually involves, who it’s for, and how it fits into a comprehensive, long-term approach to care. We walk through the most common procedures available — including gastric bypass, sleeve gastrectomy, and duodenal switch variations — and clarify why older procedures like gastric banding are no longer recommended.

Dr. Klein addresses common fears around surgery, including concerns about surgical complications, dumping syndrome and lifelong changes, while offering a realistic and balanced perspective on risk.

We explore the long-term outcomes as well—how surgery impacts conditions like type 2 diabetes, sleep apnea, and cancer and even mortality, and what the evidence shows about weight maintenance years down the road.

If bariatric surgery has ever felt confusing, intimidating, or “not for you,” this episode will help bring clarity to the conversation.

Resources & Links
Ontario Bariatric Network
https://www.ontariobariatricnetwork.ca/

High Metabolic Clinic
https://www.highmetabolicclinic.com/

In this episode, I walk through what’s actually happening with generic semaglutide right now—and what it means for you in real life, not just in headlines.

I explain where semaglutide fits in the bigger picture, how it compares to tirzepatide, and why generics are entering the market now. I also break down what “bioequivalence” really means—and why that nuance matters when it comes to effectiveness and side effects.

I talk about early pricing estimates, what we might see happen with brand-name costs, and how pharmacy-level substitution could impact what patients are actually given. We get into the practical questions I’m already hearing: what the devices will look like, whether dosing will feel the same, and how switching between products might affect different patients.

I also share how I’m thinking about this clinically—who will likely transition easily, and who may need a more cautious, individualized approach. And importantly, I address a growing issue: access to medication is not the same as access to care. Obesity treatment is more than a prescription—it’s ongoing, structured medical care.

Bottom line: I’m genuinely encouraged by the potential for improved access—but your treatment should still be guided by your individual response, not just what’s available.

This is an evolving space, and I’ll keep you updated as we learn more.

WORK WITH ME

O​​ntario-Wide Virtual Obesity Management Clinic https://www.highmetabolicclinic.com

Join my Healthy Lifestyle Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweight

Binge Eating Disorder Treatment - https://www.sashahighmd.com/bed

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

FOLLOW ME on Instagram - https://www.instagram.com/sashahighmd/

Long-term change isn’t just about knowing what to do—it’s about how we see ourselves while we’re doing it. In today’s podcast episode, we explore why so many people get stuck in that gap between where we are and who we’re trying to become.

I’m joined by Registered Psychotherapist Margo Green, and we talk about how visualization and imagery can make the future feel more real and connected to who you are today. We also dive into identity-based motivation, and how the way you see yourself quietly shapes your behaviours—often more than motivation ever does.

We cover practical ways to use these tools during difficult moments, and how to begin shifting identity in a realistic, sustainable way.

Key takeaway: Motivation fades, but identity drives behaviour.

If you’re feeling stuck, start with one small shift in how you see yourself—and take action from there.

If you’d like therapy support from Margo, you can find her at:
www.highmetabolicclinic.com/psychotherapy

In this episode of the Obesity Physician Podcast, the dietitians from High Metabolic Health—Nada, Lauren, and Tedi—break down what actually works when it comes to eating for weight loss.

If you’re tired of restrictive diets and conflicting nutrition advice, this conversation focuses on practical, sustainable principles instead of quick fixes. The team shares how to build a solid foundation for long-term success, including how to structure your meals, what foods to prioritize (and limit), and where to begin your journey toward better metabolic health.

What You’ll Learn
- Why dieting often fails—and what to focus on instead
- The core eating foundations for sustainable weight loss
- How to build a plate that keeps you full, satisfied, and energized
- Key foods to prioritize for metabolic health
- Foods and habits to limit (without strict restriction)
- Simple, realistic starting points for your weight loss journey

WORK WITH OUR DIETITIANS
https://www.highmetabolicclinic.com/nutrition

WORK WITH ME
Join my Weight Loss Coaching Program for women, Best Weight
https://www.sashahighmd.com/bestweight

Recover Strong for Binge Eating
https://www.sashahighmd.com/bed

O​​ntario-Wide Virtual Obesity Management Clinic
https://www.highmetabolicclinic.com

Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey. https://www.sashahighmd.com/podcast-guide

FOLLOW SASHA
Instagram - https://www.instagram.com/sashahighmd/

In this episode, I break down everything you need to know about GLP-1 medications like Ozempic, Wegovy, and Mounjaro—including the real-world side effects I see in clinical practice.

While these medications can be incredibly effective for improving metabolic health, there’s often confusion online: some people are scared away by exaggerated side effect stories, while others underestimate what to expect when starting treatment. My goal here is to give a balanced, evidence-informed perspective so patients can make informed decisions without fear or misinformation.

This episode is for educational purposes only and does not replace personalized medical advice. Always speak with your licensed healthcare provider before starting or changing any treatment.

We cover side effects and how to manage them, like:

Nausea, bloating, diarrhea, constipation

Sulphur burps and reflux

Appetite suppression and food aversions

Injection site reactions

Gallbladder disease

Hair thinning

Ozempic face

Rare: NAION

If you’re in Ontario and need support with obesity or metabolic health, you can request a referral to my multidisciplinary clinic, the High Metabolic Clinic. Learn more at www.highmetabolicclinic.com.