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 & LinksOntario Bariatric Networkhttps://www.ontariobariatricnetwork.ca/High Metabolic Clinichttps://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 journeyWORK WITH OUR DIETITIANShttps://www.highmetabolicclinic.com/nutritionWORK WITH MEJoin my Weight Loss Coaching Program for women, Best Weighthttps://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comTaking 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-guideFOLLOW SASHAInstagram - 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.

Hi everyone, I have a quick update I want to share. The High on Life Podcast has a new name! It’s now The Obesity Doctor Podcast. I loved the old name — it was fun and fit my personal brand — but over time I realized the conversations here have become very clearly rooted in obesity medicine. We talk about the biology of weight, behaviour change, medications, metabolism, mindset, psychology… and the realities of navigating all of that in real life. This shift is about better alignment — making it clear that this podcast is all about evidence-based, straightforward medical education, while also supporting the ways we care for and nourish our bodies. That’s been a big part of what I've done from day one, and it continues to be central to these conversations. I’ll also be bringing on other obesity physicians and health experts to share their perspectives, so you’ll get a broader, deeper look at the science and the practice behind lasting health. Nothing is changing about the conversations themselves — same nuance, same depth, same approach. It’s still about understanding your body, making sense of your patterns, and building health that lasts. If you’ve been here for a while—thank you for being part of this. And if you’re new, welcome! Thanks for trusting me as a voice and advocate in the world of medicine, health and obesity care. I’m excited for this next chapter, and I can’t wait to keep exploring these topics with you. Thanks for listening!

In this episode, I share how marathon training reshaped the way I think about food—and how those lessons apply to weight loss and metabolic health. Many people assume that eating less is the key to losing weight, but restriction can actually backfire, slowing metabolism and increasing cravings.I walk through the five most important lessons I’ve learned:1. Fuel for energy, not just calories – Nourishing your body properly supports metabolism, fat loss, and mental clarity.2. Hunger is a signal, not a failure – Learn to respond strategically to hunger instead of ignoring it.3. Carbs and sugar aren’t the enemy – Used in the right context, they support energy, recovery, and metabolic health.4. Focus on quality and timing – Protein, healthy fats, and carbs in the right balance enhance results.5. Restriction backfires—fueling wins – Sustainable weight loss comes from intentional, moderate fueling. I also share personal anecdotes from my running journey and patient experiences to show how these strategies work in real life. By shifting your mindset from restriction to fueling, you can improve energy, optimize metabolic health, and build habits that actually last.Tune in for practical tips to fuel your body, support weight loss, and maintain metabolic health—without guilt or obsession.WORK WITH MEJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comTaking 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-guideFOLLOW SASHAInstagram - https://www.instagram.com/sashahighmd/

Scarcity isn’t just about lacking resources—it’s a mindset that shows up early and often. I see it in how we eat (finishing food, eating when not hungry, “last supper” thinking), and how that drives the restrict–overeat cycle. This isn’t a discipline problem—it’s a natural response to perceived scarcity. On today’s podcast, we talk about how to shift this in a practical way: creating consistency with meals and nutrition reducing urgency around food building trust in your body and your routines I share small, everyday examples (like airplane snacks and hotel toiletries) to highlight how subtle and automatic scarcity thinking can be. The core idea: many of our behaviours—around food, business, and decision-making—are responses to perceived scarcity. The shift isn’t about “thinking positively,” but about building consistency and trust so that urgency starts to quiet down. A more sustainable way to operate—in both health and business. 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 Business & Career Coaching for Women Physicians www.sashahighmd.com/entrepreneur   FOLLOW SASHA Instagram - https://www.instagram.com/sashahighmd/

In this episode, we break down how to lose fat without sacrificing muscle so your metabolism stays strong and your results actually last.The ProblemExtreme calorie cutting, like eating 1,200 calories per day, may lead to quick weight loss but often at the cost of muscle. Losing muscle slows your metabolism and makes weight regain more likely.The Smarter Approach: Body Recomposition1. Create a Small Calorie Deficit Reduce intake by about 200 to 300 calories instead of drastically cutting. If you are stuck eating very low calories, you may need to slowly increase them before trying to lose fat again.2.Prioritize ProteinAim for 0.8 to 1 gram of protein per pound of ideal body weight each day. Spread protein evenly throughout the day, targeting around 30 grams per meal to support muscle maintenance and growth.3. Balance Your Macros Simply Start with a 1 to 1 ratio of protein to carbohydrates.Fats fill the remaining calories in your daily target. Include a carbohydrate source at each meal to support energy and training.4. Resistance trainingIncorporate resistance training at least twice per week, with the goal to build up to three times per week. Resistance training is essential to preserve and build lean muscle while losing fat.Bottom LineCrash diets wreck metabolism. Strength-focused nutrition reshapes you.RESOURCES: BMR (Basal Metabolic Rate) CALCULATOR: https://www.calculator.net/bmr-calculator.html***Disclaimer: The information in this podcast episode is for educational purposes only, and is not individual nutrition therapy, for understanding individual needs please consult with your health care professional.GROCERY GUIDE: https://www.sashahighmd.com/high-on-life-podcast-grocery-guideWORK WITH USJoin us in our Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comTaking 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-guideFOLLOW US ON INSTAGRAM:Instagramhttps://www.instagram.com/sashahighmd/

GLP-1 medications are either wildly overhyped or harshly criticized depending on the week—and one of the loudest concerns right now is that they “cause muscle loss.” In this episode, I’m digging into what the research actually shows about lean mass changes on GLP-1s, what’s being misunderstood online, and what patients and clinicians can do to protect muscle while still benefiting from these powerful therapies. To help me unpack this, I’m joined by Dr. Michael Tsoukas, Associate Professor of Medicine in the Division of Endocrinology at the McGill University Health Centre, Co-Director of the Metabolic & Weight Optimization Clinic, and a clinician-scientist whose work focuses on GLP-1 pharmacotherapy and obesity treatment. He’s trained at Tufts, McGill, and Harvard, and has authored over 50 peer-reviewed publications.We talk about where the muscle-loss concern came from, how GLP-1 weight loss compares to bariatric surgery and diet-only approaches, and whether lean mass loss always reflects true functional muscle loss. We also get practical, discussing resistance training and protein targets (it’s more than you may think!).If you’re on a GLP-1, considering one, or prescribing them—this is a science-based conversation that separates fear from facts.Guest: Dr. Michael TsoukasWebsite: mwoc.caWORK WITH MEJoin my Weight Loss Coaching Program for women, Best Weight https://www.sashahighmd.com/bestweightRecover Strong for Binge Eatinghttps://www.sashahighmd.com/bedO​​ntario-Wide Virtual Obesity Management Clinichttps://www.highmetabolicclinic.comTaking 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-guideFOLLOW SASHAInstagramhttps://www.instagram.com/sashahighmd/