Above: Members of the medical stream within LHSC’s Bariatric Centre of Excellence are committed to making a positive difference for patients as they pursue comprehensive, non-surgical lifestyle improvements through this latest offering.
January 17, 2025
The Bariatric Centre of Excellence at London Health Sciences Centre (LHSC) introduced a new medical stream for patients this past March as an additional patient care offering to complement its full-service bariatric surgery program. This expansion, supported through the Ontario Bariatric Network, is the result of several years of dedicated effort from the team’s co-medical leads, Drs. Jaclyn Ernst and Tayyab Khan, who worked tirelessly to spearhead the approval process. The medical bariatric program allows for a whole person non-surgical approach to care that targets not only weight loss but also broader lifestyle improvements.
Health discipline colleagues Lena Khalil, registered dietitian, Kim Dales, social worker, and Spencer Raposo, kinesiologist, work alongside program physicians Dr. Ernst, Dr. Khan, and Dr. Rasha Abdul-Karim to deliver this new service. Their multidisciplinary approach ensures that patients receive comprehensive support, addressing not just the physical aspects of weight loss, but also the emotional and psychological factors that play a critical role in sustainable health changes.
Structured phases for long-term success
The medical stream consists of two distinct phases designed to help patients achieve sustainable lifestyle changes.
The first phase, which lasts six months, is an intensive treatment period where patients attend weekly group sessions as well as monthly check-ins with their physician. The weekly sessions cover a variety of topics, including nutrition, diet and lifestyle education, physical education, and emotional well-being, helping patients understand the complex and often intertwined series of factors contributing to weight and offering strategies for lasting change. During this initial phase, patients also follow a meal replacement regimen, with the option of incorporating pharmacotherapy to support weight loss where appropriate.
The second phase focuses on maintenance. During this six-month period, patients meet monthly for group sessions and continue to have regular follow-up appointments with their physicians. This phase is designed to ensure that the improvements made during the treatment phase are sustained over time, reinforcing new habits and behaviours.
Although the program is primarily focused on group support, health discipline members are also available for personalized support as needed.
Diverse patient needs addressed
The new program adds more options for patients requiring bariatric services as it fills an important non-surgical gap that was previously missing in our region, and helps to ensure appropriate care based on an individual’s needs is available closer to home. Referrals for the program come from a range of health-care providers, including primary care providers and specialists.
For some patients, the medical stream serves as an initial step before surgery, especially for those with a higher BMI who may not yet qualify for bariatric surgery. For others, the medical pathway is preferred as the only course of treatment.
“We designed the program based on best practices and clinical evidence, but also from a place of understanding that success will look a bit different for everyone,” says Spencer Raposo, Kinesiologist at LHSC. “What helps to make the offering resonate for patients is that the format and breadth of the education and supports we provide gives patients the flexibility to practice the learnings in ways that best align to their own individual goals and needs.”
The inaugural cohort completed phase one back in September, with all 30 patients achieving positive health outcomes.
Collaboration leads to broader influences
Beyond the individual perseverance of patients giving their all as they take on the intensive work, collaboration has been a key driver of the program’s success – not only among the program’s team members, but also between patients. The members of the cohort groups have really come together, and patients have formed strong bonds, leaning on each other as they work through the program.
“We are seeing patients opt to expand their journey beyond the hospital’s walls,” says Lena Khalil, Registered Dietitian at LHSC. “They have created their own independent Facebook groups and other online chats to support each other through their day-to-day challenges, root each other on, and celebrate individual wins. They’re also applying their learnings about nutrition, emotional wellbeing, and physical activity within their homes where they are serving as a living example for their families and friends. This is creating a cascade of positive influence beyond the individual, which is leading to a much broader of an impact than we could have initially imagined.”
Achieving and defining success
The goal of the medical stream is not simply weight loss, but the improvement of overall health and quality of life. While weight loss is an important measure of progress for patients, much of the success that feels the most impactful is seen in outcomes like improved self-confidence, increased physical activity, reduced reliance on medications for other weight-influenced medical conditions, and the ability to enjoy life’s simple pleasures—whether that’s walking further, playing with grandchildren, or simply feeling more energized.
“This has proven to be an efficient, effective, and powerful way to help people,” says Kim Dales, Social Worker at LHSC. “One of the most rewarding aspects has been seeing patients develop healthier relationships with themselves, as that kind of self-reflection and self-acceptance is what can often drive the life-long changes that go well beyond weight loss. We set out to make this type of comprehensive, non-surgical care available to patients in our region, and in working with our first cohort, have truly exceeded all our initial expectations of what success would look like as we not only see our patients realizing their health goals, they are also starting to live the rest of their lives to the fullest.”