Dr. Ali Zentner: Shedding light on a misunderstood challenge

Dr. Ali Zentner was selected by her peers for the Innovative Practice Award in the Medical Post Awards.
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Dr. Ali Zentner

Why she won
For the past 20 years, Vancouver-based internist Dr. Ali Zentner has focused on metabolic medicine and obesity. In 2012, she opened the Revolution Medical Clinic: a multidisciplinary obesity clinic run solely through the public system, staffed by three other internal medicine specialists, an anesthetist, a dietician, nurses and support staff. It currently serves more than 5,000 patients, offering several programs, including bariatric conditioning for people wanting bariatric surgery.

The clinic has also trained more than 350 physicians in obesity medicine, has 20 to 30 medical trainees per year and runs a peer support/mentorship program for primary care physicians to learn about obesity medicine. The clinic also operates a “Get to Surgery” program for patients awaiting joint replacement, offering evidence-based treatments to improve patients’ metabolic parameters and treat their obesity while waiting for surgery.

“We offer comprehensive obesity treatment for a population of patients who have otherwise been told that this was ‘all their fault,’” Dr. Zentner said. “We are the clinic where evidence and empathy meet. I believe we have left our mark on changing the culture of weight bias in medicine.”

Read: Awesome docs: The Medical Post Awards celebrate Canada’s physicians

What one judge said…
Dr. Zentner scaled up an innovative model of care to address what is arguably the greatest health challenge of our generation!”


What has been most gratifying about this work? Most challenging?
I think the most gratifying part of my work is being able to provide treatment in a field that has long been misunderstood. I work as an obesity specialist. My patients have been fat shamed and blamed for their weight all too often. They have been told that this is their fault and that their weight is a lack of will. Medicine has a great deal to answer for in this respect. I am so grateful to be able to change the conversation around weight. The world demands a new generation of kindness and compassion more than ever before.

Science has shown us that obesity is the result of a complicated physiological mismatch; the result of genetic predispositions, environmental factors and a complicated biological dysfunction. Like any disease, the body does not do what it is supposed to do. But beyond any disease the world still prejudges patients as "lazy" and "unmotivated." People living with obesity deserve the same respect and empathy we provide to anyone with a chronic disease.

What has been most challenging? Battling weight bias is the greatest hill to climb here. It impacts every aspect of care, how patients are treated, what treatments are offered and available to them and how they are received. Weight bias determines what medications are covered in obesity medicine and who gets care. It is a constant challenge in my every day and in the overall work I do but I know in the end that impacting this barrier will make the most significant difference in patient care.

What would you like physicians outside your area of focus to know about the work you do?
I want them to know that weight regulation is complex and that weight gain and obesity are the result of a number of genetic, physiological and environmental factors. I want doctors to understand that medicine at its purest should not care how people come to us- how they need care- medicine should care how people get care and get treatment. No other disease has to earn treatment as does obesity. I also want them to know that indeed we are upon a golden age of care and there is so much that can be done to offer treatment to patients living with obesity.

What are you most proud of in terms of your career?
When I was a kid, my father always told me that no matter what, my brain could be “my ticket” to something bigger than my beginnings. I never really wanted to be a doctor—it was his dream for me and not mine. But I realized that I was probably too independent to ever work for someone else and I loved science so medicine made sense. What am I most proud of? I’m proud that I took what I had in life and made things happen well beyond my station. I’d like to think I’ve made an impact in the lives of others—but also on this profession and that makes me feel that my father was certainly right. I’m proud that I never took anything for granted and that I worked really hard to get to where I am today. Overall, I’m proud that a kid from North End Winnipeg who grew up with a lot of love and very little money used grit and a ridiculous sense of optimism to make something happen that changed the narrative in an important way.

Whats something about yourself youre working to improve?
I’m not great at patience. I started gardening several years ago to help teach me that. I learned to grow things from seed. I have a 200-square-foot patio in downtown Vancouver, and I grow everything from artichokes to eggplants to garlic. I’m not sure that I’m that much more patient than when I started but my garlic is impressive.

When it comes to stress, what’s the best medicine?
I could say something profound like having good supports and family and friends and a life outside medicine—but I have all that and I still get stressed. I think what we do is so stressful on such a different level that I am going to defer the answer to this question to someone wiser than me. If you find out the best medicine for stress, let me know—I’ll take a case of it.

What brings you joy?
So many things and some really special people. I like finding joy in both little things and grand gestures. Anything from the perfect cup of tea with a biscuit to a baked potato with caviar. From Hanging out with my husband on the couch to a Broadway show with my best friend. I like being wowed by this world and the people in it and a range of experiences from the most fabulous to the mundane.

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