how a montreal exec found confidence in obesity management with glp-1 medication
7 minute read
if you imagine people living in larger bodies as lazy or unambitious, deon ramgoolam rips that stereotype to shreds. he’s an accomplished business executive in montreal in circles where his colleagues look very much the part of health-conscious thriving professionals.
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what is it like to be “the fat kid” at school? the one who is sidelined from sports and dating, who just keeps on going.
and then that kid becomes an adult living with obesity, always listening to that inner voice who is a relentless critic.
deon ramgoolam, 56, knows all about the disadvantages that come with being in a larger body, although he had a great group of friends at school and competed in debating at the national level.
“being fat was always part of my identity, part of my persona, and i never really felt entirely comfortable in my body,” he says of his weight. his sister also carried extra weight and their father, a doctor, would encourage exercise and diet, which reflected conventional thinking at the time. “we’d go through periods of extensive exercise and diet where we’d lose weight and feel good about things, but then invariably the weight would come back on.”
as an adult, he enjoyed food and had a habit of eating large portions with martinis and wine for dinner, especially meals out with clients. “i could not leave any food on the plate. i would have to eat everything. because it was my reward. this was my reward for a hard day. i get to enjoy this food. i get to have a bottle of wine because i deserved it. that’s how my mind was working.”
if you imagine people living in larger bodies as lazy or unambitious, deon rips that stereotype to shreds. he’s an accomplished business executive in montreal in circles where his colleagues look very much the part of health-conscious thriving professionals. as well, he has a master’s degree in politics, served as chief of staff to the leader of the liberal party in manitoba and then worked for ministers in former prime minister jean chrétien’s government before transitioning to health care.
“with obesity, you have the psychosocial where you often see yourself as being inferior to others. i work in the pharmaceutical industry, which is full of fit, athletic, good-looking people,” he says.
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self-blame and living with obesity
“so, you know, this is every meeting room i would walk into. this is what i would confront. and i would say, ‘my god, why can’t i be like that? what am i lacking? why am i so weak? why am i so weak that i can’t do the work that i need to do, just to move a bit more, eat a bit less, resist that dessert?’”
beyond the withering self-blame, he says people living with obesity are often tormented by photos of themselves. deon would go to a splashy event where photos were taken, and he’d look at those photos with sadness.
“i would never say, ‘wow, this is a great looking group, what a great memory of that evening.’ i would just look at them and say, ‘i’m really fat.’” he would throw the photos out, so he wouldn’t be reminded of his size.
but obesity is not something you can escape.
“there’s the stigma of being weak-willed, not able to control cravings, being susceptible to advertising for food. that has an impact on your sense of self-worth and self-confidence so that food becomes a balm to heal what ails you and provides you with comfort.”
what changed deon’s health was a connection to a leader in obesity management, dr. remi rabasa-lhoret, an endocrinologist in montreal who talked to him about new drugs in development. this was when researchers were just starting to see people with type 2 diabetes losing weight on ozempic, the semaglutide medication first approved for treatment of type 2 diabetes. after the landmark clinical trial of semaglutide for weight loss was published, funded by the ozempic manufacturer, novo nordisk, dr. remi rabasa-lhoret suggested he try it. and so, he did.
losing weight and gaining confidence
this was in 2022, after his weight had climbed to almost 300 pounds during the isolation of the global pandemic. the impact of the medication was liberating, releasing him from his addiction to food. “for the first time in years, i started to feel good in my body. i would look at myself in the mirror and smile. now my wife says i can’t stop looking at myself in the mirror,” he says, smiling broadly.
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“i started on ozempic, and it started to work right away. people understand it as a weight loss drug, but it changes your relationship with addiction. that’s how i see it, because i clearly had an addiction to food and i had an addiction to alcohol.”
he could now entertain clients with the big steak dinner, enjoying his food but stopping when he felt full. it was a novel experience not to leave his plate clean.
“i felt empowered,” he says. “i no longer had to eat to excess, to drink to excess, because the desire was gone. so, it shifted the mindset in a way that i had never experienced in my first 47 years of living as somebody who was fat and obese.”
deon has become passionate about helping people living with obesity know that there are treatment options and they don’t have to go it alone. he joined obesity matters, the advocacy and support community, rallying for reliable information about ozempic and other glp-1 (glucagon-like peptide-1) agonists, which mimic the glp-1 hormone and regulates blood sugar and appetite.
beyond social media ‘nonsense’
“the sad part is that there’s so much nonsense on social media about glp-1s. and so oftentimes people’s first reaction is, ‘oh, i’m going to get ozempic face’ or ‘i’m going to lose all my muscles and waste away.’ no,” he says, noting that he hasn’t experienced adverse effects of medication.
in fact, his weight loss and adherence to the drug have sparked his commitment to take much better care of himself. he works out three or four times a week, becoming stronger and more agile at an age when maintaining muscle mass and agility are even more important.
“there’s also that good feeling that comes with exercise, feeling healthy and well, but it’s a way that i now feel most of the time.” though he still has chronic pain associated with obesity, including knee arthritis and back pain that comes from carrying an extra 100 pounds for decades. when you lose that weight, the damage doesn’t necessarily go away.
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“i’ve been working with an athletic therapist to try and improve that. i’m certainly not as mobile as i would like to be. i still live with these limitations related to obesity. i would love to be able to walk for hours. my partner loves to hike, but after 20 or 30 minutes, my back starts to throb, my knee starts to hurt, and i can’t. i suspect these limitations will be with me for the rest of my life.”
still, his message to others with obesity is about self-kindness and finding community: “it’s not your fault. and if you are open to getting help, there is help for you through groups like obesity matters,” he says.
“for canadians who are contemplating the medication, once they understand that this is not their fault and this is a chronic disease which has a biological route and a psychosocial route, which can be effectively treated by medication, they need to know it’s medication you have to stay on for the rest of your life.”
he emphasizes that there’s still a lot of education needed for both people and clinicians, highlighting obesity canada programs that help clinicians learn how to manage obesity in their patients.
made-in-canada obesity treatment
most importantly, he says he is grateful to the thought leaders in obesity medicine here in canada and the made-in-canada success of glp-1s, which were developed by endocrinologist and university of toronto professor dr. dan drucker (named one of time magazine’s 100 most influential people in 2024). deon also mentions the pioneering work of dr. arya sharma, who started the canadian obesity network that is now obesity canada, and canadian obesity physicians dr. sean wharton, dr. david macklin and dr. megha poddar.
“canada really punches above its class when it comes to thought leaders in obesity medicine. they are also in their own right considered to be world authorities in the management of obesity,” he says.
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he also points to pharma-economic modelling that shows that glp-1s at a population health level could have a remarkable impact on prosperity. dr. peter singer, leader in bioethics, professor emeritus at the university of toronto and former special advisor to the world health organization, writes that canada could prove this, given the fact that semaglutide is now generic and more easily accessible. this could potentially add billions to canada’s wealth in the next 20 years through decreases in absenteeism, people living independently longer and a reduction in heart attacks, strokes and cardiac rehabilitation.
canada is the first g7 country to approve a generic version of semaglutide.
“the glp-1 drugs have remarkable effectiveness beyond obesity, now proven in heart disease, kidney disease, liver disease, in sleep apnea, in osteoarthritis, all proven in large-scale, high-quality randomized clinical trials,” deon notes, hopeful about improved health for all of us.
“we are fortunate that there is a pharmaceutical industry that has brought this drug to canadians, who can now benefit from it. and it will be available now as well [in pill form] to even a larger group of people. so, people will have a chance to live healthier lives carrying less weight and living with less chronic disease.”
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