When Dr. Sean Wharton started medical school at the University of Toronto he felt incredibly proud to be there, but he also saw that very few of the other students looked like him. Wharton was one of only three Black students in his class of 270 that year. It wasn’t surprising—his background had been part of what spurred him to study medicine in the first place. “I thought that being a Black male with the capacity to get into medicine, I should do it for our community,” he says.
At the time Black physicians were rare in Canada. “It was clear to me that we were not being represented within the health care professions at the level where we were running the actual team. When you think of the people who are running the team, oftentimes, it's the physicians, the specialists,” he says.
While there were many people of colour working in nursing or long-term care, there were very few doctors, let alone specialists. Wharton knew that given the population of Toronto who identify as Black, it couldn’t just be that there was a lack of interest from the community in practicing medicine. He wondered where the disconnect was happening—were people from marginalized communities being directed away from medicine in high school? Undergraduate studies? He wanted to know more and he wanted to be a role model for those who might be thinking of this work.
“I wanted to try to rise to being the leader of the team, so that I could be a mentor for the many Black students who have worked hard, but frequently are left with a closed door to professional and academic positions. There were few mentors to help us believe that we could succeed at this level. I was fortunate to have Dr. Miriam Rossi, a Black woman, as the Associate Dean at the University of Toronto and she was a great mentor,” Wharton says.
His advocacy in this area started during his years as a medical student. In the year 2000, he and fellow students started the University of Toronto’s Black Medical Students Association. At the time, the group was small and they concentrated on encouraging undergraduate students to consider a career in medicine. Their work over the last 20 years has had a significant impact and the program now has 15 Black medical students in the graduating class of 2024. Wharton has been there throughout the years, continuing to mentor and support members of the group even while his own career has flourished.
Wharton specializes in obesity treatment and management. He has become a leading expert in this area, speaking at international conferences about bariatric surgery and new medications. Much of his work is in the area of type 2 diabetes, a condition often linked to obesity, and it was clear that there was a great need for better representation in this area.
“These conditions affect marginalized groups and racialized groups the most,” he says. “When you have the highest burden of the disease and the worst treatment, as a racialized group, there should really be people from that field advocating at the physician level, at the community care level and at the nursing level. We need that representation within the marginalized groups. I think we need more Blacks, Filipinos, Latinos and Indigenous Peoples in diabetes, we really do.”
The connection between elevated weight and diabetes interested Wharton as a physician, but he also saw a need for better understanding of obesity and the stigma it comes with. “The lack of understanding of elevated weight was fascinating to me, I wondered why we didn’t know more about this? Oh, because people think that those living with obesity are lazy, non-intelligent, and non-accountable,” he says, his voice expressing his annoyance with these incorrect stereotypes. Elevated weight, he explains, is not a personality or character flaw, it’s not something where the person just needs to eat less and exercise more, and it’s definitely not an easy issue to manage. However, weight bias is rampant in the medical profession, which makes it much harder to support people dealing with elevated weight and the issues that may arise from it, like type 2 diabetes.
“The bias really spoke to me,” he says. Wharton has spent the last 15 years working on research and clinical practice in obesity, and his initial thinking about weight bias has broadened. As a lead author on the Obesity Canada Clinical Practice Guidelines, Wharton focused on educating health care providers about their weight bias and how unhelpful it can be.
He also ensured that there was increased focus on systemic barriers, like race and socioeconomic status, to provide an overall picture of the intersectional issues that often accompany elevated weight. “The voices of these people were not being recognized in any way, shape or form by so many others, particularly by the people who are supposed to be treating them and supposed to be the kindest to them, their health care providers. I really felt there needed to be a change.”
Wharton, who gave the Inaugural Lecture in Black Health at the University of Toronto in 2020, focused the talk on how his work in obesity has allowed him to see the parallels between structural racism and weight bias in medicine. The contrast was a stark one and those watching the talk left with much to think about in terms of how far medicine has to go on both of these issues.
For Wharton, this work and the opportunity to break down these barriers continues to inspire him. “What I love most about obesity medicine, and diabetes comes into this as well, is that it isn’t just about a biological science, it’s also a social science. The way people feel about this condition, the way it impacts their families, the way it impacts their lives. The ideas and biases about it tells us so much about how we are as human beings, who we care for, how we’re compassionate, how we’re not compassionate, how we show empathy and how we don’t show empathy,” he says. “It’s about biology and hormones, but it’s also about human beings and how we relate to them. I like the idea of science mixing with social science so that we’re actually taking care of people, not just scientifically taking care of them, but using that information to treat people in an equitable fashion on a daily basis.”
— Written by Krista Lamb