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Metabolic Health & Weight
When your weight, energy or blood sugar has changed — but you don’t know why
Changes in weight, appetite, energy, blood sugar, cholesterol or blood pressure can be frustrating, especially when you’ve already tried changing your diet or exercise routine.
At Sage, we look beyond a single number on the scale. Metabolic health is influenced by many factors, including nutrition, physical activity, sleep, medications, medical conditions, genetics, age, hormonal changes and other aspects of your health.
Our goal is to understand your individual health picture, identify what needs attention, and use the right tools for the right patient at the right time.
Metabolic Concerns We Help With
Metabolic health is broader than weight alone. Depending on your needs, Sage may provide assessment and treatment for concerns such as:
Difficulty losing weight or maintaining weight
Weight changes can occur for many reasons. We look at your medical history, medications, eating patterns, activity, sleep, health conditions and other relevant factors rather than assuming there is one explanation.
Prediabetes and blood sugar concerns
Prediabetes may not cause obvious symptoms, but identifying it can provide an opportunity to reduce the risk of progressing to type 2 diabetes. Assessment may include appropriate blood glucose testing and review of cardiovascular and metabolic risk factors.
Type 2 diabetes
Sage’s nurse practitioners can provide chronic disease management, including diabetes care, while other practitioners may support nutrition, lifestyle and related health goals. Depending on your situation, collaboration with your family physician or diabetes specialist may also be appropriate.
Insulin resistance and metabolic dysfunction
Insulin resistance can be associated with prediabetes, type 2 diabetes and other metabolic risk factors. Rather than assuming that insulin resistance explains every symptom, we assess whether it is clinically relevant to your health picture.
High cholesterol or triglycerides
Abnormal cholesterol and triglyceride levels can contribute to cardiovascular risk. Management may include nutrition and lifestyle strategies, cardiovascular risk assessment and, when appropriate, prescription medication.
High blood pressure
Blood pressure is an important part of metabolic and cardiovascular health. Persistent elevation may require medical treatment as well as lifestyle support.
Metabolic dysfunction-associated steatotic liver disease (MASLD)
Fat accumulation in the liver can occur alongside metabolic risk factors such as insulin resistance, type 2 diabetes, high cholesterol and excess adiposity. Assessment and management may involve bloodwork, medical risk assessment, imaging and collaboration with other healthcare professionals when appropriate.
Weight concerns associated with hormonal or reproductive health
Conditions such as menopause, perimenopause and PCOS can overlap with changes in appetite, body composition, blood sugar regulation and cardiovascular risk. When relevant, these factors can be considered as part of a broader assessment.
Weight-related concerns affecting sleep, mobility or quality of life
Metabolic health is not only about weight. We may also consider sleep, energy, physical function, joint symptoms, cardiovascular risk and how your health is affecting your day-to-day life.
Some conditions require ongoing medical management or specialist care. In those situations, Sage can provide supportive care while collaborating with your physician, specialist or other healthcare professional.
Your Symptoms Are the Starting Point — Not the Whole Story
The same symptom can have very different explanations.
For example, difficulty losing weight may be associated with changes in eating patterns, sleep, medications, reduced physical activity, menopause, thyroid disease, PCOS, insulin resistance, depression, certain medical conditions or simply the complex biology of long-term weight regulation.
Fatigue may be related to sleep, anemia, thyroid disease, diabetes, medication effects, nutritional factors or many other causes.
Elevated cholesterol may reflect genetics, diet, metabolic health, age, medications or other medical factors.
That’s why we don’t believe in applying the same “metabolism protocol” to everyone.
The first step is understanding what is actually going on.
Our Approach
Individualized care, not a standard weight-loss protocol
Your assessment may include:
- Your current symptoms and health concerns
- Medical and family history
- Current medications and supplements
- Previous bloodwork, imaging and medical investigations
- Nutrition and eating patterns
- Physical activity and strength
- Sleep and recovery
- Stress and mental wellbeing when relevant
- Hormonal and reproductive health when relevant
- Cardiovascular and metabolic risk factors
- Your goals, preferences and previous experiences with treatment
From there, your practitioner can determine what requires further investigation and what can be addressed immediately.
There is no single Sage protocol for metabolic health or weight management.
Some patients may benefit primarily from nutrition and lifestyle support. Others may need medical assessment, prescription medication, treatment of an underlying condition, or a combination of approaches.
Comprehensive Care, Without Unnecessary Testing
Testing should answer a clinical question.
We don’t believe that ordering every available test automatically creates better healthcare. If a test is unlikely to change your assessment or treatment plan, it may not be necessary.
Depending on your symptoms, history and risk factors, assessment may include appropriate:
Bloodwork
Potential investigations may include blood glucose or A1C, lipid testing, liver enzymes, kidney function, thyroid testing, blood counts or other tests when clinically indicated.
Cardiovascular risk assessment
Cholesterol and other cardiovascular risk factors may be reviewed together rather than interpreted in isolation. Additional assessment may be appropriate depending on your age, medical history and risk profile.
Diagnostic imaging
If there is a clinical reason to investigate a condition such as fatty liver or another structural concern, imaging such as an ultrasound may be considered or arranged through the appropriate healthcare pathway.
Condition-specific investigation
If symptoms suggest another medical condition — for example, a thyroid disorder, PCOS or another endocrine problem — your practitioner may recommend targeted investigation rather than broad, nonspecific testing.
Referral or collaboration
Sometimes the most appropriate next step is additional assessment through your family physician, a medical specialist, or another healthcare professional.
Testing is not a requirement for every patient. The appropriate investigation depends on the person sitting in front of us.
One Team. Multiple Healthcare Perspectives.
Metabolic health often crosses several areas of healthcare. That’s where an integrated team can be particularly useful.
Naturopathic medicine
Naturopathic doctors can provide individualized assessment and support using nutrition, lifestyle interventions and other evidence-informed approaches that may be appropriate to your situation.
Nurse practitioner care
Sage nurse practitioners can assess medical concerns, order and interpret diagnostic testing, manage chronic conditions and prescribe medication when appropriate. Their services include diabetes, hypertension, dyslipidemia and weight-loss support.
Registered dietitians
Nutrition is an important part of metabolic health, but there is no single diet that works for everyone. Sage’s registered dietitians provide individualized nutrition counselling based on your health conditions, goals, preferences and lifestyle.
Prescription medication
For some patients, medication is an appropriate part of treatment. Depending on your health profile, this may include medication for diabetes, blood pressure, cholesterol or weight management.
Lifestyle and behavioural support
Nutrition, physical activity, sleep and stress can all influence metabolic health. When appropriate, your care plan may address these areas with realistic, sustainable changes rather than restrictive rules.
Collaboration and referral
If your needs extend beyond what can appropriately be managed at Sage, we are comfortable recommending collaboration with your family physician, specialist or another healthcare professional.
The goal isn’t to choose between conventional and naturopathic medicine. It’s to use the right tools for the right patient at the right time.
Meet Some of Our Practitioners
Dr. Rahima Hirji, ND
Doctor of Naturopathic Medicine
Dr. Deanna Walker, ND
Doctor of Naturopathic Medicine
Dr. Heather Robinson, ND
Doctor of Naturopathic Medicine
Dr. Emile Sabga, BSC (Hon), ND
Doctor of Naturopathic Medicine
Dominique Williams, MSW, RSW
Registered Social Worker
What Might Treatment Look Like?
Treatment depends on what your assessment shows.
For one person, the focus may be improving nutrition, physical activity, sleep and other health behaviours.
For another, treatment may include medical management of diabetes, high blood pressure or cholesterol.
For someone living with obesity and related health concerns, prescription weight-management medication may be an appropriate option to discuss with a qualified prescriber. Canadian clinical guidelines recognize medication as one component of long-term obesity management for eligible patients, alongside health-behaviour interventions.
Treatment may also include:
Individualized nutrition counselling
Support with meal planning and eating patterns
Strength and physical activity strategies
Sleep and recovery support
Management of relevant medical conditions
Prescription medication when appropriate
Monitoring of blood sugar, cholesterol, blood pressure or other relevant markers
Support for metabolic concerns associated with menopause or PCOS
Collaboration with physicians or specialists
Targeted supplements when there is a clear clinical reason for them
The plan should evolve as your health changes.
We don’t expect every patient to follow the same diet, take the same supplements or pursue the same treatment.
What to Expect
We listen.
Your first appointment starts with understanding what has changed, what you’ve tried and what you want help with.
We assess.
We review your medical history, symptoms, medications, lifestyle, nutrition and previous investigations to identify the most relevant patterns and concerns.
We determine whether further investigation is needed.
If bloodwork, imaging or another investigation could meaningfully change your care, we discuss the appropriate next step.
We build an individualized plan.
Your treatment may involve one practitioner or several members of the Sage team, depending on your needs.
We reassess and adjust.
Metabolic health changes over time. Follow-up allows us to review your response, monitor relevant health markers and modify the plan when needed.
Frequently Asked Questions
Not necessarily. Metabolic health includes blood sugar, cholesterol, blood pressure, cardiovascular risk, physical function and other measures of health. Your goals should be individualized and should not be based on weight alone.
Not necessarily. Testing depends on your symptoms, medical history, medications, previous results and risk factors. If testing is appropriate, your practitioner will explain what question the investigation is intended to answer.
Yes. Sage nurse practitioners provide chronic disease management, including diabetes care. Nutrition and lifestyle support can also be incorporated when appropriate. Depending on your situation, your care may also involve collaboration with your family physician or diabetes specialist.
Sage has nurse practitioners who can prescribe medication when clinically appropriate. Whether medication is suitable depends on your medical history, health risks, current medications, goals, preferences and other factors. Medication is not appropriate or necessary for everyone.
No. Nutrition recommendations should be individualized. Sage’s dietitians can help develop practical strategies that consider your health needs, preferences, culture, schedule and ability to maintain the plan long term. Canadian obesity guidelines also recommend personalized, nutritionally adequate and sustainable nutrition approaches.
No. Specialized testing is not automatically necessary. We prefer investigations that answer a specific clinical question and have the potential to influence your care.
Reference ranges are only one part of an assessment. Your practitioner will consider your symptoms, medical history, medications, risk factors and previous results alongside appropriate testing. If another medical investigation is warranted, referral or collaboration may be recommended.
Yes. These concerns can be assessed and managed as part of a broader metabolic-health plan. Depending on your cardiovascular risk, treatment may include lifestyle and nutrition interventions, monitoring and prescription medication. Cardiovascular risk assessment is important because cholesterol values should be interpreted in the context of the person’s overall risk profile.
That information is important. Instead of simply giving you another diet, we can review what you’ve tried, how your health has changed, your medications and medical history, and whether there are medical or metabolic concerns that require attention.
Not necessarily. Some patients only need one practitioner. Others benefit from combining medical care, nutrition support and other services. If another member of the Sage team would be helpful, your practitioner can recommend that as part of your care.
You Don’t Have to Figure Out Your Metabolic Health Alone
If changes in weight, blood sugar, cholesterol, blood pressure, energy or appetite have left you unsure about what to do next, a good place to start is a proper assessment.
At Sage, we bring together different healthcare perspectives so that your care can be matched to your actual needs — not a predetermined protocol.
Use the right tools. At the right time. For the right patient.
