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It’s no secret that obesity is an epidemic in the U.S. However, many patients and providers don’t realize that obesity is a chronic disease—it’s not a reflection of a person’s work ethic, personality, or discipline.
Many factors contribute to obesity, including genetics, lifestyle, sleep quality, stress, and medications. Some of those factors are within a patient’s control—but many are not. Almost 42% of adults in the U.S. and nearly 20% of children have obesity. That’s 115 million people with a body mass index (BMI) greater than 30. Obesity is related to serious health conditions, including:
- Depression
- Diabetes
- Heart disease
- High blood pressure
- Infertility
- Obstructive sleep apnea
- Stroke
- High cholesterol
Still, many patients come to me in tears, feeling guilty and shameful about their weight. I start their treatment plan with one simple message: Obesity is not your fault, and you deserve a helping hand to feel better long term.
Patients and providers should treat obesity like the chronic disease that it is. Patients need a long-term care plan and support for obesity, just like they’d get for high blood pressure or diabetes.
We promise our patients whole-person care, long after they achieve their health goals. And to get there, we start at the beginning—understanding how their condition began, and how obesity becomes a chronic disease that requires ongoing medical support.
How obesity becomes a chronic disease.
Weight gain is the result of an energy imbalance: When you take in more calories than you use during activity, your body stores excess energy as fat. Over time, this imbalance causes the release of hormones that begin a state of chronic inflammation. Carrying excess weight can result in insulin resistance, which leads to type 2 diabetes and complications such as non-alcoholic fatty liver disease, vision problems, and heart disease.
Once inflammation and hormonal imbalance take hold, even the most disciplined patients with obesity cannot sustain weight loss on their own, regardless of how much they change their eating and exercise habits. That’s because obesity doesn’t happen overnight, and likewise, a few changes and a single procedure or medication won’t cure the condition.
This vicious cycle can lead patients to feel depressed, frustrated, and isolated—all of which can contribute to further weight gain. But with long-term obesity care and support, you can break that cycle and live a healthier, freer life.
Un-learning old habits to empower success.
Education is one of our most impactful ways to sustain healthy weight management. There is so much misinformation about weight loss, from family, friends, social media, and the diet industry. It can be hard to know what’s right.
Eating patterns
In our practice, long-term obesity care starts with encouraging you to put past unsuccessful weight loss attempts behind you. Unsustainable fad diets (for example. ketogenic diet, very-low calorie diet, liquid diet) and blaming yourself for craving sweets or high-carbohydrate foods contribute to the cycle of gain-lose-gain.
When I see a new patient, I ask them to tell me about their family’s food culture and what they’ve learned about nutrition. For example, many people grow up thinking that drinking fruit juice is a healthier choice than drinking soda. But most juices and lemonade have just as much sugar as cola—and consuming too much sugar contributes to excess weight gain.
Patients sometimes tell me they’ve been drinking smoothies to lose weight. They seem surprised when I tell them that, depending upon the ingredients, smoothies can be another source of sugar, without the fiber and other nutrients in whole fruit.
So, learning to read food labels and understand how much sugar they’re consuming is a good place to start empowering patients to feel better long term.
Lifestyle
Often, less healthy food “choices” aren’t really decisions at all. Research shows that when the body is sleep-deprived or under stress the appetite increases, especially for calorie-rich foods. So, I try to help patients shake free from guilt and control the controllable.
My patients and I discuss their sleep, stress levels, and activity habits, so I can assess the many factors that can lead to obesity. Once we have an individualized understanding, our team of experts works to support healthy changes.
At MedStar Washington Hospital Center, our non-surgical Weight Loss Program helps many patients improve their health. We build a complete weight loss plan that includes regular follow-up appointments with weight loss specialists, a nutrition plan with follow-up with a registered dietician, exercise plans, and weight-related behavioral counseling groups with a mental health professional, and monthly support groups.
Related reading: Weighing Your Options: 4 Tools to Break the Cycle of Obesity.
Weight management options to fit your life and budget.
Most of us could benefit from healthier food choices and more activity. For patients with obesity, getting healthy often requires additional support. I discuss all the available options with my patients so they can feel empowered to choose their own path to weight loss and are more likely to stick with the plan we develop together.
Surgery
Bariatric surgery is a procedure to help help managing type 2 diabetes, high blood pressure, obstructive sleep apnea, and high cholesterol. MedStar Washington Hospital Center offers minimally invasive and laparoscopic procedures supported by nutritional counseling and follow-up services for life time.
Medications
Exciting, new medications to treat type 2 diabetes, including GLP1-RA drugs like Wegovy and Zepbound, have been shown to help some patients lose weight quickly. These medications are effective, but not all are approved for weight loss without type 2 diabetes, and they are not always covered by insurance. So, we will work with you to find an affordable option.
Metformin, for example, is an affordable type 2 diabetes medication that helps control the amount of glucose (sugar) in the blood. It also increases the body’s response to insulin. Side effects are usually mild, and research has shown that it helps patients lose more weight than lifestyle changes alone. My patients say metformin reduces their cravings for sweets and helps them take control over their calorie intake.
Related reading: Science vs. Stigma: Research Examines New Drug’s Effects on Weight Loss.
Obesity is a disease, not a character flaw. Lasting weight management starts by banishing shame and learning real facts about nutrition and exercise. Don’t be afraid to ask for help—it’s rewarding to see patients return to the clinic with smiles on their faces, encouraged by the progress they’ve made with our support.
My colleagues and I are passionate about helping you achieve your best health and we’re here to support your weight management journey every step of the way.
