On initial patient consultations, I frequently hear variations of the phrase “If I had more willpower I would be able to lose weight” or “I’m not strong enough to lose weight”. Most are professionals or students with exceptional willpower, work ethic, and knowledge. We need to recognize that obesity is a chronic disease and needs to be treated as such. The American Medical Association (AMA) designated obesity a disease in 2013. fI the treatment of obesity were as simple as “eat less and move more” then >42% of Americans would not have obesity. I believe there are very few people that choose to have obesity, just as people do not choose to have high blood pressure.
Obesity can be caused by many factors including genetics, imbalances of physiologic forces (e.g. gut hormones and brain chemicals) that strongly resist weight loss, mental stress, eating disorders, and food choices (e.g. immediately rewarding ultra-processed foods). Additionally, physical inactivity may be due to ill health, or a previous bad experience with “exercise”.
The effective management and treatment of obesity is based on the Obesity Medicine Association’s Four Pillars:
- Nutrition- focusing on a healthy diet that includes all the necessary nutrients you body needs.
- Physical Activity- finding activity that you can safely perform with gradual increases in time and movement.
- Behavior- including sleep, improving eating habits, remaining positive, recognizinghunger cues, and learning mindful eating.
- Medication Management- the proper anti-obesity medications (AOMs) are part of an obesity treatment plan. This also may include weight loss surgery.
If you are dealing with overweight/obesity, please consider seeing a physician who can either treat obesity or refer you to an obesity medicine specialist who will utilize an evidence-based and comprehensive approach. Effective treatment will include a personalized care plan that results in long- term sustainable weight management.