Obesity's Underlying Impacts

More than 100 million adults suffer from obesity, a serious chronic disease that can impact people’s lives in numerous ways.

Defined as having a body mass index of 30 or higher, obesity not only increases a person’s risk of several diseases, including heart disease, diabetes, and cancer, but it can also cause mental health issues and make people more prone to soft tissue injuries. There’s also the issue of obesity-related bias, which people with the disease face every day.

Obesity and other diseases

When you think about it, obesity really is at the center of so many of the common diseases that we currently deal with in the U.S. In addition to heart disease and diabetes, many different types of cancers—including breast, prostate, and colon cancer—have a weight-related risk component. And we know that rates of these diseases aren’t diminishing. We’re diagnosing folks with colon cancer at younger ages, and the same is true for heart disease and diabetes.

Mental health issues

Mental health problems and difficult relationships with food are very common among the patients we see in our weight loss clinic. More than half of our patients tell us that they eat for comfort or for stress relief, or to have a bit of pleasure in an otherwise difficult life.

One issue involving obesity that often goes under-recognized are musculoskeletal injuries, which can then lead to mobility limitations. When very obese patients have even minor falls, it can often lead to injuries to their muscles and tendons.

Obesity-related bias

There’s been a movement in our field for quite some time to firmly consider obesity as a disease, so I think we're in a much better place than we used to be in terms of our attitude towards it. But that doesn’t mean there isn’t obesity-related bias.

Unfortunately, bias still exists among the public, medical providers, and even within our specialty of obesity medicine. We see patients in our clinic who come in with very low levels of self-esteem because they’ve been frustrated by their care, either by other outpatient providers, or especially if they’ve been admitted to the hospital.

What’s so troubling about that is that it creates a kind of a reinforcing cycle of futility. Patients often tell me, “What's the point? It's so hard to lose weight, and there's all this negativity.” That kind of thinking often results in even more eating.

The acceptance movement that seeks to eliminate the stigma of obesity is a direct response to that negativity. And while some people say that messaging prevents people from losing excess weight and improving their health, I don’t believe that’s true. In fact, that kind of thinking is just another example of obesity bias—the idea that somehow our accommodations to those with severe obesity are somehow driving it.

Solving the obesity epidemic

Unfortunately, I don’t think messages about the increased health risks associated with obesity is enough of a motivating factor for most people. People are well aware of these risks. At this point, we’re limited to treating it on a patient by patient basis. And there aren’t a lot of effective public health level initiatives to treat obesity right now.

Many of our patients can see a lot of progress by taking one of the new weight loss medications that are on the market today, but I believe we can have the greatest impact when we combine these medications with improvements in lifestyle.

In our clinic, when someone taking one of these weight loss medications makes even minor gestures toward better eating, as well as a reasonable change in their activity level, they’re often able to lose 30% of their body weight or even more.

During the clinical trials of these new medications, the average weight loss was somewhere around 16% to 22%. But by combining these medications with adjustments in diet and exercise, we’re able to help patients achieve sustainable weight loss at levels that are comparable to what we see with bariatric surgery. 

Implementing better lifestyle training and support into clinical settings, along with these new medications, will give us the greatest impact.

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