Obesity Is a Complex Disease — Is Your Doctor Treating It That Way?

The standard weight loss advice — “Eat less and move more” — is not aging well.

Today, more Americans than ever have obesity (about 4 in 10 adults), and obesity was formally declared a disease by the American Medical Education in 2013.

But the good news is that researchers and doctors are continuing to learn more about it, and new treatment options are emerging. We now know many genetic, biological, developmental, behavioral and environmental factors contribute to weight gain and the development of obesity.

Yet, there’s still a widespread belief that obesity is a lifestyle choice — that people develop it because they choose to eat too much or exercise too little. People who have obesity are stigmatized and stereotyped in many aspects of their lives — sometimes even at the place they go to seek help.

Weight bias in healthcare

“Studies find that weight bias is common in healthcare,” says W. Scott Butsch, MD, Director of Obesity Medicine.

While medical professionals strive to provide the best possible care for their patients, studies have shown that some of them also carry negative attitudes toward patients who have obesity, or feel out of their element when it comes to treating it.

Those attitudes can affect patient care, Dr. Butsch says.

Medical professionals as a whole need to be better educated about the biology of obesity, he asserts, as well as the factors that play into it and their own biases — which they may or may not realize they have.

Having obesity heightens a person’s risk of developing diabetes, heart disease, hypertension and cancer, so it’s an appropriate and important topic for doctors to discuss with their patients. But patients deserve for the conversation to be thorough and compassionate.

“As a physician, telling someone to eat less and move more is like telling someone who has depression just to cheer up,” he says. “For whatever reason, some doctors continue to do this when they discuss obesity.”

Obesity medicine

In response to the obesity epidemic, obesity medicine was born. Obesity medicine specialists are trained to address the many factors that contribute to obesity and help patients meet their goals.

They take a comprehensive and individualized approach to helping people manage their obesity. This may include coordinating care with dietitians, behavioral healthcare providers or primary care doctors on one or more of the following treatments:

• Nutrition education and changes to diet.
• Exercise plans.
• Behavioral counseling.
• Anti-obesity medicines.
• Minimally invasive therapies.
• Surgery.

“Treating obesity with a multidisciplinary, comprehensive approach that addresses the physical, behavioral and environmental aspects of the disease is truly key to patients’ success,” Dr. Butsch says.

Start the conversation

Ready to have a productive conversation about weight with your doctor? The first step is to find a doctor who gets it. This may take more than one try. “If you feel that you’re being judged by your doctor, then you have the opportunity to seek another physician who is more knowledgeable in the field of obesity, more sensitive and more empathetic,” Dr. Butsch says.

If your primary care doctor isn’t doing an adequate job in addressing your weight goals, ask to be referred. There are physicians who are board-certified in obesity medicine, as well as specialty clinics that exist for this purpose.