Introduction and Background
Obesity is a complex multifactorial disease requiring a comprehensive and multifaceted approach to care. Integral to success in a medically managed weight loss program are individualized treatment plans and monitored timely visits.
Overweight and obesity afflicts 21% of females age 12-19 years, 34.4% of women age 20-39 years and 42.1% of women age 40-59 years.
Obesity Is Now Recognized As A Disease
In 2014, the American Medical Association (AMA) classified obesity as a disease. Obesity during the childbearing years is associated with infertility, polycystic ovarian disease, an increased risk of diabetes, hypertension, and preeclampsia, as well as higher cesarian delivery rates.
Beyond the childbearing years, obesity can further increase the risk of heart, lung, kidney, gastrointestinal, and neurologic disorders. Carrying excessive weight may also increase psychiatric illnesses (such as depression), sleep apnea, urinary incontinence, and bone and joint disease. The latter increases the need for orthopedic surgical operations. Most alarmingly, it is estimated that up to 41% of cases of cancer can be attributed to overweight and obesity.
What Is Obesity?
In most cases, obesity is defined as an elevated body mass index (BMI) greater than or equal to 30 Kg. For overweight, the BMI inflation is 25-29 Kg.
The American Medical Association (AMA) recognizes obesity as a disease process with multiple pathophysiologic aspects that require a range of interventions to advance prevention and treatment. Obesity should be treated as an urgent and chronic clinical condition.
Obesity may be caused by a range of factors that include genetics/epigenetics, medical, endocrine, immune, neurobehavioral, environmental, metabolic, cultural and socioeconomic influences. The first priority in treating obesity is to alleviate any feelings of guilt, provide validation and hope.
Stages of Change
Most patients with obesity have tried repeatedly to lose weight and improve their health. At any time, patients may be in one of five stages of behavioral change:
• Pre-contemplation – unawareness of the problem • Contemplation – thinking of change within the next 6 months
• Preparation – making plans to change now
• Action – implementation of changes
• Maintenance relapse – restart of unfavorable behavior.
Weight loss should be thought of as improving one’s health, first and foremost, and not a cosmetic issue. Even a 5-10% sustained weight loss can improve your health and significantly reduce key risk factors such as blood pressure, decrease medication use, and significantly lower the risk of developing arthritis, sleep apnea and numerous other diseases.
What to Expect?
Your supervised medical weight loss program will include:
• A medical history and directed physical exam
• Height, weight, blood pressure,
• Waist measurement
• Body composition analysis
Indicated laboratory tests may be needed and then an individualized treatment plan will focus on the four cornerstones of treatment:
• Physical activity
• Behavior modification