Understanding Obesity
Obesity is a chronic disease influenced by sedentary lifestyles, poor dietary choices, environmental factors and genetic predispositions. The consumption of fast and processed foods, combined with unhealthy habits, accelerates the prevalence of obesity. Additionally, certain genetic factors can increase the risk.
Having excess fat tissue, also known as adipose tissue, can cause the body's immune system to overreact and release excessive inflammatory substances. This overreaction, called a cytokine storm, can result in widespread damage to the body and the immune system. Additionally, fat deposits in major organs such as the heart, liver and pancreas can contribute to serious conditions, including diabetes, liver failure and heart disease.
Diagnosing Obesity
The Body Mass Index (BMI) is the primary tool used to classify obesity. It calculates body size and fat based on weight and height:
- Normal BMI: 18–24.9 kg/m²
- Overweight: ≥ 25 kg/m²
- Class 1 Obesity: 30–34.9 kg/m²
- Class 3 (Morbid) Obesity: ≥ 40 kg/m²
Pediatric obesity is diagnosed when BMI exceeds two standard deviations above the World Health Organization growth median.
Additionally, waist circumference may be used to track abdominal fat and treatment progress.
Who is Obesity Medicine for?
Obesity medicine is designed for individuals whose weight negatively impacts their overall health and quality of life. However, it's important to note that the principles of obesity medicine may not be relevant for:
- Bodybuilders or High-Performance Athletes: These individuals often have higher body weight due to increased muscle mass, which is not indicative of obesity.
- Pregnant Women: Pregnancy naturally involves weight gain as part of a healthy process and requires specialized care tailored to maternal and fetal health.
If you fall into one of these categories, alternative medical advice tailored to your specific needs may be more appropriate.
When to Treat Obesity
Treatment is recommended for patients with:
- BMI ≥ 30 kg/m²
- BMI ≥ 27 kg/m² with comorbid conditions such as coronary artery disease, diabetes, sleep apnea, hypertension, high cholesterol or arthritis.
Medication options:
Semaglutide: A medication that helps the body use insulin better and curbs appetite.
Other options: These medications are potential options for managing obesity, and their use depends on a patient's medical history, current health conditions and treatment goals. Tirzepatide, Metformin, Topiramate, Wellbutrin, Contrave and Phentermine.
Bariatric Surgical Options
Surgical interventions may be suitable for patients with:
- BMI ≥ 40 kg/m²
- BMI ≥ 30 kg/m² with conditions like uncontrolled diabetes.
Procedures:
- Gastric Sleeve: Reduces stomach size to limit food intake.
- Roux-en-Y Gastric Bypass: Alters stomach size and digestive pathways to aid weight loss.
Long-Term Goals
Obesity management requires sustained effort. In addition to medications or surgery, patients should focus on:
- Physical activity: At least 150 minutes per week.
- Healthy diet: For example, the Mediterranean diet, proven to support cardiovascular health.
Consistent healthy choices empower patients to take control of their health.
Nelson Mandela said, "It always seems impossible until it's done."
Jennie Zheng, MD, is a physician board-certified in family medicine and obesity medicine at UT Health East Texas Physicians in Bullard. "I believe most patients will be encouraged and motivated once they see positive changes being made to their health."
To schedule an appointment with Dr. Zheng, visit UTHealthEastTexasDoctors.com or call 903-596-DOCS.