The epidemic of obesity in the United States has not slowed down, despite the other pandemic that took over the world. Over 40% of Americans classify as obese, while almost two-thirds of the country is overweight, and that is a cause of concern. With a barrage of information coming your way from the diet industry, YouTube, and infomercials promising a beach body, it is not easy for anyone to identify the safe and proper method to lose weight.
An obesity specialist is the solution to that problem. Going by other terms such as a bariatric specialist, bariatrician, weight loss doctor, or diet doctor, an obesity specialist possesses expertise in the evaluation and non-surgical management of obesity and its’ associated health issues that largely include modifications in diet and exercise, behavioral therapy, and medications. A bariatric specialist provides medical weight management for people who are overweight or obese.
“Metabolic surgery is a more accurate description” for surgical interventions used to treat obesity, because they aren’t intended solely to reduce a person’s body weight, but to also address comorbidities of obesity such as diabetes and hypertension.
Anyone struggling to maintain a healthy weight should immediately consult an obesity medicine specialist.
What is Obesity?
Obesity is a chronic disease characterized by excessive body fat. The amount of body fat in a person is represented by a value known as their Body Mass Index (BMI), which takes into their height and weight. While the normal BMI falls between 18.5 and 24.9 kg/m2, values exceeding 30 kg/m2 represent obesity. BMIs between 24.9 and 29.9 kg/m2 (overweight) are also a cause of concern, as they may soon develop into obesity.
If your BMI is higher than 24.9 kg/m2 and you are willing to take the steps to correct that, it may be time to consult an obesity medicine specialist. It is simple to calculate your BMI online but if you are not comfortable with that, your primary care physician can help you out.
Similarly, the circumference of your waist is another metric to go by. An obese male’s waist exceeds 40 inches (102cm), while an obese female’s waist is higher than 35 inches (89cm).
Consulting an obesity specialist is particularly important because obesity can be the cause of many serious health issues, including but not limited to:
- Diabetes, especially Type 2
- Hypertension and cardiovascular disease
- Joint pain, linked to gout or osteoarthritis
- Respiratory problems, such as asthma
- Sleep apnea
- Psychiatric troubles, including anxiety and depression
- Cancer, especially of the colon, breast, gallbladder, or the endometrium
- Digestive diseases such as fatty liver disease, gall stones, and gallbladder disease
- Liver disease
- Gynecologic problems, such as irregularity of periods and infertility
Consequently, obesity is not something that can be taken lightly. Losing weight significantly minimizes the probability of developing any of these unpleasant comorbidities.
What does an Obesity Specialist do?
A general healthcare provider may provide basic guidance for weight loss, but an obesity specialist has completed specialized education that equips them with an extensive understanding of the genetic, biological, environmental, social, and behavioral factors that cause obesity and how it can best be treated.
While some people find success in their weight-management journey by seeing a general practitioner or nutritionist, there are many unique benefits to working with an experienced bariatric physician, including:
- Multi-faceted approach to maintaining a healthy weight
- Dietary advice to promote healthy food choices
- Exercise plans customized to each patient’s needs and limitations
- Behavioral modification therapy
- Sustainable lifestyle changes for permanent weight management
This higher level of competency in obesity care results in the assessment and management of obesity-related health problems so that in-hospital and long-term outpatient complications can be minimized. To accomplish this, obesity specialists perform a wide variety of responsibilities which include the following.
Understanding the Medical History
Obesity specialists provide you with a broad treatment plan that caters to your personal needs and preferences and to do that, knowing you is of utmost importance. An evaluation of the medical history begins with a health history, covering aspects such as eating habits, frequency of physical activity, and past attempts at weight loss. This conversation is followed by a physical exam which measures your height, weight, BMI, waist circumference, and blood pressure among other variables.
To understand what goes on beneath the surface, an obesity specialist may also order laboratory tests to determine any health problems as a result of obesity or those that may have caused the excessive weight gain. Depending on the need, these tests may include:
- Blood sugar level (for diabetes)
- Lipid and cholesterol levels, and/or an ECG (for cardiovascular disease)
- Liver function
- Kidney function
- Levels of thyroid-stimulating hormone
- Exercise testing (assess the efficiency of the heart during exercise)
- Underwater weighing
- DEXA scan (bone density)
- Electrical bioimpedance
- Resting metabolic rate (to measure calories burnt at rest)
- Anthropomorphic measurements via skin folds, limb circumference, and bone measurements
Obesity specialists recognize that a person does not just become obese on a whim. It is a consequence of a poor diet and exercise, and an inability to change that due to a certain mindset, and to correct that, an obesity medicine specialist counsels their patient on a wide variety of topics.
This conversation could surround healthy eating habits such as eating plant-based food, controlling portion sizes, and consuming fewer calories, or around healthy exercise habits such as incorporating walking into their daily routine and adopting habits such as using the stairs. Coping strategies including stimulus control, contingency management via rewarding positive behavior, cognitive restructuring, and self-monitoring are also introduced to the patient.
They also broach sensitive topics such as the effect of mental health on obesity (and vice versa), the medical complications surrounding obesity, and the benefits and risks of taking medications. If none of these interventions seem to be working, an obesity specialist is the one that discusses the prospect of weight loss surgery. They do not perform this surgery themselves but refer the patients to a bariatric surgeon instead.
Crafting a Treatment Plan
After thoroughly studying the patient’s case and considering their habits, goals, needs, preferences, and how ready they are to make a change, an obesity specialist crafts a treatment plan that includes:
- Dietary modifications, via a nutrition plan
- Advice on maintaining a food diary
- Exercise and physical activity, including structured exercise programs, participation in sports, and household chores that enhance the activity
- Information on support groups and counseling to help you through the process
- Medication plan, if needed
This personalized and comprehensive plan may employ additional personnel such as nutritionists, exercise physiologists, and psychologists if need be.
With each follow-up, the obesity specialist tracks the progress of the patient, repeating the tests conducted above, making the required changes to the diet and exercise plan, and the dosage of the medications. If nothing seems to be working, a referral to a bariatric surgeon may be the next step.
When Should You See An Obesity Specialist?
As mentioned above, a BMI exceeding 24.9 kg/m2 or the ideal waist circumference are viable indicators for visiting an obesity medicine specialist. However, there are additional factors that may also mean it is time. These include:
- Two or more risk factors that present with major obesity-associated comorbidities including coronary artery disease, hypertension, and Type 2 diabetes
- Failure at past weight loss programs
- Feeling of impulsiveness when it comes to overeating and bingeing food
Most importantly, the decisiveness towards making necessary lifestyle changes and doing all that it takes to reduce your weight is a necessary precursor for meeting an obesity specialist.
If you or your loved one is overweight and on the verge of obesity, meeting an obesity medicine specialist registered under the American Board of Obesity Medicine (ABOM) should be on your to-do list (for children, consult a child obesity specialist). Finding one is very simple!
All you need to do is ask your primary healthcare provider (usually a family physician) for a referral to an obesity specialist the next time you visit them and confirm with your insurance company whether you need that referral. Taking the first step towards turning your life around could not be simpler than this.
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