Obesity: One Disease, Many Solutions - Physician's Weekly

Obesity is a complex disease with a web of interlocking causes that are unique to each patient, including genetics, nutrition, hormones, medication, environment and sleep. Unfortunately, the frequency of obesity cases in the United States continues to rise. A serious disease that continues to grow in prevalence, obesity currently affects more than one-third of US adults and can lead to other serious conditions, such as heart disease, stroke, type 2 diabetes, and certain types of cancer.

However, a spectrum of treatment options exists to help patients with obesity achieve their health goals, including nutritional adjustments, physical activity, behavioral changes, anti-obesity medications, and for certain patients, surgical approaches.

All evidence-based treatments are effective, and in general, one is not more effective than another. As clinicians, it is our responsibility to understand every treatment option available, share guidance-supported solutions with patients with obesity, and provide personalized advice to help these patients determine which options are right for them.

Nutrition Principles

There are a few principles that I urge patients with obesity to consider in regard to the evaluation of potential eating plans while embarking on their journey for treatment of obesity:

1. Focus on minimizing intake of highly/ultra-processed foods and instead move toward more whole foods.
2. Reach for high-fiber, complex carbohydrates versus items that include added sugar.
3. Read food labels to become familiar with serving sizes and ingredient lists.
4. Track meals, snacks, and any drinks to build a resource of data that can continue to guide food plan selections.

Fitness Habits

For patients with obesity who are striving to incorporate fitness routines or habits into their daily lives, I recommend:

1. Moving more! From parking a little further away at the office to walking for 10 minutes during a lunch break or taking the stairs instead of the elevator, there are a variety of ways to incorporate more movements into daily routines.
2. Physical activity can, and should, be enjoyable. I encourage patients to find an enjoyable activity to incorporate into their daily routines, such as dancing or listening to a book or podcast while walking.
3. Add-in resistance training. I recommend patients strive to complete resistance training twice per week.

Treatments on the Horizon

Our understanding of obesity is always evolving, and new treatments are constantly being trialed. A few promising updates include:

• New medication trials, such as those focused on peptide combinations, are demonstrating considerable weight loss and obesity-related disease prevention.
• Current research is evaluating approaches to decrease fat mass loss while maintaining or gaining lean mass and increasing metabolic rate.
• A significant amount of research is striving to understand the ideal candidates for "browning of white fat." Because brown adipose tissue is a well-established metabolically active organ for glucose metabolism, research is delving into environmental factors, such as types of exercise, supplements and pharmaceutical agents. The emphasis around this is to create an environment that will treat and or prevent cardiometabolic diseases.

Staying up-to-date on the latest obesity treatment research and updates is critical to patient success. Explore the best in obesity treatment's resources and tools through the Obesity Medicine Association (OMA). To learn more about obesity treatment or to become an OMA member, visit wwww.obesitymedicine.org/join.