Obesity means a person has too much body fat. It is sometimes described as when a person has a body weight that is greater than what is healthy for their height, but that does not take into account the added weight of muscle mass. Obesity is a condition of excess weight due to too much body fat, not too much muscle.
Obesity is not a disease itself. It is a condition that can increase a person’s risk for certain health problems such as heart attack, stroke, type 2 diabetes, breathing problems, and some types of cancer.
According to statistics from the US Centers for Disease Control and Prevention, 36 percent of adults and 17 percent of children and teens in America are obese.
Doctors Who Treat Obesity
As your obesity is diagnosed, treated and managed, you may encounter the following team of doctors and specialists.
Internist or Family Physician – Doctors who provide general medical care for adults. An internist or family physician typically diagnoses adults who are obese and can manage their weight loss program.
Pediatrician – Doctor who specializes in the medical care of children. A pediatrician typically diagnoses children who are obese and can manage their weight loss program.
Endocrinologist – Doctor who specializes in the endocrine system. An obese person may be referred to an endocrinologist for treatment of type 2 diabetes or a hormone problem related to weight gain, such as an underactive thyroid.
Bariatric Surgeon – A doctor who performs weight loss surgeries, such as those that reduce the size of the stomach. These surgeries can help some very obese people lose weight.
Psychiatrist - A doctor who specializes in mental health. An obese patient may be referred to a psychiatrist for treatment of mental health issues, such as depression and stress, which may be related to obesity.
Psychologist - A therapist with an advanced degree in the study of the brain and behavior. An obese patient may be referred to a psychologist for therapy or counseling for mental health issues, such as depression and stress, which may be related to obesity.
Registered Dietitian – A nutrition professional who has passed a national exam to become a registered dietitian. Dietitians work with obese people on ways to change their eating habits so that they can lose weight.
Exercise Physiologist or Trainer - Trained and certified exercise professionals who evaluate a person’s level of fitness and teach people new exercise programs. Exercise physiologists and certified trainers can help obese people lose weight by teaching them exercise programs that are appropriate for their fitness level.
How to Prepare for Your Obesity Doctor Visit
Having made your appointment with a healthcare provider, there are certain actions you can take to maximize the benefit of your doctor visit for obesity.
- Write down a list of any symptoms or recent health problems, including any that may seem unrelated to your weight.
- Write down key personal information, including prior illnesses, chronic illnesses, diet and exercise habits, and any major stresses or recent life changes.
- Make a list of all medications, vitamins, and supplements that you are taking. Include the dosage you are taking of each.
- Be prepared to talk about difficult topics such as overeating, triggers for overeating, or stresses in your life that affect your mood, eating habits, and physical activity.
- Be prepared to answer many questions and to take an active role in managing your weight and your medical care. Obesity is a complex issue that requires active participation by patients.
Questions to Ask Your Doctor About Obesity
From your initial diagnosis throughout your treatment and care, you will have questions about your condition. Below is a list of questions to discuss with your doctor so you can make informed decisions about your condition and your care.
Questions About My Diagnosis
- What is the difference between being overweight and being obese?
- How many pounds do I need to lose?
- What is my risk for having a heart attack or stroke?
- What is my risk for developing diabetes?
Questions About My Treatment
- Can I take medication to help me lose weight?
- How do weight loss medications work? Are there side effects?
- Will I have to take medication for the rest of my life?
- Are there vitamins or supplements that can help me lose weight?
- Am I candidate for weight loss surgery?
- How do you decide which medication or therapy is best for me?
Questions About My Lifestyle & Family
- How do I get started changing my diet?
- How do I get started exercising if I haven’t exercised before?
- Would meditation or yoga help me lose weight?
- Are there support groups in my area for people like me who are trying to lose a lot of weight?
Common Tests or Labs to Diagnose Obesity
Obesity is diagnosed based on a physical examination. In many cases, a doctor can determine if you are obese by looking at your body. They can also take body measurements to calculate your body mass index (BMI) and waist circumference. These tests are described in the table below.
|Test||Why Test?||What Happens?||Results|
|Body mass index (BMI)||To determine if a person’s weight is too much for their height||Height and weight are measured. BMI is calculated by dividing weight in kilograms by height in meters squared (kg/m2).||BMI 18.5 – 24.9 = normal
BMI 25 – 29.9 = overweight
BMI 30 or higher = obese
|Waist circumference||To determine if a person has excess fat around the waist||A tape measure is used to measure around the waist.||The following waist measurements indicate increased health risks related to excess body fat around the waist.
Women: more than 35 inches
Men: more than 40 inches
BMI indicates whether your weight is too much for your height. Measuring waist circumference helps determine whether you are at increased risk for certain health problems related to obesity. Excess fat around the waist increases your risk of developing type 2 diabetes and heart disease.
In most cases, a high BMI indicates that a person has excess body fat. However, some people have a high BMI because they have excess muscle. These people tend to be high-performing athletes or people who lift weights extensively (such as body builders). When a person’s BMI is high but he or she does not appear to have excess body fat, skin fold measurements and other tests can be performed to calculate body fat percentage. This is a way to distinguish between excess body fat and excess muscle tissue. These tests are not commonly performed, however, because excess body fat is usually evident during a physical exam.
Common Medications and Treatments for Obesity
The main treatment for obesity is weight loss achieved through changes in diet and increasing physical activity. While the optimal diet and the amount and type of exercise for each person will vary, weight loss programs are focused on eating fewer calories and burning more calories through exercise. Your doctor can recommend the type of diet and exercise program that is right for you and refer you to a registered dietitian and exercise trainer to help guide you.
Weight-loss medications are also available. These work best when combined with healthy eating habits and increased physical activity. The table below describes the common prescription weight-loss medications used to treat obesity.
|Drug Category||How it works|
Weight loss surgery (also called bariatric surgery) may be an option for people with severe obesity (BMI more than 40) or a BMI more than 35 with a serious health problem related to obesity. The table below describes the four common weight loss surgeries in the United States.
|Type of surgery||How it works|
|Adjustable gastric band (AGB)||
|Roux-en-Y gastric bypass (RYGB)||
|Biliopancreatic diversion with a duodenal switch (BPD-DS)||
|Vertical sleeve gastrectomy (VSG)||