Losing weight is about more than looking better—it’s about reclaiming your health. Beyond the physical changes, weight loss drastically can reduce the risk of serious health conditions like diabetes and heart disease. It also boosts mental well-being and improves mobility. Mythili Vedala, MD, a primary care physician board certified in obesity medicine with the Memorial Hermann Medical Group The Woodlands Medical Weight Management clinic talks about how the journey to a healthier weight is about more than just numbers—it’s about making lasting lifestyle changes that address the root causes for the extra weight.
The Problem Plaguing Us Today
The CDC reports that more than two in five adults in the United States are obese, a condition defined as having a body mass index (BMI) over 30. Dr. Vedala said that “with so many people being labeled as obese, this number is trending toward epidemic levels.” She said that this ever-growing trajectory can be attributed primarily to lifestyle changes across the United States over the past couple of decades:
- Diet and environment. Americans have moved away from nutritious, balanced meals and opted for fast foods and ultra-processed foods, none of which support health. These meals—and the soft drinks that often accompany them—are high in sugars and carbohydrates. “You’re getting energy-dense foods,” Dr. Vedala explained, “but these calories lack essential nutrients.”
- Sedentary lifestyle. The proliferation of computers and smartphones in both offices and homes has enabled a sedentary lifestyle for most adults. In fact, the CDC reports that the median reported sitting time for U.S. adults is between 6.5 and 8 hours a day! Dr. Vedala says that this lifestyle means “you’re not moving, you’re gaining weight and it becomes more difficult to move.”
- Portion sizes. Whether you’re prompted to up-size your combo meal at the drive-through window or you sit down at a fast casual restaurant with a plate of food brimming to the edge, portion sizes have become larger. In fact, researchers writing in the American Journal of Public Heath have found that portion sizes in the United States increased noticeably in the 1980s and have “continued in parallel with increasing body weights.”
- According to Dr. Vedala, there are some considerations regarding family history, genetics, and biology that make obesity not simply a calorie-in-calorie-out problem.
While you may be more aware of how these factors affect obesity rates today, you still may not understand the impact obesity has on your body. There are many comorbidities associated with obesity, including:
- Cardiovascular disease. The risk of developing high blood pressure, cholesterol levels, and the potential for diabetes are all associated with obesity. Furthermore, these conditions can lead to an array of cardiovascular diseases, such as heart attacks, strokes, or peripheral artery disease.
- Insulin resistance that becomes pre-diabetes or diabetes is significantly higher in individuals who are obese.
- This can include breast, colon and endometrial cancers.
- Respiratory issues. This can include the onset of asthma (or the aggravation of existing asthma) as well as sleep apnea.
- Joint damage. The extra weight an obese individual carries impacts their joints, though the joints affected can vary—back, hips, knees, or feet—and there’s a risk for developing osteoarthritis at a young age. Some individuals may need joint replacements, but the irony is that many of these procedures cannot be done until a certain amount of weight is lost.
- Metabolic liver disease. Also known as fatty liver disease, is often associated with excessive alcohol use. However, this disease can affect people even if they don't drink. For those with obesity who do drink, the risk of developing metabolic liver disease is significantly increased.
- Unstable mental health. Obesity can cause many mental health issues that have significant psychological effects on individuals, including anxiety and depression.
While many of these issues are associated with excessive weight gain, individuals may see positive effects on these systems with weight loss.
Beginning the Weight Loss Journey
Dr. Vedala says that there is no “magic pill” to help a person lose weight in a healthy way. Instead, an individual needs to approach losing weight as a journey, one that will take a lot of time and effort to make slow, sustainable changes over time. For those who have attempted a weight loss journey in the past only to see their efforts fail, it is important that their physicians look at underlying causes, according to Dr. Vedala.
“I feel that the best results are obtained only if you treat the individual as a whole, not just focusing on the number that they want to reach,” Dr. Vedala explained. “You have to look at all the underlying causes that could have contributed to their situation: Is it their mental health? Is their musculoskeletal health in order? Is it their heart or hormonal health? Once we understand what is contributing to their obesity, we can target those issues and help the patient get on the right track in their journey.”
Dr. Vedala said that the following lists some of your options as you begin your weight loss journey:
- Diet and exercise. This is the solution that most of us are familiar with when it comes to losing weight—and for good reason. This is the cornerstone option for any weight loss program, especially if the core issue is a calorie-in-calorie-out situation. But Dr. Vedala explained that there are many other issues that could contribute to obesity. “You could give a person an hour-long lecture on diet and exercise, but they won't implement any of that information if you haven’t addressed their underlying issue.”
- Mental health. If a person is clinically depressed, it could be very difficult to get them to modify their diet and begin exercise. Underlying mental health issues must be addressed if an individual is to be successful.
- Sleep quality. Poor sleep quality, sleep deprivation, or severe sleep apnea all make an individual extremely tired and unfocused. Going without proper sleep can impact whether an individual will routinely exercise.
- Weight loss medications. This is a newer science and a solution that Dr. Vedala said didn’t exist many years ago. There are a couple of different types of medications available to help people lose weight, including oral medications, which help reduce “food noise,” and injectable medications that target and block receptors in your gut.
- Bariatric surgery. These surgical weight loss procedures include a gastric sleeve, gastric bypass or duodenal switch. Given that these options are invasive, patients must meet certain criteria before their doctors can refer them for bariatric surgery.
“Having the conversation about weight loss is a sensitive topic for both patients and physicians,” explained Dr. Vedala. “However, there are far more resources now than we had 10, 15 or 20 years ago. If you can start that conversation with your primary care physician, know that there are new resources to help you.”
Starting the conversation about weight loss is just the first step, but it’s a crucial one. As more resources become available, it’s even more imperative to address the complex emotional and psychological aspects of weight management, which are essential to support you on your weight loss journey.
“A patient should not be ashamed—the treatment of food addiction or attachment is no different than the treatment for addictions or attachments to smoking or alcohol,” said Dr. Vedala. “However, while you can live without smoking or drinking, you must consume calories. And I think that’s why weight loss is a much bigger challenge.”
