Obesity is a Chronic Disease

Did you know that genetics account for approximately 50% of the difference in body weight between individuals? There are many other factors that may cause or contribute to excess body weight, including medications, environmental exposures, certain infections, and more.

This is why two people who eat and exercise similarly may have major differences in their body size and shape. We all have one friend who seems to be able to eat anything they want and never gain weight, while many of us have been trying our best to watch what we eat, exercise, and follow all the standard medical advice, but still find ourselves gaining weight year after year.

The influence of genetics and environmental factors on body weight is important to understand because it leads us to recognize obesity as a complex, chronic disease impacted by many factors. Patients with obesity have a greater amount of body fat compared to individuals without obesity, but that is only part of the picture. The fat tissue in patients with obesity acts differently, and leads to numerous health complications.

Mechanical Effects

Patients with obesity often experience health issues that are directly related to physical forces of excess weight. These include the effect on the joints (worsening osteoarthritis, chronic back pain, etc.).  Excess weight carried in the abdomen can contribute to gastro-esophageal reflux (GERD) with associated complications such as erosive esophagitis or Barrett’s esophagus. Excess weight in the trunk/abdomen also may impact lung function, leading to shortness of breath and exercise intolerance. Further, it may cause/contribute to obstructive sleep apnea, which itself is associated with additional negative health outcomes.

Hormonal Effects

Adipose tissue (fat) is not inert! Adipose tissue is metabolically active, and secretes a variety of hormones and signaling molecules into the body. These impact systemic inflammation and immune function. The interaction between adipose tissue and other organs through this signaling leads to many of the metabolic complications of obesity. Examples include: high blood pressure, insulin resistance and type 2 diabetes, high cholesterol, polycystic ovarian syndrome (PCOS), chronic kidney disease, and 13 common types of cancer. Hormonal shifts that occur with changes in body weight are also the reason that it is so hard to maintain weight loss; your fat cells are actively working against you!

The Bottom Line

Obesity is a chronic medical condition with serious impacts on your overall health. In the same way that diabetes care does not start and end with “don’t eat too many sweets,” obesity treatment is more than telling patients to eat less and exercise more.

You deserve comprehensive and effective treatment! Several of the newest medications approved for the management of obesity have impacts that go beyond simply losing pounds. They can have positive impacts on metabolic health, including improving blood sugar control in diabetes, reducing the risk of cardiovascular events like heart attack or stroke in patients with established cardiovascular disease, treating sleep apnea, and treating obesity related liver disease. The goal of obesity treatment is not simply to lose weight, but rather to improve your overall health, functioning, and longevity.