Medical Weight Management
The battle against COVID-19 has brought our other pandemic to center stage - obesity. February 28 through March 6th is celebrated as Obesity Care Week (OCW) every year. OCW’s vision is to promote a society that understands, respects and accepts the complexities of obesity and values science and clinically-based care.
Obesity is no longer considered a lifestyle choice or simply the result of a lack of willpower. The American Medical Association, World Health Organization, along with many medical societies now recognize obesity as a chronic progressive disease resulting from multiple environmental and strong genetic factors. 93 million Americans are affected by the chronic disease of obesity. Approximately 75% of those affected by severe obesity have at least one co-morbid condition (diabetes, hypertension, sleep apnea, etc.), which significantly increases the risk of premature death. Life expectancy for a 20-year-old male affected by severe obesity is 13 years shorter than a normal weight male of the same age. No state has a prevalence of obesity less than 20% — 22 states have a prevalence between 25-30%, and 25 states have a prevalence greater than 30%. Annual direct medical expenditures attributable to obesity are $147 billion. Weight management can greatly improve overall health and lessen the impact of the diseases and conditions that accompany obesity. Obesity management is about more than reducing numbers on a scale. Success is different for every individual. Obtaining a weight in the recommended range may be unrealistic for some persons with obesity. The success of obesity management is measured by improvements in health-related behaviors and well-being (e.g. improved energy, self-esteem, or quality of life), not just by the amount of weight lost. Here are a few facts:
Medical weight management reduces the effects of chronic diseases, improves lives, and saves $:
Excess weight is associated with developing over 40 chronic diseases such as type 2 diabetes, high blood pressure, high cholesterol, heart disease, stroke, gallbladder disease, sleep apnea, osteoarthritis, and at least 13 different types of cancer. The risk for developing these diseases can increase as an individual’s weight increases. And the overall risk of developing diabetes can double for people with obesity rather than excess weight. Diabetes is one of the most expensive diseases to have.
Nearly 32% of U.S. adults have hypertension (high blood pressure). Modest weight-loss, as small as 10 pounds, can lower one’s blood pressure. We have had several patients successfully come off medications.
The CDC reports that 9.4% of Americans have diabetes, with an additional 84.1 million people diagnosed with prediabetes. National Diabetes Prevention Program (DPP), a seminal study, demonstrated a 59% reduction in progression from prediabetes to diabetes when lifestyle modifications are made. We have had several patients successfully come off insulin and cut down their pill burden.
Obesity costs the global economy about $2 trillion annually, or 2.8% of global GDP, comparable to the costs of smoking or armed violence, war, and terrorism combined.
Individuals with obesity have 42% higher healthcare costs than normal-weight; for people with severe obesity, healthcare costs are 81% higher.
Each 1-point increase in BMI leads to a 4% increase in medical costs and a 7% increase in pharmaceutical costs.
Sleep apnea may lead to additional chronic diseases, including type 2 diabetes and cardiovascular diseases. Medical weight management can reduce the severity of sleep apnea. Coming off a CPAP machine after losing a sufficient amount of weight is a real possibility.
Medical weight management can decrease inflammation. This is beneficial in several direct and indirect ways.
Obesity is the fifth leading risk of death worldwide and is attributed to 5% of all preventable global deaths each year.
BMI of 40 or more is associated with a 50-100% increased risk of premature death than healthy-weight individuals.
Obesity reduces life expectancy by nine years for women and by twelve years for men.
Obesity-related cancers account for 40% of all cancers diagnosed in the U.S. Rates of 12 out of 13 obesity-related cancers increased by 7% from 2005 to 2014, while cancers not associated with overweight and obesity fell by 13%.
Medical weight management options are available for individuals living with excess weight and obesity and have proven results:
Physician, Dietician, Exercise coach, and Behaviour modification are the four pillars of an effective evidence-based treatment program.
Due to its progressive nature, obesity requires life-long treatment and control.
Individuals participating in weight management programs tend to lose 3-5% more weight than those following self-directed programs.
Overall, lifestyle modifications generally result in a weight-loss of 5-10% of excess body weight. Lifestyle modifications have manageable goals and include eating habits, physical activity, and overall behavior modifications.
Medications approved for long-term obesity treatment, when used with lifestyle modifications, lead to greater weight loss and increased likelihood of meaningful 1-year weight outcomes. These medications are as safe as any other medications when used by a trained physician.
Some of the medications used for long-term weight management have been proven to achieve 5-15% weight loss. Results of the use of medication for the treatment of obesity may vary.
Medical weight management reduces effects of chronic diseases:
Nearly 32% of U.S. adults have hypertension (high blood pressure). Modest weight-loss, as small as 10 pounds, can lower one’s blood pressure.
The CDC reports that 9.4% of Americans have diabetes, with an additional 84.1 million people diagnosed with prediabetes. National Diabetes Prevention Program (DPP), a seminal study, demonstrated a 59% reduction in progression from prediabetes to diabetes when lifestyle modifications are made.
Sleep apnea may lead to additional chronic diseases, including type 2 diabetes and cardiovascular diseases. Medical weight management can reduce the severity of sleep apnea.
Medical weight management can decrease inflammatory markers, which are predictors of chronic disease.
Due to its progressive nature, obesity requires life-long treatment and control.
Obesity is the fifth leading risk of death worldwide and is attributed to 5% of all preventable global deaths each year.
BMI of 40 or more is associated with a 50-100% increased risk of premature death than healthy-weight individuals.
Obesity reduces life expectancy by nine years for women and by 12 years for men.
Obesity-related cancers account for 40% of all cancers diagnosed in the U.S. Rates of 12 out of 13 obesity-related cancers increased by 7% from 2005 to 2014, while cancers not associated with overweight and obesity fell by 13%.
Obesity costs the global economy about $2 trillion annually, or 2.8% of global GDP, comparable to the costs of smoking or armed violence, war, and terrorism combined.
Individuals with obesity have 42% higher healthcare costs than normal-weight; for people with severe obesity, healthcare costs are 81% higher.
Each 1-point increase in BMI leads to a 4% increase in medical costs and a 7% increase in pharmaceutical costs.
Medical weight management provided by an obesity medicine physician is a resource for patients affected by excess weight or obesity:
Optimization of body composition analysis and resting energy expenditure (referred to as metabolism in common parlance) is the endgame. Obesity medicine physicians are trained to interpret body composition analysis, an essential part of the evidence-based treatment plan.
Minorities and middle-aged adults suffer from higher rates of obesity:
Non-Hispanic blacks have the highest age-adjusted rates of obesity (48.1%), followed by Hispanics (42.5%), non-Hispanic whites (34.5%), and non-Hispanic Asians (11.7%).
Obesity is higher among middle-aged adults (age 40-59 years; 40.2%) and older adults (age 60 and over; 37.0%) than among younger adults (age 20–39; 32.3%).
The costs and health effects of being overweight and living with obesity are high:
Just over 70% of Americans are currently overweight, with nearly 40% having obesity. In 2008 the total amount spent on medical costs associated with obesity was $147 billion. That equates to an individual increase in health care costs of $1,429 each year compared to an individual without obesity. A substantial and rising percentage of healthcare costs are associated with the treatment of obesity. In 2015, 7.91% of health spending went toward obesity-related illness, and spending on obesity-related illness increased 29% between 2001 and 2015.
Severe obesity (BMI of 40 or more) affects nearly 8% of adults aged 20 and older and is associated with a 50-100% increased risk of premature death.
The National Institutes of Health reports that adults suffering from severe obesity are most likely to die from cancer, diabetes, or heart disease. Years of lost life could be as high as compared to a healthy adult of the same age.
Obesity Medicine
An obesity medicine physician is a physician with expertise in the sub-specialty of obesity medicine. This sub-specialty requires competency in and a thorough understanding of the treatment of obesity and the genetic, biological, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions, including diet, physical activity, behavioral change, and pharmacotherapy. He or she also utilizes a comprehensive approach and may include additional resources such as nutritionists, exercise physiologists, psychologists, and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre-, peri-, and post-surgical care of bariatric surgery patients promotes the prevention of obesity, and advocates for those who suffer from obesity.
Check out this story Our Weight Management Program
References:
http://www.obesitymedicine.org/
http://www.stopobesityalliance.org/
Posted 3/4/2021
About Us
Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP, for their excellence and contributions to medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.
