Weighing in on Obesity Management

by: Christine Kessler MN, ANP-C, CNS, BC-ADM, CDTC, FAANP

Some quip that America has become a “waist-land.” Sadly, this jest reflects a devastating truth; the rate of obesity has more than doubled since 1970, now affecting at least two out of every three Americans and this trend will continue. Among children and adolescents, obesity has tripled. With this stunning rise comes a crescendo of nearly 200 obesity-associated complications, many serious such as type 2 diabetes, cardiovascular disease, and various forms of cancer, as well as increased healthcare costs.

Primary care providers form the front line in identifying patients with, or at risk for, obesity-related complications and initiating weight loss interventions. Unfortunately, societal and medical bias against those with excessive weight may impede effective weight management. Shame and blame, often felt but unspoken, can inhabit the exam room bringing with it a sense of hopelessness felt by both patient and provider which is often prompted by failed prior weight loss interventions, weight regain and a misunderstanding of the pathogenesis of obesity. To counter both bias and medical inertia, obesity should be understood as a chronic disease, not a character flaw. Simply eating too much and moving too little is an outdated etiologic view of a condition that has multifactorial causes, chiefly genetics.  The “new frontier” of obesity research focuses on appetite regulation and the remarkable bio-directional influences of gut incretins, the microbiome, neural pathways and neuropeptides on fat mass regulation and energy expenditure.  Many things can disrupt this biochemical balance and cause untoward weight gain.

Regardless of its specific cause, obesity is now known to be a major contributor to preventable death, and there should be as urgent a desire to treat a BMI of 30 as there is a systolic blood pressure of 200 mmHg. Successful medical management of the chronic disease of obesity must be attentive, lifelong, and multifaceted and include behavioral and lifestyle interventions, weight-loss medication and bariatric surgery.

If you wish to explore the intriguing foundations of obesigenesis, adiposopathy, and appetite regulation and arm yourself with reality-based, truly effective weight loss strategies, come to my presentation –Weighing in on Obesity Management and join the attack on fat!

See Christine Kessler MN, ANP-C, CNS, BC-ADM, CDTC, FAANP this summer at the GAPA 2018 Summer Conference in Sandestin, FL. Click here for details.

 

 

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