Obesity Medicine

There are many diseases and health problems that result from obesity and overweight, which prompted hospitals to establish specialized departments that treat obese patients, as well as medical centers that care for this category and provide them with the necessary consultations along with treatment or surgical plans if the need arises, so patients undergo a diet and exercise program or behavioral treatment that takes into account the psychological aspect.

Hence, “obesity medicine” arose after it was found that it is linked to several diseases that can be prevented or their risks can be reduced by simply eliminating excess weight. Some obese people suffer from health disorders that prevent them from losing weight through traditional methods, and they need medical intervention to determine the cause. 

Thus, programs dedicated to weight management were developed within what is now known as “obesity medicine” aimed at helping overweight people lose weight in a healthy way through balancing the basic health aspects of life, namely nutrition, physical activity and mental health.

These programs contribute to modifying unhealthy behaviors in a thoughtful manner according to each person and his need to be able to change his lifestyle over time. It is wrong for a patient to follow a random diet because it is a delicate issue that needs a specialized doctor to assess the condition by conducting a clinical examination, body mass calculations, measuring the waist circumference, taking the medical history, knowing other treatments that the patient is taking, and requesting laboratory tests for him. Accordingly, the doctor chooses the appropriate and effective treatment for the patient’s condition.

Perhaps the presence of such programs is due to the various reasons that can lead to obesity. Nutrition is not the only factor, but genes can be a key factor, which has been proven by studies that found that about two thirds of obesity cases are due to genetic factors in addition to environmental changes that increase inactivity and lack of physical activity while increasing the demand for unhealthy foods. There is a wide range of treatment options such as healthy eating, physical activity, behavioral therapy, anti-obesity medications, and weight-loss surgeries. Weight management needs a personalized plan to develop the appropriate treatment according to each person’s condition. 

Treatments and Programs

After determining the cause, the doctor moves to treatment, which requires the development of a comprehensive weight management plan. Now the patient has to know that it takes time to lose weight and it cannot be done in a short period of time. The patient needs to change his wrong behavior and replace it with healthy habits to lose weight and keep it off. After losing the excess weight, the specialist doctor develops a diet program in which the patient does not feel deprived from food, which encourages him to follow this lifestyle on the long term.

Therapy may include following a special diet while taking some medications to treat the defect that led to this weight gain, or the doctor may resort to surgery and that the type of operation is determined according to the patient’s weight and general health condition.

The medical procedure must be appropriate to the patient’s condition in order to ensure optimal results and reach the ideal weight. The more accurate the procedures, the greater the body’s ability to get rid of excess weight. 

Among the treatment programs adopted:

Increasing physical activity: What is meant here is not sports races or making a lot of effort, but it is enough to add a little movement, such as parking the car far away, or taking the stairs instead of the elevator, or walking in the market for some time. With time, the body will get used to moving, and the obese patient will enjoy walking, so his physical activity will increase little by little. The goal is to exercise about 150 minutes per week. This will become a daily routine.

Behavioral therapy: Among the modern treatments of obesity and overweight are those related to the psychological aspect, after it has been proven that there is a close relationship between the body and the mind. The behavioral therapist deals with the psychological aspects of weight management, with the aim of identifying the thought and behavior patterns that motivate the patient not to eat without feeling hungry, which is the problem that some suffer from where they eat food or sweets when feeling sad or vice versa; this is called emotional eating. Behavioral therapy helps develop skills and enhance mental capacity with the aim of changing lifestyle and aiding weight loss with long-term health benefits.

Low-calorie diet: Follow a special diet that breaks down localized fat, in addition to following some special exercises under the supervision of a special trainer who determines the appropriate exercises to lose body fat. Meals should be rich in protein and low in fats and carbohydrates, and they are part of the treatment plan under the supervision of a specialist doctor to include replacing one or more meals per day that includes foods that provide a specific number of calories, for example, between 800 and 1200 calories per day.

Anti-obesity drugs: Only the doctor decides whether the medical condition requires taking anti-obesity drugs or not, which are diverse and work in different ways that help regulate appetite and reduce food portions. Anti-obesity medications can also help prevent weight regain, and other medications help you lose weight by changing the way your body absorbs food. This can be done, for example, by reducing the amount of fat your body absorbs.

Weight-loss surgery: After the failure of all types of obesity treatments, and after determining the BMI, the final solution for treating obesity may be surgery, especially for cases that suffer from chronic diseases or have a risk of developing a chronic disease in the future due to excess weight. Surgical procedures reduce appetite and the amount of food a person can comfortably eat in one sitting. It has been shown to cause metabolic and hormonal changes, which play a key role in weight regulation. The hormonal changes that occur prevent weight regain.

Laboratory tests to determine the causes of obesity

Weight management requires diagnosing the cause of obesity by conducting a series of lab tests to determine the cause in order to develop the appropriate treatment plan. The beginning of excess weight management to get rid of obesity requires determining the cause in the first place, and this is done by conducting a set of laboratory tests to determine the cause then finding the right treatment. Also, each body has its own nutritional needs. After the examinations, the doctor can develop a diet with a comprehensive treatment plan to prevent the risk of developing health problems during dieting, such as not losing weight or fainting and dizziness. After determining the BMI and the rate of obesity or weight gain that the patient suffers from, the doctor initially resorts to conducting some tests to ensure that there is no health problem that contributes to weight gain, in rare cases as a result of a medical problem that affects the slow metabolism, such as Cushing’s syndrome or thyroid inactivity.

The lab tests required to determine the cause of obesity:

Thyroid hormone (TSH), which is secreted by the pituitary gland to stimulate the thyroid gland and induce it to secrete its functional hormones. Hypothyroidism means excess TSH secretion and obesity is one of its symptoms.

Vitamin D analysis, since its deficiency in the body affects weight loss due to its hormonal functions that have an effect on the thyroid gland functions, which controls metabolic rates. Therefore, vitamin D must be measured in the body before following a diet in order for the doctor to prescribe vitamins necessary to increase low levels of vitamin D.

Cholesterol analysis to know the levels of fats in the blood, namely the triglycerides that accumulate as a result of converting calories into fats and are stored in fat cells, and these fats also increase the risk of diabetes. 

Blood sugar test: Studies have shown that obese people are more likely to develop type 2 diabetes because the body is unable to manage carbohydrates, which leads to high blood glucose and increased insulin resistance.

Complete blood count: A low level of hemoglobin in the body indicates a lack of iron, which stimulates the production of hemoglobin and thus increases the level of energy needed at the gym, while iron deficiency affects thyroid hormones.

Liver function tests: Obesity causes the accumulation of fat above the liver, causing fatty liver disease, and this in turn affects the liver function tests. Obesity can also cause health problems in the gallbladder, which increases the bile in the blood, as bile tests are part of the liver function tests.

FSH is the ovarian stimulating hormone. Ovarian laziness means an increase of this hormone in the body. The ovary secretes estrogen, which is necessary to regulate the storage of body fats.

LH is one of the female sex hormones; high LH hormone occurs in the case of PCOS, which causes overweight and obesity.

Estrogen, known as the female hormone secreted by the ovaries, but after menopause, this hormone decreases significantly, which leads to obesity, especially in the abdomen and buttocks area, where fat accumulates. Estrogen regulates fat storage in some areas of the body, so it is one of the hormones that cause obesity.

Testosterone, known as the male sex hormone, is present in high levels in men and in low levels in women. One of the testosterone hormone functions is to strengthen the muscles, help burn fat and strengthen the bones. The deficiency of this hormone in the body of a woman or a man leads to the accumulation of fat in the body and thus is one of the causes of obesity.

Cortisol is a hormone secreted by the adrenal gland and has multiple functions, including regulating metabolism related to energy storage and consumption in addition to regulating the distribution of fat in the body.

Leptin hormone is responsible for regulating the sensation of hunger and satiety, as its deficiency leads to an increase in appetite and thus may be a cause of obesity.