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Understanding Obesity and Overall Health

By Yong Choi, MD, FACS, FASMBS, Chief Medical Officer and Bariatric Surgeon at St. Luke's Health—The Woodlands Hospital

April 08, 2023 Posted in: Leadership

Obesity is an epidemic in the U.S. and more than 35 percent of adults in Texas have the condition. If you’re one of them, you probably know how much it can impact your physical and mental health and overall quality of life. It’s also a very challenging condition to address—but it’s not a failure on your part. Obesity is a treatable medical condition that happens to people for a variety of reasons. Understanding obesity and what your treatment options are can put you on the path to a healthy life.

Understand Obesity and What Causes It

All bodies have and need fat, also called adipose tissue. This tissue plays an essential role in metabolism, or how the body gets energy from food. It also helps regulate hormones, the  chemical messengers in the body. Obesity happens when the body has an unhealthy amount of adipose tissue, which can lead to serious health conditions and poor quality of life. 

Unfortunately, many of my patients encounter people who still believe obesity is caused only by eating too much and not moving enough. While those factors can certainly cause obesity or contribute to it, that’s not the whole story. And lack of willpower doesn’t cause obesity either. It’s a complex medical condition that can cause or become worse by:

  • Endocrine disorders, such as certain thyroid conditions

  • Genetics or inherited syndromes

  • Hormone-related medical conditions, such as Cushing’s syndrome or polycystic ovarian syndrome

  • Medical conditions that affect metabolism

  • Social health factors, such as low access to fresh foods and safe places to exercise

  • Some medications used to treat other conditions

The Effects of Obesity on Physical Health

Obesity is a leading cause of preventable death, second only to smoking, and can lead to serious physical health concerns. Conditions that can be caused or made worse by obesity include:

  • Arthritis

  • Diabetes

  • Fatty liver disease

  • Gallstones

  • Gastroesophageal reflux disease (GERD)

  • High blood pressure

  • High cholesterol 

  • Inflammation, especially in people with higher amounts of abdominal fat

  • Lung problems

  • Sleep apnea

  • Several types of cancer, including breast, colorectal, ovarian, pancreatic and thyroid cancer

  • Stroke

  • Weakened immune system

In addition to chronic health conditions, people with obesity are also at a higher risk of complications and worse outcomes from some acute viruses and illnesses, including COVID-19.

People who receive obesity treatment, including my patients, commonly experience significant improvements in other medical conditions. For example, managing chronic conditions like diabetes or high blood pressure can become easier with weight loss. Some people can even decrease or eliminate the medications they take for conditions like diabetes and high blood pressure. Addressing your obesity can also help improve your general well-being and quality of life.

Mental Health and Obesity

The relationship between obesity and mental health is complex. Not everyone with obesity experiences mental health issues but they are at higher risk for developing them, including anxiety and depression. Additionally, mental health issues may be related to obesity or be the cause of obesity.

Some of my patients found it difficult to travel or participate in certain activities with friends and family, which decreased their quality of life and led to depression. Discrimination and stigma related to obesity or difficulty getting out of the home also contribute to social isolation and loneliness. It’s understandable, then, how poor body image, low self-esteem and stigma are linked to mental health issues.

Underlying mental health conditions may increase the risk of becoming obese. Hormonal imbalances, low energy levels or decreased interest in participating in activities caused by a mental health condition can all contribute to weight gain. And mental health issues often make it more challenging to lose weight.

No matter which came first—mental health issues or obesity—support groups, individual counseling and other types of support can be very helpful. 

Medical Bias 

Medical studies also indicate some doctors with little experience treating obesity still hold their patients with obesity responsible for their health problems. Naturally, this can leave many feeling judged, embarrassed and less likely to return or continue seeking help for health in general. Clearly, even to this day, there’s a lot that providers and medical researchers don’t understand about obesity. It's not only a matter of calories and inactivity.

Fortunately, as researchers continue to uncover more of the science behind obesity, a growing number of my medical colleagues hold a different and more compassionate view of treating it. The American Medical Association recognizes obesity as a disease. We also understand obesity affects people differently, and regardless of where a patient is on their journey, everyone deserves to be treated with dignity and respect. 

Yes, You Can!

If obesity has you feeling hopeless, I understand. I can also tell you that I’ve had many patients who used to feel the same way, but they don’t anymore. Several successful treatment options are available to address obesity, from dietary services to medication to bariatric surgery. Often more than one treatment is used. The best one for you depends on your particular environmental or lifestyle factors, medical history and personal preferences.

Wherever you are in your weight loss journey, you aren’t alone. At St. Luke’s Health, we know you are more than your weight. We take a multidisciplinary approach to obesity treatment with a team of physicians, dietitians and mental health experts who work together by your side. To successfully lose weight and keep it off, we want our patients to receive the support, education, and treatment needed to improve physical health and quality of life.

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