FAQ

Yes, obesity is a chronic, progressive, and prevalent disease.1-3
The American Association of Clinical Endocrinology (AACE) and the American College of Endocrinology (ACE) have published practice guidelines for treating patients with obesity.2

Obesity is one of the most prevalent diseases in the US, affecting more than 109 million (41.9%) adults.4,5

Social determinants of health, environmental factors, and genetics all contribute to obesity.6,7
Specific factors influencing obesity include socioeconomic status and food insecurity (social factors), food availability and quality (environmental factors), and gene mutations (genetic factors).8-11

Even if patients achieve weight loss with reduced-calorie intake, metabolic adaptation to appetite-regulating hormones drives weight regain and persists, making long-term weight management very challenging.11,12

Yes, cardiovascular mortality rates climb 7% for every 2 years lived with obesity.13*
*Based on data from the original cohort study of the Framingham Heart Study (FHS). This cohort study followed 5,209 participants (aged 28-62 years at the time of enrollment) for approximately 48 years beginning in 1948 with examinations at 2-year intervals. The current study included only participants who were free from preexisting diseases of diabetes, cardiovascular diseases, and cancer at baseline (n=5,036).13
How does obesity impact patients aside from their physical health?
Obesity has negative effects on mental health and influences health status both directly and indirectly. The impact of overweight and obesity on mental health includes depression, body image dissatisfaction, eating disorders, and stress.14

As obesity rates have risen in the last several decades, so has the evidence of weight stigma and weight bias. In fact, weight discrimination in the US is commonly reported at rates comparable with those of racial discrimination.14

Yes, cardiovascular mortality rates climb 7% for every 2 years lived with obesity.13*
*Based on data from the original cohort study of the Framingham Heart Study (FHS). This cohort study followed 5,209 participants (aged 28-62 years at the time of enrollment) for approximately 48 years beginning in 1948 with examinations at 2-year intervals. The current study included only participants who were free from preexisting diseases of diabetes, cardiovascular diseases, and cancer at baseline (n=5,036).13
How does obesity impact patients aside from their physical health?
Obesity has negative effects on mental health and influences health status both directly and indirectly. The impact of overweight and obesity on mental health includes depression, body image dissatisfaction, eating disorders, and stress.14

You may want to consider pharmacological treatments for your patients with overweight or obesity who2:

• Have tried lifestyle changes but can’t reach a healthier weight
• Are having difficulty with weight management
• Have a BMI of ≥27 kg/m2 and a weight-related comorbidity
• Have a BMI that is ≥30 kg/m2

While many of your patients may have greater weight-loss goals, a study showed that a modest weight loss of 5% or more can have a clinically meaningful impact.16
In the study, weight loss of 5% was associated with improvement in cardiovascular risk factors such as glycemic control, blood pressure, HDL cholesterol, and triglycerides.16
Studies also show that higher levels of weight loss can be associated with greater improvements in some comorbidities. Be sure to emphasize the difference that a weight loss of 5% or more can make in reducing the risk of comorbid conditions.16

You may want to consider pharmacological treatments for your patients with overweight or obesity who2:

• Have tried lifestyle changes but can’t reach a healthier weight
• Are having difficulty with weight management
• Have a BMI of ≥27 kg/m2 and a weight-related comorbidity
• Have a BMI that is ≥30 kg/m2

While many of your patients may have greater weight-loss goals, a study showed that a modest weight loss of 5% or more can have a clinically meaningful impact.16
In the study, weight loss of 5% was associated with improvement in cardiovascular risk factors such as glycemic control, blood pressure, HDL cholesterol, and triglycerides.16
Studies also show that higher levels of weight loss can be associated with greater improvements in some comorbidities. Be sure to emphasize the difference that a weight loss of 5% or more can make in reducing the risk of comorbid conditions.16
HDL, high-density lipoprotein.

Obesity is a chronic, progressive, and prevalent disease that requires long-term management, but many people with obesity still lack the support they need to manage their weight.1,3,18 By partnering with your patients to develop comprehensive and individualized approaches to weight loss and weight management, you can make a huge impact on your patients’ lives and help fill the gaps in their health care that are keeping them from successful weight loss.

Obesity in adolescence is on the rise, with a 3-fold increase in prevalence since the 1970s.19 Many of the weight-related conditions we see in the adult population, like hypertension, type 2 diabetes, and dyslipidemia, are now becoming more common in people younger than 18 years of age who have obesity. Because obesity is a chronic condition, ongoing monitoring and treatment are required, which may include intensive lifestyle modification, pharmacotherapy, or even surgical intervention.20

Cultural influences, such as traditions and views about body image, can impact whether or not your patients will accept your 
weight-management advice. Understanding your patients’ cultural nuances can help you create a plan that fits their lifestyles.

Obesity is a chronic, progressive pathology that has no cure and requires specific treatment to lose weight and continuous follow-up to avoid weight regain. There are several treatments for obesity but none of them cures it definitively. Unfortunately, physiological adaptations to weight loss favor weight regain. These adaptations include variations in the levels of circulating hormones that regulate appetite and energy balance.

Lifestyle changes and drugs approved for obesity have limited efficacy and their effects disappear when they are discontinued and/or discontinued. Bariatric surgery produces a significant weight loss, which is maintained in the long term (> 5 years). However, approximately 20% of the subjects who undergo this type of treatment regain the lost weight because they are not able, for various reasons, to maintain the changes in their lifestyle. To avoid weight regain, people must maintain lifestyle habits that counteract the physiological adaptations and factors that favor weight regain.

There is consistent evidence that obesity is associated with certain types of cancer. These include but are not limited to: endometrial cancer and ovarian cancer in postmenopausal women, breast cancer in men and women, oesophageal cancer, stomach cancer, liver cancer (secondary to a fatty liver), gallbladder cancer, colorectal cancer, pancreatic cancer, kidney cancer, multiple myeloma, and meningioma.
The percentage of cases of cancer attributed to obesity varies widely depending on the type of cancer, with figures of up to 54% for gallbladder cancer in women or 44% for oesophageal cancer in men.
Several mechanisms have been proposed to explain how obesity increases the risk of developing these types of cancer. Fatty tissue (adipose) produces oestrogens and high levels of oestrogens has been associated with the development of breast cancer, ovarian cancer and endometrial cancer. People with obesity also have increased levels of insulin (hyperinsulinaemia or insulin resistance) and insulin-like growth factor (IGF-1). High levels of insulin and IGF-1 have been associated with the development colon cancer, kidney cancer, prostate cancer and endometrial cancer. People with obesity have chronic, low-grade inflammation, which over time can damage the body’s DNA and initiate cancer. Compared to people of a normal weight, obese people have conditions or alterations that are associated with localised chronic inflammation and these represent risk factors for certain cancers. For example, chronic inflammation that produces gastroesophageal reflux disease is a cause of oesophageal adenocarcinoma.

There are conditions associated with obesity in both men and women that can interfere with their chances of conceiving (either naturally or by means of assisted reproductive techniques) and with the normal evolution of pregnancy.Some women suffer hormonal imbalances that affect their menstrual cycles, interfere with ovulation and cause infertility. Obesity is closely related to polycystic ovary syndrome, a condition in which the ovaries do not produce enough hormones and so the egg neither reaches maturity nor is released (anovulation), thus giving rise to infertility.
In the case of men, obesity can reduce both the quantity of sperm and their activity with functional and morphological alterations. The good news is that losing weight (through dieting or bariatric surgery) significantly improves the chances of conceiving and having a healthy pregnancy.Recommendations are to avoid becoming pregnant for at least 1 year after bariatric surgery, as the health of the foetus is largely dependent on the mother’s nutritional status and the possibility of nutritional deficiencies are a significant source of risk for maternal and foetal wellbeing.

“Miracle diets” are those that attempt to achieve rapid weight loss results without much effort, and have multiple health risks. These increase the risk of nutritional deficiencies that can cause an alteration in taste and appetite, hair loss, weak nails, as well as favouring osteoporosis or blood coagulation disorders. Furthermore, vitamin deficiency can cause irritability, ocular, cutaneous, and gastrointestinal lesions, as well as lack of memory and difficulty in concentrating, among others. They also produce negative psychological effects like anxiety, stress and depression that can trigger eating behaviour disorders. And they favour the rebound effect, when returning to previous eating habits.

The recommendations for starting doing regular physical exercise recommend dedicating about 30 minutes daily to physical activity, therefore it is very important to plan daily tasks, leaving this minimal space for health care. If despite this you cannot find this gap, it could be split up into several sections of not less than 10 continuous minutes.

Multiple activities can be carried out with a low economic impact: go walking at a fast pace or run, train with free APPs and tutorials, practice in parks with physical exercise equipment, “low cost” gymnasiums, swimming at the beach…

The causes of emotional eating are complicated and very diverse, each case must be analysed on an individual basis. The emotions that most frequently trigger an episode of emotional eating are boredom, loneliness, sadness and anxiety. In such a situation, food acts as a means to immediately relieve the negative or unpleasant emotion, even if only temporarily. When this behaviour becomes established as a regular method for dealing with difficult situations or negative emotions then it is called emotional eating.

Emotional eating can occur in obese and non-obese people, with or without a psychiatric disorder. It can lead to the onset of obesity and make it hard to adhere to any weight loss treatments. It may also predispose the development of eating disorders. Assessment and treatment by a mental health professional, psychologist or psychiatrist can help overcome this problem.

Some people with obesity may have had an eating disorder at some time in their lives or suffered alterations in the way they eat that could be diagnosed as eating disorders. Any denial, guilt or shame associated with this problem sometimes means the disorder goes undiagnosed, which hampers the necessary referral to psychotherapy.

Patients with a favourable evolution after bariatric surgery generally feel better psychologically. This is due to the improvement in their state of health, quality of life and self-esteem, allowing them to better adapt to their work, social, and personal environments. However, surgery for obesity is not a treatment for psychiatric disorders such as depression, anxiety or eating disorders, amongst others. Individuals who suffer from a mental health disorder should be assessed in order to receive the most appropriate therapy and promote the best progress possible for any weight loss treatment.