What is obesity?

It is a complex, chronic health problem. When someone has obesity, their body fat is above a certain level that can have harmful effects on health. Measuring body mass index (BMI) is generally accepted as the first step to find out how much a person is overweight.

BMI is a measure of body fat based on height and weight. A BMI of 25 to 30 is overweight. A BMI over 30 is obese. Your doctor can check your BMI for you. You can also use a BMI tool online to find out your BMI.

To diagnose risk factors not shown by BMI, your doctor may measure your:

• Waist circumference.

• Waist-to-hip ratio.

• Waist-to-height ratio.

These measurements show the degree of abdominal obesity. People with abdominal obesity have an increased risk for:

• Heart disease.

• Diabetes.

• High blood pressure.

• Dyslipidemia.

• Metabolic dysfunction-associated steatotic liver disease.

Why see a bariatric doctor?

If you are obese, it’s important that you get the right treatment. Obesity can lead to serious health problems, such as:

• Diabetes.

• Arthritis.

• High blood pressure.

• Heart disease.

• Stroke.

• Sleep apnea.

• Liver disease.

• Certain lung diseases, such as asthma.

• Certain cancers.

You may start your treatment with your primary doctor. If you need more help, you may want to see a bariatric doctor. They may have new ideas or ways to lose weight that can help you.

What to expect at your first visit

At your first visit, your bariatric doctor may:

• Ask about your health history. This includes your history of eating habits, exercise, and weight loss.

• Give you a physical exam. This includes BMI, waist circumference, and blood pressure.

Your doctor will order tests to check health factors related to obesity. And they look for health problems that can cause weight gain.

You may have tests, such as:

• Blood sugar levels. This checks for diabetes.

• Lipid and cholesterol levels.

• Thyroid-stimulating hormone levels.

• Liver blood tests.

• Kidney function blood tests.

• Vitamin D levels.

• Electrocardiogram. This looks at your heart rhythm.

• Exercise testing. This checks how well your heart works during exercise.

• Resting metabolic rate. This looks at how many calories you burn at rest.

After all the tests are done, people with obesity are grouped based on whether the extra weight is causing organ or tissue damage. Or if it affects daily function. People with preclinical obesity do not have obvious effects related to extra weight. Those with clinical obesity have health issues related to their weight. Knowing which type a person has helps doctors guide what counseling and treatment is best for them.

Making a treatment plan 

Your doctor will make a treatment plan for you. The plan is based on your health needs and preferences. They will:

• Find out how ready you are to start an exercise program.

• Help you make realistic weight loss goals.

• Give you a nutrition plan.

• Tell you to keep a food diary.

• Talk with you about medicine for weight loss, if needed.

They will teach you about:

• Healthy eating habits.

• Healthy exercise habits.

• How to change health behaviors.

• How mental health affects obesity.

• The health problems from obesity.

• The benefits and risks of medicines.

At each follow-up visit, your doctor will check your progress. They will make changes to your plan as needed. As you lose weight and your health improves, your doctor might change some of your medicines. If your weight loss stops or you regain weight, they may talk with you about weight loss surgery.

Finding a bariatric doctor

Talk first with your primary doctor. They may be able to refer you to a bariatric doctor. You can also go to the Obesity Medicine Association website. They have an online listing of bariatric doctors.