The diagnosis of overweight or obesity is based on a measurement called Body Mass Index (BMI). Generally, patients with BMI of 30 or greater are considered candidates for medical weight management, as are those with BMI 27 or above who also have weight-associated medical conditions such as diabetes, hypertension, high cholesterol, or sleep apnea. Patients who do not meet these criteria but have an increased abdominal circumference (>35 inches for females, >40 inches for males) are also candidates. 

BMI is a calculated number based on a patient’s height and weight that allows us to estimate their body fat content. It is not the most accurate measurement of overweight or obesity, but it is easy to calculate and is closely associated with body fat in most individuals. A normal BMI is between 18.5-24.9. Patients with a BMI of 25-29.9 are considered overweight, and patients with a BMI > 30 are considered to be in the obese range.

Higher BMI is associated with higher risk of medical complications (see below). The weight management treatments that we offer are generally based on a patient’s BMI. For patients who have a BMI in the overweight category without complications, we generally recommend nutritional counseling and exercise. Patients with a BMI of 27 or greater who also have weight-related medical issues (co-morbidities) are offered weight loss medications. Patients with even higher BMI may qualify for weight loss (bariatric) surgery.

There are numerous medical conditions that are associated with or perhaps even caused by obesity, known as weight-related comorbidities. Some of these diseases include high blood pressure, adult-onset diabetes mellitus, high cholesterol, obstructive sleep apnea, polycystic ovarian syndrome, several types of cancer, and heartburn. Many other medical problems are made worse when associated with obesity including cancer, fatty liver disease, osteoarthritis, and asthma. 

Metabolic syndrome is a cluster of diseases that occur in conjunction with obesity. Specifically, patients with increased blood pressure, increased blood sugar, abnormal cholesterol and/or lipid levels, and excess abdominal fat have metabolic syndrome. This disease process is associated with increased risk of heart attack, stroke, and diabetes. Weight loss is the most effective treatment for metabolic syndrome and can result in resolution of some or all medical conditions associated with this syndrome. 

Patients with a BMI 30 or greater are considered candidates for medication therapy, as are patients with a BMI 27 or greater who have obesity-related co-morbidities. 

Between weight loss medication and lifestyle changes, one can expect to lose on average between 5-20% of your total body weight. Studies show that weight loss of this amount can improve many obesity-related co-morbidities.

Obesity is defined as a chronic, progressive disease. Currently there is no cure of obesity. In the past few years, obesity has been recognized as a disease and has been studied intensively. There are currently several FDA-approved medications and several surgical options, as well as an improved understanding of the role of behavioral health, nutrition counseling, and physical activity in the management of obesity. The advice to "eat less and exercise more" was not helpful in the past and is still inadequate in the treatment of obesity. With the currently available treatment options, obesity treatment is more successful than ever.