Weight and Obesity: 10 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Lorna Collier on May 9, 2021
  • Unseen doctor weighing male patient on scale
    Tips From Obesity Medicine Doctors for Losing Weight
    Obesity in America is at epidemic levels, say bariatric medicine doctors (specialists who help you lose weight). Being overweight or obese is linked to many serious illnesses, such as heart disease, diabetes, certain cancers and Alzheimer’s disease. But as we all know, it can be very hard to lose and keep off excess weight. Obesity medicine doctors use diet, exercise, lifestyle changes and medication to help patients get and stay healthy. (They don't perform bariatric surgery, but occasionally refer patients for it.) We asked three leading bariatric medicine specialists for their top tips—advice you can use to help beat obesity.
  • Diverse group of people exercising with kettle bells inside garage gym
    1. “Exercise doesn’t help you lose weight.”
    “The vast majority of people who come to me say the biggest reason they’re struggling with their weight is because they don’t exercise enough,” says Angela Fitch, MD, associate director of the Massachusetts General Hospital Weight Center in Boston. But, she says, “Exercise does not produce a lot of weight loss,” according to research. It can even cause you to eat more because you’re so hungry afterward. “One of the best-kept secrets is that exercise can get in the way of weight loss,” says Wendy Scinta, MD, president of the Obesity Medicine Association and a family practitioner in upstate New York.
  • Young Caucasian woman doing plank exercise or yoga in apartment with cat next to her
    2. “Working out can help you maintain weight loss.”
    Exercise may not help with getting pounds off, but it can help them stay off, says Dr. Fitch. "What the data has shown recently is the biggest reason to exercise is to maintain your weight loss." Dr. Fitch points out that after age 30, "We start to lose muscle mass every day if we're not doing something physically active. Muscle mass is responsible for how many calories you burn at rest." She recommends including regular strength training—which can be done with weights or "body strength" exercises like lunges, squats, planking and push-ups.
  • Different colored diet pills against colored measuring tape
    3. “Weight loss drugs can make a big difference.”
    “The newest data coming out shows that medication is really helpful to get people where they need to be,” says Dr. Fitch. “They are going to be 4 to 6 times more successful with medication than they would be without it.” Today’s drug arsenal offers many options for people to fight cravings and suppress appetite, but often need to be taken long-term so the weight stays off, says Dr. Fitch. She recommends them for people who have an obese BMI of 30, or a BMI of 27 if they also have at least two obesity-related conditions (like diabetes).
  • Unseen overweight man with plate of burgers and fries and soda sitting on couch
    4. “Understanding why you overeat is key to treatment.”
    “Each person is going to have a different reason they are overweight,” says Craig Primack, MD, an obesity medicine specialist in Arizona. Often there’s an emotional component to overeating, he says, such as loneliness, boredom, stress, depression or fatigue. Knowing why someone overeats helps doctors tailor obesity treatment, he says, which can include medication, behavioral and nutritional counseling, and behavioral or lifestyle changes. Dr. Fitch compares obesity to cancer: "We have different types of cancer and they're not treated all the same—obesity is quite similar."
  • Female friends laughing over lunch at restaurant
    5. “Diets aren’t one-size-fits-all.”
    "Your friend may have gone on this one particular diet and lost weight, but the same diet or plan may not work for you," says Dr. Primack. One reason is that more than 200 different genes (including 20 major ones) affect the likelihood of you being overweight, he says, so it's unlikely you have the same genetic underpinnings for your obesity as someone else. This means what works for your friend might not work for you. Dr. Primack thinks that in the near future, people will be able to get genetic testing to find personalized treatment for their obesity.
  • Young Caucasian woman sound asleep in bed
    6. “Getting enough sleep helps you lose weight.”
    "Sleep is a huge part of weight loss," says Dr. Primack. When you don't sleep enough, sleep hormones go awry: ghrelin, which makes you feel hungry, goes up, while leptin, which tells you you’re full, goes down. Your metabolism also slows. "Even when you are doing all the things you should be doing—like dieting and exercising—if you're not sleeping, it doesn't give you as much benefit," he says. Dr. Primack recommends melatonin (1 to 2 milligrams taken 7 hours before sleep) and turning off screens at least an hour before you turn in for the night.
  • Assortment of healthy foods including lean meat, fish, fruit, nuts, vegetables and grains
    7. “Consider high-protein, low-carb diets and fasting.”
    "The general philosophy behind most diets nowadays is lower carbs," says Dr. Primack. "I don't like very low carbohydrates, but [rather] lower carbs and higher protein." Dr. Scinta says she tries to work with what patients like to eat; sometimes she recommends ketogenic or paleo diets. "Those are my faves," she says. Intermittent fasting also "is very healthy for you," says Dr. Scinta, and can be an especially good plan for breakfast-skippers. With intermittent fasting, you eat only during an eight-hour period in the day, and fast the remaining 16 hours, ingesting only liquids like black coffee (no cream), tea and water.
  • Protein shake with straw and cup of protein powder in background
    8. “Low-calorie meal-replacement diets cause fast weight loss.”
    Dr. Scinta says she sometimes puts patients more than 50 pounds overweight on total meal replacement plans (usually only 800 to 1,000 calories per day in the form of shakes, bars and soups). The products she uses "are very specially formulated so you can get all the nutrients in," and cause fast weight loss, she says, which motivates people to continue. Dr. Fitch says such replacement programs should be directed by a physician, but if people want to buy the occasional shake or bar, to pick ones with "at least 15 grams of protein and less than 10 grams of carbs."
  • Restaurant container of various sugars and artificial sweeteners
    9. “Artificial sweeteners are O.K.”
    While some research shows artificial sweeteners can cause people to gain weight, Dr. Scinta says she hasn't seen this with her patients and that the data is mixed. "I think it can be a very good tool in weight loss, especially if you're doing something like the ketogenic diet where people just want to have something kind of sweet in there," she says. "Fat and protein can be kind of boring after a while, so if you can throw a little Stevia in your yogurt, it can make it more enticing."
  • Unseen woman pouring water out of bottle into glass
    10. “Use the '20-minute' rule to manage cravings.”
    "Cravings last about 20 minutes, so if you can get past 20 minutes, it will go away," says Dr. Primack. "We think of it as a wave, starting out low from when hunger is first perceptible to when it goes away." He suggests setting an alarm for 20 minutes after your craving hits. Tell yourself that if you're still hungry after that point, you can eat something. Dr. Fitch also suggests taking a walk or doing other exercise when cravings hit. Or, try drinking water. "Sometimes you're actually thirsty and not hungry, but you don't recognize it," she says.
Weight and Obesity: 10 Things Doctors Want You to Know
Contributors
  1. The Connection Between Sleep and Overeating. National Sleep Foundation. https://www.sleepfoundation.org/articles/connection-between-sleep-and-overeating
  2. Health Risks of Being Overweight. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight
  3. Kiliaan, AJ, Arnoldussen, IAC, Gustafson DR. Adipokines: a link between obesity and dementia? The Lancet. Vol. 13, Issue 9, P913-923, Sept. 01, 2014. https://doi.org/10.1016/S1474-4422(14)70085-7
Was this helpful?
157
Last Review Date: 2021 May 9
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.