Obesity
Obesity is a chronic, relapsing disease driven by a complex interaction of genetics, hormones, environment, and behavior. It is defined by a BMI of 30 or higher, but the clinical focus is on metabolic health, fat distribution, and complication risk rather than BMI alone. Medical management has advanced significantly with medications that target appetite-regulating pathways in the brain.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
Weight that is difficult to lose despite reduced intake, fatigue, joint pain especially in knees and hips, sleep apnea and snoring, shortness of breath with exertion, low mood, and insulin resistance symptoms. Visceral fat accumulation raises cardiovascular and metabolic risk independently of total body weight.
Causes & Risk Factors
Hormonal factors including leptin resistance, ghrelin dysregulation, and insulin resistance create a physiological environment that resists weight loss. Genetic predisposition accounts for 40–70% of BMI variance. Sleep deprivation, high-stress environment, processed food availability, and certain medications (antidepressants, antipsychotics, steroids) contribute significantly.
How We Evaluate
We assess BMI and waist circumference, blood pressure, fasting glucose, insulin, A1C, lipid panel, liver enzymes, TSH, and screen for sleep apnea. We discuss previous weight-loss attempts, diet history, and mental health factors before building a plan.
Treatment Options
Structured nutrition and behavioral change are foundational. GLP-1 receptor agonists (semaglutide, tirzepatide) produce 15–22% body weight loss in clinical trials with favorable metabolic effects. We also evaluate candidates for other obesity medications and coordinate bariatric surgery referrals when appropriate.
When It Is Urgent
Seek emergency care for chest pain, difficulty breathing at rest, or symptoms of pulmonary embolism (sudden leg swelling, shortness of breath, pleuritic chest pain), all of which occur at higher rates with obesity.
Frequently Asked Questions
Is semaglutide (Ozempic/Wegovy) available at your practice?
Yes. We evaluate patients for GLP-1 receptor agonists including semaglutide and tirzepatide, discuss eligibility and realistic expectations, and provide ongoing monitoring during treatment.
Does insurance cover weight-loss medications?
Coverage varies by plan and medication. GLP-1 agonists approved for diabetes (Ozempic) have broader coverage than those approved specifically for weight loss (Wegovy). We help document medical necessity and can advise on manufacturer savings programs.
How much weight can I realistically expect to lose?
Clinical trials for semaglutide show an average 15% body weight reduction over 68 weeks. Results vary — lifestyle adherence, starting weight, and individual metabolic factors all influence outcomes.
Get a Clear Plan for Obesity
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.