Dr. Nisha Kuruvadi is a board-certified internal medicine and obesity medicine doctor with Sharp Community Medical Group.
Most of us grew up hearing that weight loss is simple — just eat less and move more. But experts now recognize that obesity is a far more complex health condition influenced by multiple factors beyond diet and exercise.
Obesity is not viewed as a matter of willpower but as a condition shaped by genetics, environment, mental health and more. By treating obesity as a medical condition, a medical weight management doctor can provide well-rounded, compassionate support to help you achieve your health goals.
There are many questions surrounding weight management and obesity. The following are among the most common I hear:
1
What is the difference between being overweight and being obese?
Overweight and obese are terms that describe ranges of weight above what is considered healthy. But there are important differences.
Obesity is usually defined by a higher body mass index (BMI), usually 30 or above, while being overweight generally falls between a BMI of 25 and 29.9. A BMI above 30 increases the risk of serious health conditions, such as heart disease, diabetes and certain cancers, making it essential to approach obesity as a medical condition.
2
Why do experts say obesity is more than “calories in, calories out”?
Your body has natural systems that help balance weight by managing hunger, fullness and energy. But for people with obesity, these systems don’t always work as they should. Genetics, hormones, stress and even gut bacteria can disrupt the body’s natural weight regulation, making weight management far more challenging.
Two key hormones, leptin and insulin, are central to this balance. Leptin tells the brain when you’re full. However, in people with obesity, it may not send accurate signals, leading to feelings of hunger even after eating. Insulin, which regulates blood sugar, can also become less effective, raising the risk of Type 2 diabetes. When these signals fall out of sync, it can feel like your body is working against your efforts to stay healthy.
3
Can obesity be genetic?
For many people, genetics and family history play a big role in weight. If you have close family members with obesity, you may inherit tendencies that make weight management harder. Genes can influence how your body stores fat, how full or hungry you feel, and how efficiently you use energy. These genetic factors can make losing weight more challenging, even if you put in the effort.
Environmental factors also add to the difficulty. For some, finding affordable, healthy food is tough, and safe spaces to exercise may be limited. Busy lives, high stress and lack of sleep also contribute to weight gain by raising levels of cortisol, which is a hormone that encourages the body to store more fat.
All of these factors must be considered. And care providers should work closely with each person to develop a plan tailored to their unique challenges and lifestyle.
4
How does obesity impact mental health?
Obesity is not only a physical health condition but also one that can affect mental health. Many people with obesity face judgment, which can lead to feelings of shame, low self-esteem and frustration. There’s also a link between obesity and mental health conditions like depression and anxiety.
When we view obesity as a health condition, rather than a personal choice, we help reduce stigma and provide support that considers both physical and mental well-being.
5
What are the best ways to prevent obesity?
Preventing obesity involves understanding the many factors that can contribute to it. Eating a balanced diet, staying physically active and managing stress can all help.
However, to treat obesity effectively, we must look at the whole picture, including genetics, environment, lifestyle and mental health. For some people, medical treatments like weight loss medications or surgery may be necessary. But lifestyle changes and emotional support are also essential for long-term health.
Moving Toward Better Health Together
Understanding obesity as a complex health condition — not just about diet or exercise — allows for better, more compassionate care. When obesity is addressed with a comprehensive plan that includes medical, environmental and lifestyle factors, a medical weight management doctor can give people the tools they need to improve their health and feel empowered.
If you or a loved one is ready for a supportive approach to weight management, talk with your primary care doctor. They may refer you to a medical weight management doctor, who can provide specialized care and advanced strategies to help you work toward better health and a more fulfilling life.
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