Managing obesity in patients with comorbidities: what to know

Obesity is a medical condition characterized by excessive body fat [1]. A healthcare provider uses a patient’s body mass index (BMI) to determine how body fat is distributed. Patients with a BMI between 25.0 and 29.9 are overweight, and patients with a BMI ≥30 are considered obese [1]. In the United States, obesity affects about half of the adult population, and childhood obesity is an increasing public health concern because of the early onset of comorbidities that can have a lifelong negative health impact on children [2,3]. Patients who are obese are at significant risk of developing comorbid chronic conditions such as diabetes, hypertension, heart disease, asthma, gout, stroke, osteoarthritis, or reproductive and sexual dysfunction [4]. Obesity comorbidities can further increase the risk of other health problems and decrease a patient’s quality of life. Patients who are obese are at higher risk of mortality and reduced life expectancy [5]. Once comorbidities are identified by a healthcare provider, managing these conditions can help a patient improve their health outcome.

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You and your healthcare provider can work on developing achievable goals for weight loss and managing comorbidities. Managing obesity requires an ongoing commitment between you and your healthcare provider. So, what might an obesity management plan look like? Depending on your medical evaluation, your healthcare provider may recommend lifestyle therapy or anti-obesity medication to help a patient lose weight [6,7]. Including exercise and a proper diet in your weight management plan can reduce obesity-related comorbidity. Anti-obesity medication is considered when lifestyle therapy fails to prevent weight gain [6]. Another option may be weight loss surgery in addition to lifestyle modifications.

Significant factors for unhealthy weight gain and obesity include a sedentary lifestyle, a lack of physical exercise, and a high-caloric diet. Your healthcare provider may recommend you add more physical activities to your schedule. A vigorous physical exercise routine of up to 150 minutes per week can increase weight loss and prevent weight regain [6, 7]. Physical exercise can help you burn calories and improve your health and fitness. Adding an exercise routine to your schedule can help reduce the risk of metabolic disease, cardiovascular disease, inflammation, and other obesity-related comorbidities [7].

A high caloric intake is a common factor that leads to obesity. Replacing a high-caloric intake with a low-calorie diet can help manage weight. A diet low in sugar and unhealthy fats can help you maintain healthy fasting blood glucose, cholesterol levels, and triglycerides [8]. A low-fat diet can help patients better manage cholesterol and triglyceride levels to reduce the risk of developing cardiovascular diseases [7]. A diet with reduced sugar intake can be beneficial for better metabolic management. Eating a healthy diet that includes whole grains, beans, plant proteins, fruits, and vegetables with complex sugars and carbohydrates can help patients who are obese better manage their blood sugar levels [9].

Changing the way you plan meals may require a lifestyle change as well. If you tend to eat fast food often, you may consider planning your meals at home and adding fresh fruits and vegetables to each meal. If you tend to eat more animal protein, you could consider adding healthy plant-based proteins such as tofu, beans, lentils, and nuts to your meal.

Type 2 diabetes is a common comorbidity of obesity that eventually leads to insulin resistance [10]. Managing diabetes in obese patients can be challenging, but it is essential for improving health and reducing the risk of complications. Medications may be necessary to control blood sugar levels in obese patients with diabetes. These medications may include metformin, insulin, or other medications prescribed by a healthcare provider [11]. Losing weight can improve insulin sensitivity and glucose control. A weight loss goal of 5% to 10% of initial body weight can improve diabetes control significantly [10].

Monitoring your blood pressure at home and keeping track of your readings can help you stay on top of your condition and better manage your blood pressure levels. Medications may be necessary to control blood pressure in obese patients with hypertension. These medications may include diuretics, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, or other medications your healthcare provider prescribes [12].

Your heart health is essential in managing your health wellness. Your healthcare provider may recommend medications to help manage cardiovascular disease. Medications may be prescribed to control blood pressure and lower cholesterol levels [13]. Cardiovascular disease in obese patients requires a comprehensive approach to address cardiovascular risk factors with the use of medication and physical activity [14].

To manage obesity and its associated comorbidities, you and your healthcare provider will work on developing an obesity management plan that includes lifestyle therapy, medication, exercise, and a healthy diet. By following a healthy diet, exercising regularly, taking medications prescribed by your healthcare provider, and losing weight, you can improve your health outcomes and reduce the risk of chronic conditions associated with obesity.

Everlywell provides access to online weight management, allowing you to discuss your weight loss goals and condition with a certified clinician from the comfort of your own home. You can partner with a healthcare provider and get support to optimize your care plan.

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