Obesity Facts and Myths: Local Expert Discusses the Obesity Epidemic and New Weight-loss Drugs

At what weight is a person considered obese? Is obesity simply the result of lifestyle choices or is it actually a disease? Do the new “weight-loss drugs” really work and are they a good option? The fact is 42% of American adults are considered obese and another 31% are overweight, according to the Centers for Disease Control and Prevention (CDC). Numerous myths and misconceptions have arisen since the obesity epidemic emerged in the 1980s. We spoke to a local physician who’s an expert on obesity to learn more about this prevalent, but misunderstood condition.

Obesity was first classified as a disease in 2013. People who weigh more than what is considered healthy for their height are described as overweight or obese. Body mass index (BMI) is a screening tool to determine obesity. BMI is a person’s weight in kilograms divided by the square of height in meters. A person with a BMI of 30 or higher falls in the obesity range. Those with a BMI above 40 are considered morbidly obese and may suffer from heart disease, stroke, diabetes, sleep apnea, certain cancers, and other life-threatening health problems.

Washington Township Medical Foundation (WTMF) family medicine physician Thomas Collins-Pallett, MD, is board-certified in obesity medicine and one of his specialties is helping patients achieve weight loss for improved health. His answers to common questions on the topic help debunk myths about obesity and address the newly publicized weight-loss drugs.

Question: Many people think obesity is solely the result of consuming too many calories combined with a lack of exercise. Is this the reality or a misconception?

Dr. Collins-Pallett: I often hear questions like, “Why can my friend maintain a healthy weight eating 3,000 calories a day while I gain weight when restricting my diet to 1,500 daily calories?” The equations are different for every individual, and no, it’s not just limited to intake and output. Aside from lifestyle, many factors contribute to obesity including composition of the calories consumed, genetics, environment, medications, stress levels, quality of sleep, and others.

Question: Please speak to the psychosocial aspects of obesity: How does the stigma of being overweight affect patients emotionally?

Dr. Collins-Pallett: Sometimes people will use food for comfort. Then, when they gain weight and begin to feel poorly about themselves, they will continue to eat to comfort themselves, which can become a bad cycle. This is where weight-loss medications can help. They can slowly reverse the cycle by disrupting that person’s use of food for comfort. In addition, losing weight makes them feel better about themselves, so they get out of the pattern of eating for the wrong reasons. It takes many years to develop destructive eating habits, so it makes sense that it takes time to change those habits for the better.

Question: Tell us more about the new weight-loss drugs that have received a lot of publicity lately, such as Ozempic, Wegovy and Zepbound. They are expensive. Does insurance cover the cost of these prescriptions?

Dr. Collins-Pallett: These medications don’t work for everyone, but when they do, they can work quite well. They make the patient feel abnormally full much quicker, which results in consuming smaller portion sizes. Over time, this can work to shrink the stomach, which leads to healthier eating habits. As I mentioned earlier, they are more effective over the long term. When used for a short period, they are like any other three-month diet plan that frequently leads to the weight returning once the diet is over (or the medication is discontinued). More often now, some insurances are covering the cost of the FDA-approved drugs not just for diabetes, but also for weight loss.

Question: What is your overall message to the community about obesity and the new weight-loss drugs?

Dr. Collins-Pallett: While these medications are great new tools that we can use to help combat obesity, it’s important to keep in mind that each person’s situation is different and requires an individualized plan. When working with my patients, we don’t look at a plan for six months or even a year or two—we develop a plan where they can work toward maintaining a healthy weight for the rest of their lives.

For more information about obesity and maintaining a healthy weight, go to CDC.gov/obesity. To learn more about Dr. Collins-Pallett, click on the Find a Doctor tab at WTMF.com