Losing weight can be a challenging endeavor. Many individuals initially resort to fundamental strategies such as increasing physical activity and reducing food intake. However, some may find it difficult to lose weight through diet and exercise alone, prompting them to consider weight loss medications. In such cases, determining the appropriate medical professional to consult becomes crucial.
Identifying the Right Specialist
Several types of doctors specialize in weight loss and related issues. Here's a breakdown of who might be the best fit for your situation:
Primary Care Provider
Your primary care provider (PCP) is an excellent starting point. They can conduct an initial evaluation, assess your overall health, and discuss your weight loss goals. Duke Primary Care providers, for instance, are trained to manage overweight and obesity, as well as related diseases. Your PCP can also recommend exercise plans, nutritional counseling, and dietary approaches to kickstart healthy eating habits.
- Annual Physical Exam: Regular check-ups with your PCP are essential for preventative care and early detection of potential underlying causes of weight gain or difficulty losing weight.
- Referral for Specialized Care: If necessary, your PCP can refer you to specialists like endocrinologists, registered dietitians, or bariatric surgeons. In some cases, you may be referred to an obesity specialist - if one is available in your area.
Endocrinologist
Endocrinologists specialize in hormonal disorders, which can significantly impact weight. Dominguez notes that many general practitioners may not feel comfortable prescribing obesity medication. There’s a huge variety of reasons a general practitioner might send one of their patients to see an endocrinologist. Endocrinologists see people of all ages, but Dominguez says she mostly sees younger adults who are curious about weight loss drugs. An endocrinologist may be the right choice if you suspect a hormonal imbalance is affecting your weight.
- Hormonal Imbalances: An endocrinologist can assess whether conditions like hypothyroidism (low thyroid hormone levels) or cortisol excess are contributing to weight gain or hindering weight loss efforts.
- Medication Management: Endocrinologists are knowledgeable about weight loss medications and can determine the most effective option for each patient, considering individual health history and potential contraindications. Medications such as Wegovy or Zepbound should not be used in people with a personal or family history of medullary thyroid cancer. Other medications have other contraindications based on their underlying mechanism of action.
- Underlying Endocrine Pathology: “One of the initial evaluations that we do is to see if there is an underlying endocrine pathology that is leading to that weight gain,” says Dominguez.
Obesity Medicine Specialist
Obesity medicine clinicians are specially trained to treat obesity and obesity-related conditions using evidence-based approaches. Because so many different factors contribute to obesity, obesity medicine clinicians develop personalized treatment plans comprised of nutrition, physical activity, behavior therapy, and medication.
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- Personalized Treatment Plans: Obesity medicine clinicians develop personalized treatment plans comprised of nutrition, physical activity, behavior therapy, and medication.
- Evidence-Based Approaches: Obesity medicine providers treat obesity as a disease.
Bariatric Surgeon
Bariatric surgeons specialize in weight loss surgery, also known as bariatric surgery, limits how much food you can eat. Some procedures also limit the amount of calories and nutrients you can absorb. a surgical option for those with severe obesity who have not achieved success with other methods.
- Surgical Options: They offer procedures like gastric bypass, sleeve gastrectomy, and adjustable gastric banding to help patients lose weight by limiting food intake or reducing calorie absorption.
- Referral: Your PCP or another specialist can refer you to a bariatric surgeon if you meet the criteria for weight loss surgery.
Registered Dietitian
Registered dietitians (RDs) are experts in nutrition and can provide personalized guidance on healthy eating habits for weight loss.
- Nutritional Counseling: They can help you create a balanced meal plan, understand portion control, and make informed food choices to support your weight loss goals.
- Lifestyle Changes: RDs can also educate you on sustainable lifestyle changes to maintain weight loss in the long term.
Mental Health Professional
A mental health professional can help address emotional and behavioral issues related to eating. Therapy can help you understand why you overeat and learn healthy ways to cope with anxiety. You also can learn how to monitor your diet and activity, understand eating triggers, and cope with food cravings.
Initial Steps in Your Weight Loss Journey
Before consulting a specialist, consider these initial steps:
Self-Assessment
- Weight History: Reflect on your weight fluctuations, previous weight loss attempts, and any patterns you've noticed.
- Lifestyle Habits: Evaluate your diet, exercise routine, stress levels, and sleep patterns.
Medical Evaluation
- Physical Exam: Your healthcare provider will conduct a general physical exam to assess your overall health.
- BMI Calculation: Your body mass index (BMI) will be calculated to determine if you fall into the overweight or obese category. A BMI of 30 or higher is considered obesity.
- Waist Measurement: Measuring your waist size. The distance around your waist is known as the circumference. Women with a waist that measures more than 35 inches (89 centimeters) and men with a waist that's more than 40 inches (102 centimeters) around may have more health risks than do people with smaller waist measurements.
- Blood Tests: Your blood can show signs of certain health conditions like diabetes, celiac disease and infections. It can also give your provider information about how your metabolism, thyroid and adrenal glands are working.
- Cancer screening tests: If your provider wants to rule out cancer, you may need screening or imaging tests. For example, a colonoscopy can detect colorectal cancer.
- Imaging tests: Tests like an MRI (magnetic resonance imaging) or CT scan (computed tomography scan) can provide detailed images of your organs, like your brain, heart, lungs and abdominal organs. You may need one of these tests if your provider wants to rule out tumors or diseases that may be visible on these scans.
- Urine test: A urinalysis can provide information about your kidneys and bladder, including certain health conditions and infections.
Lifestyle Modifications
- Dietary Changes: Focus on reducing calorie intake, practicing portion control, and making healthier food choices. Cutting calories. The key to weight loss is reducing how many calories you take in. The first step is to review your typical eating and drinking habits. You can see how many calories you usually consume and where you can cut back. You and your health care professional can decide how many calories you need to take in each day to lose weight.
- Increased Physical Activity: Aim for at least 150 minutes of moderate-intensity exercise per week. People with obesity need to get at least 150 minutes a week of moderate-intensity physical activity. This can help prevent further weight gain or maintain the loss of a modest amount of weight.
Treatment Options
Depending on the underlying cause of your weight issues and your overall health, your doctor may recommend a combination of the following treatment options:
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Lifestyle Changes
- Diet and Exercise: Reducing calories and practicing healthier eating habits are key to overcoming obesity. Although you may lose weight quickly at first, steady weight loss over the long term is considered the safest way to lose weight. There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you.
- Behavior Modification: A behavior modification program can help you make lifestyle changes to lose weight and keep it off.
Weight-Loss Medications
Weight-loss medicines are meant to be used along with diet, exercise and behavior changes, not instead of them. Weight-loss medicines may not work for everyone, and the effects may wane over time.
Endoscopic Procedures
These types of procedures don't require any cuts, also called incisions, in the skin. After you are under anesthesia, flexible tubes and tools are inserted through the mouth and down the throat into the stomach.
- Endoscopic sleeve gastroplasty: This procedure involves placing stitches in the stomach to reduce the amount of food and liquid the stomach can hold at one time.
- Intragastric balloon for weight loss: In this procedure, you have a small balloon placed into the stomach. The balloon is then filled with water to reduce the amount of space in the stomach, so you'll feel full eating less food. Intragastric balloons are left in place for up to 6 months and are then removed using an endoscope.
Weight-Loss Surgery
Also known as bariatric surgery, weight-loss surgery limits how much food you can eat. Some procedures also limit the amount of calories and nutrients you can absorb.
- Adjustable gastric banding: In this surgery, an inflatable band placed around the outside of the stomach divides it into two pouches. The surgeon pulls the band tight, like a belt, to create a narrow pathway between the two pouches. The band keeps the opening from getting bigger.
- Gastric bypass surgery: In gastric bypass, also called Roux-en-Y (roo-en-wy) gastric bypass, the surgeon creates a small pouch at the top of the stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch.
- Gastric sleeve: In this surgery, part of the stomach is removed, creating a smaller reservoir for food.
Unexplained Weight Loss
If you are experiencing unexplained weight loss, it is crucial to seek medical attention to determine the underlying cause.
When to Seek Medical Advice
If you’re losing weight and don’t know why, don’t try to treat it at home. See a provider to find out the cause so you can receive the treatment you need.
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Diagnostic Tests
A healthcare provider may order specific medical tests based on your symptoms, family history and other factors. For example, if you have symptoms of a peptic ulcer, your provider may recommend an upper endoscopy.
Treatment
Your treatment for unexplained weight loss depends on what’s causing it. For example, if you have a toothache, you may need to see a dentist. If the cause is a peptic ulcer, your provider may treat it with antibiotics. People with celiac disease must avoid all gluten.
Prevention
Many of the conditions that lead to unexplained weight loss can’t be prevented. But there are some steps you can take to help prevent some of them, including:
- Annual physical exam: See your primary care provider for an annual physical exam.
- Vaccinations and screenings: Get poked and checked! Be sure that you receive all recommended vaccines and cancer screenings.
- Medication adherence: Take prescription medications as instructed. Reach out to your healthcare provider if you experience any side effects, including changes in appetite or weight after starting a new medication.
- Oral hygiene: Take good care of your teeth and gums.
Finding an Obesity Doctor Near You
Searching for an obesity doctor near you? Find the right treatment with a specially trained obesity doctor or healthcare provider near you. Search the Obesity Medicine Association’s member directory by city, state, or zip code for an obesity medicine clinician in your area.