How You Manage Your Obesity Is Your Choice

Obesity is a chronic disease according to the American Medical Association. This new understanding of obesity has implications for staying healthy.¹

Because obesity is chronic in nature, adopting a "long-game" mindset is helpful. Most of us have been taught to manage obesity through temporary "weight loss" efforts. But, weight loss is challenging, and weight often comes back. So, is that really enough?²

That’s not to say that concerted efforts to lose weight are not a needed part of the plan sometimes. But concerted weight loss efforts are only a small part of the story. And rather than being the whole story, it may be time to see them as only one potential part of the story.

What is an obesity management plan?

In my experience, it can help to make an obesity management plan. An obesity management plan is a more comprehensive approach to staying healthy – one that goes beyond weight loss. The objective is to optimize all aspects of your health in a more holistic way. And, to use the full range of options that suit you and your individual needs and preferences.

Not everyone experiences obesity in the same way or for the same reasons. That means not everyone needs to address it in the same way. Your obesity management plan for your health is unique to you.

For example, some people experience serious health conditions from obesity at a lower weight than others and may need a more intensive intervention sooner than expected. Or, some people struggle to lose weight effectively or do not wish to lose weight. And in my experience, some people can live a fulfilling lives at a higher weight.^3,4

Make a plan that is right for you

A default strategy to manage health issues of obesity is to lose weight. That can be effective and sometimes it works out. But what if it doesn’t?

Maybe you are able to lose some weight but not enough weight to improve your health. Or maybe although you try, you do not lose much, and your weight remains high. Or, perhaps you have no interest in losing weight or cannot prioritize it right now.

In that case, it is important to manage the health issues that result from your obesity at your current weight and work to prevent any future health issues. That means getting regular check-ups and getting prompt treatment for any comorbidities.

This may seem obvious, but unfortunately, regular medical care is often avoided. Many people feel shame about not being able to lose weight and the health issues that may arise because of their weight. And many healthcare providers still shame patients for this and insist on weight loss being a primary avenue of care for some conditions. If you feel this type of shame or if you are feeling that way from your provider, it is important to know you are not alone.⁵

How to create a plan

You may want to consult with your healthcare provider to create a plan that is well informed. An obesity management plan answers these questions:

At what weight do I start to become uncomfortable or sick?

Everyone’s tolerance for carrying excess weight is unique. Some people experience disruptions in metabolism, like type 2 diabetes, at a lower weight than others. Some people have very active jobs or lives where extra weight will be quickly noticed because it makes certain activities uncomfortable and stresses the joints.

Therefore, it is worth considering for your specific situation. What is the weight that you find acceptable for comfort and wellness?

When I do have an obesity-related health problem, what are my options?

When you decide you need to take treatment and get to a healthier place, it helps to be informed about your options. Sometimes the issue can be treated and managed directly at your current weight. Sometimes, treatment may involve losing weight.

There are a wide range of options in that case, ranging from intensive lifestyle treatments to medical interventions like medications and surgery. What are the pros and cons of each option? And, at what point are the downsides of any treatment worth it to you?

What is my risk for complications of obesity, and how do I manage that?

Some people have more risk associated with obesity than others. For example, maybe you have a job that depends on having a healthy weight that you also can’t afford to lose. So you wish to mitigate that later risk by losing weight now. Or, maybe you have a really strong family history of type 2 diabetes, heart disease, or certain cancers. In that case, you may want to consider losing weight now to prevent future issues, even if you are currently healthy.

What can I do to reduce my health risk regardless of my weight?

There are habits that can reduce your risk of obesity complications, no matter what your weight is currently. Living an active lifestyle can strengthen your body to prevent chronic diseases that obesity can cause. And some dietary changes can help prevent chronic diseases, regardless of weight loss. A high fiber diet, for example, can help reduce cholesterol and cancer risk.^6,7

So it is worth considering which of these habits are you interested in, able to work on today, and make a more regular part of your life?

Your plan, your choice

Being proactive and thinking through your options are the first steps to feeling in control of your health when you have obesity. That way you can consider your specific issues and your priorities. Being absolute about health in obesity – that you have to lose all your weight or just remain "unhealthy" – is not helpful or true.

Unfortunately, that thinking is still the default in our society. So making an obesity management plan can help you find a more balanced mindset. There are many routes and many choices that you can make to live a longer, healthier life.