Obesity medicine: some little-known facts

Endocrinology, Diabetes & Metabolism


Why lose weight?

The topic of obesity has elicited great interest in the recent decades. While the desire to lose weight has historically been associated with vanity, it is now recognized that excessive fat accumulation can lead to many adverse health effects. In fact, over 200 obesity-associated disorders have been identified, some of which are reversible with effective weight reduction. 

Obesity and hormones

Many people do not realize that obesity is a disease with a strong biological basis. In ancient times when food supply was uncertain, the biological processes involved in energy and body weight regulation ensured the survival of our ancestors. In modern day abundance, however, this same biology became the culprit of undesirable weight gain. The link between obesity and energy regulation lies in a series of hormones that allows fat tissues to communicate with the brain. Research has confirmed that a body fat mass set point exists in each adult. When our body’s fat mass is below this set point, a series of appetite-stimulating hormones are released, and our brain perceives a state of starvation. This results in an increase in appetite with a strong desire to seek high caloric food, and decrease in metabolic rate with pervasive tiredness. The result is uncontrollable weight gain. To treat obesity effectively, therefore, intervention strategies to reduce the body fat mass set point are needed.

What determines the body fat mass set point? 

Genetics, early life events and perpetuating lifestyle habits all contribute to the body fat mass set point. Food constituents also affect the composition of the bacteria that lives in our gut, leading to weight gain. A thorough evaluation by a specialist in obesity medicine is essential to decipher the root cause of obesity for individualized management. 

Multidisciplinary obesity management

Effective management of obesity involves multiple approaches, including lifestyle modification, medication titration, proper use of Food and Drug Administration (FDA) approved anti-obesity drugs, endoscopic procedures and metabolic surgery. These approaches may be used separately or in combination. An endocrinologist with a sub-specialization in obesity medicine can provide the initial assessment and regular follow-up during medical treatment of obesity. A metabolic and bariatric surgeon can provide surgery-related advice and assessment. A dietitian and physiotherapist can provide support in lifestyle modification. 

For further information, please contact your doctor.

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