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4d
Obesity care reimagined: Integrating chronic disease management and sustained interventions.

Obesity is a multifaceted, escalating global health crisis, affecting over a billion people in 2022 and projected to impact more than half the adult population by 2050. As a chronic, relapsing, multifactorial disease, it increases the risk of serious non-communicable diseases (e.g., type 2 diabetes, cardiovascular diseases, certain cancers) and contributes to over 5 million deaths annually. The global economic burden is projected to reach $4.32 trillion by 2035, alongside psychosocial challenges such as stigma, low self-esteem, and social isolation.

For adults with a BMI ≥30 kg/m², or ≥27 kg/m² with at least one obesity-related comorbidity, pharmacologic therapy should be considered when lifestyle interventions alone fail to achieve ≥5% weight loss after 3–6 months. When paired with behavioral and lifestyle measures, long-acting, once-weekly GLP-1 receptor agonists have been associated with substantial, sustained weight loss (e.g., a mean 12.1% reduction in body weight) and improvements in BMI, waist circumference, and blood pressure.

Viewing obesity as a chronic disease means shifting from short-term fixes to long-term care strategies. Management should address genetic, metabolic, environmental, and social drivers while evaluating the impact of functional limitations and emotional factors—such as psychological distress, stigma, and disordered eating—that may compromise adherence. Personalized care, aligned to each patient’s clinical, functional, and psychosocial profile, is essential for durable outcomes.

How can functional and emotional burden assessments be systematically integrated into obesity care to improve adherence and outcomes? What strategies can HCPs use to embed these therapies into long-term care plans that integrate pharmacologic, behavioral, and lifestyle support?

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  • 4d
    Ideally all of my patients with obesity can join one of our lifestyle groups that addresses alot of these issues and lends a tremendous amount of support to the patient.
  • 1w
    Obese patients have been told for years that they are at fault for their obesity. Lack of discipline in eating and lack of exercise. These myths must be broken and that obesity is a chronic illness like high blood pressure and high cholesterol and diabetes and needs to be managed with medication and physician guidance to help achieve desired goals. Also this includes use of other behavioral modalities
  • 3w
    It is a great time to practice Bariatric medicine with the slew of the choices available paritcularly in GLP-1 class and related meds and has given a new dimension in managing obesity and their benefits go beyond just weight loss and diabetes in to improved CV , Renal and Sleep Apnea positive outcomes As much these meds have a bilogical effect in achieving these results cornerstone and pivotal aspect is individualizing the management and that stems from educating pts in the holisitic aspect of weight management in understanding and incorporating the diet , exercise and lifestyle modifications and taking their psycho social and economic factors in consideration ! So detailed analysis and evaluation of these aspects should be done before embarking on the medical therapy and needs to be drilled on every visit in to the psyche of the pts , Collobration with a dietician , psyhcotherapy if needed , enrollment in to structured exercise program or home work out routine with the help of the apps , Enouragement and rewards on achieving the goals and above all need to be reminded that Obesity is a chronic disease and needs to be managed in the same perspective and intensity like HTN , Diabetes and Hyperlipidemia to achieve realistic goals
  • 3w
    • Better targeting: EOSS + PROMs identify who needs more than calories-in/calories-out. 
    • Adherence drivers: Tracking function, QoL, stigma, and eating symptoms surfaces the real barriers to taking meds and showing up. 
    • Evidence-aligned meds: Long-acting, once-weekly incretin therapies produce the largest average losses with lifestyle support, and switching/intensifying when needed is guideline-concordant. 
  • 3w
    by working with mental health, nutrition and when necessary with CDE and psychology to improve and detect social barriers and decrease potential stressors linked to noncompliance and making bad nutritional/lifestyle choices ; identifying financial stressors and applying for financial help when possible ; connecting to local food banks and church organizations for help .

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