The Persistent Benefits of Obesity Care

Like never before, we are in the midst of intensive public discourse about obesity, obesity care, and weight loss. Some of it is frivolous and some of it is frankly misleading. But what is really good in the middle of all this is that more people than ever before have options for dealing with obesity and they are straining to learn about their options. If we set aside all the fluff that surrounds this subject, the real struggle is to understand obesity care (not just weight loss) and the persistent benefits it can bring. It’s essential as well to put those benefits in perspective with risks that come with various options for obesity treatment.

Persistent Benefits

Scientists and clinicians who understand obesity know that it is a complex, chronic disease. Often, it is progressive, meaning that a person with mild obesity or overweight, in the absence of treatment, may gain weight and progress to more severe obesity along with the complications that brings.

New research published in Circulation: Cardiovascular Quality and Outcomes offers a long view of the outcomes from behavioral weight management programs. Jamie Hartmann-Boyce and colleagues conducted a systematic review and meta-analysis of weight regain after these programs and the effect on cardiometabolic health outcomes.

In sum, they found persistent benefits for obesity care up to five years after these programs – despite the common occurrence of weight regain. Blood pressure, cholesterol, and blood sugar control improvements held up well over time. Data on cardiovascular events and diabetes were less certain across the 124 studies they included in their analysis.

We find this impressive because these are all behavioral programs offering modest efficacy. No surgery or drugs. And yet, the benefits persist.

Life Experiences of a Young Person with Severe Obesity

We have now known Maria Caprigno for more than a decade. She has shared her story here, presented before the National Academies of Science, Engineering, and Medicine, and won awards for her tireless advocacy.

So it brings joy to hear her sharing this week on public radio the perspective she has gained in the 13 years since she had bariatric surgery at the age of 14:

“I had been told at that point by my pediatrician that the way I was gaining weight every year, I wouldn’t see my 18th birthday. We really thought the obesity was going to kill me.”

“I was like, ‘If someone’s going to be a guinea pig, I’m ready to do it. Because if I can help anyone else who’s suffering the way I have been, it’s going to be worth it in the end, and if I get more than four more years out of my life, it’s going to be worth it.’”

Maria is now a first-grade teacher and the mother of two beautiful children. Her surgeon, Evan Nadler, says admiringly of her, “She’s one of the first people to really understand obesity care.”

Making Choices

Social and life pressures, along with deficiencies in healthcare systems, do not make it easy to pursue obesity care. One size, one single approach, does not meet the needs of every person living with obesity – young or old. Each of these options has risks and benefits.

But the fact is that good obesity care, delivered by health professionals who understand this disease, can have persistent benefits for life and health. Young or old, people should have the option to make the choices that are best for them.

Click here for the study by Hartmann-Boyce et al, here for a commentary about it, and here for further reporting. For Caprigno’s story on NPR, click here.

Still Life, cubo-futurist painting by Aleksandra Ekster / WikiArt

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April 20, 2023