FAQs
Get answers to common questions about obesity and learn how to be the best partner and advocate for your patients today
Yes, obesity is a chronic, progressive, and prevalent disease.1-3
The American Association of Clinical Endocrinology (AACE) and the American College of Endocrinology (ACE) have published practice guidelines for treating patients with obesity.2
Obesity is one of the most prevalent diseases in the US, affecting more than 106 million adults.4,5*
*Prevalence of obesity based on NHANES data for 2021-2023 and data from the 2024 US Census estimates.
Social determinants of health, environmental factors, and genetics all contribute to obesity.6,7
Specific factors influencing obesity include socioeconomic status and food insecurity (social factors), food availability and quality (environmental factors), and gene mutations (genetic factors).8-11
Even if patients achieve weight loss with reduced-calorie intake, metabolic adaptation to appetite-regulating hormones drives weight regain and persists, making long-term weight management very challenging.9,12
Yes, cardiovascular mortality rates climb 7% for every 2 years lived with obesity.13*
*Based on data from the original cohort study of the Framingham Heart Study (FHS). This cohort study followed 5,209 participants (aged 28-62 years at the time of enrollment) for approximately 48 years beginning in 1948 with examinations at 2-year intervals. The current study included only participants who were free from preexisting diseases of diabetes, cardiovascular diseases, and cancer at baseline (n=5,036).13
Obesity has negative effects on mental health and influences health status both directly and indirectly. The impact of overweight and obesity on mental health includes depression, body image dissatisfaction, eating disorders, and stress.14
Obesity is associated with at least 60 serious comorbidities that include obstructive sleep apnea (OSA), type 2 diabetes, prediabetes, dyslipidemia, metabolic dysfunction-associated steatotic liver disease (MASLD), female infertility, hypertension, osteoarthritis, polycystic ovary syndrome (PCOS), and many more. Yet, studies have shown that weight loss of as little as 5% can help improve many of those comorbidities.1,2,15,16
From 2017 to March 2020, the obesity prevalence among adolescents aged 12-19 years in the US was 22.2%. Since the 1970s, adolescent obesity rates have more than tripled, and rates of severe obesity have increased by 5 times.17,18
Adolescents may be at a higher risk for obesity if they19,20:
- Have parents with obesity
- Come from certain ethnic backgrounds—eg, Hispanic, or non-Hispanic Black
- Have lower-income households
- Have lower head-of-household education level
70%-80% of adolescents with obesity may become adults with obesity.21 Many of the same weight-related conditions seen in adults are now being seen in adolescents with obesity. These include19,22:
- Dyslipidemia
- Prediabetes
- Type 2 diabetes (T2D)
- Polycystic ovary syndrome (PCOS)
- Metabolic dysfunction-associated steatotic liver disease (MASLD)
- Hypertension
- Obstructive sleep apnea (OSA)
That’s why it’s so important to start the obesity conversation early with adolescents and their families.
As obesity rates have risen in the last several decades, so has the evidence of weight stigma and weight bias. In fact, weight discrimination in the United States is commonly reported at rates comparable with those of racial discrimination.14
Consider the 5As model, a behavioral intervention strategy that has been modified for obesity management. It helps increase patient motivation and behavior change in weight-management consultations.23
ASK for permission to discuss weight
ASSESS obesity class and stage
ADVISE on obesity risks
AGREE on realistic weight-loss expectations
ASSIST by providing education, resources, and support
Having a conversation focused on weight history can serve as a helpful complement to a full clinical and physical assessment before starting a weight-management plan. Some topics to consider when beginning a weight-history discussion include:
- Changes in weight over time
- Factors in weight changes
- Descriptions of past weight-management efforts
- Current habits
While many of your patients may have greater weight-loss goals, a study showed that a modest weight loss of 5% or more can have a clinically meaningful impact.16
In the study, weight loss of 5% was associated with improvement in cardiovascular risk factors such as glycemic control, blood pressure, HDL cholesterol, and triglycerides.16
Studies also show that higher levels of weight loss can be associated with greater improvements in some comorbidities. Be sure to emphasize the difference that a weight loss of 5% or more can make in reducing the risk of comorbid conditions.16
SMART goals help patients clearly define their weight-management objectives. To be SMART, a goal is24:
Specific
- Focuses on a specific behavior or accomplishment
Measurable
- Provides a framework to measure accomplishments
Achievable
- Recognizes the time frame and resources available to the patient
Relevant
- Remains true to the problem at hand
Time-Bound
- Describes the time frame within which the objective is to be achieved
Cultural influences, such as traditions and views about body image, can impact whether or not your patients will accept your weight-management advice. Understanding your patients’ cultural nuances can help you create a plan that fits their lifestyles.25-27
HDL, high-density lipoprotein.
Obesity is a chronic, progressive, and prevalent disease that requires long-term management, but many people with obesity still lack the support they need to manage their weight. By partnering with your patients to develop comprehensive and individualized approaches to weight loss and weight management, you can make a huge impact on your patients’ lives and help fill the gaps in their health care that are keeping them from successful weight loss.1,3,28
You can contact the Obesity Care Advocacy Network (OCAN) to advocate for individual patients, reach out to legislators, understand current policy, and more.
This is a brief overview
For additional information on the treatment of obesity, visit the Treatment Options page.
Successful weight management requires a comprehensive long-term plan. Many treatment options are based on BMI and comorbidities.2
- BMI ≥25 with comorbidities: Start with healthy eating, physical activity, and behavioral therapy
- BMI ≥27 with comorbidities or BMI ≥30: Consider adding pharmacological options for appropriate patients as an adjunct to diet and lifestyle modifications
- BMI ≥35 with comorbidities or BMI ≥40: Consider bariatric surgery for appropriate patients as an adjunct to diet and lifestyle modifications
Healthy eating, physical activity, and behavioral therapy should be continued throughout treatment of obesity.
You may want to consider pharmacological treatments for your patients with overweight or obesity who2:
- Have tried lifestyle changes but can’t reach a healthier weight
- Are having difficulty with weight management
- Have a BMI of ≥27 kg/m2 and a weight-related comorbidity
- Have a BMI of ≥30 kg/m2
Companies are promoting and selling non–FDA-approved or knockoff weight-management medicines directly to patients. These medicines can expose patients to unknown safety risks. So it's important that you educate them about the possible risks of knockoff medications.
If you have a patient who has experienced negative side effects from knockoff medicines, you are encouraged to report those to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Diagnosis is an important step in managing obesity.
1. Tondt J, Freshwater M, Hurtado Andrade M, et al. Obesity algorithm 2024. Obesity Medicine Association. January 2024. Accessed June 11, 2025. https://obesitymedicine.org/resources/obesity-algorithm/
2. Garvey WT, Mechanick JI, Brett EM, et al; Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(suppl 3):1-203.
3. Centers for Disease Control and Prevention. Adult obesity facts. Published May 14, 2024. Accessed June 11, 2025. https://www.cdc.gov/obesity/adult-obesity-facts/index.html
4. Emmerich SD, Fryar CD, Stierman B, Ogden CL. Obesity and severe obesity prevalence in adults: United States, August 2021-August 2023. NCHS Data Brief. 2024;(508):1-10.
5. US Census. Quick facts. Accessed June 11, 2025. https://www.census.gov/quickfacts/fact/table/US/LND110210
6. Thaker VV. Genetic and epigenetic causes of obesity. Adolesc MedState Art Rev. 2017;28(2):379-405.
7. Gilmore LA, Duhé AF, Frost EA, Redman LM. The technology boom: a new era in obesity management. J Diabetes Sci Technol. 2014;8(3):596-608.
8. Masood M, Aggarwal A, Reidpath DD. Effect of national culture on BMI: a multilevel analysis of 53 countries. BMC Public Health. 2019;19(1):1212.
9. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604.
10. Hemmingsson E, Nowicka P, Ulijaszek S, Sørensen TIA. The social origins of obesity within and across generations. Obes Rev. 2023;24(1):e13514.
11. Okunogbe A, Nugent R, Spencer G, Powis J, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health. 2022;7(9):e009773.
12. Lam YY, Ravussin E. Indirect calorimetry: an indispensable tool to understand and predict obesity. Eur J Clin Nutr. 2017;71(3):318-322.
13. Abdullah A, Wolfe R, Stoelwinder JU, et al. The number of years lived with obesity and the risk of all-cause and cause-specific mortality. Int J Epidemiol. 2011;40(4):985-996.
14. Puhl RM, Phelan SM, Nadglowski J, Kyle TK. Overcoming weight bias in the management of patients with diabetes and obesity. Clin Diabetes. 2016;34(1):44-50.
15. Centers for Disease Control and Prevention. Obesity and cancer. Updated June 11, 2025. Accessed June 11, 2025. https://www.cdc.gov/cancer/risk-factors/obesity.html
16. Ryan DH, Yockey SR. Weight loss and improvement in comorbidity: differences at 5%, 10%, 15%, and over. Curr Obes Rep. 2017;6(2):187-194.
17. Centers for Disease Control and Prevention. Childhood obesity facts. Published April 2, 2024. Accessed June 11, 2025. https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html
18. Fryar CD, Carroll MD, Afful J; Division of Health and Nutrition Examination Surveys. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2-19 years: United States, 1963-1965 through 2017-2018. Centers for Disease Control and Prevention. 2020. Updated February 8, 2021. Accessed June 11, 2025. https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/obesity-child.htm
19. Hampl SE, Hassink SG, Skinner AC, et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics. 2023;151(2):e2022060640.
20. Ruiz LD, Zuelch ML, Dimitratos SM, Scherr RE. Adolescent obesity: diet quality, psychosocial health, and cardiometabolic risk factor. Nutrients. 2019;12(1):43.
21. Simmonds M, Llewellyn, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev. 2016;17(2):95-107.
22. Ibáñez L, de Zegher F. Adolescent PCOS: a postpubertal central obesity syndrome. Trends Mol Med. 2023;29(5):354-363.
23. Agency for Healthcare Research and Quality. Five major steps to intervention (The "5 As"). Accessed June 11, 2025. https://www.ahrq.gov/prevention/guidelines/tobacco/5steps.html
24. Centers for Disease Control and Prevention. Writing SMART objectives. Published August 2018. Accessed June 11, 2025. https://www.cdc.gov/healthyyouth/evaluation/pdf/brief3b.pdf
25. Dao MC, Thiron S, Messer E, et al. Cultural influences on the regulation of energy intake and obesity: a qualitative study comparing food customs and attitudes to eating in adults from France and the United States. Nutrients. 2021;13:1-16.
26. Chithambo TP, Huey SJ. Black/white differences in perceived weight and attractiveness among overweight women. J Obes. 2013;2013:320326.
27. Overcash F, Reicks M. Diet quality and eating practices among Hispanic/Latino men and women: NHANES 2011-2016. Int J Environ Res Pub Health. 2021;18(3):1302.
28. Ward ZJ, Bleich SN, Cradock AL, Barrett JL, et. al. Projected U.S. state-level prevalence of adult obesity and severe obesity. N Engl J Med. 2019;381(25):2440-2450.
