The world in which we live doesn’t always make it easy to be healthy. Ultra‑processed foods are engineered to be addictive. Nourishing foods are more expensive and less accessible than junk. Busy schedules and work demands disrupt sleep. Socioeconomic stress shapes daily choices.
This reality poses additional challenges for people with overweight or obesity. Many individuals face body-shaming and struggle to receive adequate, whole-person care. This can lead to feelings of negativity and hopelessness that make people less likely to seek care.
Obesity Care Week each March invites health care providers to raise awareness, educate and advocate for people living with obesity in the pursuit of creating lasting change. To learn more about how obesity care should look, we checked in with Dr. Benjamin Duffy, an Obesity Medicine Specialist and Director of ThedaCare Weight Wellness Solutions.
A More Nuanced Understanding
Obesity is not a personal failing. Rather, it’s a chronic and relapsing disease that impacts both health and social well-being, Dr. Duffy says.
“We know that addressing obesity goes far beyond the adage, ‘Calories in, calories out,’” he says. “Effectively treating this disease requires a lifelong approach that often includes many types of treatment.”
Types of Obesity
People with obesity can suffer from one or more of three main obesity disease processes, Dr. Duffy says.
These include:
- “Gut hunger” hormone imbalances can lead to always feeling hungry and prevent a person from feeling full.
- “Head hunger” leads to cravings and spikes in the brain’s pleasure center surrounding food. Many highly processed foods also are designed to have this effect.
- Biological processes outside of overeating can cause weight gain. These may include perimenopause, menopause, age-related metabolism slowdowns, certain medications and diseases like polycystic ovarian syndrome (PCOS).
Guiding Principles in Obesity Care
As health care providers increasingly come to understand the complex nature of obesity, they’re developing a more thoughtful and comprehensive approach to treating the disease.
Dr. Duffy shares these five guiding principles of obesity care:
1. Obesity is a chronic disease.
Dr. Duffy likens obesity to cancer. It’s a condition that requires more intensive treatment at the outset and close monitoring over the longer term. It is progressive and relapsing and increases the risk for many health conditions. These include type 2 diabetes, high blood pressure, cardiovascular disease, certain cancers, sleep apnea, mental health problems and degenerative joint disease.
2. Obesity is driven by powerful underlying biology, not choice.
A combination of genetic, environmental and social factors affects how a person experiences obesity. Obesity is not a personal failure due to lack of willpower.
“The human body is wired to prevent starvation. Obesity isn’t a moral failure,” Dr. Duffy says. “It’s the result of powerful survival systems operating in a health-hostile environment that constantly pushes excess.”
3. Obesity is treatable.
Obesity treatment focuses on changes that benefit a person’s overall health, not just weight loss. A comprehensive, medically supervised program like ThedaCare Weight Wellness Solutions integrates weight loss with strength-building, specialized health coaching, behavioral health support, medications and surgical options.
“Setbacks are to be expected and should not cause guilt or shame,” Dr. Duffy says. “We work together to shift from self-judgment to curiosity to help us change our behavior patterns.”
4. Weight bias, stigma and discrimination cause harm.
People living with obesity experience discrimination in employment, social situations and medical care. They deserve respect, support and appropriate treatment.
“I think the most powerful effect of GLP-1 weight-loss medications has been the realization that obesity is a disease, highlighted by the fact that medicine helps so profoundly,” Dr. Duffy says. “Let’s stop judging people for a burden they often bear very publicly.”
5. Today’s Health-Hostile Environment Impacts Obesity
Dr. Duffy’s team helps people understand how outside forces can impact health outcomes. These include access to healthy food, grocery store design, income inequality and employment conditions.
Consider these factors:
- Socioeconomic forces have a powerful impact on a person’s food choices. For example, a person or family who primarily eats cheaper, highly processed food tends to consume more calories with less nutritional benefit.
- Shift work has a negative effect on a person’s sleep schedule. That’s especially true for people who work on rotating shifts that constantly upset their circadian rhythms. Good-quality sleep is an essential part of addressing obesity.
- Emotional eating happens when a person uses food to modulate their brain chemistry. “Emotional eating is a form of self-medication,” Dr. Duffy says. “Highly processed foods rapidly stimulate dopamine and reward pathways, creating temporary mood shifts that reinforce non-hunger-based eating.”
A Comprehensive Approach
ThedaCare Weight Wellness Solutions offers a complete team of physicians and other experts who help people learn about weight management solutions, healthy eating and physical activity. The program offers a continuum of solutions, from lifestyle modifications and interventions to obesity medicine to weight loss surgery.
“Our program is much more than a quick and easy fix,” Dr. Duffy says. “It’s a larger process of taking back control and consciously choosing to live more healthfully.”
Interested in exploring ThedaCare Weight Wellness Solutions?
Register for your initial class today — available virtually and in person.
