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Supporting women in their effort to maintain a healthy weight

Sarah Krauss, MD, FACOG

by Sarah Krauss, MD, FACOG

As an ob/gyn physician, I help women live their healthiest lives. An important part of that is maintaining an ideal body mass index (BMI), which plays a major role in chronic disease prevention and overall quality of life. That is why I consider it an important part of my practice to help women understand the complex disease of obesity.

Obesity is a chronic, progressive, and relapsing disease. Having obesity will increase an individual’s risk of other medical issues like heart disease, diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea, and even some cancers. In June 2013, the American Medical Association (AMA) officially recognized obesity as a disease requiring a range of interventions.

It’s important for women to understand that obesity is not their fault. Factors like certain disease states and medications, genetic predispositions, hormonal imbalances, stress, societal and cultural influences, and even negative childhood experiences play a role. Even exposure to certain chemicals in our modern society can play a part. Although weight gain and weight loss are fundamentally about calories in versus calories out, patients need to realize that losing weight often means battling against one’s own biology.

Before I begin the conversation about weight loss, I always ask my patients if it’s ok to discuss their weight. Some women are not ready to have a conversation about obesity with me. For those who are, I start by assessing their BMI, which is a solid indicator of whether their weight is increasing their risk of other diseases. I then discuss the health risks associated with obesity, set expectations for weight loss, and explore ways that I can support them on their journey.

I offer patients a variety of interventions to help with weight loss. We discuss nutrition, behavior, and physical activity. In some cases, I may suggest therapy. We also explore how prescription medications can help. There are many medications available to assist with weight loss. Some are pills that are taken orally, and some are weekly injectable medications like Wegovy and Zepbound, which have been in the media recently. The weight loss plan is then personalized based on medical history, prior weight loss attempts, and health goals.

For my patients who are ready to make a change, we meet monthly during the active phase of weight loss. During these meetings, we openly acknowledge their efforts, reflect on their dietary habits, and make changes where necessary. We may discuss alternatives for favorite foods and strategies to continue their health journey on upcoming vacations or holidays. We continue to discuss their motivation for change and how this change is meant to be for the long run. At every visit, we talk about how the habits that are formed are meant to help with long-term maintenance of weight loss. Once patients have reached their goal weight, we discuss a maintenance plan, and visits are reduced to once every three months. After a year of maintenance, patients continue to come for their annual exam. Now that the AMA recognizes obesity as a disease, office visits are typically covered by insurance.

If you would like to have an assessment of your body mass index and begin a weight loss plan, I welcome you to schedule an appointment with me.