A large, new study from the CDC has confirmed that obesity significantly increases the risk for hospitalization and death among those who contract COVID-19. The study serves as a reminder for healthcare providers that obesity is a serious condition that leads to numerous complications. It also provides an urgent framework for clinicians to speak with their patients about nutrition.
Nutrition is one of the four pillars of obesity treatment—the others being physical activity, behavioral counseling, and pharmacotherapy— and improved outcomes are seen when nutritional interventions are included in treatment plans. Given the importance of good nutrition, patients need personalized, evidence-based guidance from their clinicians.
Unfortunately, many clinicians don’t broach the topic of nutrition when speaking to patients with obesity. Reasons for this reluctance include a lack of knowledge about obesity and its treatment, weight bias, time or reimbursement challenges, fear of making patients uncomfortable, and a belief that patients aren’t motivated to address their obesity.
Some of these barriers are real—for example, clinicians are generally pressed for time—but misconceptions also surround nutrition and obesity, including:
1l Obesity is caused by overeating. While overeating may play a role, the development and persistence of obesity is the result of numerous genetic, environmental, and biologic factors. In addition to influencing obesity, these factors also influence hunger, satiety, propensity for specific foods, and response to nutritional interventions.
2l There is a perfect diet and once it is identified and implemented, obesity will resolve. Given that obesity is a chronic condition, any nutritional plan needs to be continued indefinitely in order to keep weight stable. Even when this is done, the body metabolically adapts to weight loss, which may require an intensification of an entire treatment plan, including nutrition.
3l Weight gain or loss is determined by a simple equation: calories in vs. calories out. In reality, weight and appetite are regulated by multiple neurohormonal processes that involve adipose tissue, endocrine organs, gastrointestinal tract peptides, and the peripheral and central nervous systems. Beyond calories, foods like as sugars, starches, and ultra-processed foods increase insulin, which promotes lipogenesis and inhibits lipolysis.
Effective conversations about nutrition and obesity are the gateway to effective treatment and improved health. Research indicates that patients generally want their providers to broach the topic. And when patients feel that their clinician is on their side, they will be much more open to discussing weight and treatment options.
Become a member of the Obesity Medicine Association to learn more about treating obesity at https://obesitymedicine.org/.
