Intellihealth’s Dr. Louis Aronne and Dr. Katherine Saunders talk with Dr. Ania Jastreboff about the importance of treating obesity like a chronic disease, the future of obesity medicine, and her approach to treating childhood obesity.
For Dr. Ania Jastreboff, education plays a vital role in obesity treatment, both in her interactions with patients and her work with the medical community.
Jastreboff is a board-certified obesity medicine physician who’s gained international recognition for her research and her efforts to help other doctors understand the complexity of obesity.
In this episode of Weight Matters, Dr. Louis Aronne and Dr. Katherine Sanders talk with Dr. Jastreboff about the importance of treating obesity like a chronic disease, the rising rates of obesity in children and adolescents, and new advancements in medication and telehealth.
Removing Stigmas Around Obesity
Any time Jastreboff starts working with a new patient, she starts by asking them to talk about their weight journey. Jastreboff then explains to the person that obesity is not their fault, it’s simply the body’s way of responding to our current environment.
“Your body is super smart. It created this amazing biology that basically at all odds helps to prevent you from starving. And this amazing biology that has been created is also what’s impacted by our obesogenic environment,” she explains. “Your body wants to store all that fat because that’s how it stores energy.”
Jastreboff believes this clarification can help people feel less guilt and shame around their experience, which in turn makes them more open to exploring different treatment options.
“As they understand the biology — that there is this dysregulation taking place, and that their bodies are really smart and they’re not letting them starve — it reframes the story. It’s not that there’s something wrong, it’s that their body is doing this to make sure that they don’t starve,” she shared.
Treating Obesity as a Chronic Disease
Just like any other chronic disease, there are many different causes and types of obesity. It’s important for doctors to understand this, because it means that people will respond differently to different treatments and medications.
“For no other disease do we think that there should be a magic pill,” Jastreboff argued. “Why would we expect that? Obesity is a complex disease just like any other disease.”
She also stressed the importance of remembering that obesity is a chronic condition, so doctors should expect to treat patients throughout the course of their lives.
“Just because someone loses weight does not mean that their obesity is cured. It means their obesity is in remission,” she explained. “If we stop the medicine, that weight set point, or how much fat our body wants to carry, goes back up. If we stop the medicine, then the weight gain recurs.”
This idea of a “set point,” is essential to understanding the root cause of obesity. Our hormones tell our body how much weight it should carry in an attempt to prevent starvation, and when we lose weight, our brains will do everything it can to help us gain it back. This also explains why “calories in, calories out,” isn’t the effective or sustainable solution that many people think it is.
“A lot of patients think it’s their job to eat less. It’s not always eating healthier or eating differently, it’s just to eat less,” Jastreboff shared. “We know caloric restriction does not reset the body fat mass set point, and so asking someone to basically eat less, to calorically restrict indefinitely, is like asking someone to hold their breath indefinitely. And eventually, biology takes over and you have to take a breath.”
The Future of Obesity Medicine
Though Jastreboff is concerned about rising obesity rates and associated metabolic issues, especially in children and adolescents, she’s also encouraged by several key advancements that are making treatment for obesity accessible for more people.
For example, the COVID-19 pandemic sped up the acceptance of telemedicine as a valuable tool for treating patients, and Jastreboff has seen great outcomes from virtual check-ins with patients who may not live near their specialist.
Additionally, the FDA has approved new drugs and will likely soon approve even more that are highly effective for obesity treatment, and there’s also a new focus on making medications available for children and adolescents.
Moving forward, Jastreboff hopes to see an increased understanding of obesity among all healthcare providers, not just specialists.
“Education for healthcare providers is one of the keys to overcoming the barrier of access,” she explained. “A majority of obesity care is actually going to come from primary care… so we really need to focus our efforts on helping primary care providers as they begin to treat patients specifically for their obesity, and then refer to obesity medicine experts or endocrinologists or others who have additional training in obesity medicine.”
Follow Weight Matters wherever you get your podcasts to never miss an episode. To learn more about Dr. Sanders and Dr. Aronne’s work to transform specialized treatments for chronic conditions through the best in medical science and advanced digital technologies, visit www.intellihealth.co/podcast
