Obesity is more than lack of willpower
Dunn said that although the weight-loss plan rules worked for her for years, things changed in her body composition when she entered menopause. Suddenly, she faced increased weight around her waist area, rising A1C levels and a constant struggle with the scale. She asked her primary care provider for a referral to Penn State Health’s COMMpanion Weight Management program.
The program takes a comprehensive approach to obesity care, combining visits with an obesity medicine specialist, U.S. Food and Drug Administration (FDA)-approved medications when appropriate, and personalized coaching to help patients develop sustainable nutrition, physical activity and behavioral strategies.
Rather than simply slashing calories, Dunn says Soleymani identified her major roadblock — insulin resistance brought on by menopausal hormonal changes. Dunn met with Alicia Fanelli, a registered dietitian, who helped her create an eating plan that prioritizes protein and fiber, along with regular exercise. Dunn tracks her progress with regular body composition scans to see how her body changes over time.
“As a society, we’ve always viewed obesity as a lack of willpower, but we now know that it’s a real disease, with its own pathophysiology,” Soleymani said. “You can’t ask a patient to rewire their brain pathways that regulate hunger and fullness or overcome the hormonal and metabolic changes that drive obesity. Medication can help address those factors.”
New weapons for weight loss
For some people, reducing calories and increasing exercise may be enough, but for most people, that formula is easier on paper than in real life. Soleymani said expecting people to lose a significant amount of weight without obesity medications is like asking someone to wage war without a weapon. Recently, the weapons have become more advanced.
GLP-1 medications, such as Wegovy and Zepbound, help control cravings and increase feelings of fullness and are one tool Soleymani and her team employ. She noted that medications and bariatric surgery aren’t one-time solutions. Obesity is a chronic disease and requires ongoing treatment. This can include medications, along with lifestyle changes and bariatric surgery when appropriate.
“Our goal isn’t short-term weight loss, nor is it simply prescribing medication,” Soleymani said. “We combine FDA-approved obesity medications with comprehensive lifestyle support to empower our patients to make sustainable changes for long-term health.”
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The Medical Minute is a health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.