Weight Loss- Treat or Refer

Hi. I’m Dr. Craig Primack, and welcome to another medical minute. Today is a very important medical minute. It’s my 20th medical minute.

Today I’m going to talk about weight loss with the philosophy of treat or refer.

Medical Disease

So what does that mean? First, let’s talk about weight. Weight is considered a medical disease, or weight loss being treated by a medical professional. Most people, unfortunately, cannot treat their weight by themselves. They’ve tried. I understand it. Some people have tried many, many, many times, and have been unsuccessful.

Unfortunately, being a medical disease, being overweight is serious. If we do nothing, we are at higher risk for other diseases, including cancer and early death. It is chronic, meaning it doesn’t easily go away, and our body uses methods, unfortunately, to fight back against our weight loss. The third is, it is treatable in a medical framework,

Medical Treatment: where one is some kind of dietary manipulation, two is activity and/or exercise, three is learning and behavior, and maintenance to learn how to keep your weight off, how to get through social situations, how to go on vacations and eat safely. Then number four is the medical side, truly, which is using medicines to help lose weight as well as some accountability, but given in the right non-shaming way.

Treat or refer is simply a philosophy that I’ve been talking about for a while. There are so many people; there’s now over a hundred million people in our country who have weight, enough weight that it’s described as obesity, and another medical diagnosis, whether it be blood pressure, diabetes, high cholesterol, or such. And the amount of people who are certified like me, there aren’t enough in the country to treat everybody who has a weight problem.

So primary care, the person you see for your primary care, should start some very basic weight loss techniques with you. Sometimes it’s a diet, it’s exercise, maybe some accountability, and if it’s working for you, great. Please continue doing it. If it isn’t working for you, or if your medical history is complex, you’ve had heart disease or diabetes with several medicines, or the things you’ve tried just haven’t worked for you in the past, you need to find someone else…

This is the refer side… a specialist in obesity medicine, or medical weight loss. There is now a certification in the United States for physicians, and there are some special certificates for nurse practitioners and physician’s assistants, where they’ve dedicated time of learning specifically for treating weight.

Start with your PCP

So I believe primary care should be treating your weight, and if they’re not treating your weight, or it’s too complex, or you’re just not getting to where you need to be, then refer you to someone who does this full-time, who has a lot of experience in combining different treatments together and making it easier for people who have had struggles regarding their weight.

Consider a Specialist

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