Working with an Obesity Specialist (Bariatric Healthcare Provider)

Obesity occurs when body fat is above a certain level. It can develop over time when you consume more calories than you use. Body mass index (BMI) is a simple and inexpensive way to measure body fat based on an individual's height and weight. Adult BMI does not measure body fat directly. It is a screening method that does not diagnose the body fatness or health of an individual.

• A BMI of 25 to 29.9 is overweight
• A BMI of 30 or more is obese
• A BMI of more than 40 is considered severe obesity

Your provider can calculate your BMI for you. You can also use the online BMI calculator at the

National Institutes of Health website at www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

If you have obesity , it’s important to get treatment. Obesity can lead to serious health problems, such as:

• High blood sugar (type 2 diabetes)

• Arthritis

• High blood pressure (hypertension)

• Heart disease

• Stroke

• Sleep apnea. If you are overweight or obese, you may have more fat stored around your neck. This makes your airway smaller and causes you to breathe irregularly, or even stop breathing altogether for short periods of time.

• Fatty Liver disease. It develops when fat builds up in your liver. It may lead to severe liver damage, cirrhosis, or even liver failure.

• Certain lung diseases like hypoventilation syndrome.

• Certain cancers

• Gallbladder and pancreatic diseases
• Kidney diseases

You may start your treatment with your primary healthcare provider. But if you need more help, you may want to see a bariatric healthcare provider. They may have new ideas or weight loss methods that can help you.

At your first visit, your bariatric healthcare provider may:

• Ask about your health history. This includes your history of eating habits, diet, exercise or physical activites, and weight loss.

• Give you a physical exam. This includes BMI, waist-to-hip ratio measurement, blood pressure, and skinfold thickness measurements (with calipers).

• Further evaluation studies

You may need some tests. These are to check for health factors linked to obesity. They also look for health problems that can cause weight gain. Tests may check your:

• Blood sugar levels to look for diabetes
• Lipid and cholesterol levels
• Thyroid-stimulating hormone levels
• Liver function
• Kidney function
• Vitamin D levels
• Heart rhythm (electrocardiogram)
• Heart function during exercise
• Resting metabolic rate, to see how many calories you burn at rest
• Urinalysis
• C-reactive protein (CRP)
• Sleep studies

Your bariatric healthcare provider will create a "tailored or customized weight loss" plan for you. The plan is based on your health needs and preferences. Its primary aim will be to help you to lose weight safely and to keep it off over the long term. Your provider will:

• Find out how ready you are to begin an exercise program
• Help you make realistic weight-loss goals
• Give you a nutrition plan based on the calories and nutrients your body needs.
• Tell you to keep a food diary
• Talk with you about a weight-loss medicine, if needed

They'll give you information about:

• Healthy eating habits
• Healthy exercise habits
• How to change health behaviors
• How mental health affects obesity
• The complications of obesity
• The benefits and risks of medicines

At each follow-up visit, your bariatric healthcare provider will check your progress. They'll also make changes to your plan as needed. As you lose weight and your health improves, your provider might change some of your medicines. If you stop losing weight or you regain weight, they may talk with you about weight-loss surgery.

Talk first with your primary healthcare provider. They may be able to refer you to a bariatric healthcare provider. You can also go to the Obesity Medicine Association website at www.obesitymedicine.org . They have an online listing of providers. You can search for ones in your area.