The medical profession has no cure for obesity.  While many people will diet, exercise, and thus, lose weight - keeping that weight off is where the real struggle lies.

Below is an article and a video in which Dr. Sharma, who-is-one-of-the-medical-obesity-experts-that-I-admire-and-respect, explores the complex biology behind weight loss and regain, and gives his medical opinion as to why obesity should be managed as a chronic disease rather than as a personal failure.

The Three Clinical Faces of Obesity
                by Dr. Arya Sharma M.D.

In my experience, patients presenting with obesity tend to fall into three categories, each of which requires a distinct management approach. They are:

1) Active Gainers
2) Weight Stable
3) Post-Weight Loss

Active Gainers are patients currently at their lifetime maximum and continuing to gain significant amounts of weight – i.e. more than the usual 0.5 to 1 lb/year. Patients in this category require immediate attention – if nothing happens, their weight will most likely just continue to increase.

The good news is that in almost every patient in this category, there is an identifiable reason for the ongoing weight gain – this can be psychosocial (e.g. depression, binge-eating disorder, etc.), due to a medical comorbidity (arthritis, chronic pain, etc.) or medications (e.g. atypical antipsychotics, hypoglycemic agents, etc.).

From a management perspective, the sooner we identify and address the underlying problem, the sooner we can slow or even halt the rate of weight gain – in this patient – gaining less weight than before is the first sign of success. There is really no point trying to embark on losing weight as long as the underlying problem driving the weight gain has not been addressed, as this is likely to make sustained weight loss even more unlikely that it already is..


Weight Stable patients are those that present with excess weight but are relatively weight stable. Even though they may be at their lifetime maximum, they have been pretty much the same weight (perhaps a few lbs up or down but nothing drastic) for several years (sometimes even decades). By definition, a patient who is weight stable is in caloric balance, and thus, by definition is not eating too much. In fact, these patients are eating the exact number of calories needed to sustain their bodies...

Truth One (1)

There’s NO Thin Woman inside every Fat Woman;
there’s just YOU …who you are… in there, whether your body is Large or Small.

After successful weight-loss, there is NO “new” YOU;
it’s just the Same YOU, only smaller.

See:
Is It REALLY up to me?

Truth Two (2)

There is no
BEFORE and AFTER,
only DURING.

See:
No Before - No After - Only During

Truth Three (3)

There
is
NO
Finish
Line.

See: