Obesity Medicine

Obesity medicine physicians have expertise in managing the disease of obesity. We share with patients our understanding of genetic, biological, environmental, social, and behavioral factors that affect body weight. We use our knowledge about nutrition, physical activity, habits, stress behaviors, and pharmacotherapy to help improve health and wellbeing. At Brown University Health, we use methods based in positivity and mindfulness. Primarily through the practice of “intuitive eating,” the program seeks to help people get off the dieting “roller coaster” and instead feel the freedom of eating normally.

Most patients with obesity blame themselves, thinking it’s a lifestyle choice — it’s just a matter of hard work and they have failed. A tendency to gain weight is mostly due to genes inherited from parents or other family members, and once the weight is on, the body works hard to keep it on. Dieting can often result in weight loss, but the weight comes back for nearly everyone, and there is a strong chance of ending up heavier than before. Exercise is often tried for weight loss but mostly falls short of patients’ goals. This leads many to dislike exercise or to stop it completely. Sleep deprivation and stress are two causes of obesity that are often overlooked and are areas where patients can often make improvements.

"Intuitive eating" is a mindful, non-diet approach to eating that’s all about taking care of your mind and body with your food choices and physical activity. The practice involves self-awareness, body attunement (learning to notice hunger and fullness levels), coping with emotion without using food, and exercise for fitness, movement, and strength. We encourage patients to stop focusing on weight loss. This leads to greater self-confidence in positive lifestyle changes, a happier mindset, and a desire to keep going with self-care long term.

During the first consultation, I have patients tell the story of their weight gain. I look for conditions related to weight gain such as diabetes, sleep apnea, and high cholesterol or blood pressure. I provide reading resources and TV shows to watch — two documentaries regarding weight, and a PowerPoint presentation, which we discuss in a follow-up visit. At the second visit, we lay out a plan for achieving a sustainable improved lifestyle using our nutritionists, health coach, and exercise physiologist. I review the role of metabolic surgery for obesity, medications approved for its treatment and, perhaps most importantly, spend time answering questions!

The program is open to anybody who wants to make positive changes in their life — only about 50 percent of obesity medicine patients have undergone weight loss surgery.