Why I don’t do “weight loss” as a primary care physician

If you've been trying to lose weight for years, you’re not alone. With new weight loss medications hitting the market, more people are asking their doctors for help. From specialized obesity clinics to online services offering quick prescriptions, the options can feel overwhelming. But how do you know what is safe and who to trust?

Why Weight Loss Should Not Be The Focus

In my practice, I emphasize improving your overall health through sustainable lifestyle changes and, when necessary, medication. While losing weight is often suggested to lower the risk of chronic conditions like diabetes, high blood pressure, or heart disease, the risk of prescribing weight loss is overlooked. The truth is, the risks of attempts at weight loss often outweigh the benefits.

Your Weight Doesn’t Define Your Health

It’s important to remember that your weight is just one small piece of your overall health. True health is determined by a variety of factors, including your daily habits, blood pressure, cholesterol levels, blood sugar, and other metabolic markers found in blood tests. For example, someone with a higher weight who exercises regularly, eats a balanced diet, and has good blood pressure and cholesterol levels can be healthier than someone with a lower weight but poor metabolic markers and unhealthy habits. Focusing on these broader indicators provides a more accurate picture of your health and helps you make lasting changes that truly benefit your well-being.

The Cycle of Dieting

When you're told to lose weight for health reasons, you might start eating more fruits and veggies, exercising more, and cutting back on alcohol. But when the weight doesn’t come off quickly—because it rarely does—you might think you’re not being strict enough.

This can lead to extreme dieting: counting every calorie, cutting out entire food groups, and pushing your body to its limits with exercise. Initially, you might see some weight loss, but your body will eventually adapt (our bodies resist losing weight), and the progress will slow down. If that happens, you might feel pressured to push even harder.

Eventually, most people can't sustain these extreme behaviors. When they return to their old habits, the weight often comes back, sometimes even more than before. This can be disheartening, leading to a cycle of stricter diets, increased frustration, and worse physical and mental health.

When Dieting Takes a Dangerous Turn

Some people may believe that if they just try harder, they can lose the weight. But this mindset can lead to dangerous behaviors. You might start skipping social events to avoid "unhealthy" foods, skipping meals if your “safe” foods aren’t available, or over-exercising despite injury or illness. This kind of rigidity can lead to binge eating, followed by feelings of guilt or shame.

For some, these behaviors can spiral into an eating disorder—a serious condition that affects both mental and physical health. Eating disorders not only severely impact quality of life, they have the highest mortality risk of any psychiatric condition besides opiate addiction. Eating disorders are more common than you might think- 9% of Americans will develop an eating disorder in their lifetime- and they aren’t just about being underweight; in fact, only 6% of those diagnosed with an eating disorder have a BMI in the “underweight” category. Those with higher BMIs are at the greatest risk, but unfortunately they are often not diagnosed and simply told to keep losing weight, which only worsens the problem.

Why Weight Loss Is Not the Solution

Not everyone who tries to lose weight will develop an eating disorder, but it's difficult to predict who will. And for most people, even if they do lose weight, they will eventually regain it, leading to a harmful cycle of yo-yo dieting. This cycle increases the risk of heart and metabolic diseases more than the weight itself—another reason to avoid making weight loss the main focus.

Instead, focusing on what you can control—like eating balanced meals, moving more, getting enough sleep, managing stress, and staying socially connected—can lead to better health outcomes. These changes may or may not result in weight loss, but they will certainly improve your overall health and well-being.

Medication and Metabolic Health

While lifestyle changes are essential, they may not be enough for everyone. Some people need medication to manage metabolic conditions like diabetes, high blood pressure, or high cholesterol. Some of these medications might cause weight loss, but that’s not the primary goal. The focus is on improving your health in the safest way possible.

Finding the Right Support

Metabolic health is complex and involves more than just your weight. It's about caring for your whole self—mind, body, and soul. I encourage you to find a doctor who understands this and who won’t just focus on the number on the scale.

If you’re struggling with conditions like diabetes, high blood pressure, PCOS, or are tired of the yo-yo dieting cycle, we’re here to help. Our physicians specialize in helping you reach your health goals through sustainable lifestyle changes and thoughtful use of medication when needed. Schedule a meet and greet today to find the right physician for you!