As physicians, we often meet patients struggling with weight gain and the effects it has on their overall health. Obesity isn’t just about appearance. It’s a medical condition that profoundly affects nearly every organ system in the body. Obesity increases inflammation, and leads to insulin resistance, high blood pressure, and abnormal cholesterol levels. These metabolic imbalances pave the way for chronic diseases like type 2 diabetes, cardiovascular disease, fatty liver disease, and certain cancers.
The consequences of obesity are staggering. Today, more than 40% of American adults meet the criteria for obesity, defined as having a body mass index (BMI) of 30 or higher. Severe obesity — defined as a BMI of 40 or greater — affects nearly 1 in 10 adults. These numbers are rising across every state. Every state now has at least 20% obesity prevalence; 20 states and several territories are in the 35–40% range, and three states — Arkansas, Mississippi, West Virginia — now exceed 40% according to CDC estimates.
Beyond personal health, the collective burden is immense, with obesity-related health care costs in the U.S. exceeding $173 billion annually. This is in part because obesity is linked to high rates of diabetes, hypertension, heart disease, sleep apnea, fatty liver, and more.
But there is hope. In recent years, medical science has made groundbreaking strides in obesity treatment, particularly with the development of GLP-1 receptor agonists. These medications, modeled after a naturally occurring gut hormone, work by helping regulate appetite, insulin response, and satiety. Unlike older weight-loss medications, which often had marginal benefits or adverse side effects, this new class of drugs is showing transformative results.
Patients using GLP-1 receptor agonists in clinical trials have consistently lost between 10% and 15% of their body weight over a year or more — an effect not previously achieved with medication alone. Even more impressively, these drugs don’t just reduce weight; they also improve or reverse the conditions associated with obesity.
In patients with type 2 diabetes, for example, GLP-1 therapies are shown to improve blood sugar control and reduce the need for insulin. In diabetic patients, GLP-1 drugs reduce the risk of major heart events (e.g., heart attacks, strokes) compared to standard treatment.
In those with cardiovascular disease, treating obesity is associated with lowered risk of major heart attacks and strokes. A recent analysis found patients on GLP-1 therapy had lower rates of heart attacks, strokes and other cardiometabolic disorders than similar patients not on these drugs. This likely reflects the combined effects of weight loss, better blood sugar control, and direct beneficial effects on blood vessels.
For people with nonalcoholic fatty liver disease (NAFLD), clinical studies show GLP-1 reduces liver fat and inflammation while improving liver enzymes. Excess weight often leads to fatty liver and inflammation. Patients with NAFLD treated with GLP-1 drugs are more likely to see their liver fat and inflammation decrease or even resolve. In other words, GLP-1 therapy can improve nonalcoholic steatohepatitis (NASH) by promoting weight loss and better metabolism.
As physicians, our role is to guide patients through the full spectrum of obesity care. That starts with understanding individual habits, like diet, activity level, sleep patterns, and stress, and providing evidence-based counseling. We often begin with lifestyle changes: adopting a whole-food, plant-forward diet and encouraging at least 150 minutes of moderate physical activity per week. Even a modest weight loss of 5–10% can reduce blood pressure, cholesterol, and blood sugar levels, offering real health gains.
When lifestyle adjustments aren’t enough — and for many people with longstanding obesity or coexisting conditions, they often aren’t — we turn to medical therapy. GLP-1 receptor agonists have become a powerful addition to our toolkit. For patients with a BMI of 30 or more, or 27 with other health conditions like hypertension or diabetes, these drugs are now a standard, evidence-based option. Primary care physicians are often the first to start these treatments, though they should work closely with patients’ cardiologists, endocrinologists, and other specialists to ensure coordinated care.
In my experience, ongoing support and accountability are crucial for success. Technology and telemedicine are playing a growing role in obesity care. Virtual visits let patients check in with their doctors or dietitians more frequently and conveniently. For instance, one recent study found that patients on weight-loss medication who followed up via video calls lost just as much weight over 6 months as those who came in person. In other words, telemedicine appointments — or a hybrid of video and office visits — produced clinically significant weight loss comparable to in-person clinics.
Mobile health tools also help with daily motivation and tracking. Smartphone apps can log meals, count steps, and send reminders to stay active. Systematic reviews show that telemedicine interventions (e.g., apps, online programs, text coaching) yield better weight loss than no intervention, and perform nearly as well as face-to-face programs. Some data indicate telemedicine programs can produce a few kilograms more loss versus usual care, especially if they include human coaching elements. This constant feedback loop fosters motivation, flags problems early, and helps patients stay on track. Research supports these tools: telemedicine programs are often more effective than standard care and are nearly as effective as in-person behavioral programs in promoting weight loss.
These tools are particularly valuable for preventing chronic diseases, as they help bridge the gap between clinical visits. Patients at risk for diabetes or heart disease can benefit from more frequent support; remote patient monitoring ensures small issues are caught early (for example, when weight starts creeping up again).
Combining lifestyle changes with modern medications and continuous care offers the best chance for success. GLP-1 receptor agonists have transformed our ability to help patients lose weight and improve diabetes and heart and liver health. Primary care doctors and cardiologists together can guide patients through diet, exercise, and medication, while using telehealth and digital tools like weight devices supported by RPM systems for extra support and motivation.
The evidence is clear that even moderate weight loss dramatically lowers health risks. Obesity, as a chronic disease, requires long-term thinking, patience, and support. But with a combination of lifestyle coaching, targeted medication like GLP-1 receptor agonists, and modern tools to stay connected and accountable, patients can make remarkable progress. And thanks to the new therapies and remote care solutions available today, patients have more resources than ever to achieve healthy weight and prevent chronic diseases. I encourage fellow providers to work closely with patients and the other members of their healthcare team to chart a path to better health and reduce the burden of obesity.
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