A bariatrician is a physician who treats patients with the disease of obesity using a combination of medication and lifestyle changes. The World Health Organization defines obesity as “an abnormal or excessive fat accumulation that presents a risk to health.” Obesity is a complex disease. There are many different factors that can cause or contribute to obesity, including genetics, environmental factors, individual behaviors, sleep, stress, hormones and medications. Many other serious health conditions are associated with obesity, such as:

• Hypertension
• Type 2 diabetes
• Cancer
• Liver disease
• Sleep apnea
• Heart disease

Bariatricians provide the comprehensive treatment needed by patients with obesity. Changes to eating habits and physical activity are important to losing weight and maintaining weight loss. Bariatricians can help guide patients through these changes by providing nutritional counseling, exercise prescriptions and behavior modification techniques. There are also medications that can be prescribed to help decrease appetite, control cravings and increase feelings of fullness. Medications must always be used in combination with changes in eating habits and physical activity.

What should a patient expect at an appointment with a bariatrician?

At the initial appointment, patients are weighed on a body composition scale. In addition to total body weight, this type of scale provides body fat mass and percentage, skeletal muscle mass, water weight and basal metabolic rate (the number of calories required to keep your body functioning at rest). A history of the patient’s weight change over the years, a review of current eating habits and level of physical activity are obtained, along with a review of the patient’s medical history, social history and current medications. Follow-up appointments include being weighed, monitoring for any adverse side effects from medication use and review of changes being made to eating habits and physical activity. It is important for patients to understand that obesity is a chronic, relapsing disease that requires lifelong management. Regular monitoring is critical in order to maintain weight loss.