For many people, trying to reach a healthier weight feels like a never-ending cycle of trying, plateauing, and regaining. Many people feel frustrated, even defeated — but as weight management expert Dr. Megha Poddar explains, the reason for the struggle isn’t a lack of willpower. It’s biology. And the good news is that real, evidence-based treatments now exist that work with your biology instead of against it.
Why Diet and Exercise Alone Often Don’t Work
For years, the message was simple: eat less, move more. But research — and lived experience — show that this advice doesn’t match the science of obesity. “Our hormones change, our appetite system changes, our metabolism changes. And all of a sudden our body is fighting us so that whenever we lose the weight, we just end up regaining it” says Dr. Poddar.
When you cut calories, your brain increases hunger and slows metabolism to defend your highest weight. That’s why so many people have been on the yo-yo dieting cycle.
Dr. Poddar adds, “when you go on a diet, you plateau with your weight and you regain it… that’s not your fault. That’s how our body and our biology has been built.”
Obesity Is a Chronic Disease — Not a Lack of Willpower
Understanding obesity as a chronic disease changes everything. Instead of blaming yourself, you can recognize that your body is working to keep you safe — even when those mechanisms make weight loss hard. Dr. Poddar explains it this way– “When you calorie restrict, your body and your brain will fight you… this is the fundamental principle to why we call obesity a chronic disease.”
The 2025 Canadian Adult Obesity Guidelines echo this: obesity requires long-term management, just like diabetes or hypertension. Short-term fixes aren’t enough; treatment must target the underlying biology — the appetite and reward systems in the brain.
The Role of the Brain: Understanding “Food Noise”
Many people describe constant mental chatter about food — what Dr. Poddar’s patients call food noise. “It is this subconscious trigger in our motivation centers of our brain to go out and get food for reward and pleasure. It’s subconscious, so we don’t actually know that it’s there.” – Dr. Poddar
Treatments that calm this overactive system make it easier to make healthy choices and feel in control around food.
Evidence-Based Treatments: The Three Pillars
According to Dr. Poddar and the Canadian guidelines, obesity treatment should focus on three proven approaches:
- Psychological or behavioral interventions — to support mindset, habits, and coping.
- Medications — to target appetite, reward, and satiety signals in the brain.
- Bariatric surgery — for those who meet specific clinical criteria.
Dr. Poddar explains, “The reason they’re successful long term is because they are all treating the fundamental symptom of wanting or appetite.” Diet and exercise remain essential for overall health, but they become more effective after biology is addressed.
How Medications Work — and What to Ask
The 2025 guidelines recognize six Health Canada-approved medications for long-term obesity management: liraglutide, semaglutide, tirzepatide, naltrexone/bupropion, orlistat, and setmelanotide (for certain genetic forms of obesity).
These medications work in different ways:
- Some increase fullness and reduce hunger.
- Others calm the reward pathway, lowering cravings and food noise.
- Several also improve metabolic and heart health independent of weight loss.
Pharmacotherapy should always be tailored to the individual. Dosing is adjusted based on response, side effects, and health goals. And stopping medication often leads to weight regain and loss of health benefits, so long-term use may be needed.
The guidelines warn against compounded or non-approved medications, which lack safety oversight.
The Importance of Support and Specialist Care
Dr. Poddar emphasizes that obesity care is most effective when patients work with a knowledgeable, supportive provider — not through quick online prescriptions. “The only people that want to be on a medication are those that understand and accept how these medications are working in their body, and it’s worth it for them.”
A qualified healthcare professional can help you:
- Understand how a treatment works in your body
- Adjust dosage safely
- Track progress based on health improvements, not just the scale
Redefining Success
Both the guidelines and Dr. Poddar agree that success is about health, not a number– “Just because your weight is lower doesn’t mean that you’re healthier. Your health is defined by your behaviors,” says Dr. Poddar.
Look for improvements in energy, mobility, sleep, blood pressure, or blood sugar as real signs of progress. She adds, “The one thing in this whole journey that we don’t have any control over is what the weight is going to be. And so we put so much emphasis and our entire success on something we have no control over. That’s a recipe for disaster.”
Advocating for Yourself
Above all, your voice matters. You deserve care that respects your goals, values, and biology.
“Advocate for what you want from treatment and make sure that you’re getting the right support that you need on the journey.” — Dr. Poddar
Diet and exercise alone aren’t enough to help many people reach a healthier weight. Medical treatments are needed to address the biological changes happening in our bodies that can drive weight regain. To find a physician near you who specializes in weight management, click here.
This article was sponsored by Novo Nordisk Canada. All content is created independently by My Weight – What To Know with no influence from Novo Nordisk
