By Madeleine Ortiz
The most commonly held belief about weight loss is that the key is simply eating less and moving more. Despite the popularity of this view, according to obesity specialist Dr. Sue Pedersen, it’s simply not true. “For most people living with obesity and excess weight,” she says, “diet and exercise alone aren’t enough.” In fact, the American Medical Association, the Canadian Medical Association and the World Health Organization all now consider obesity to be a chronic disease, and like all other chronic diseases, it requires long-term, medical treatment.
After a lifetime of believing your weight is your fault and thinking that if you only had more willpower, you could figure it out, it can be hard to accept this medical reality. But Dr. Yves Robitaille, director of a metabolic medical center in Montreal, Canada, says blaming yourself and your own “lack of willpower” is actually taking the easy way out of a tough situation. The more challenging, yet more effective approach is seeking medical attention. Accepting obesity as a chronic disease and taking the steps to get proper care and treatment can seem more challenging than going on another diet, but if you’re really wanting to reach a healthier weight, it’s the best long-term solution. But what will seeking medical attention actually be like? Here’s what to expect:
1. A visit to your family physician
Most of the time, reaching out for professional support starts with your family physician. When you’re ready to talk about weight with your doctor, it’s important to come armed with your own research and specific questions. Talking about weight can feel intimidating, but the more information you have, the more confident you will feel. Our physician’s visit checklist is a great guide that can help you fully prepare for the most productive conversation possible. You can even bring helpful videos and articles to the appointment to help make your case. Here are a few that we recommend:
2. Treatment Recommendations
Obesity is officially recognized as a chronic disease, but continuing education for doctors has lagged behind. Some physicians may be able to prescribe the treatment (like medication or a referral to a dietitian or psychologist) that will be most helpful to you, but other doctors may not feel comfortable recommending any specific options. In these cases, you may need to ask for a referral to a specialist. Looking at our physician locator will help you figure out the best options in your area- and don’t forget, many offices now offer virtual visits so don’t be afraid to reach out to a clinic that is farther away than you might normally consider. Seeing all the options available will also help you figure out which physicians/ clinics are covered by your existing health insurance.
3. Seeing a specialist
Once you’ve made an appointment with the specialist, think through exactly what you’d like to talk with them about. Bring your medical history (including a timeline of diets you’ve been on and any weight you’ve lost and regained). Decide what your goals are, both short and long-term, and think about which treatment options might be a good fit for you. Additionally, be open to treatment suggestions from the specialist. Many patients are surprised to find great success in treatments they were at first opposed to or perhaps had never heard of before the specialist recommended them.
Recognize that it may take a few appointments before you’re seeing the success you want to see. As dietitian Danielle Turcotte says, it’s the follow-up appointment with your physician that’s the most important.
4. Get costs covered
Regardless of whether it’s your primary physician or a specialist who prescribes a given treatment, the next step in the journey is to make sure that it’s covered by your insurance. And if it’s not, to take the steps needed to advocate for yourself to get it covered. You don’t have to take “no” for an answer. Look into formal exception processes, alternate healthcare programs or even a spouse’s insurance policy to help get the coverage you need. When it comes to coverage, it’s all about the three P’s – patience, persistence and paperwork. These articles can provide more detailed information on how if you’re stuck at this step.
If you feel like the process to for getting insurance coverage is never ending, a letter from your physician explaining the clinical rationale for why you need the treatment (the comorbidities it will treat, the improvement to your quality of life, etc.) can be a most powerful tool in persuading your insurer (or your employer) to cover the medication or treatment. Here is a template of a letter a physician in Canada has used successfully with insurance companies that you can share with your physician.
5. Stick with it
Seeking medical attention is a real step forward to reaching a healthier weight. Don’t let denial (or worse, self-blame) keep you from getting the treatment you deserve. And remember, getting treatment is a long-term, sometimes lifetime process. Even with medical support, you will hit plateaus and bumps in the road on your weight loss journey. The most important thing to do is to continue regular visits with your medical team. The sooner you can re-adjust your course with your doctor, the sooner you will be back on the road to a healthy weight and your best life.