Blog
Obesity
Covenant Metabolic Specialists Health Library
Covenant Metabolic Specialists
Physician Reviewed
Dec 3, 2025
Obesity is now recognized as a chronic, relapsing, neuro‑hormonal disease characterized by excess adipose tissue that impairs health. It drives a plethora of cardiometabolic illnesses—type 2 diabetes, fatty liver disease, sleep apnea, hypertension, osteoarthritis, infertility, and multiple cancers. Treating obesity therefore improves almost every downstream organ system, making it central to modern preventive medicine.
Symptoms
Early physical signs are an expanding waistline, dyspnea on exertion, and musculoskeletal pain. Over time patients develop gastroesophageal reflux, snoring or apneic pauses during sleep, plantar fasciitis, intertrigo in skin folds, fatigue, depression, and social stigma. Laboratory clues include rising fasting insulin, elevated triglycerides, fatty liver enzymes, and vitamin D deficiency.
Causes
Positive energy balance is driven by ultra‑processed high‑calorie foods, sugar‑sweetened beverages, sedentary lifestyles, disrupted sleep, psychosocial stress, endocrine disruptors, medications such as antipsychotics or glucocorticoids, and genetic or epigenetic predisposition influencing appetite regulation and basal metabolic rate. The modern food environment overwhelms hypothalamic satiety signaling and promotes weight gain.
Risk Factors
Risk increases with family history, prenatal exposure to maternal obesity or diabetes, early rapid weight gain in childhood, low socioeconomic status, limited access to safe outdoor spaces, night‑shift work, chronic stress, and certain endocrine conditions such as hypothyroidism or Cushing syndrome. Medications like insulin, valproate, or SSRIs add pounds.
Diagnosis
Diagnosis relies on BMI ≥30 kg/m² or BMI ≥27 kg/m² with obesity‑related comorbidity. Waist circumference assesses visceral fat. Body‑composition tools such as DXA or bioimpedance clarify fat distribution. Baseline labs screen for complications: glucose, A1c, lipids, liver enzymes, TSH, vitamin D, and sleep apnea questionnaires.
Treatments
Evidence‑based treatment combines reduced‑calorie, protein‑adequate diets, 150–300 minutes weekly physical activity, cognitive‑behavioral therapy, and anti‑obesity pharmacotherapy—GLP‑1 receptor agonists, dual GIP/GLP‑1 agonists, bupropion–naltrexone, phentermine–topiramate, or orlistat. Bariatric‑metabolic surgery remains most effective for class III obesity, yielding durable weight loss and disease remission.
Prevention
Primary prevention includes breastfeeding, limiting sugary drinks in children, compulsory physical education, urban planning for walkability, taxation of sugar‑sweetened beverages, front‑of‑pack labeling, and workplace wellness. Regular BMI and waist checks identify early trend increases so interventions can start before obesity criteria are met.
Our Take
At Covenant we treat obesity like any other chronic disease: with scientific therapies, measurable targets, and empathy—not blame. Our multidisciplinary clinic provides dietitians, psychologists, exercise physiologists, and endocrinologists under one roof so patients receive integrated, stigma‑free care.
Obesity management dramatically reduces cardiovascular, hepatic, and renal morbidity. By coupling lifestyle change with modern pharmacology and, when appropriate, surgery, Covenant helps patients transform weight trajectories into lifelong health gains.
