About 40.3% of US adults had obesity in the most recent national survey, and 9.4% had severe obesity.[2] Despite how common it is, obesity is still often treated as a matter of willpower. Medicine sees it differently.
What “chronic disease” means
A chronic disease is long-lasting, has biological causes and needs ongoing management. The AACE/ACE clinical practice guidelines describe obesity this way and recommend assessing it not only by body mass index, but by the weight-related complications a person has and how severe they are.[1]
Weight is influenced by genetics, hormones, brain appetite signaling, sleep, stress, certain medications, and where and how people live and work. None of that is a character flaw.
No one is blamed for high blood pressure. Obesity deserves the same respect, and the same quality of care.
Care that targets health, not just weight
Treatment aims at what weight is doing to health: blood sugar, blood pressure, sleep, liver health, joints, mobility and quality of life. The AACE/ACE guidelines note that weight loss of about 5 to 10% can meaningfully improve many weight-related conditions, with larger losses helping some conditions more.[1]
The treatment toolbox
- Lifestyle therapy, meaning nutrition, physical activity and behavior support, is the foundation. The USPSTF recommends intensive, multicomponent behavioral programs for adults with a BMI of 30 or higher.[4]
- Anti-obesity medication may be added for adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition.[3]
- Metabolic and bariatric surgery is an option for some people with more severe obesity, through a surgical program.
Why “long term” matters
Like diabetes or high blood pressure, obesity tends to return when treatment stops. That doesn’t mean treatment failed. It means care continues, with adjustments as life and health change. Prevention works too: in people with prediabetes, a structured lifestyle program cut the incidence of type 2 diabetes by 58%.[5]
Sources and references
- Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22 Suppl 3:1-203. View source
- Emmerich SD, Fryar CD, Stierman B, Ogden CL. Obesity and severe obesity prevalence in adults: United States, August 2021–August 2023. NCHS Data Brief, no. 508. Hyattsville, MD: National Center for Health Statistics; 2024. View source
- Apovian CM, Aronne LJ, Bessesen DH, McDonnell ME, Murad MH, Pagotto U, Ryan DH, Still CD. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(2):342-362. View source
- US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et al. Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(11):1163-1171. View source
- Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403. View source
This answer is general education for adults and isn’t a substitute for a personal medical evaluation. Individual results vary. In an emergency, call 911.