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Conditions

Weight-related conditions

Obesity rarely travels alone. These are the conditions most often improved by medical weight care.

Written by Dr. Richard Kowalsky, MD, board-certified in obesity medicine Last updated Sources cited Editorial policy

Obesity and overweight

A chronic disease affecting about 40% of US adults, defined in adults as a BMI of 30 or higher.[1]

Signs, assessment and care

What you may notice

  • Gradual weight gain over years
  • Fatigue or reduced mobility
  • Weight-related conditions developing

How it’s assessed

  • BMI and waist circumference
  • Review of weight-related complications
  • History, medications and labs

How weight care can help

  • Plan across nutrition, activity and behavior
  • Medication when criteria are met
  • Long-term follow-up

Prediabetes and type 2 diabetes

Blood sugar that runs high. A lifestyle program cut new type 2 diabetes cases by 58% in people with prediabetes.[3]

Signs, assessment and care

What you may notice

  • Often no symptoms at first
  • Thirst, frequent urination or fatigue
  • Darkened skin folds (acanthosis)

How it’s assessed

  • HbA1c and fasting glucose
  • Review of diabetes medicines
  • Kidney, eye and foot care reminders

How weight care can help

  • Weight loss improves blood sugar control
  • Some diabetes medicines also aid weight loss
  • Medicines that cause low sugar may need adjusting

High blood pressure

Blood pressure often rises with weight and often improves as weight comes down.[2]

Signs, assessment and care

What you may notice

  • Usually silent
  • Headaches only when very high
  • Found at routine checks

How it’s assessed

  • Repeated blood pressure readings
  • Home monitoring
  • Review of salt intake and medications

How weight care can help

  • Weight loss can lower blood pressure
  • Medicines may need to be reduced over time
  • Coordination with your primary care physician

Obstructive sleep apnea

Pauses in breathing during sleep, closely linked to excess weight.[2]

Signs, assessment and care

What you may notice

  • Loud snoring or witnessed pauses
  • Daytime sleepiness
  • Morning headaches

How it’s assessed

  • Screening questions
  • Referral for a sleep study
  • Review of CPAP use if diagnosed

How weight care can help

  • Weight loss can reduce severity
  • Better sleep supports appetite control
  • Ongoing sleep-specialist care

Fatty liver disease (MASLD)

Fat buildup in the liver linked to weight and insulin resistance.[2]

Signs, assessment and care

What you may notice

  • Usually no symptoms
  • Abnormal liver tests
  • Found on ultrasound

How it’s assessed

  • Liver blood tests
  • Imaging reports
  • Coordination with hepatology when needed

How weight care can help

  • Weight loss reduces liver fat
  • Alcohol guidance
  • Treatment of related diabetes and cholesterol

Polycystic ovary syndrome (PCOS)

A common hormonal condition often involving insulin resistance and weight gain.[4]

Signs, assessment and care

What you may notice

  • Irregular periods
  • Excess hair growth or acne
  • Difficulty losing weight

How it’s assessed

  • History and gynecologic records
  • Metabolic labs
  • Coordination with your gynecologist

How weight care can help

  • Lifestyle care for everyone with PCOS
  • Modest weight loss can improve symptoms
  • Medication planned around pregnancy goals

Weight changes in menopause

Fat gain speeds up and muscle declines during the menopause transition.[5]

Signs, assessment and care

What you may notice

  • Weight shifting to the waist
  • Loss of strength
  • Poor sleep and night sweats

How it’s assessed

  • Body measurements
  • Metabolic screening
  • Review of symptoms and medications

How weight care can help

  • Strength training and protein
  • Sleep care
  • Medication when appropriate

Joint pain and osteoarthritis

Extra weight adds load to the knees and hips, and pain limits activity.[2]

Signs, assessment and care

What you may notice

  • Knee or hip pain with walking
  • Stiffness
  • Avoiding activity because of pain

How it’s assessed

  • Activity and pain history
  • Mobility assessment
  • Coordination with orthopedics or physical therapy

How weight care can help

  • Weight loss can reduce joint load and pain
  • Low-impact activity plans
  • Strength work around the joint

Weight regain

The body’s hormonal response to weight loss pushes weight back up.[6]

Signs, assessment and care

What you may notice

  • Weight returning after a diet
  • Increased hunger after weight loss
  • Regain after stopping medication

How it’s assessed

  • History of past weight loss
  • Medication history
  • Review of life changes

How weight care can help

  • A planned maintenance phase
  • Activity and self-monitoring
  • Long-term medication for some people

Weight loss of about 5 to 10% can improve many weight-related conditions; some improve more with larger losses.[2]

Words you’ll hear

A short glossary of terms used in obesity medicine.

Body mass index (BMI)
Weight in kilograms divided by height in meters squared. A screening number, not a full picture of health. A BMI of 30 or higher is classified as obesity in adults.
Waist circumference
A measure of abdominal fat, which is more closely linked with metabolic risk than weight alone.
Severe obesity
A BMI of 40 or higher. In the latest CDC data it affects about 9.4% of US adults.[1]
Weight-related conditions
Health problems caused or worsened by excess weight, such as type 2 diabetes, high blood pressure, sleep apnea and fatty liver disease.
MASLD
Metabolic dysfunction-associated steatotic liver disease, the newer name for non-alcoholic fatty liver disease.
HbA1c
A blood test that reflects average blood sugar over about three months, used to diagnose prediabetes and diabetes.
GLP-1
Glucagon-like peptide-1, a gut hormone involved in appetite and blood sugar. Several anti-obesity medications act on its receptor.
Metabolic adaptation
Changes after weight loss, including shifts in appetite hormones and energy use, that make regain more likely.[6]

When to see a physician about weight

You don’t need to wait for a diagnosis. These are good reasons to ask for a medical weight evaluation.

  • Your BMI is 30 or higher, or 27 or higher with a weight-related condition
  • Your blood sugar, blood pressure or cholesterol is rising
  • You snore loudly or wake up unrefreshed
  • Joint pain is keeping you from moving
  • You’ve lost weight before and regained it
  • You have PCOS or are going through menopause and your weight is changing

Emergencies: call 911 or go to the nearest emergency room for chest pain, severe abdominal pain (especially pain spreading to the back, or with vomiting or fever), signs of severe dehydration such as confusion, fainting or very little urine, or very low blood sugar with confusion or loss of consciousness.

Sources and references

  1. 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
  2. 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
  3. 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
  4. Teede HJ, Tay CT, Laven JSE, Dokras A, Moran LJ, Piltonen TT, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469. View source
  5. Greendale GA, Sternfeld B, Huang M, Han W, Karvonen-Gutierrez C, Ruppert K, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. View source
  6. Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604. View source

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