Obesity and Health: What Doctors Want You to Know

I was a normal weight in college and could eat whatever I wanted. Dancing was my hobby and I did it for hours a day. But when I went to medical school, I traded in my dancing shoes for my studying sweats. The time I once spent moving was now spent sitting, and because of all the stress of school, my eating habits became a little less healthy. Comfort foods like Big Macs and Oreos got me through all-nighters about physiology. 

That was the beginning of my struggles with obesity, a health condition that affects 42% of Americans, according to the Centers for Disease Control and Prevention. People who are obese have a body mass index (BMI) over 30; BMI is a measure of the ratio between height and weight. Hypertension (high blood pressure), high cholesterol, type 2 diabetes and sleep apnea are all conditions associated with obesity. 

These conditions are all risk factors for heart disease, which is the No. 1 cause of death in the U.S. Obesity is also associated with a marked decline in life expectancy, from three to 13 years less life, depending on a number of other factors, like sex, age and smoking status. For many people who are obese, reducing weight can be a powerful and safe way to improve overall health and increase life expectancy. 

For me, unhealthy weight gain happened gradually and in a way where I didn’t even notice it myself. I’m about 5’4”, and, in college, I weighed about 120 lbs, meaning I had a pretty healthy BMI of about 20. In medical school, I didn’t notice my transformation until a friend pointed it out, and by that time I was up to 190 lbs for a BMI of 32.5. That’s when I started trying different diets and health programs. I tried Weight Watchers, and various low-carb or low- calorie diets, but even when I managed to lose weight, it always came back. 

Fast forward 15 years and throw in a happy marriage and three kids. By the time I gave birth to my youngest, I weighed 220 lbs (BMI: 37.8). My blood pressure and cholesterol were up above healthy levels, and I had sleep apnea, meaning my breathing would stop and start without notice while sleeping. It’s a potentially serious condition that can contribute to high blood pressure, fatigue, and heart problems, among other negative health outcomes. I wore a sleep apnea mask every night and I was tired every day. I didn’t have a ton of energy to play with my kids, and I was starting to develop back and joint problems from the wear and tear of carrying more weight around than my 5’4” frame could easily support. 

As a doctor, I knew intuitively that overeating and lack of activity were contributing to the problem, but I found it hard to break my unhealthy habits. I’m the kind of person who is always hungry, and being a doctor is hard work; it’s not always easy to make healthier decisions when you work so hard. And, as a doctor, I knew that it was about much more than a number on a scale: I was hurting my overall health.

So, when K Health announced internally that it was launching a new program to manage weight loss through prescribing a class of promising new medications while also managing associated chronic conditions like hypertension and type 2 diabetes, I raised my hand to participate as both a doctor and a patient. At K Health, we are serious about the way we care for our  patients. We go through rigorous planning and testing before we introduce a new area of coverage for our practice. We need to make sure our patients are getting the best and safest care possible. What’s great about this program is that it’s not just about losing weight; it’s about whole health, caring for you when you’re healthy, when you’re sick, managing chronic conditions, and being there for you as your doctor, whenever you need it. 

I was the first K Health patient who started on Ozempic, one of three medications we now prescribe for obesity (the others are Saxenda and Wegovy). Ozempic is the brand name for a medication called semaglutide. It comes as an injection that you administer yourself once a week. That may sound a little scary, but the device makes it easy: You just put the tiny needle against your skin and press a button and it’s over in an instant with just a little pinch. 

I’m 39 years old now, and when I started the medication, I weighed 168 lbs. Ten weeks later, I’m down to 146. In addition to taking Ozempic, I’m eating a healthier amount and staying more active, primarily by getting my step count up and playing with my kids more, which is something I now have a much easier time doing. I have more energy and just generally feel healthier. My friends and husband have all noticed and I’m wearing clothing that I haven’t fit into in years. Importantly, I’m starting to see noticeable health benefits: Two weeks ago, I stopped having to use my sleep apnea mask. 

How Does Ozempic Work? 

Ozempic is a medication used to treat type 2 diabetes. It increases insulin production. It also has been found to help with weight loss. Although the exact mechanism is unclear, Ozempic decreases appetite and keeps the stomach full for longer, which decreases hunger. Since I started it, it’s hard for me to finish all the food on my plate which is a new and welcome change for me. 

With the use of this medication to treat obesity, success is defined by weight loss of at least 5% of initial weight in three months. That may not sound like a lot, but consider that this weight loss is expected even if you don’t try diet and weight loss in conjunction with the medication.

That said, if you couple Ozempic with diet and exercise, you may see better results. In a clinical study of Ozempic conducted by the medication’s manufacturer Novo Nordisk, participants lost about 10% of their body weight after about 16 months. In this trial, the participants also modified their diets and added exercise to their routines. 

There are people who have achieved much better results than that. The Hangry Woman, a YouTuber who has vlogged about Ozempic who also has latent autoimmune disease in adults (LADA), a type of diabetes, has lost 13% of her body weight in six months. She has also seen her A1C reduce to 7% from 10% before she started the medication. While these results are not guaranteed, my personal story has confirmed my own optimism about the medications: I’ve lost 13% of my weight in 10 weeks, and I can’t wait to have my lab tests and vital signs retaken by my primary care physician at K Health, because I know, just based on how I’m feeling, that I’m going to show real improvement. 

It’s important to note that Ozempic and other similar medications do have some side effects that some people experience, including bloating, diarrhea or constipation. During the usual course of treatment, our strategy is to slowly increase the dosage of the medication, but doing that can sometimes trigger or intensify these side effects, so we monitor patients closely throughout the process to make sure they are okay. Sometimes we even decrease dosage if the side effects become unbearable. In my case, I have so far not experienced and side effects. I started at 0.25 mg for my first four weeks. I increased to 0.5 mg and was at that dosage for four weeks. Now I’m taking 1.0 mg and will probably stay on this dose for as long as I continue to lose weight, before considering increasing to the maximum dose of 2.0 mg.

How Does the K Health Weight Loss Management Program Work? 

It’s important to know that this is not strictly a “weight loss” program. At K Health, we’re here to manage your whole health. There are many health conditions associated with obesity, and if you have a BMI over 30, there is a good chance you have high blood pressure or that your cholesterol is high. Reducing your weight is a fantastic way to address these issues. 

Here’s how it works: 

First, we determine if you meet the criteria for the program, which include: 

• Have a BMI over 30
• Or, have BMI over 27 with at least one weight-associated comorbidity, like hypertension, diabetes or high cholesterol
• Have been unable to lose weight with lifestyle modifications alone

We also disinclude people who have: 

• Had bariatric surgery, including bypass, sleeve or lap band
• Are pregnant or breastfeeding
• Have had thyroid disease
• Have a history of disordered eating

If you qualify, the next step is a visit with a physician to discuss your overall health, other conditions and obesity. We then order blood tests, which you need to complete on your own at a local lab. The purpose of the tests is to establish baseline levels of things like cholesterol, fasting blood sugar, and A1C, while also checking for other factors that might mean the program isn’t right for you, like abnormal thyroid function or high triglycerides. At K Health, we have a partnership with Quest Diagnostics for more affordable lab testing; the company has about 2,000 locations across the U.S.

The next step is a follow up visit with your primary care physician at K Health to go over your lab results and to discuss management of other chronic conditions you may have that are associated with obesity. After your doctor writes you a prescription for one of the obesity medications we prescribe, our care team will help you with the process of getting prior authorization from your health insurance to pay for the medications. Ozempic and others can cost more than $1,000 a month if not covered by insurance, so K Health works with you closely to get the required information over to your insurance company to secure coverage. 

Many of our patients are able to obtain prior authorization and the whole process, from first visit to picking up your medications can take as little as a week or two, depending on how quickly you get your labs and schedule follow up visits. 

After that, it’s once-weekly injections with monthly follow ups to make sure you are responding to the medication and there are no intolerable side effects. As determined by your doctor, the dose will be slowly raised to get the best results. No further labs are needed unless there seem to be abnormalities that require follow up.

What Do You Need to Do to Get Started? 

Online medical weight loss management with K Health is a whole-body health program that is about improving your health and managing chronic conditions through healthy, sustainable weight loss. Getting started is as easy as clicking here and then selecting “I am interested in weight management” on the next screen. 

Your appointment will be virtual, confidential and easy. Starting on Ozempic and feeling better than I have in years is one of the best decisions I’ve ever made and I’m so excited for us to offer the same to you.