The importance of weight discrimination for people with obesity has been highlighted by research which has found that more than 40% of those living with obesity have experienced weight discrimination. Evidence suggests that weight bias among obese individuals puts their health at risk more than health issues caused by obesity itself.Although bias, stigma, and discrimination towards individuals living with obesity are factors that make it difficult for them to lose weight, weight bias and stigma among healthcare professionals are common, causing individuals living with obesity to avoid treatment and potentially exacerbating obesity-related health issues. The concept that one's own efforts matter contributes to stigma, discrimination, and bias. This issue will be more frequent among primary care providers treating individuals living with obesity; thus, it is important to acknowledge the issues of bias, stigma, and discrimination towards individuals living with obesity and to seek out solutions. In this review, I will discuss the concept of weight bias, stigma, and discrimination, the problems they cause, and seek solutions to weight prejudice, stigma, and discrimination.
Compensatory changes in energy consumption and neuro-hormonal changes following weight loss make it difficult to maintain the reduced weight and may cause weight regain. Therefore, establishing a long-term weight control plan and strategy starting from the initial weight loss period is necessary. Both the patient and doctor should know that weight loss cannot occur continuously, and that maintaining weight after the weight loss period is the basic course of obesity treatment. No single dietary pattern is effective for weight maintenance, and a variety of dietary control methods — such as calorie restriction and healthy proportions of carbohydrates,proteins, fats, and meal replacements — should be used to target an integrated and healthy dietary habit. An increase in physical activity is needed for weight loss and maintenance; however, rather than recommending an excessive amount of exercise,it is better to set realistic and long-term achievable goals. It is necessary to reset the goal according to the patient's weight maintenance stage and continuously apply behavioral therapies, such as self-monitoring and stress management. In previous studies, since the degree of weight loss and changes in behavioral patterns over the course of one year were important factors in maintaining long-term weight loss, obesity therapists should closely examine patient data and behavioral patterns across a period of one year and actively intervene when needed.
Nutrition counseling and dietary intervention are essential to obesity management because weight reduction is the consequence of negative energy balance. The first step of the nutrition counseling in patients with obesity is thorough evaluation of the nutritional status. During the nutritional evaluation, amount of energy consumption, dietary habits, and medical and socioeconomic factors influencing diets should be evaluated. Diet interventions including low calorie diet, low fat diet, low carbohydrate diet, and high protein diet are all effective in weight reduction as long as decrease in energy consumption is accompanied. Amount of energy restriction and choice of diet interventions should be individualized based the medical condition and characteristics of each patient.
Obesity is a major public health problem worldwide, with several methods having been proposed as a means of weight loss. If diet, exercise, and medication are insufficient, a healthcare professional may suggest weight loss treatments, including bariatric surgery or medical devices. Antiobesity medical devices are an option for patients who do not want to undergo bariatric surgery. Compared with bariatric surgery, medical devices have the advantage of being reversible and easier to operate. The U.S. Food and Drug Administration (FDA) regulates medical devices, including those used for weight loss and weight management. This article provides an overview of the FDA-regulated weight loss and weight management devices.
Early evaluation of obesity is important. Obesity is defined as an excessive accumulation of fat that causes harm to health. Among patients who visit a hospital for weight-related issues, diseases other than body fat gain may be present; however, people often cannot distinguish between these issues and concerns. Therefore, among patients who visit the hospital with weight gain concerns, it is necessary to determine whether the weight gain is actually the result of excessive fat accumulation. After being diagnosed with obesity, the cause and degree of obesity, the amount and distribution of body fat, and the degree of risk should be evaluated. Additionally, obesity-related complications should be identified and, even if there are no complications, all related risk factors should be evaluated and managed. In all these processes, diagnostic methods such as history taking, physical examination, body fat measurement, blood tests, and imaging tests are necessary, but history taking and physical examination, which can provide a lot of information from the beginning, should not be overlooked.
Familial hypercholesterolemia (FH) is a genetic disease that is not well known or diagnosed in Korea. This disease is associated with persistently high levels of lowdensity lipoprotein cholesterol (LDL-C), which increase the risk of coronary artery disease at a young age. Therefore, early diagnosis and treatment are important; however, there are no global consensus diagnostic criteria. In Korea, the Dutch Lipid Clinic Network diagnostic criteria, and the Simon Broome diagnostic criteria were used for diagnosis of FH according to the agreement announced at the Korean Society of Lipid and Atherosclerosis (KSoLA) in 2022. Recently, the absence of coronary artery calcification has been considered a good prognostic factor, even among patients with very high LDL-C levels who are considered to be at high risk for atherosclerotic cardiovascular disease. We describe throughout this paper the diagnosis and treatment of FH in a young male without coronary artery calcification.