With the recent studies demonstrating that weight management medication semaglutide (Wegovy) reduces cardiovascular events and is an effective treatment of heart failure (HFpEF), there is now much discussion around what this means for the cardiology community in terms of treating obesity.


Historically, there have not been many doctors of any discipline that were comfortable to help patients manage their weight.  This is due to many factors, including far too little education about obesity for health care professionals, a bias and stigma on the part of doctors thinking it’s their patient’s own fault (ie not understanding the biology of appetite and weight regulation), not knowing how to open the conversation around weight, not knowing how to advise patients (beyond ‘eat less, move more’ which is not helpful), minimally effective/difficult to access weight loss medications, and time constraints in clinic.


There are over 200 health conditions associated with obesity, including conditions of every organ system.  The majority of adults in most developed countries carry elevated weight.  Thus, pretty much all health care providers will see patients with ailments related to elevated weight.


Thus, while there is particularly compelling new evidence that should compel cardiologists to engage in treating obesity, all health care providers need to engage in treating obesity.  When a person presents to a health care professional with a health issue related to elevated weight, it is (never was) simply not acceptable to ignore or overlook the weight issue. Obesity is not simply a concomitant issue – it is often a cause or contributor to a patient’s presenting complaint.  


While we are making headway with doctors’ comfort in discussing and treating obesity, we still have a long way to go.  A physician should not prescribe a treatment or manage a health condition they are not comfortable with – that’s where the education  comes in.  All health care professionals need to learn about effective weight management, as well as the use of appropriate treatment strategies, in their practices.  And remember, it’s ok to ask for help!  Just as I (as an endocrinologist and obesity medicine specialist) would not feel comfortable to manage the nuances of blood thinners in cardiac patients, it is a-ok for a doctor newer to the obesity treatment field to reach out to an obesity expert for help and guidance, with a view towards eventually becoming comfortable to manage the condition themselves.


This, my friends, is one of the many reasons I write this blog – to help educate and disseminate knowledge, empowering health care professionals and people living with obesity towards understanding and treating this medical condition.


Disclaimer: I am an investigator in clinical trials of semaglutide.  I receive honoraria as a continuing medical education speaker and consultant from the makers of semaglutide (Novo Nordisk).


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