Obesity

What it is

Obesity is a chronic disease with multiple causes, characterized by an accumulation of body fat that affects health. It isn't simply a lack of willpower: genetics, hormones, sleep, medications, environment and a history of restrictive dieting all influence weight and how the body defends it. Obesity increases the risk of diabetes, hypertension, sleep apnea, joint problems, infertility and certain types of cancer. Treatment with the endocrinologist starts with a thorough, non-judgmental evaluation and combines diet, physical activity, attention to sleep and mental health, and, when indicated, medication or surgical referral, always with realistic goals and ongoing follow-up.

Most common symptoms

• Body mass index of 30 or higher
• Increased waist circumference
• Fatigue and shortness of breath on exertion
• Joint pain, especially in the knees and spine
• Snoring and unrefreshing sleep
• Menstrual changes and difficulty getting pregnant

Causes and risk factors

• Genetic predisposition and family history
• A high-calorie diet and a sedentary lifestyle
• Hormonal disorders, such as hypothyroidism and polyendocrine metabolic ovarian syndrome (SOMP)
• Use of medications that promote weight gain
• Insufficient sleep, stress and emotional issues
• A history of very restrictive diets with rebound weight gain

How it is diagnosed

The evaluation begins with the patient's weight history over her lifetime, eating habits, sleep, physical activity, current medications and previous weight-loss attempts. The physical exam measures weight, height, body mass index, waist circumference and blood pressure, and bioimpedance estimates the proportion of fat and muscle mass. Lab tests check glucose, insulin, cholesterol, thyroid function, liver function and other hormones, to identify the causes and consequences of excess weight. When there is loud snoring or excessive sleepiness, the endocrinologist may order a sleep apnea workup.

How we treat it at Femi Saúde

Treatment is individualized and long-term. The foundation is habit change with achievable goals: guided nutrition, progressive physical activity, regular sleep and psychological support when needed. Medications for obesity may be indicated when lifestyle change alone isn't enough, always taking the patient's health conditions and preferences into account. Bariatric surgery is discussed in cases of more severe obesity or when associated diseases are present. Throughout the process, the endocrinology team at Femi Saúde monitors body composition to preserve muscle mass, and treats associated conditions such as diabetes and high cholesterol.

What we offer