Dr. Wood’s handout starts from a point many patients have never been told. Obesity is a chronic disease in the same way high blood pressure, diabetes and heart disease are, and it is common: the CDC found that 40.3% of American adults had obesity between August 2021 and August 2023 (CDC), and 19.7% of children and teens aged 2 to 19 did from 2017 to March 2020 (CDC).
Appetite runs on hormones
The body signals hunger and fullness through a set of gut and brain hormones. Dr. Wood’s handout names several — ghrelin, GLP-1, CCK, OXM, leptin and amylin — and notes that in many people with obesity those signals do not work the way they should.
“Appetite is regulated by hormones, not willpower or conscious thought.”
— Kelly Wood, MD, MSPH
When the signal to stop eating comes late or weakly, “just eat less” is advice to fight your own biology with no help.
Everything else that pushes weight up
Hormones are one part. Her list of contributors also includes:
- Emotional triggers and the emotional environment at home and work
- Your occupation and how much it lets you move
- Genetics
- Injuries that limit activity
- Medications that cause weight gain as a side effect
- Sleep habits
- Even the bacteria in your gut
What treating it actually involves
Nutrition changes, more activity and resistance training remain the core. But because obesity has so many causes, Dr. Wood treats the emotional, social and behavioral side alongside the food — and, when it is appropriate, adds FDA-approved medication. The goal does not have to be dramatic: according to the NIDDK, losing 5% to 10% of your starting weight may lower blood sugar, blood pressure and triglycerides (NIDDK).
That is the thinking behind medical weight management at Total Body Renewal: labs and a body composition scan first, then a plan that addresses the causes you actually have.