Obesity Is a Chronic Disease—Start the Conversation in Primary Care, Says Monu Khanna, MD

In this interview with Patient Care Online, Monu Khanna, MD, urges primary care physicians to approach obesity as a chronic, treatable disease—and to begin addressing it proactively during routine patient visits. Dr. Khanna discusses the importance of documentation, non-stigmatizing communication, and setting realistic expectations with patients at different life stages. She emphasizes that tackling obesity early, and with compassion, can help reduce the risk of associated cardiometabolic diseases like hypertension, diabetes, and cardiovascular disease. Her key message: prevention begins with honest conversation and personalized care.

Patient Care: What recommendations would you give to physicians—including primary care physicians—regarding the prevention and management of obesity-related cardiometabolic diseases?

Monu Khanna, MD: As we now know, obesity is a chronic disease. It has to be acknowledged, it has to be addressed, and it has to be documented. If we don’t document it as a separate problem, it’s unlikely to get the attention it deserves.

If unhealthy weight is at the root of high blood pressure, cardiovascular disease, and diabetes, then addressing weight—looking at things through an obesity-related lens—allows us to impact all of those chronic conditions.

It starts with a non-stigmatizing, inclusive discussion, where weight isn’t considered a taboo subject. You should feel comfortable talking about it and educating your patients that there’s no need to fear weight-related concerns. There are strategies, support teams, and many effective medications now available for weight management.

It’s also important to set realistic expectations. For example, as women go through different physiological stages—such as back-to-back pregnancies or menopause—there may be periods of significant weight gain. Patients need to know that these are natural, expected phases of life.

For men, we often see weight gain after retirement. Their eating habits may stay the same, but they’ve become more sedentary, which increases cardiovascular risk. These are key moments when weight should be addressed through honest conversations and appropriate screening.

And again, obesity is a disease—just like diabetes or cancer. There are treatment options, and there are specialized physicians and healthcare providers who can help. Addressing obesity meaningfully can significantly improve a patient’s physical, mental, and emotional health.