Updates in Managing Obesity for World Obesity Day 2026, With Raghuveer Vedala, MD

Obesity remains one of the most significant public health challenges in the United States, affecting millions of adults and contributing to a growing burden of chronic disease.

According to the Centers for Disease Control and Prevention (CDC), more than 40% of US adults meet criteria for obesity, with nearly 10% classified as having severe obesity.¹ The condition is also increasingly prevalent among younger populations, with approximately 1 in 5 children and adolescents aged 2 to 19 years affected.¹ These trends have placed obesity at the center of national discussions on preventive health and chronic disease management.

The health consequences of obesity extend well beyond weight alone. Excess adiposity is strongly associated with increased risk for cardiovascular disease, type 2 diabetes, metabolic-associated steatotic liver disease, obstructive sleep apnea, and several forms of cancer.²

In recent years, clinicians and researchers have increasingly framed obesity as a complex, chronic disease influenced by genetic, metabolic, environmental, and behavioral factors rather than solely lifestyle choices. This shift in understanding has helped drive more comprehensive and multidisciplinary approaches to treatment.

The therapeutic landscape has also evolved rapidly with the emergence of glucagon-like peptide-1 (GLP-1)–based therapies. Agents such as semaglutide and the dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist tirzepatide have demonstrated substantial and sustained weight reduction in clinical trials, marking a significant advancement in pharmacologic treatment options for obesity.³ These medications work by targeting metabolic pathways regulate appetite, satiety, and energy balance, offering clinicians additional tools beyond lifestyle modification alone.

Despite these advances, experts emphasize effective obesity care still requires a comprehensive strategy, including nutrition counseling, physical activity, behavioral support, pharmacotherapy when appropriate, and, in some cases, bariatric surgery. With primary care clinicians frequently managing the chronic conditions associated with obesity and maintaining long-term relationships with patients, they are uniquely positioned to identify weight-related risks, initiate treatment discussions, and coordinate multidisciplinary care aimed at improving long-term health outcomes.

In recognition of World Obesity Day, Patient Care Online sat down with Raghuveer Vedala, MD, assistant professor of Family and Preventive Medicine at the University of Oklahoma College of Medicine and a clinical physician in the Norman Regional Health System, to discuss the management of obesity and scope of the issue as a public health crisis.

Q&A with Raghuveer Vedala, MD, on Obesity Management

Patient Care Online:
Given the stigma around the condition, how do you counsel patients to avoid feelings of guilt or shame and to reframe obesity as a preventable disease?

Raghuveer Vedala, MD:
So I think the first thing we’ve got to do is address weight bias. It’s a hard subject, like you said, to somewhat talk about. In my realm, I am a primary care physician first and foremost, and then I have my weight loss practice. But I’m kind of used to asking for permission before we talk about anything, and I think that’s a really easy way to approach it.

For example, when someone comes in and it’s a visit where you’re just doing a routine follow-up on their chronic conditions, but then you notice that their mood has been down, you ask for permission. Like, “Hey, I saw your depression screen today. Can we talk about this? Is that okay?” And you can do the same thing with weight.

If we approach it from a sense of compassion, I think patients are a lot more open to talking about it. Sometimes it’s as simple as saying, “We’ve been talking about your high blood pressure for a while now, but I noticed we’ve been tracking your weight and it’s been going up. Is it okay if we talk about it?”

Sometimes I think the word obesity even has some negative connotation to it. With my patients, I often just call it weight and talk about how weight could be the root cause of some of these chronic conditions. Just like we treat blood pressure as a vital sign, if we can learn to treat weight the same way and talk to our patients about the choices and tools that are available, then we can work together on lifestyle changes. And that’s the goal and the hope for a healthier country.

Patient Care Online:
Do you believe that the level of interdisciplinary work currently being done on a broader scale is enough to address the growing issue? If not, how could it be improved?

Raghuveer Vedala, MD:
That’s a great question. I think there definitely has been a shift toward more interdisciplinary work. You can see it not even just in the clinical sense. Patients are a lot more aware now, and we even see it on things like social media.

For example, this concept of prioritizing protein has become more common with newer dietary guidelines. You can even get protein in coffee now—Starbucks is selling it. But I think what’s happening is that we’re becoming more aware of how much weight contributes to comorbid conditions.

It’s not just primary care anymore. We see cardiologists starting GLP-1 therapies in patients because we understand that weight is often a root cause. We know the cardiometabolic risks that come from excess weight are significant, and weight management has even been included in newer blood pressure guidelines.

The more we research how much weight contributes to disease, the more we see it affecting different specialties. For example, in gastroenterology, physicians deal with the liver as well as the colon and esophagus, and we know fatty liver disease—what we now call metabolic-associated steatotic liver disease—is strongly influenced by weight. Medications like semaglutide have even received approvals related to metabolic liver disease and are commonly started for weight loss.

And it doesn’t end there. We’re looking at this in rheumatology, where weight reduction may help autoimmune disease outcomes, and even in psychiatry, where some studies are exploring whether weight reduction could help reduce rates of depression.

So I think we are becoming more aware. Some of that awareness may also come from the financial and global impact of the new GLP-1 medications and how much attention they’re getting. But the side effect of that is that people are more aware now, and weight management is becoming more of a front-page issue. We’re trying to work as a team rather than just saying, “Talk to primary care, eat less, and exercise more.” We now know it’s much more multifactorial, and I think that’s a great step in the right direction.

Patient Care Online:
How do you generally choose between lifestyle interventions and pharmacological treatments when dealing with obesity or overweight?

Raghuveer Vedala, MD:
So from our perspective, especially through the Obesity Medicine Association (OMA), one of the things we talk about is the four pillars of obesity medicine: diet and exercise, behavioral therapy, medical intervention, and finally bariatric surgery.

One thing we want patients to understand is that when we start medications, it’s not a replacement for lifestyle changes. It’s meant to be adjunct therapy. Patients tend to have better outcomes if they tailor their lifestyle in addition to taking medications.

For example, when someone has high blood pressure, we may put them on blood pressure medication, but we’re also telling them to get regular cardiovascular exercise and reduce their salt intake. Similarly, with weight management, we still emphasize lifestyle changes.

We talk about proper nutrition, increasing protein and fiber intake, and getting regular exercise—both cardiovascular activity and strength training. Strength training is important because as we lose weight, we can also lose muscle mass, and we want to retain that muscle mass.

Even when patients do all of this, they may not always reach their weight-loss goals. They may reach what we call a set point where weight loss stalls. At that point, medications can be used as an additional tool alongside lifestyle management to help them reach their goal weight.

So medications are more of an adjunct benefit rather than something that should be used alone. Even if someone used medication alone, they wouldn’t get the full benefits. Many of these medications also have side effects, such as constipation, and lifestyle changes like improved diet and physical activity can help mitigate those side effects.

Patients also need to meet certain criteria before we can discuss medication management. For example, a BMI above 30, which is considered class 1 obesity, or a BMI above 27 with at least 2 comorbid conditions related to weight, such as prediabetes, high cholesterol, or high blood pressure.

Patient Care Online:
What advice would you give clinicians currently dealing with obesity in their clinics? What strategic changes can be enacted today that will help better address the condition?

Raghuveer Vedala, MD:
First of all, if clinicians are interested in diving deeper into weight management or treating obesity, I think it’s a good idea to become certified through the Obesity Medicine Association. That allows clinicians to learn more in depth about the pharmacology and pathophysiology of obesity, which can help them better counsel patients.

Otherwise, it can be as simple as learning about these medications and learning how to talk to patients about weight. If that’s not feasible in a clinic setting, clinicians can always refer to obesity medicine providers, endocrinologists, or other specialists who are already trained and managing these conditions.

Beyond that, I think even just taking five minutes during a visit can make a difference. I know clinicians have many things to cover during appointments, but simply mentioning weight with compassion can at least start the conversation.

When I work with residents and students in my clinic who may not feel fully comfortable with the topic yet, that’s what I encourage them to do—just start the conversation with the patient. Talk about weight, and if you’re unsure what steps to take next, it’s okay to look things up, ask for help, or refer the patient.

Medicine is always evolving, and we’re constantly learning new things. The goal is to help our patients, and collaboration is part of that process. The benefit is that in the process of helping patients, clinicians are also learning something new that they can apply to the next patient they see. So I think it really starts with a small spark of interest, 5 to 10 minutes of time, and beginning that conversation with patients.

Editor’s Note: Vedala has no relevant disclosures to report.

References

1. Centers for Disease Control and Prevention. Adult obesity facts. Updated May 2024. Accessed March 4, 2026. https://www.cdc.gov/obesity/data/adult.html
2. Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021;143(21):e984-e1010. doi:10.1161/CIR.0000000000000973
3. Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002. doi:10.1056/NEJMoa2032183