I have been overweight since I was 9 years old. My struggle with my weight has affected almost all aspects of my personal and professional life. It has degraded my self-image, my relationships, and my health. There is something about obesity that adds an extra layer of complication because it is a disease that you can see.
My experience with obesity is comparable to suffering with a giant tumor on my face everyone can see. I have a list a mile long of the moments of shame and disgust I have felt from suffering from this disease. Moments of unrequited love, derogatory comments from a work supervisor or a husband, that moment I couldn't fit on the rollercoaster with my little girl or I had to ask for a seatbelt extender on the airplane. I spent hundreds of dollars on weight loss programs, food, medicines, and supplements to try to help. I worked out. I ate healthy. The weight stayed on. Nothing seemed to work and if it did it wasn't sustainable.
Unfortunately, over the years, the disease became part of my identity and something I just accepted as part of me. I would say things like, "I'm just going to be fat and happy", or "this is just who I am and people can like it or hate it." Instead of fighting against it, I embraced it. I made fat jokes about myself. I only made friends with other obese people. I stopped working out. I stopped eating healthy foods. I let it take me over. I couldn't walk more than 50 feet without getting short of breath. My back ached constantly. My legs were swollen. I couldn't sleep and had to wear a CPAP to rest. I was clinically depressed. The struggles with this disease continued to manifest in every glance in the mirror, every glance from a bystander at the gym, every kiss from my husband...my shame had taken over my life and I was suffering. Physically, emotionally, and mentally suffering.
Gone are those days.
Obesity is not who I am. Obesity does not control me. Obesity no longer has to be my story. Obesity is just my chronic disease and now I have the tools to treat it.
Obesity is a chronic disease. Let me say that again.....IT IS A CHRONIC DISEASE.
It is not my food choices.
It is not my heritage.
It is not my lack of motivation.
It is not my laziness.
It is not my source of shame (anymore).
It is NOT MY FAULT.
I watch many of my patients struggling with chronic diseases and always feel compassion for them. The diabetic has to keep watch on her blood sugar. The patient with celiac can't eat gluten (it's in so much!). My patient with asthma who can't breathe. These are all chronic diseases that my patients suffer with. I have an extreme amount of compassion for my patients suffering from these diseases because it isn't their fault. For reasons laid out here obesity doesn't get this kind of compassion. When other people and even other doctors see a patient with obesity the compassion fades away. The response is frustration, judgement, disgust, and just overall disdain.
To help us understand why I want to use an illustration from one of my favorite children's books: "You Are Special" by Max Lucado. It tells the story of the Wemmicks, small wooden people created by a woodcarver named Eli. The Wemmicks spend their days giving each other stickers—gold stars for those they admire and gray dots for those they don't. The main character, Punchinello, struggles with feelings of inadequacy and receives many gray dots because he is clumsy. All the other Wemmicks give him lots of grey dots because he isn't doing things right. He can't help that he is clumsy but he just keeps getting more and more grey dots. I've gotten lots of grey dots because of having obesity.

Feeling down, Punchinello meets a Wemmick named Lucia, who has no stickers at all. Whenever anyone tries to stick a sticker onto her they just fall off. Intrigued, he learns that she doesn't care about others' opinions because she knows she is loved by Eli (the maker). Inspired by Lucia's confidence, Punchinello visits Eli, who reassures him of his worth and uniqueness, emphasizing that true value comes from within and from being loved by the creator. Eli can keep the stickers from sticking if he goes and visits Eli every day. The book is a great lesson in focusing on inner beauty and our identity as sons and daughters of God. We get so wrapped up in the opinions of others it is easy to lose focus on who we truly are.
My point? There is no changing how humans will interact. Until the end of time, we will all judge each other. We will all try to stick gold stars or grey dots on each other. There may be no cure for my obesity. I'll have it my entire life. I'll get grey dots. I have been on treatment with a GLP-1 now for the last 14 months and have lost 80 pounds. Even now, since I have lost weight, people compliment me. Of course everyone always asks: "how did you do it?" When I say I'm finally on the right treatment and getting help by using a GLP-1, they still have this kind of "look" of judgment that I am using medication to treat my disease. I had one person tell me the medicine was just a "crutch" and I should just eat better. However, I'm not letting the grey dots stick on me anymore. That person doesn't understand the physiology of my disease and the years I spent "just eating better" and has bought into stigma and mis-information associated with obesity. What they think doesn't matter. This just gives me a great opportunity to do some graceful education with them about the disease of obesity and the grey dots just fall to the ground. My medicine isn't a crutch...it is a tool and a treatment for my disease. Do we call insulin for a diabetic a crutch? No, we do not. That is not what treatments are. Treatments are management and care to prevent, cure, ameliorate, or slow progression of a medical condition. The medical condition of obesity.
Your identity is not in this disease. Your identity is a son or daughter of the most high God who loves you and sees you. He knit you together and he made you. We live in a broken and sinful world. One of the greatest sources of suffering in humanity is chronic disease. My obesity means my body is broken...but I'm still God's. This disease no longer defines who I am. That is the most important thing anyone with any chronic disease needs to understand. The disease doesn't define you. Remember whose you are.
Now, to the science.
The treatment of obesity has four pillars that work together to form a foundation for successful treatment, laid out by years of research and the American Obesity Association. The goal is not just weight loss but maintenance of weight.

Nutrition: Nothing fits everyone. Some people do better with low carb, others with low fat. Some people do amazing with calorie counting, and others need to focus on macros and intermittent fasting. The goal is to make small changes over time that are sustainable in the long term. Cut out one soda or bag of chips. Limit yourself to one glass of wine a week. These are little changes you can stick with. Medical interventions make this pillar much easier to incorporate.
Physical activity: Walking, cycling, dancing in your living room- whatever makes you happy. One important activity during the weight loss phase of treatment is resistance training at least 3 times a week. This can be as simple as resistance band use at home. Resistance band chair exercises can be found on YouTube and are easy and quick. Studies have shown losing weight without incorporating resistance training can keep your muscle loss under 10%. If not using resistance training you may lose up to 50% of your muscle mass. We want you to burn fat and not muscle.
Behavior: This can include many aspects, but sleep, mental health, and spiritual health are huge. Anything less than 7 hours of sleep at night increases a hormone called cortisol in your body. Higher levels can cause weight gain and make it very hard to lose weight. Things like untreated obstructive sleep apnea can contribute to this as well, so get screened and get treatment for this if you think you may be suffering from a sleep condition. Good mental and spiritual health is also important when changing your behavior. Many patients suffer from food/sugar addiction and an unhealthy relationship with food, and many have suffered abuse and stigma of this disease over many years. Not addressing this aspect of treatment is a mistake. Therapy can help, specifically cognitive behavioral therapy for weight loss. With treating and addressing mental health issues your sleep also improves, promoting weight loss. Spiritual attack can come as you try to treat this disease so staying in prayer and meditation is important as you move through treatment. As your body changes and habits change you move into an overall state of feeling more energy and more encouragement and it is important to stay focused and spend time in prayer and worship if this is something that is part of your life. Taking time for self care and doing things that bring you joy are important in getting your focus onto your health and well being.
Medical Interventions: In my days at Emmanuel University our campus pastor Tracy Reynolds used to talk about "tools in our toolbox" to live a healthy spiritual life. Medications and surgical interventions are just "tools in the toolbox" to treat obesity. There has been an introduction of newer meds into this class in the last few years that have been revolutionary for a lot of patients when it comes to weight loss. 12-40% body weight loss has been seen with the newer class of meds called GLP-1 agonists. These meds bind to receptors on your stomach and small intestine to slow down your digestion and help you feel full longer. Studies have shown that patients with obesity have very low levels of this hormone compared to people without obesity. Like many other obesity treatments from the past, the effects don't wear off, and they keep working for as long as you take them. If you decide to use them, you should understand that they are meant for long-term use. While not all patients will need to stay on them forever, most patients will need a dose in the maintenance phase to continue to benefit from the hormonal balance of the drug.
Over the last few years, I have changed the focus of my medical career to work tirelessly to define obesity as a disease and not a personal flaw. As a doctor who suffers from obesity, I know I have a unique perspective and I hope this article has helped you. I hope you will continue to talk about obesity and you will continue to show grace to others who continue to perpetuate the lies and stigma associated with this disease. If you don't have obesity I hope you will change how you view this condition and offer more compassion to those suffering. Share this post, educate your friends and family, and most importantly stick less dots.

What a beautiful article. I appreciate your transparency and candor. I'm intrigued by your openness to using all the tools available rather than sticking gold stars on some and grey dots on others. Thank you.