ConditionICD-10: E66.9

Obesity

A chronic medical condition characterized by excessive body fat that may impair health.

Key facts

•42.4% of US adults have obesity (CDC, 2024)
•GLP-1 medications can reduce body weight by 15–22% over 12–18 months
•Wegovy and Zepbound are FDA-approved for chronic weight management
•Compounded semaglutide/tirzepatide offer lower-cost alternatives via telehealth
•Obesity is recognized as a disease by the AMA (2013) and WHO

Why GLP-1 medications

GLP-1 receptor agonists slow gastric emptying, increase satiety, and reduce hunger signals — making them the most effective non-surgical treatment for obesity. Phase 3 trials (STEP for semaglutide, SURMOUNT for tirzepatide) show sustained weight loss greater than any prior medication class.

Common symptoms

BMI ≥ 30 (calculated as weight in kg ÷ height in m²)
Excess body fat especially around the abdomen
Difficulty with everyday physical activity
Shortness of breath, fatigue, joint pain
Sleep disturbance (snoring, sleep apnea)
Skin issues in fat folds (intertrigo, acanthosis nigricans)

How obesity is diagnosed

BMI is the standard screening tool: BMI 25–29.9 = overweight, ≥30 = obesity (class I 30–34.9, class II 35–39.9, class III ≥40). BMI has limits (does not distinguish muscle from fat) so clinicians may add waist circumference, body composition, or metabolic labs. Class III obesity is sometimes called "severe" obesity and may qualify for bariatric surgery or higher-intensity treatment.

Treatment options

Lifestyle (first-line)

Diet (Mediterranean, low-carb), exercise (150+ min/wk moderate intensity), behavioral therapy. Average weight loss: 5–10% body weight over 12 months.

GLP-1 medications

Wegovy (semaglutide), Zepbound (tirzepatide) FDA-approved. Average loss: 15–22% body weight. Long-term use required to maintain loss.

Other anti-obesity meds

Contrave (naltrexone-bupropion), Qsymia (phentermine-topiramate), Saxenda (liraglutide), Plenity (hydrogel device). Less effective than GLP-1s, but cheaper or simpler.

Bariatric surgery

Gastric sleeve, gastric bypass. Best for BMI ≥40 or BMI ≥35 with comorbidity. Average loss: 25–35% body weight, durable long-term.

Lifestyle & self-care

Build a sustainable calorie deficit (300–500 cal/day) — not aggressive restriction
Prioritize protein (1.2–1.6 g per kg body weight) to preserve muscle during weight loss
Strength training 2–3x/week prevents muscle loss that comes with rapid weight loss
Track food intake for 2–4 weeks for awareness, then loosen
Sleep 7+ hours — poor sleep increases hunger hormones (ghrelin) and reduces leptin
Build social support — peers, accountability partners, behavioral coaches improve outcomes

When to see a doctor

Make an appointment if you have:

→BMI ≥ 30 (or ≥ 27 with weight-related condition)
→Difficulty losing weight despite consistent lifestyle effort
→Weight gain affecting joints, breathing, or daily function
→Family history of T2D, heart disease, or stroke
→Considering anti-obesity medications or surgery

Medications for Obesity

Compounded Tirzepatide

tirzepatide (compounded)

From $149/mo

Compounded Semaglutide

semaglutide (compounded)

From $99/mo

Saxenda

liraglutide

From $1100/mo

Zepbound

tirzepatide

From $349/mo

Wegovy

semaglutide

From $1349/mo

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Sources

Educational content; not a substitute for professional medical advice. Always consult a licensed clinician.