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Can Obesity be Considered a Disease [Podcast]

Posted September 03, 2020 by Dr. Adrian Dan

Listen to this episode of the Healthy Vitals Podcast.

Dr. Adrian Dan discusses obesity as a metabolic disease.


Featured Guest:

Adrian Dan, MD

Dr. Adrian Dan is an experienced metabolic and bariatric surgeon who has practiced in Akron, Ohio, since 2006. Driven by a passion to treat obesity and its many coexistent conditions, he takes pride in providing the most current and effective surgical procedures for patients in Northeastern Ohio. Dr. Dan joined Summa Health System in 2006. He currently serves as program director of the Advanced GI MIS Foregut and Bariatric Surgery Fellowship Program and medical director of the Weight Management Institute. In 2022, Dr. Dan performed the first robotic single anastomosis duodenoileostomy (SADI-S) in Ohio.

Transcription:

Scott Webb (Host): Obesity is not a choice. It's actually a metabolic disease. The good news is that it's a disease that can be treated. And when it is treated medically or surgically patients live longer and healthier lives joining me today to discuss obesity and treatment options is Dr. Adrian Dan he's a Bariatric Surgeon at Summa Health. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Doctor, thanks so much for joining me today. We're talking about obesity. So I'd like to have you just start by defining the terms. How do we define obesity?

 

How is obesity defined?

 

Dr. Dan: With regards to obesity, there are various definitions through the years, but over the last few decades, it has become more, more consistent. And typically it's based not just on a person's weight, but on their weight related to their height, or what's called a body mass index. The BMI. And class one obesity begins with a BMI of 30 to 35. And over 40 is what we refer to as morbid obesity. And over 50 BMI is what we refer to as super morbid obesity.

Host: And is BMI something that we can measure ourselves or do we really need to see a doctor for that?

 

Can we measure BMI ourselves?

 

Dr. Dan: Nobody will need to see a doctor for that specific calculation. There's various calculators available online, and also this information, the weight and the height are easily and readily available to everyone and readily available to Doctors. That's why it's so commonly utilized. But one thing I think is important to underscore here is that obesity, excess weight in various other conditions are really the same disease and same condition with different manifestations. So we have to look beyond just the weight, beyond just the BMI.

Host: Yeah, I hear what you're saying. That that's a good place to start, but there's more to completing that picture. And when we talk about obesity Doctor, is it technically or medically speaking a disease?

 

Is obesity a disease?

 

Dr. Dan: There is no doubt that obesity is a disease in 1998, the World Health Organization deemed it to be an academic in 2013, the CDC declared it a disease. And it seems like the right thing to do. A lot of people suffering from conditions related to this root condition. But over the past few years, we have been able to gather refutable scientific evidence and proof of the dysfunctions in the body. They make it a disease, no different than any other condition, such as a thyroid problem or cancer or any other condition that we refer to asthma as a disease and I'll tell you, it's got one of the biggest hurdles that we're facing right now, before we even talk about what the treatments for obesity can do before we even talk about any of that, we have to get over the hurdle of living with the premise that obesity is a choice or an act or a behavior. All too often, we see obesity as a condition that has social consequences rather than medical consequences. And unfortunately we portray it many times as a character flaw, willpower issue, discipline issue. And it turns out that we couldn't have been further from the truth.

Host: You know, I think that's so true. And I think that like with many things there probably is a lot of mental stigma about obesity in terms of the obese, you know, dealing with it and really understanding, you know, kind of how they got there. And with everybody else understanding, as you say that it's not a behavior, it's not a choice, right?

 

Dr. Adrian Dan on obesity stigma

 

Dr. Dan: Absolutely. So the stigma, the prejudice, the bias against not individuals with obesity, but those seeking treatment for it is highly pervasive in our society. And that's the first thing that we have to put aside. This is no different than people who think that the earth is still flat. And when you look at the evidence that I cited earlier mentioned for example there are very sophisticated labs throughout the world that are conducting research on obesity. Identifying that the GI hormones peptides and the communication between our GI tract and our brain is highly different in patients with obesity, even the bacteria, what we call the microbiota, the bacteria that lives in our GI tract is very different. We haven't been able to look at the way that the brain perceives food and responds to food with pleasure stimuli.

And we see all these things amongst many others to be very different in patients with obesity. And what's even more interesting is that when these measurable parameters are looked at after bariatric surgery, they all change. So while the reactor is not able to change your genetics, we have found it to be highly, highly effective tool in changing the metabolic dysfunctions that lead to obesity. And I'll tell you I'll have patients a year after surgery coming to my office on the way to the gym, in their workout clothes, with pictures of things they never thought they'd ever do again, just thrilled about having their life back. And I can promise you that I did nothing to their discipline. There's no such thing as a discipline burden, but what we did do is we did fix the metabolic dysfunction that leads to obesity, diabetes, and fatty liver disease, amongst many other things, again, the same disease with different manifestations.

Host: That is really cool. So awesome that you can help people. And I do want to get to the surgical and nonsurgical options, but before we get there what other health complications or implications are there for obesity?

 

What health complications are related to obesity?

 

Dr. Dan: First and foremost, I think people all know that that obesity can lead to diabetes, high blood pressure, gastroesophageal reflux, obstructive sleep apnea, high cholesterol, and Scott, the list goes on and on. I could sit here for the next 10 minutes and read a list of the 229 conditions that have been linked in some way or another to obesity. But those are the big ones that really erode people's health. And at the end of the day, they decrease their lifespan. So whether it's medical, weight loss, or surgical weight loss, it's important to realize that obesity really can affect your health and taking care of the obesity will also lead to the resolution of many of those conditions and putting them into remission. But in addition to that, newer data shows that resolution of obesity, whether it's through medical or surgical means can lead to preventative aspects to your health. For example, in women who undergo bariatric surgery and are morbidly obese, they actually cut their cancer risk by 50%. And my listeners have heard me, right, I'm going to repeat it five, 0%. The weight of stroke, heart attack, congestive heart failure, mortality, atrial fibrillation, and development of kidney disease are caught by substantial numbers anywhere from 33 to 70%.

Host: Those are some amazing numbers of 50% and 33 to 70. And you said 229 of that list could be. Really amazing. And so let's get to the surgical and medical options for the obese. If you're consulting with a patient, where do you start with them?

 

Dr. Adrian Dan on surgical and medical options for the obese

 

Dr. Dan: By the time that a patient has seen me as a bariatric surgeon, they've already tried numerous diets with their primary care physician when people are affected in their lively hoods their quality of life is ravaged by obesity. By the time they see us, this is not a wake up call. This is something we've been dealing with for years, we perform bariatric surgery, we have done so with the minimally invasive approaches here at Summa Health System for nearly 20 years. We also have one of the most robust obesity medicine centers and both aspects of treating obesity, whether it's through medical means with diet and exercise, sometimes medication or with surgical are important, but the literature overwhelmingly shows that obesity surgery is by far the most effective way to obtain long-term resolution of obesity in the associated comorbid conditions. And I think everyone is in agreement with that, including our obesity medicine Doctors who compliment what we do and support the patients, not just for the portion before surgery and immediately after, but for the rest of their lives to ensure that the tool that's in place can be utilized to maintain that weight loss and those health benefits for decades to come.

Host: It's so great that there are medical and surgical options and the surgical option, you know, can be so life changing, so game changing and great that people have a support system in place, you know, before, during and well after the surgery. That's really amazing. As we wrap up here today, Dr. Dan, and thank you so much for your time, a little off script, but are people suffering from obesity at higher risk for COVID-19 complications?

 

Are people suffering from obesity at a higher risk for COVID-19 complications?

 

Dr. Dan: Absolutely. So the data is still early in preliminary. We have identified a few things that tend to make people more susceptible to having a bad outcome after COVID-19 infection. There's a lot of insurers out there that don't feel that weight loss surgery, or metabolic surgery to resolve diabetes. And these conditions that we mentioned is part of the comprehensive healthcare package that some patients should get. But now we've seen that it's tremendously important portion of somebody's overall healthcare armamentarium. In addition to that with a COVID-19 crisis, we've seen that obesity, diabetes, hypertension in age are the main factors that lead to poor outcomes after infection. Now, age, we've all admitted and have to come to the realization we can't do much about that, but obesity, diabetes and hypertension are treatable. And it's also important, we mentioned at the beginning that the one thing we have to advocate is a pervasive notion that this is a choice.

And when we tell people that this is their choice and their behavior alone, that's leading to this, they'll stop seeking the help that is so important to improve their overall health. People are also sometimes also concerned about the safety of the operations. I always say, if you think of Bariatric and metabolic surgery is potentially unsafe, boy, you've got to take another look at what we're doing today, because things have changed tremendously. In data from the CMS, obesity surgery, whether with a gastric bypass or a gastric sleeve has been shown to actually be safer than a average gallbladder surgery or an average hysterectomy, or an average hip replacement. And in patients with diabetes, those who have the condition, it's safer then all of those are even safer than an appendectomy. And low and behold, that's the operation that actually cures diabetes and it's the safest of all of them. So those are the things we have to keep in mind. And COVID-19 was just another reminder of how much those conditions that are related to obesity can affect your overall health.

Host: Absolutely. And thanks so much for your time today Doctor, for your time, your expertise and understanding. It's really helped me to understand a little bit better. And really, especially to know that obesity is a disease and like many diseases, it is treatable, of course, but people have to seek the treatment. And whether they're dealing with the stigma or prejudice, whatever they're dealing, whatever's holding them up, basically in the end what we want them to do is to seek medical advice, treatment, possibly leading to the surgical options, the very safe surgical options that we've discussed today. So thanks so much Dr. Dan and you stay well.

Dr. Dan: Thank you, Scott. And we're here to support those patients along their entire journey, whether they're interested in medical or surgical weight loss options, and that we're going to do that in a compassionate and nonjudgmental way. And we're looking forward to taking care of anybody who needs our services. Thank you, Scott.

Host: Thanks again, Dr. Dan, for more information or to book an appointment to visit Summahealth.org. If you found this podcast helpful and informative, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well and we'll talk again next time.

 

About the Author

Adrian Dan, MD

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Iriel Hopkins and Marlo Schmidt discuss ways in which Summa Health System contributes to a healthier community.

Sudden Infant Death Syndrome – What You Need to Know [Podcast]

Karen Frantz DeSeptis and Ericka Malone lead a discussion on SIDS, and important information you need to know.

An Overview of Osteoporosis: Prevention to Treatment [Podcast]

Natalie Hiltbrand, an Osteoporosis Specialist at Summa Health, leads a discussion on osteoporosis treatment, as well as prevention.

10 Early Signs of Diabetes That Shouldn't Be Ignored

FsoHigh blood sugar can cause gradual, unassuming symptoms that can sneak up on you. Frequent urination and excessive thirst — the telltale signs of type 2 diabetes — are often mild and can easily be attributed to other factors.

In fact, most people don’t even know they have high blood sugar until they’re diagnosed with type 2 diabetes.

Diabetesis a chronic condition that causes glucose (or sugar) levels in the body to rise. The problem is ignoring or writing off the symptoms…

How to introduce moderate exercise into your routine

Study after study has shown the positive effects of light-to-moderate physical activity and the negative effects of little or no exercise. Regular exercise is one of the most beneficial (and cost-effective) activities you can do to better your health.

Some benefits include:

  • Reduced risk of cardiovascular disease: Stroke and heart diseaseare two of the leading causes of death in the U.S. According to the CDC, just 150 minutes a week of moderate-intensity activity can put…

Addressing Common Pelvic Health Issues [Podcast]

Dr. Megan Cesta and senior physical therapist Amy Senn discuss common pelvic health issues women may experience.

Sunscreen 101 - 5 reasons you should make it part of your daily routine

Reviewed July 2025

Did you know skin cancer is the most common form of cancer in the United States? According to the American Academy of Dermatology, one in five Americans will develop skin cancer in their lifetime, and men 65 or older are twice as likely to develop melanoma — the deadliest form of skin cancer — than women.

As we head into the summer months, most of us know the importance of wearing sunscreen in the hot, blazing sun. But what you may not realize is…

Best and worst foods for your next sizzling cookout

Nothing says summer like the classic American barbeque: hamburgers, hot dogs and macaroni salad with berry pie for dessert. Cookouts with family and friends are a favorite summer pastime to enjoy good food, the great outdoors and warmer temperatures.

But considering on average a person consumes upwards of 2,000 calories on typical barbeque fare, it’s not a bad idea to switch up this year’s cookouts to include healthier options. Who said cookouts had to be unhealthy…

Food allergy vs. food intolerance: How to tell the difference

Chances are good at one time or another you have experienced unpleasant symptoms — an upset stomach, diarrhea, nausea or bloating — after eating a delicious meal. Reactions from food are common, but it can be challenging to understand the cause.

Food intolerance can trigger some of the same physical symptoms as a food allergy. But, understanding the difference is vital to your health. Eating a food that your body is intolerant to can leave you feeling uncomfortable, but eating…

Weight Loss Options Built for Your Needs

Obesity and the need to lose weight is a deeply personal journey. With many new medical options available, it can be difficult to select the best individual approach to be successful with long-term weight loss.

Obesity is the second-highest cause of preventable deaths in the United States. The rate at which obesity has worsened over the past 20 years, especially in the state of Ohio is alarming, and there is now a growing amount of national attention focused on the problem. In…

7 ways to reduce sodium without sacrificing flavor this holiday season

With so many celebrations centered on food, it’s easy to lose track of how much we’re consuming — including our sodium intake. In fact, it’s not unusual for a typical holiday meal to meet or exceed our recommended daily value for sodium.

But, what’s all the fuss about? Sodium, or salt, is a mineral that’s essential for life. It’s regulated by your kidneys and is required for nerve and muscle function and maintaining your body’s…

All About Sleep Apnea [Podcast]

Dr. James Bavis & Dr. Ketan Deoras explain sleep apnea as well as signs, symptoms, and what to expect.

Breast Cancer: The Importance of Knowing Your Risk [Podcast]

Dr. Keristen Brantley & Dr. Victoria Van Fossen discuss Breast Cancer Prevention and Treatment.

Alzheimer’s Awareness: Symptoms, Stages, and Support [Podcast]

Amanda Harvan sheds light on the symptoms, stages and support of Alzheimer's.

Are veggie burgers really a healthier choice?

It’s no secret that meatless meals are becoming more popular. While this is certainly not anything new for our vegan or vegetarian consumers, terms like “plant based” and “meat alternatives” are quickly becoming more mainstream. Wildly popular, meatless burgers are even entering the fast food market with Burger King’s addition of the “Impossible Whopper” to their regular menu. But, are veggie burgers actually healthier than a…

Men’s Well-Being: All About Prostate Health [Podcast]

Dr. Kevin Spear discusses men's health and different risk factors and how to ensure optimal well-being.

Good vs. Bad: Understanding your cholesterol levels

Cholesterol normally gets a bad rap, but is it really as bad as it sounds? 

Cholesterol is essential for your body — in healthy doses, of course. Cholesterol is a waxy, fat-like substance produced by the liver, which your body needs to build cells and produce certain hormones and vitamin D. 

Your body produces all the cholesterol it needs to function. The problem is many people don’t only get cholesterol from their liver. They also get high amounts of…

The Latest Updates on COVID-19 [Podcast]

Dr. Thomas File shares the latest updates on COVID-19.

Breaking the Stigma of Mental Illness [Podcast]

Emily Hionides-Horner discusses 7 ways to overcome mental health stigma.

The Modern Guide to Heart Health [Podcast]

Dr. Peter Bittenbender shares his insight on the modern guide to heart health.

Tips on Maintaining Fitness and Physical Health During the Pandemic [Podcast]

Dr. Cipriani discusses tips on maintaining physician health during the pandemic.

Tips on Maintaining Fitness and Physical Health During the Pandemic [Podcast]

Dr. Cipriani discusses tips on maintaining physician health during the pandemic.

Tips for Managing Anxiety [Podcast]

Dr. Leslie Zaynor discusses tips for managing anxiety.

4 Impactful Lifestyle Changes That Help Improve Your Cholesterol

Cholesterol is a waxy, fat-like substance that is produced by the liver and has many important functions in your body. Your body uses it to protect nerves, make cell tissues, keep your cells flexible and produce certain hormones. In addition to your liver making cholesterol, there are many foods that contain cholesterol, including eggs, meats and dairy products. Eating too much of these foods can add too much cholesterol to your body and have negative side effects. 

Too…

Your Options for Weight Loss

The desire to lose weight and the process chosen to go about it is a deeply personal journey. With many new options on the market, it can be tough to understand the best approach to reaching long-term weight loss.

Obesity is now ranked as the second-highest cause of preventable deaths in the United States. The rate at which obesity has worsened over the past 20 years is alarming, and there is now a growing amount of national attention focused on the problem. It is also important to note that Obesity has been proven to increase the risk for cancer including Colon and Breast cancers. Weight loss is an important cancer risk reduction effort for many patients at higher risk for cancer and a component of cancer survivorship plans as well.

Breaking Down Protein Powders

In the last decade or two, protein powders have become increasingly popular among physically active and health-conscious individuals.

Protein powders are concentrated sources of protein — the essential building block for muscle, tissue, bones and blood — made from either animal or plant sources. While whole foods come complete with the essential vitamins, minerals and fiber you require, protein powders are an easy, convenient way to bolster your protein intake when…

First Unified World Obesity Day

Obesity has been deemed a disease of worldwide epidemic proportions. In the United States, obesity directly affects 40% of the adult population and an additional 30% are considered overweight. Obesity is now ranked as the second-highest cause of preventable deaths in the United States. The rate at which obesity has worsened over the past 20 years is alarming, and there is now a growing amount of national attention focused on the problem.

When talking about obesity, it is very…

5 Ways to Make Healthy Eating a Piece of Cake

Eat healthy. Exercise. Lose the extra holiday L-Bs. These are some of the most common goals many of us try to accomplish each year. But, it’s just about the time of year when these all-too familiar New Year’s Resolutions start to fall by the wayside.

Life can get in the way, temptations arise and we can default to old habits. So this year, let’s try something different. Instead of listing the same goals year after year, let’s put to practice lifestyle…

Are short workouts effective?

As a general goal, it is recommended that we get at least 30 minutes of physical activity every day, more if you’re looking to lose weight. However, some people find it hard to carve out those 30 minutes every day. Some may only have time for a short 10-minute workout. So, is it still worth exercising even if it’s only for a few minutes at a time?

Studies have shown that short workouts throughout the day are just as beneficial as long continuous ones.

 

In this…

How to Successfully Manage Your Diabetes During the Holidays

The holidays can be tough for anyone on a diet with all the celebrating, snacking and treats. Those with diabetes have to be especially careful around the holidays because gaining weight or rising blood sugar could be dangerous to your health.

If you slip into bad eating habits and they extend well into the New Year, you can do long-term damage to your body. Just a little preparation can go a long way towards keeping your weight and blood sugar down – check out these…

Here's the scoop on intermittent fasting

This recent weight loss trend places more of an emphasis on WHEN you eat than WHAT you eat (but keep in mind that both are important for success). Intermittent fasting (IF) is an eating pattern that cycles between periods of fasting and eating.

Depending on the type of intermittent fasting pattern you choose, your fasting time may be a few hours or a whole day a few times per week. During the fasting periods, you eat either very little or nothing at all.

Here are some of the…

What Does A Fast Food Meal Do To Your Body?

It’s quick, fast, and cheap; it also tastes really good! Americans spend roughly $50 billion on fast food each year. With the availability of food “on-demand” more and more people are opting for prepared foods, whether through a drive thru or delivered to your door.

But have you ever felt not-so-great after eating fast food--maybe a little tired or bloated? Did you notice you became hungry again pretty soon after eating? That’s because although most…

Battle it Out: Artificial Sweetener v. Sugar

The sweeter things in life are present at most celebrations...weddings, birthdays, work promotions, new baby, office parties...you get the idea. But if you are like many Americans trying to cut back on your refined sugar intake for health reasons and/or weight management, you may think opting for sugar replacements might be a healthier choice.

When it comes to real sugar (sucrose) versus artificial sweeteners, like the ones found in diet sodas and ‘zero-calorie”…

Myths vs. Facts: Binge Eating

According to the American Psychiatric Association, eating disorders affect millions of Americans, mostly women between 12 and 35 years old. There are three main types of eating disorders: anorexia, bulimia and binge eating disorder (BED). The focus of this blog post will be on BED.

BED is the most common eating disorder in the US. It can be characterized by recurring episodes in which large quantities of food are consumed (more food than most people would consume over the same…

Sugar: It may be an Addiction

Most of us know that too much sugar is not good for our overall health. But what you may not know is that growing research is showing what’s bad for the body may also be bad for the brain.

A recent study published in Scientific Reports found that a group of men between 35 and 55 who consumed more than 67 grams of sugar daily from sweetened foods and beverages were more likely to develop anxietydepression, and other common mental disorders after 5 years, compared with men with a lower daily sugar intake. In no way does this imply that excess sugar causes mental disorders in the general population; rather this was a select study which also found no similar correlation for the women who participated in the research.

What are macros?

Paleo, keto, macros, carbs, complex carbs, clean eating, plant-based...we could keep going but I think you get the idea. With so many buzzwords out there, it can be difficult to analyze which ones would be a good addition to your weight loss journey or can help maintain a healthy lifestyle. Let’s explore one of these nutrition buzzwords: Macros.

Macros are short for macronutrients. These nutrients include protein, carbohydrates and fats and make up the caloric content of food.

Controversial Use of E-cigarettes and Vaping- A "Heated" Debate

Electronic Nicotine Delivery Systems (ENDS) first entered the US market around 2007.  Wells Fargo Securities analysts now claim that these products have grown into a $4.4 billion industry. These products have many names including e-cigarettes, vapes, vaporizers, vape pens, hookah pens, and e-pipes among others. Most use a heating mechanism to turn liquid into a vapor that is then inhaled as an aerosol. E-cigs differ from traditional cigarettes because they do not “burn” or contain the 7,000 chemicals present in traditional combustible cigarettes. The tobacco industry continues to develop and market new nicotine delivery devices and without question the controversy over these products is still a heated debate.

Carbs: The Good, the Bad and the Yummy

Atkins, paleo, low-carb, no carb, how do you choose? If weight loss is a priority for you, or if you are just looking to eat healthier, there is an abundance of diets, meal plans and fads out there.

But what exactly are carbohydrates (carbs) and why are some of them so “bad” for us? Below is a breakdown of the types of carbohydrates, what they do to our bodies, which ones we can eat and those to avoid.

The Gift of Heart Health

When you think of February, you may think of Valentine's Day, chocolate and flowers. February also marks American Heart Month, a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health. Heart disease is the leading cause of death for men and women in the United States. But the good news is it's also one of the most preventable.

Making heart-healthy choices, knowing your family health history and the risk factors for heart…

Medical Nutrition Therapy or Nutrition Education?

Medical Nutrition Therapy or Nutrition Education?

Obesity currently affects 34% of all Americans. It contributes to many other conditions, including Type 2 Diabetes, GERD, Sleep Apnea, Hypertension, Hyperlipidemia, Joint Disorders, and a variety of cancers. Improving or eliminating obesity often can improve or cure these conditions, including Type 2 Diabetes.

A registered dietitian can approach obesity through either medical nutrition therapy or nutrition education.

Medical…

Eating-Mindfully

We eat for many reasons beyond hunger, which is why learning to eat mindfully helps you maintain or even lose weight if desired. As we celebrate Healthy Weight week this week, here are ten tips that provide some food for thought.

1. Reject the Diet Mentality.Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet…

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