• Healthcare

Treating Obesity as a Brain Disease: A Physician’s Approach

April 05, 2023

• Obesity medicine physician Fatima Cody Stanford, MD, MPH, MPA, believes in treating obesity as a brain disease, focusing on the brain’s pathways and function.
• Dr. Stanford’s approach involves empathy and understanding for her patients, emphasizing improving their overall well-being rather than solely focusing on weight regulation.
• Her success in treating a young patient without her realizing that she was seeing an obesity medicine specialist is a testament to her approach and the importance of avoiding the stigma associated with obesity.

According to the Centers for Disease Control and Prevention, obesity affects more than 40% of individuals in the United States. It might be difficult for doctors to treat patients with this stigmatized ailment without making them feel humiliated or embarrassed. Fatima Cody Stanford, MD, MPH, MPA, a specialist in obesity medicine at Massachusetts General Hospital and an adjunct professor at Harvard Medical School, has discovered a way to treat obese patients without making them feel guilty or ashamed as reported by the American Medical Association (AMA).

Obesity and the Brain

Dr. Stanford’s approach to treating obesity is to focus on the brain. She explains that people have two pathways in their brain: the proopiomelanocortin (POMC) pathway, which tells people to eat less and store less food, and the Agouti-related protein (AgRP) pathway, which tells people to eat more and keep more food in the body. People with obesity have an active AgRP pathway. Dr. Stanford uses Food and Drug Administration-approved anti-obesity medications (Orlistat, Phentermine/topiramate, Naltrexone/bupropion XR, Liraglutide, and Semaglutide) that predominantly target the brain to treat the disease. These medications upregulate the POMC and  downregulate the AgRP pathways, changing how the brain sees weight.

Yet, the strategy used by Dr. Stanford extends beyond using drugs. She steers clear of becoming obsessed with the scale and emphasizes the patient as a whole. Dr. Stanford discusses ways to improve her patient’s quality of life as part of her interactions. She strives to treat them how she would like to be treated by placing herself in their position, understanding their challenges, and empathizing with them.

One of Dr. Stanford’s patients has seen great success with this strategy. The patient was a young child who was being treated by Dr. Stanford for two years for obesity before learning that she specialized in obesity care. One day, the child’s parents inquired about the effectiveness of her appointments with her “weight doctor.” The youngster was oblivious to their subject matter.

Dr. Stanford takes significant pride in knowing that the child had no idea what she did for a living and did not feel like her visits were combative or embarrassing. Dr. Stanford believes this is the key to treating a condition as stigmatized as obesity. Being empathetic and treating patients with respect and dignity is essential.

In summary, Dr. Stanford’s method of treating obesity by utilizing the brain’s pathways to regulate weight rather than focusing on the scale or eating habits is both efficient and kind. She can assist people without making them feel criticized or ashamed by concentrating on the brain’s natural ability to regulate weight.