Obesity as a Chronic Disease 

Obesity is a chronic disease that affects more than 40% of adults in the United States (Pennings et al, 2025). Obesity is associated with pathophysiologic mechanisms involving the brain, the stomach, and hormones secreted by the gastrointestinal tract and pancreas. The Obesity Medicine Association (OMA) defines obesity as a:

“A chronic, progressive, relapsing, and treatable multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.” (Fitch and Bays, 2022)

(Pennings et al, 2025)

Obesity has many potential contributors, including those that are:

  • genetic
  • developmental
  • behavioral
  • result from exposure to certain infections or toxic substances

Practice Pearl | Cognitive Impact of Obesity Across the Lifespan

John Batsis, MD, FACP, AGSF, FTOS, FGSA, University of North Carolina at Chapel Hill


Obesity in itself is a disease that affects the person over the course of their lifespan. We know from our data that it actually can affect one’s cognition. The longer the duration of someone having excess fat over the course of their lifespan, the higher the risk of developing cognitive impairment as they age.


The increased adiposity associated with obesity can result in endocrinopathies, immunopathies, and biomechanical dysfunctions that contribute to the development of type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, sleep apnea, and cancer, as well as other obesity-related complications (Pennings et al, 2025). Obesity is also associated with increased mortality risk. Thus, obesity contributes to a substantial proportion of the chronic conditions that are managed by primary care providers. 



Among people with obesity, weight loss is associated with reduced morbidity and mortality (Pennings et al., 2025; Garvey et al., 2015; Gallagher et al., 2021; American Diabetes Association [ADA], 2025). For example, a 5% weight loss can improve risk factors for cardiovascular disease. A 10% to 15% weight loss improves sleep apnea and reduces new onset type 2 diabetes, metabolic dysfunction–associated steatohepatitis (MASH; previously referred to as nonalcoholic fatty liver disease), cardiovascular disease risk, and overall mortality (Pennings et al., 2025). Substantial weight loss can lead to the remission of type 2 diabetes.


Although obesity is common among people who are seen by primary care providers, the majority of patients with obesity do not discuss it with their clinicians and only a very small percentage have obesity listed in their primary care medical records. The lack of acknowledgment of obesity as a problem to be treated reduces opportunities for treatment (Pennings et al., 2025). Recognizing that obesity is a disease with widespread impacts is an important step toward improved management.

Practice Pearl | Obesity Is a Complex Chronic Disease

Michael Knight, MD, MSHP
George Washington University School of Medicine and Health Sciences


As a result of biomedical advances and research, we have been able to understand and be able to stand firm that obesity is a chronic disease... it is complex. It is relapsing, it is remitting. It also affects over 180 comorbid conditions.


Obesity Management in Practice

Recognize Obesity as a Disease in Need of Treatment | Assess for the Presence of Bias and Work to Address It | Seek Resources and Continuing Education  | The 6 As Approach to Weight Management | Become Familiar with Principles of Readiness to Change  | Consider Motivational Interviewing Strategies | Identify Opportunities for Reimbursement | Practice Management References