The Educated Patient Podcast: How Personalized Obesity Medicine Is Changing Lives

For many people, weight has been a lifelong challenge — one marked by frustration, shame, and the exhausting feeling of repeatedly trying and failing. In today’s episode of The Educated Patient Podcast, Alina Elperin, M.D., an internal medicine and obesity medicine specialist at Forward Focus Concierge Medicine, breaks down why obesity is far more complex than most patients have ever been told.

After more than a decade in primary care, Elperin saw the same pattern again and again: Patients were developing conditions such as high blood pressure, diabetes and heart disease because the underlying metabolic issues driving their weight struggles were never addressed. This experience pushed her to focus her practice on obesity medicine, a field rooted in science, compassion and a deeper understanding of how the body regulates weight.

One of her core messages is that obesity is not a simple matter of willpower. Weight regulation depends on a mix of hormones, genetics, environment, sleep, stress and food cues that differ from person to person. Many patients spend years blaming themselves for something that biology largely controls. Hunger and fullness hormones, for example, may behave differently in individuals with obesity, making cravings and overeating much harder to manage without support.

Elperin helps patients understand how these systems work and why metabolism may slow down over time. She educates listeners on the role of modern treatments, including GLP-1 medications and older non-GLP-1 options, which can help regulate hunger signals and support metabolic health. These medications are not a magic solution, nor are they appropriate for everyone, but they can make weight management more achievable for many people when combined with lifestyle strategies.

Lifestyle changes still matter, but Elperin emphasizes the importance of personalizing them. Sleep, nutrition, physical activity and stress management are highly individual, and small, sustainable changes often lead to the best long-term improvements. Part of her approach involves identifying barriers, setting realistic goals and helping patients rebuild confidence in their ability to care for their health.

She also explains that weight-loss plateaus are a normal part of the process. Metabolism adapts, hormones shift and the body temporarily stabilizes before progress resumes. Plateaus signal the need for reassessment, not a reason to feel discouraged.

In the end, Elperin views obesity as a chronic condition that deserves ongoing care, follow-up and support — just like any other long-term health condition.