Treating extreme obesity involves gradual medically guided weight loss, medication, and sometimes surgery. Support groups and talking with a mental health professional can help.

Extreme obesity, also known as morbid obesity, is a metabolic health condition that healthcare professionals define as having a body mass index (BMI) of 40 or more.

BMI is a measurement that considers your height rather than only your weight. It’s determined by dividing your weight in kilograms (kg) by your height in meters squared (m2).

If you have extreme obesity, help is available.

You should start by talking with a primary care doctor. They can recommend a treatment plan based on your overall health.

When you have extreme obesity, weight loss should be undertaken with the support of a healthcare professional. Avoid making drastic changes, especially without medical guidance, as they can have adverse health effects.

Keep reading to learn which healthcare professionals treat extreme obesity, how it’s treated, and where to find the social support you need.

Weight discrimination and health

Although studies often suggest that obesity is a risk factor for certain health conditions, they rarely account for the role weight stigma and discrimination play in health. Discrimination is one of the social determinants of health — the conditions in daily life that affect our health — and it can and does contribute to health disparities.

Discrimination can be subtle and may include factors that make people uncomfortable when seeking care, for instance, not having chairs that can accommodate people with severe obesity.

Weight discrimination in healthcare can prevent people at high body weights from seeking medical care — and those who do may not receive accurate diagnoses or treatment, because doctors may attribute their health concerns solely to their weight.

As a result, any health condition a person may have may be more advanced by the time they receive a diagnosis.

Meanwhile, experiences of weight stigma in daily life, even outside of medical settings, are associated with negative mental and physical health outcomes.

Everyone deserves appropriate and compassionate healthcare.

Different types of healthcare professionals can help you manage extreme obesity. Your team may include multiple specialists who guide your care.

They can include:

  • Primary care doctor: A primary care doctor provides general medical care, monitors your overall health, and can refer you to specialists.
  • Endocrinologist: An endocrinologist specializes in treating health conditions relating to hormones and metabolism, such as diabetes.
  • Obesity specialists: Some doctors may specialize in treating obesity. These can include primary care doctors, bariatricians, or obesity medicine specialists.
  • Registered dietitian: A dietitian is a board certified expert in nutrition who provides medical nutrition therapy and counseling to help treat or manage medical conditions.
  • Bariatric surgeon: A bariatric surgeon performs weight loss surgeries, like gastric bypass and gastric sleeve surgeries.
  • Mental health professional: A mental health professional may include a psychologist, therapist, or counselor to help you manage your mental health. Obesity, as well as other health conditions, can increase the risk of mood disorders like depression or anxiety.
  • Physical or occupational therapist: A doctor may recommend working with a physical therapist to support your mobility, movement, and function, or an occupational therapist to help you perform daily tasks safely.

To manage a health condition like extreme obesity, it’s best to work with an experienced healthcare professional you trust and who makes you feel comfortable. If you don’t feel comfortable with your doctor, you can find a new one.

If you look for a new healthcare professional, some things to consider include:

  • whether they are in your insurance network
  • their experience in treating people with obesity
  • how easy they are to communicate with and understand
  • if they and their staff are helpful, friendly, and available when you need an appointment
  • location and ease of access

Find a medical specialist in your area today

Your healthcare team for treating extreme obesity may comprise several people who can provide support.

Sometimes, a certain medical specialist will be required to help diagnose, manage, or treat a healthcare condition.

You can find the following medical specialists in your area today:

Treatment for extreme obesity typically involves an initial goal of losing 10% of your body weight.

Doctors may also treat any health conditions you may have as a complication of extreme obesity, such as diabetes, heart disease, or sleep apnea.

Medical Perspective

Extreme obesity is a serious health condition that can have long-term health effects. Someone experiencing this condition who wants to take steps towards treatment should consider consulting with their healthcare professional or a physician who is board-certified in obesity medicine, who can help evaluate for comorbid conditions and develop a comprehensive approach to obesity management.

— Jillian Foglesong Stabile, MD, FAAFP, DABOM

Learn how obesity affects the body.

Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Changes to your eating plan

Losing the initial 10% of your body weight should happen gradually, at a rate of about 1 to 2 pounds per week. It should occur primarily through changes to your eating plan, as vigorous exercise may have health risks for people with extreme obesity.

Changing your eating plan typically includes:

Weight loss medications

Doctors may also prescribe weight loss medications, such as:

  • GLP-1 agonists like liraglutide (Saxenda), semaglutide (Wegovy), and tirzepatide (Zepbound)
  • orlistat (Xenical and Alli)
  • phentermine/topiramate (Qsymia)
  • naltrexone/bupropion (Contrave)
  • setmelanotide (Imcivree) for certain types of genetic hypothalamic obesity
  • appetite suppressants, including phentermine (Adipex-P or Lomaira)

Weight loss medications typically work by increasing your metabolism, reducing your appetite, or reducing your body’s absorption of nutrients from food.

While insurance may not cover medication solely for weight management, these medications may be covered by insurance for underlying conditions, such as type 2 diabetes and increased heart attack and stroke risk.

Safe physical activity

You can continue your usual physical activity without increasing it until you lose 10% of your body weight.

After that point, healthcare professionals may recommend increasing your physical activity in a way that is safe for you. That may include activities like:

  • arm raises, in which you raise your arms out in front of your body or above your head for a few moments before lowering them
  • arm circles, in which you raise your arms to your sides and move your hands in small or large circles
  • sit-to-stand, in which you stand up for a moment and sit down, repeating the activity if you can
  • stepping in place
  • walking outdoors

Talk with a healthcare professional before drastically increasing your physical activity. Some people with extreme obesity may have health considerations that would make increasing their level of physical activity unsafe.

Weight loss surgery

If other weight loss methods do not work, a doctor may recommend weight loss surgery (or bariatric surgery) if you meet the requirements. Weight loss surgery generally helps you feel fuller after consuming fewer calories, which can lead to weight loss and help prevent weight gain.

Weight loss procedures can include:

  • gastric band surgery, which involves placing a band around your stomach to compress it
  • gastric sleeve surgery, which involves removing up to 80% of the stomach
  • gastric bypass surgery, which involves removing a portion of the stomach and small intestine to create a small stomach pouch; this also reduces the amount of nutrients absorbed by the small intestine
  • endoscopic sleeve gastroplasty, a less invasive alternative to gastric sleeve surgery that also reduces the size of the stomach
  • intragastric balloon, a nonsurgical temporary device inserted into the stomach through an endoscope

It’s important to note that all of these surgeries have the potential for complications and may not be right for everyone with extreme obesity. It’s important to talk with your care team.

Most insurance plans cover weight loss surgery if you meet the requirements, which typically include trying other interventions, like dietary changes and weight loss medications, for a specific time period (this may vary by plan).

Many people with health conditions like extreme obesity find support from connecting with others on a similar journey.

You can access support through advocacy organizations, such as:

  • Obesity Action Coalition, a national nonprofit organization that promotes increased education surrounding obesity, giving a voice to those who have it, and supporting advocacy efforts
  • Overeaters Anonymous, which provides a way to connect with others through meetings online, in-person, or over the phone, though you can also connect with members over email and social media through non-real-time meetings
  • Obesity Matters, a Canadian member organization with community forums and support groups, where you can also receive information on weight interventions

Many people may also connect with others through online forums like Facebook groups, such as the Overweight, Obese, Morbidly Obese Support Group, or a subreddit, such as r/SuperMorbidlyObese, which is for people “who currently (or have had) extreme obesity and are looking to lose weight and lead a healthier life.”

Support groups and online forums can be a great source of motivation, support, and encouragement.

Keep in mind that these groups are not generally moderated by healthcare professionals but by individuals, most of whom are effectively anonymous. It’s important to talk with a healthcare professional before following advice from anyone on the internet. Only follow medical advice from a healthcare professional familiar with your health situation and needs.

Extreme obesity and the associated stigma and discrimination you may experience can negatively affect your mental health, contributing to:

It can help to talk with a mental health professional about what you’re feeling and experiencing. They can help you practice strategies to support your mental health, which may also benefit your overall motivation and sense of self.

This can include:

Help is available

Remember that you’re not alone and resources are available to you right now. If you have immediate thoughts of harming yourself or others:

Extreme obesity is a type of obesity defined as having a BMI of over 40.

Healthcare professionals, including doctors and dietitians, can help treat obesity and support weight loss.

Initial treatment usually involves dietary changes that help you lose 10% of your total body weight.

Weight loss may include exercise, medication, and sometimes surgery. Be sure to talk with a healthcare professional to learn what is safe for you.

You can also find support from other people who have or have had extreme obesity. You can connect through support groups and online forums.