Obesity and Insulin Resistance are Major Concerns in the Prevention and Treatment of Comorbidities

For a long time the assumption has been that, although weight reduction was necessary and desirable, comorbidities were far more important and needed treatment even if weight loss was not a treatment goal, preferably with medication. This controversy leads to postponement of treatment, and later on causes too intensive medical treatment. Thus, raising the health care costs to unacceptable levels, leading to the medicalization of individuals and declining of the own responsibility of patients for their health, leaving it up to individuals when to regard their own weight as a problem that should be dealt with. The aim of this article was to produce evidence to support a shift of paradigm regarding the relationship between body weight and comorbidities. The central problem is insulin resistance which leads to a cascade of health problems. This condition should be diagnosed in primary practice and obesity clinics, to ensure a better tailor-made treatment for patients. Treatment should start at the earliest stage possible, when comorbidities are still reversible and includes a personalized dietary advice and counseling preferably by a dietitian to tackle insulin resistance. An exercise program is part of the treatment.