Multidisciplinary Approaches to Obesity Management

Innovations in Diabetes & Metabolic Care | Summer 2025

According to the Centers for Disease Control and Prevention’s 2023 Adult Obesity Prevalence Maps, one in five American adults is obese. Rates jump to 36 percent in the Midwest.

Margarita Barreiro, MD

“We know the trend is not slowing down,” says Margarita Barreiro, MD, an endocrinologist with the University Hospitals Diabetes & Metabolic Care Center and an assistant professor at Case Western Reserve University School of Medicine. “Obesity is associated with a wide range of comorbidities throughout the United States, including cardiovascular disease, type 2 diabetes and certain cancers.”

The UH Diabetes & Metabolic Care Center offers evidence-based obesity management grounded in a collaborative, team-based model. “At University Hospitals, our primary care providers are at the forefront of our multidisciplinary approach,” Dr. Barreiro says. “We rely on them to screen patients struggling with obesity, jumpstart lifestyle modifications and get them connected to the specialists within our center.”

Patients referred to the center receive personalized care tailored to their specific health goals. In addition to endocrinologists, advanced practice providers, nutritionists, behavioral health specialists and clinical pharmacists are available to offer treatment, medication management, and nutritional and exercise education that meets individuals where they are in their weight loss journey.

“We know that consistent follow-up is essential for sustained weight loss,” says Dr. Barreiro. “When we approach obesity management in a multifaceted manner, we find that patients achieve more robust results.”

An added benefit of the center’s collaborative model is that patients have greater access to timely care. “Treating obesity requires steady feedback, whether we are adjusting medications, diet or behavior,” says Dr. Barreiro. “Knowing that I can rely on our team members to provide concurrent treatment, I can be confident that patients are getting the support they need until my next appointment with them.”

Targeting Sustained Weight Loss

Setting individualized weight-loss goals is crucial for improving health. “The gold standard used to be a five percent reduction in body weight, but newer data show that targeting 10 percent is better for reversing comorbidities,” Dr. Barreiro says. “If patients are able to achieve 10 percent or more, we know that hypertension and diabetes will improve.”

Achieving lasting weight loss often requires a combination of therapies. Medications such as glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) receptor agonists have gained significant popularity because they help regulate blood sugar, appetite and digestion.

“Recent recommendations from the American College of Cardiology endorse that GLP-1 or GIP/GLP-1 can be started as first-line weight management interventions in addition to lifestyle modification, emphasizing that patients should not be required to fail lifestyle changes prior to starting pharmacotherapy,” Dr. Barreiro says. “We know that counterregulatory hormone mechanisms require increasing calorie deficits to lose or maintain weight over time. Options, including medication or bariatric surgery, are key components of comprehensive medical weight loss programs.”

The University Hospitals Bariatric Surgery Center provides a safe and effective option for patients struggling to maintain weight loss through non-surgical methods. “We can get patients connected to the expert providers on the bariatric team,” Dr. Barreiro says. “Medical weight loss and surgical weight loss should go hand-in-hand, depending on the needs of each patient.”

Providing Empowering Resources

Maintaining a healthy weight is a complex, lifelong process. “We continue to learn about the many factors that contribute to obesity,” Dr. Barreiro says. “There are environmental, genetic and neurohormonal reasons why people struggle to lose weight.”

The UH Diabetes & Metabolic Care Center offers comprehensive management for the full spectrum of available weight loss medications. Patients can also choose to participate in group classes if that suits their learning style. Apps provide additional tools to log food intake, track blood sugar levels or calculate calorie burn.

“Our goal is to provide the resources people want to get the help they need,” Dr. Barreiro says. “If somebody would benefit from a service or program, we strive to ensure it is available.”

For more information, call the UH Diabetes & Metabolic Care Center at 216-435-1071.

Contributing Expert:
Margarita Barreiro, MD
Endocrinologist
University Hospitals Diabetes & Metabolic Care Center
University Hospitals Cleveland Medical Center
Assistant Professor
Case Western Reserve University School of Medicine