5280 Health: How do I know if I really need to lose weight?
Dr. Michael Snyder: The first thing I ask people who come to me is, Why? Is it societal standards or personal health? If you’re just there because you need to be a Cherry Creek size zero, you’ve been manipulated by society. People who have real weight issues, their body mass index (BMI) is 35-plus. That’s important because the Journal of the American Medical Association says you can’t be fat and healthy. That doesn’t exist.

Why not?
Obesity is a disease of excess fat or adipose tissue storage, which is pro-inflammatory. Inflammation leads to hypertension, diabetes, cancer. Why cancer? Inflammation is a cornerstone of cancer development and progression. Plus, cancer detection technology wasn’t designed for those with serious weight issues. Either way, obesity is going to kill you.

What should people try before considering surgery?
The Mediterranean diet [based on the traditional cuisines of countries like Greece and Italy and typically heavy on vegetables, fruits, herbs, nuts, beans, and whole grains] is a very rational approach; no one is getting rich off it, and it’s the king of not vilifying food groups. Most people believe calories in and calories out equals weight loss and weight gain, but the genetic component is more important. People say my patients who get weight-loss surgery are lazy. No. They have done more than you have ever done to lose weight.