What is weight and metabolism management?
Weight and metabolism management is the assessment of body weight as a medical issue. Weight is addressed not on its own but together with blood sugar, the insulin response, thyroid function, blood lipids, blood pressure, the sleep routine and current medication. The aim is not appearance but the assessment and monitoring of metabolic risk.
The World Health Organization (opens in a new tab) reports that, as of 2022, 2.5 billion adults worldwide were overweight, 890 million adults were living with obesity, and 43% of adults over the age of 18 were overweight. The same source states that a body mass index above what is expected contributed to an estimated 3.7 million deaths from noncommunicable diseases in 2021.
The Ministry of Health of the Republic of Türkiye, General Directorate of Public Health (opens in a new tab), reports the prevalence of obesity over the age of 15 as 31.5% (39.1% in women, 24.6% in men) based on the results of the Türkiye Beslenme ve Sağlık Araştırması-2017, and states that obesity increases the risk of type 2 diabetes, hypertension, coronary artery disease, hyperlipidaemia and metabolic syndrome.
In which situations do people seek a consultation?
- If you have difficulty losing weight
- If you are gaining weight although your eating habits have not changed
- If there is unintentional weight loss
- If there is marked accumulation of weight around the waist
- If fatigue, drowsiness after meals or cravings for sweet foods accompany the weight
- If a cycle of losing weight and putting it back on keeps repeating
- If raised blood pressure, blood sugar or blood lipids accompany the weight
- If there is a family history of type 2 diabetes, thyroid disease or heart disease
What the assessment covers
| Topic | Why it is assessed |
|---|---|
| Blood sugar and HbA1c | Because weight and blood sugar balance may affect each other |
| Fasting insulin and the related calculations | To assess the insulin response |
| Thyroid function tests | Because they may reveal the reason for a change in weight |
| Lipid profile | To assess overall metabolic risk |
| Liver function tests | To assess for fatty liver |
| Blood pressure | Because excess weight may raise blood pressure |
| Body mass index and waist circumference | Because they show the amount of weight and its distribution |
| Sleep routine | Because a sleep disorder may affect the course of weight |
| Current medication | Because some medicines may lead to a change in weight |
How does the assessment proceed?
- Weight history. When the change in weight began, how quickly it happened, the methods tried previously and their results.
- Eating and activity routine. The number of meals, the intervals between them, their content and how quickly you eat; the daily level of activity.
- Measurements. Height, weight, body mass index, waist circumference, blood pressure.
- Laboratory. Those of the above considered necessary are requested.
- Drawing up the plan together. Gradual, sustainable changes are planned and the follow-up interval is set. If detailed nutritional work is needed, it is planned separately.
In which patients is it assessed differently?
- In patients who are pregnant or breastfeeding, no weight-loss target is set; follow-up is carried out together with obstetrics and gynaecology
- In patients with a history of an eating disorder, restrictive dietary advice is not appropriate; the assessment is planned together with the relevant specialty
- In patients with advanced kidney or liver failure, dietary changes are planned separately
- In patients undergoing active oncology treatment, follow-up lies with the relevant specialty
- In patients with unintentional weight loss, this is a different situation from weight management, and its cause is investigated as a priority
- In patients over 65, preserving muscle mass is also taken into account
- In patients whose muscle mass is markedly high, body mass index on its own may be misleading
- In patients under 18 years of age, care falls within the field of paediatrics
Follow-up and how often it is needed
Because every patient’s course unfolds differently, it would be wrong to give a definite answer on how often follow-up is needed. During follow-up the measurements are repeated so that the course can be monitored; a single measurement shows a point, while measurements repeated at set intervals show a direction. The course of weight, waist circumference, blood sugar, blood pressure and blood lipids is assessed together.
The World Health Organization recommends reaching and maintaining a healthy body weight, and doing at least 150 minutes of moderate-intensity physical activity a week. This recommendation is general; the level appropriate for you is determined after an examination.
What should you do before and after the consultation?
When you come for the consultation, bring:
- A list of all the medicines and supplements you use
- Your test results from the past year
- Your eating and sleep records from the past few days
- A list of the methods you have tried before
After the consultation, you are given a written plan. Apply the recommended changes gradually; it generally takes weeks to months for the effect to show in the measurements and laboratory values.
Risks and points to be aware of
No rapid weight-loss target is set. Rapid, severely restrictive regimes may lead to muscle loss, gallbladder problems and regaining the weight that was lost.
Diet lists circulating on the internet are not suitable for everyone. Separate assessment is needed in pregnancy, in kidney disease, where there is a history of an eating disorder, and with certain medicines.
Products and supplements intended for weight loss should not be used without consulting a physician. Products of uncertain content may affect heart rhythm, blood pressure and liver function, and may interact with the medicines you take.
Unintentional weight loss is not a weight management issue. Unexpected weight loss is assessed separately and as a priority.
The assessment is not based on body or appearance. The measurements are used as indicators of metabolic risk.
Results vary from person to person.
When should you see a physician without delay?
If you notice these symptoms, consult a physician without delay:
- Unintentional and unexplained weight loss
- Marked weight gain over a short period, with swelling in the legs
- Passing urine frequently, excessive thirst, a dry mouth
- Raised blood pressure accompanying weight gain
- Excessive daytime sleepiness, snoring at night and pauses in breathing
- Swelling in the neck, hoarseness and feeling cold, along with weight gain
- Palpitations, restlessness or nausea after using a weight-loss product
In the event of chest pain, shortness of breath, altered consciousness or fainting, go directly to the emergency department.
Frequently asked questions
I can’t lose weight; is my metabolism slow?
The answer varies from person to person. Difficulty losing weight rarely has a single cause; the insulin response, thyroid function, the sleep routine, the intervals between meals, the level of activity and current medication can all play a part. During the examination these factors are assessed together to find what applies in your case.
Which tests are requested in a weight assessment?
There is no standard list. Blood sugar, HbA1c, fasting insulin and the related calculations, thyroid function tests, a lipid profile and liver function tests are generally assessed. Which of them are needed is determined at the end of the examination.
Is a diet list provided?
Advice is based on your existing eating routine and takes the form of changes that are feasible. If a detailed nutrition programme is needed, it is planned separately under Nutrition and Dietary Counselling.
How long will it take me to lose weight?
No period of time or amount can be given in advance; the course varies from person to person. Gradual, sustainable changes are preferred. What is monitored during follow-up is not weight alone but the course of waist circumference, blood sugar, blood pressure and blood lipids.
Can I use a weight-loss medicine or supplement?
Using them without assessment by a physician is not recommended. Products of uncertain content may affect heart rhythm, blood pressure and liver function. Please report every product you use to your physician.
Why is waist circumference measured in weight follow-up?
Waist circumference gives information about where weight has accumulated. Fat distribution may differ between two people of the same weight; for this reason the scales alone do not give enough information. For the measurement method, see our article How Is Waist Circumference Measured?.
Sources
- World Health Organization, Obesity and overweight fact sheet, 8 December 2025. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, General Directorate of Public Health, Obezite (data from the Türkiye Beslenme ve Sağlık Araştırması-2017). https://hsgm.saglik.gov.tr/tr/obezite (opens in a new tab)
