Ep 246 - Metabolic Adaptation and How Obesity Disease Management Is Like Mowing the Lawn with Carah Horn
Are you struggling to see obesity as more than a number on the scale? Do you wonder why shame and stigma still dominate the conversation around bariatric surgery?
In this episode, we explore the truth about obesity as a chronic disease and how we can shift the narrative to one of compassion, education, and long-term support. Our guest, Carah Horn, brings her clinical expertise and lived experience to the table in an eye-opening and empowering conversation. We talk about the outdated perceptions surrounding bariatric surgery, the crisis in obesity care, and why finding the right provider makes all the difference. Carah shares powerful analogies—like her “lawn care” metaphor—to help us understand why long-term maintenance and ongoing support matter. She also explains the dangers of anti-obesity medications without proper oversight and how the BariNation Community provides a unique space for education, encouragement, and behavior change. Whether you are post-op, pre-op, or still considering surgery, this episode will leave you feeling seen, supported, and more equipped for the road ahead.
IN THIS EPISODE:
- (00:00) Introduction and opening
- (01:24) Carah shares her professional background in obesity disease and bariatric surgery
- (12:19) The narrative surrounding obesity needs to change, and finding the correct doctor
- (19:14) Carah speaks to the crisis of care, anti-obesity medications and comorbid conditions
- (33:03) Each patient is different, and she encourages going back to your surgeon when health changes occur
- (39:31) Carah shares the word picture she tells her patients
- (56:12) Making your bariatric journey positive rather than negative and using the tools provided by the BariNation Community
KEY TAKEAWAYS:
- Obesity is a complex, chronic disease affecting every aspect of a person’s life—physical, emotional, and social. It should be promoted as a legitimate medical condition that requires real treatment. Unfortunately, shame and stigma surrounding obesity prevent many people from seeking treatment.
- Treating obesity is about improving health, not appearance. Viewing it through the lens of disease management—similar to diabetes or cancer—can help shift public perception and lead to better care. Medications and surgery are tools to treat the underlying condition, not just to achieve a certain weight.
- The lack of long-term support and education around obesity medications is dangerous. When prescribed without proper medical oversight or behavioral support, these medications can lead to serious health risks. Without a comprehensive program—including nutrition guidance, mental health care, and consistent follow-up—patients are more likely to misuse medications, relapse, or face complications, especially if access to treatment is suddenly lost.
RESOURCES:
- BariNation Website
- Join the BariNation Membership community meetups to support you on your journey with obesity treatment. https://barination.com/pages/join-our-community
- Want to see bonus content? Head over to
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