From Skinny Fat to Bariatric Surgery: What Obesity Really Looks Like With Dr Evan Nadler

I’m grateful to Dr. Urban A. Kenny for having me on @DecodingHealthPodcast for a real, no-fluff conversation about childhood obesity and what it actually is, not what people assume it is.

In this episode, we break down why BMI is only a screening tool and not a diagnosis, how I define obesity clinically, and why pediatric obesity is a chronic disease driven largely by genetics, biology, and environment, not just “willpower.” We also get honest about the real barriers families face: insurance coverage, affordability of treatment (including GLP-1 medications), access to care, and why the “eat less, move more” advice usually falls apart once a child is already dealing with severe obesity.

We also talk through the full treatment spectrum, lifestyle changes, anti-obesity medications, and pediatric bariatric surgery, plus why I’m treatment-agnostic. The goal isn’t one perfect solution. The goal is helping each patient find the right next step, at the right time, with the best tools available.

If you’re a parent, clinician, or someone trying to understand pediatric obesity, insulin resistance, type 2 diabetes risk, fatty liver disease (MASLD), sleep apnea, or how these conditions progress faster in kids than adults, this one is worth your time.

Watch the full podcast below.