Dr Enam Abood is the founder of the Harley Street Health Centre. She runs our Healthy Weight Clinic. In this Q&A we got to spend time with her to talk about managing weight and obesity in a GP setting and her thoughts on this complex topic.

Q: Dr Abood, obesity is often talked about in very simplistic terms. How do you approach it in your practice?

Dr Enam Abood:
The first thing I try to do is slow the conversation down. Obesity is not a moral failing, and it’s rarely just about willpower. When someone comes to see me about their weight, I’m not only looking at numbers on a scale — I’m looking at the whole person. Their medical history, emotional wellbeing, daily routine, family life, support system, stress levels, sleep, hormones, genetics, and their relationship with food all matter.
Weight issues are deeply personal. Many patients have tried repeatedly to lose weight and feel shame or frustration before they even sit down in the consultation. My role as a doctor is to create a safe, non-judgemental space and to work with the patient as an individual, not apply a one-size-fits-all solution.

Q: You often talk about “going back to basics.” What do you mean by that?

Dr Enam Abood:

“Back to basics” doesn’t mean simplistic or outdated — it means foundational. Before we talk about medications or advanced interventions, we need to understand what’s actually happening in someone’s body and life.
Is their thyroid working correctly? How are their hormones acting? Do they have PCOS? Do they have a genetic predisposition? Do they have insulin resistance?
Do they live in chronic stress? What is realistic for them in view of their life demands?
And then nutritionally, ensuring adequate protein, fat and fibre intake, stablising blood sugar, improving sleep, reducing stress and finding healthy and realistic ways to move in ways that become a lifestyle, not a plaster over giant gaps in the foundations.
We have to work together to create a strong foundation or no weight loss can be sustained.

Q: How do emotional factors fit into weight management?

Dr Enam Abood:

They are central. Food is often used for comfort or regulation, especially during periods of stress or emotional strain. Emotional eating does not indicate weakness — it indicates unmet needs. Addressing emotional wellbeing is often the key that allows physical change to happen.

Q: Are there core fundamentals that apply to everyone, even though patients are individuals?

Dr Enam Abood:
Yes. Human physiology follows certain rules, but how we apply them must be individualised. Stable blood sugar, adequate protein, regular movement, and sleep are fundamental. The approach must fit the patient’s life, health conditions, and emotional capacity.

Q: How do conditions like metabolic syndrome and PCOS change the picture?

Dr Enam Abood:
They make weight management more complex. With metabolic syndrome, we must address insulin resistance, inflammation, and cardiovascular risk. With PCOS, hormonal imbalance plays a significant role. These conditions require tailored strategies and realistic expectations.

Q: What about hereditary or genetic factors?

Dr Enam Abood:
Genetics influence appetite, fat storage, and insulin sensitivity. Understanding family history helps guide treatment and reframes the conversation away from blame.

Q: Where do medications fit into obesity management?

Dr Enam Abood:
Medication can be helpful for some patients but is never a standalone solution. It works best when combined with sustainable lifestyle changes and ongoing medical support. The Healthy Weight Clinic ensures this. There are many online pharmacies providing the medication without additional support and this concerns me.

Q: What practical first steps should someone expect when they see their GP about weight?

Dr Enam Abood:
A thorough assessment, relevant blood tests, discussion of lifestyle and emotional health, and realistic goal setting. Sometimes the first goal is improved energy or metabolic health rather than weight loss. Unfortunately, some GPs are very behind in their knowledge, have never had weight issues themselves, and are not empathetic. It’s important to have this conversation with the right GP.

Q: What message would you most want patients to hear?

Dr Enam Abood:
You are not broken. Obesity is a complex medical condition, and with the right support and specific plan, change is possible.