Obesity treatment - where to start and which doctor should you see?

The best way to start obesity treatment is an appointment with a doctor who will measure your weight and waist, order tests and draw up a plan with you. You can book this appointment with a GP (family doctor) under the NFZ (Poland's National Health Fund) or privately with a doctor who treats obesity. You do not need a referral for either. According to the 2024 guidelines of the Polish Society for the Treatment of Obesity (PTLO), obesity and its complications should first be diagnosed by a GP, who refers you to a specialist when needed (PTLO 2024). Obesity is a chronic disease, listed in the WHO classification under code E66, and it does not go away on its own. It helps to prepare for your first appointment, because the doctor will ask about your weight history, the medicines you take and your previous attempts to lose weight.

In brief

• Your first appointment can be with a GP under the NFZ or privately with a doctor who treats obesity. You do not need a referral for either.
• Obesity medicine is not a recognised medical specialty in Poland. Obesity is most often treated by GPs, internists, diabetologists and endocrinologists, and PTLO runs a certification programme for doctors.
• Bring your test results, a list of your medicines with doses and a written weight history, including your lowest and highest weight as an adult.
• It is best to have your weight, height, waist and blood pressure measured at the clinic, at least at the start of treatment. The first appointment and follow-up appointments can take place online if you provide up-to-date results and measurements and the doctor considers this safe.

Where should you start obesity treatment?

Start by checking your BMI and waist measurement, then book an appointment with a doctor who will confirm the diagnosis, assess your risk of complications and order tests. Changes to eating, physical activity, psychological support and any medication come only after this assessment.

BMI is your weight in kilograms divided by the square of your height in metres. A result from 25 to 29.9 means overweight, and 30 or more means obesity. For someone 165 cm tall, obesity starts at about 82 kg. Waist circumference is measured halfway between the lowest rib and the top of the hip bone. PTLO considers abdominal obesity to be present when the waist measures at least 80 cm in women and 94 cm in men, regardless of BMI.

BMI alone cannot tell fat apart from muscle and water. In 2025, an international expert commission recommended confirming excess body fat with at least one additional measurement, such as waist circumference. With a BMI above 40, no additional measurement is needed (Rubino et al., Lancet Diabetes & Endocrinology 2025). Measuring yourself at home helps you decide whether to see a doctor, but the diagnosis is made by the doctor.

An appointment also makes sense if your BMI is in the overweight range but you have high blood pressure (hypertension), prediabetes or abnormal blood lipids. Rapid weight gain without any change in how you eat is another reason for an appointment, because weight gain can be caused by an illness or by a medicine you take.

Which symptoms need an urgent appointment with a doctor?

If your weight is rising quickly and you have also developed swelling in your legs, breathlessness or marked weakness, see a doctor without delay. The cause may be an illness that needs urgent investigation.

Which doctor should you see about obesity?

You can go to a GP or to a doctor who treats obesity, most often an internist, diabetologist or endocrinologist. An NFZ GP will take measurements, order basic tests and can manage your treatment, and will refer you to a specialist outpatient clinic if other conditions you have require it.

How does a GP help with obesity treatment?

According to the PTLO guidelines, the GP measures your weight, height and waist. If the result is abnormal, the GP tells you and asks whether you would like to talk about treatment. PTLO stresses that the doctor should not skip this question. The GP then takes your history, examines you, orders tests and sets a treatment goal. The GP may also suggest medication or refer you to a bariatric surgery centre.

However, a GP has fewer options than the team at an obesity clinic. In primary care (POZ), you can get up to 3 dietary advice sessions a year only under coordinated care (opieka koordynowana), an NFZ programme for patients with chronic conditions such as diabetes, prediabetes or heart disease. If you have obesity alone, your GP practice does not provide a dietitian, and there is no psychologist or physiotherapist on its team. We explain how to choose and change your GP in our article on POZ (primary care) doctors.

What is an obesitolog?

"Obesitolog" is the informal Polish name for a doctor who treats obesity (an obesity specialist). There is no such specialty in Poland. The term usually refers to a GP, internist, diabetologist or endocrinologist who has completed additional courses or postgraduate training in obesity treatment. PTLO runs a certification programme for doctors and treatment centres; the society's website has a map of certified centres. A private appointment with a doctor who treats obesity does not require a referral.

When choosing a doctor, ask how treatment will continue: who orders tests, how often follow-up appointments take place, whether a dietitian or psychodietitian (a dietitian trained in the psychology of eating) is involved and what happens if your weight goes down more slowly than expected.

When do you need an endocrinologist, diabetologist or surgeon?

In the PTLO algorithm, the doctor refers you to another specialist or orders additional tests if they find or suspect hormonal disorders, diabetes, heart disease, swelling, depression, gallstones, obstructive sleep apnoea or secondary obesity (obesity caused by another disease). Under the NFZ, you need a referral for a specialist outpatient clinic.

A surgeon assessing you for an operation also takes into account the highest BMI you have ever had, not only your current one.

How can a dietitian and psychologist help with obesity treatment?

A dietitian draws up an eating plan suited to your health conditions, preferences and daily schedule. A psychologist or psychodietitian helps when food is a way of coping with emotions. Neither of them makes a diagnosis or prescribes medicines, so they work together with the doctor.

PTLO describes obesity treatment as a combination of changes to eating, physical activity, psychological support and, when needed, medication or surgery. Medication does not replace the other elements. If you are prescribed a medicine, you still need to keep changing your diet, being more active and working with a psychologist, and the PTLO guidelines tell doctors to remind patients of this at every appointment.

The doctor will also ask about your mood, stress and eating disorders. Episodes of binge eating, eating at night or symptoms of depression mean you should see a clinical psychologist or psychiatrist. European guidelines for obesity management in primary care say that treatment should also address self-esteem and body image. According to these guidelines, the success of treatment is not determined by how quickly your weight goes down (Durrer Schutz et al. 2019).

People with obesity often face prejudice, including in healthcare settings. According to a 2020 international expert consensus statement, this stigma harms physical and mental health, and people affected by it are less likely to receive appropriate care (Rubino et al. 2020). Conversations about weight at the clinic should be factual and free of judgement.

How do you prepare for your first appointment with an obesity doctor?

Bring test results from the last few months and a list of all your medicines and supplements with their doses, and write down your weight history. The doctor will also ask about your sleep, work, eating, alcohol and previous attempts to lose weight, so it helps to think about your answers before the appointment.

What should you bring to your first appointment?

• Blood test results, hospital discharge summaries and imaging reports, such as an abdominal ultrasound
• A list of your medicines with doses, including over-the-counter medicines and supplements
• Your lowest and highest weight as an adult and what was happening when it changed, such as pregnancy, a new job, quitting smoking or a new medicine
• A description of previous attempts to lose weight: which diets and medicines, what the result was and why you stopped
• Home blood pressure readings, if you have them
• Information about a planned pregnancy or breastfeeding, because the choice of treatment depends on it

What will the doctor ask at your first appointment?

According to the PTLO guidelines, the medical history covers your weight history, type of work (especially shift and night work), eating habits, use of alcohol, tobacco and other substances, physical activity, mental health, eating disorders, medical conditions and the medicines you take. The doctor will ask women whether their periods are regular and men about erectile problems.

The doctor asks about medicines because some of them promote weight gain. According to PTLO, this applies to varying degrees to some antipsychotics (most of all olanzapine and clozapine), some antidepressants and some diabetes medicines, as well as corticosteroids. You should not stop these medicines on your own. Only the doctor treating that condition should decide whether to change them.

Try to answer the question about alcohol honestly. At Nasz Gabinet, we offer support from an addiction treatment clinic, alongside obesity treatment, to people whose drinking is hazardous, and treatment for alcohol dependence to those who are dependent.

What questions should you ask the doctor?

• Do I have obesity, and do I already have any of its complications?
• Which tests do I need, and why?
• What goal are we setting for the first 3-6 months?
• Am I eligible for medication, and how long would that treatment last?
• Who will help me change my eating habits, and how often will follow-up appointments be?
• Which symptoms should make me come in before my scheduled follow-up?

What happens at the first appointment, and when can you have an online consultation?

At the start of treatment, it is best to have your weight, height, waist and blood pressure measured at the clinic, using medical scales, a non-stretch tape and a cuff of the right size for your arm. If your first appointment is online, the doctor relies on the results and measurements you provide and decides whether you need an examination at the clinic. Follow-up appointments during treatment can take place remotely if the doctor has up-to-date measurements and sees no need to examine you.

PTLO recommends assessing weight status on the basis of measurements rather than self-reported weight and height. At the clinic, the doctor also examines you, for example checking your legs for swelling.

Which tests does a doctor order for obesity?

The recommended laboratory tests include:

• Fasting blood glucose and, if needed, an oral glucose tolerance test (OGTT) or glycated haemoglobin (HbA1c)
• Lipid profile
• Uric acid
• TSH
• ALT and AST
• Creatinine with eGFR
• Full blood count and urinalysis

You do not need to have the full set done before the appointment. The doctor will order any missing tests and decide whether additional ones are needed.

What treatment goal is set at the start?

The doctor sets the treatment goal together with you. In the first stage, this is usually a 5-10% reduction in body weight over 3-6 months, which means 5-10 kg for someone weighing 100 kg. Canadian guidelines emphasise that obesity treatment should improve health, functioning and quality of life, not only reduce body weight (Wharton et al. 2020).

When does a doctor suggest medication for obesity?

A doctor may suggest an obesity medicine for adults with a BMI of 30 or more, or a BMI of 27 or more and at least one weight-related condition, if changes to eating and physical activity have not been effective enough. A BMI in this range alone does not mean a medicine will be prescribed. PTLO advises against courses of medication shorter than 6 months; ideally, treatment should last at least a year. This article does not replace a medical consultation.

Should you have obesity treatment under the NFZ or privately?

Under the NFZ, an appointment with a GP and basic tests are free, but you need a referral for a specialist outpatient clinic, and you usually have to wait for an appointment. Privately, you pay for appointments, you do not need a referral and you choose the date yourself.

In a report from November 2023, the Supreme Audit Office (NIK) found that the system did not provide comprehensive care for people with obesity and that waiting lists for clinics were getting longer (NIK 2023). PTLO points out that surgery is the only element of care fully funded from public money. The KOS-BAR pilot programme of comprehensive care for patients with severe obesity ended on 30 June 2026 (Ministry of Health). Medicines licensed for treating obesity are not reimbursed for this indication, so you pay the full price for them even if an NFZ doctor prescribes them.

You can combine both routes. Tests ordered by your GP are done free of charge at your GP practice, and you can take the results to a private appointment.

How do you start obesity treatment at Nasz Gabinet?

At Nasz Gabinet, obesity treatment starts with a medical appointment, at the clinic or online, with no referral needed. The first appointment costs PLN 250. The doctor assesses your measurements and test results and decides whether the treatment is suitable for you. A dietitian draws up your eating plan, and a psychodietitian helps when emotional eating is the problem. Medical follow-up appointments take place online every 4 weeks. We do not sell medicines, we do not treat children or adolescents and we do not perform bariatric surgery. If surgery is indicated, we refer you to a centre that performs it.

Frequently asked questions

Do you need a referral to see an obesity doctor?

You do not need a referral to see an obesity doctor at a private clinic. You do not need one for an NFZ GP either. Under the NFZ, a referral is required for specialist outpatient clinics, such as endocrinology, diabetology, metabolic disease or surgical clinics. It is usually issued by your GP after an initial assessment and tests.

Can a GP prescribe obesity medication?

A GP can prescribe obesity medication if it is suitable for you and you have no contraindications. Under the PTLO guidelines, your GP can manage obesity treatment, including medication. However, obesity medicines are not reimbursed for this indication, so you pay the full price regardless of who wrote the prescription.

Do you need to have tests done before your first appointment?

You do not need to have any tests done before your first appointment. If you have results from the last few months, bring them, because the doctor can use them. The doctor will order any missing tests after taking your history. The tests are chosen to suit the individual patient: the basics are blood glucose, a lipid profile, TSH, liver function tests and creatinine, and additional tests are ordered when there are specific symptoms.

Can the first appointment be online?

Your first appointment can be online if you provide recent test results and reliable measurements of your weight, height, waist and blood pressure. The doctor can then discuss your medical history and suggest a plan. If an examination at the clinic is needed, for example because of swelling or unclear results, the doctor will let you know. At the start of treatment, however, it is best for the doctor to take the measurements at the clinic.

Should you see a doctor if you are overweight?

Yes, especially if your waist measures at least 80 cm (women) or 94 cm (men), or if you have high blood pressure, prediabetes or abnormal blood lipids. With a BMI of 27 or more and a weight-related condition, the doctor may also consider medication. Seeing a doctor early means complications can be picked up before they cause symptoms.

Sources

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• Rubino F, Cummings DE, Eckel RH et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025;13(3):221-262. PMID 39824205, DOI00316-4)
• Rubino F, Puhl RM, Cummings DE et al. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020;26(4):485-497. PMID 32127716, DOI
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• Ministerstwo Zdrowia (Ministry of Health). Komunikat ws. programu pilotażowego KOS-BAR (Announcement on the KOS-BAR pilot programme). gov.pl
• Polskie Towarzystwo Leczenia Otyłości (Polish Society for the Treatment of Obesity). Program certyfikacji lekarzy i ośrodków (Certification programme for doctors and centres). ptlo.org.pl