A Letter from Dr. Sowa

Why she advocates for a more holistic approach to health, starting with the metabolism 

I come from a family with excess weight, heart disease, and type 2 diabetes. As a child growing up around women who were chronically dieting and struggling with their weight, so much of the focus was on the cosmetic importance of weight, but I wish I could go back and tell my family what I know now! The truth is, most people (over 90% of those I see) who struggle with their weight have something on the inside that’s impacting the outside—and their overall health outcomes. 

If my family members had treated their underlying health conditions instead of constantly dieting, they likely would have prevented many of their health problems and lost the weight they wanted to lose. Too many people feel powerless about their health, including weight, and it doesn’t need to be that way! 

Traditional medicine doesn’t address the root cause

When I started pursuing medicine as a career, I believed I would be treating these root causes of disease. But as my medical training continued, I realized that in almost every traditional medical context, I was taught to treat the late stages of disease instead of addressing the cause and preventing it. I became increasingly unhappy knowing that many patients I saw would continue to suffer chronically since no one empowered them with tools to help them long-term. 

Thankfully, I learned about a field of medicine where I felt I could make a major difference: obesity medicine. Since metabolic dysfunction is at the core of many chronic illnesses we develop, treating that dysfunction ends up diminishing cancer, heart disease, hypertension, and chronic pain, in addition to improving overall quality of life. 

I never looked back! Now I’m board certified in both Internal Medicine and Obesity Medicine—and I get to incorporate holistic approaches to health in my practice that treat symptoms and make foundational core changes in my patients’ lives. 

My field is a relatively new one, and there are still many misconceptions about weight and health. Many doctors tell their overweight patients simply to lose weight but don’t tell them how. Or they write a prescription and call it a day. If you’re having a hard time losing weight, it’s not your fault. Here are four myths about health and weight I wish everyone knew the truth about. 

MYTH: Weight is about willpower. 

This couldn’t be further from the truth! We all know incredible, strong, and successful people who have “failed” at diet after diet, and it’s not because they lacked willpower. Over 400 genes and 40+ hormones are involved in weight regulation—and that’s part of your biology, not part of your ability to stick to a plan.

You probably also know at least one naturally thin person who doesn’t have to try to stay that way, which is just more evidence that weight isn’t all about calories. Genetics and hormones play a huge factor in how your body stores, burns, and distributes fat. 

MYTH: You can tell if someone is healthy based on their appearance. 

In general, our society places way too much value on appearances, especially regarding weight. There is nothing inherently good or bad about your BMI or number on the scale—and this is one of the first things I teach my patients when I start working with them. 

Your health is about so much more than just weight, which is why I do comprehensive lab work for all of my clients to see what’s going on under the surface. While being overweight or obese is correlated with many conditions, nine times out of ten, the excess weight is connected to an underlying metabolic issue. Telling someone to lose weight to reduce their risk of disease doesn’t work because their treatment of underlying conditions needs to begin for the weight to come off. 

MYTH: Losing weight is always the answer. 

Some people are at a healthy weight and still feel stuck in the cycle of feeling like they need to lose more. I always focus on physical health—based on the best scientific markers we have—in my practice. Some places like med spas offer weight loss services for cosmetic purposes, but that’s not what I do, which means not everyone will qualify for medications like Wegovy when they come to me. Some don’t need medication, and lifestyle interventions still make a huge difference in their overall health! 

It’s also why I don’t ignore weight loss’s emotional and psychological components— losing weight doesn’t automatically make other life problems go away. Sometimes it leads to issues of its own! The right mindset will take you very far in your health journey. With weight medicine especially, you can’t treat just one thing without acknowledging the rest of the person—and I believe my focus on mindset is a core reason my method is so effective for getting results that last. 

MYTH: Medication alone is enough. 

Writing prescriptions and leaving people to figure it out on their own is far from the most effective way to see health transformation, and it’s why I left a more traditional medical practice to start my private practice. Combining medical advancements with lifestyle interventions is the most effective way to lose weight, keep it off, and prevent future disease. 

Making medically driven, holistic metabolic healthcare accessible 

For years, I’ve worked with patients in my New York City private practice to achieve incredible results. Over 90% of my patients with a BMI of 30 or more lose more than 10% of their body weight by 4 months and more than 15% by 6 months. 

But what I’m really proud of is how many keep off the weight. Over 90% maintain their weight loss within 5% because of the mindset and habit foundations I incorporate alongside medical interventions. 

I’ve loved working with my patients in private practice, but I knew that many more people across the country would benefit from my approach. When I started doing telehealth during the pandemic, I realized that I could grow and scale my metabolic health clinic across America. Now I’m licensed in over 12 states, and I’m proud that my success at the private practice level has translated into my telehealth practice, where I work with patients in a group setting that I’ve termed The Weight Biology Reset program. 

But not everyone can make that investment, so I also wanted to develop an affordable metabolism testing kit that can empower anyone to understand their underlying metabolism blockers from the comfort of home. If nothing else, I truly believe everyone can benefit from the Weight Biology Kit because knowledge is power! 

In America, we have a long way to go in helping people get the care they need when it comes to metabolic health. Today, 50% of Americans are eligible for weight loss medication, and only 2% receive them. 

My goal is to help as many people get access as possible. Thank you for joining me on this journey to build a healthier world. 

In health,

Dr. Alexandra Sowa, MD, MA 

Board certified Obesity Medicine and Internal Medicine Physician

Founder & CEO of SoWell Health