Understanding the Root Cause of Obesity: My Journey From Critical Care to Weight Loss Medicine

When I first began my career in medicine, I found myself immersed in the intensity of critical care—treating life-threatening conditions, managing emergencies, and helping patients navigate the most vulnerable moments of their lives. But somewhere along that path, a deeper realization began to unfold: many of these critical conditions—diabetes, cardiovascular disease, stroke, and even cancer—had a common and often overlooked thread running through them: obesity.

That was the beginning of my transformation—from a critical care practitioner to a dedicated weight loss specialist. What started as a personal journey to better understand metabolic syndrome soon branched into a professional calling that shifted my focus from acute care to preventative and holistic medicine.

Obesity: More Than a Cosmetic Concern

For too long, obesity has been seen as a cosmetic issue, a matter of personal appearance or self-discipline. But through years of clinical practice and research, I have come to understand what the science is now making increasingly clear: obesity is a chronic, progressive disease. It is a leading cause of mortality and a major risk factor for several types of cancer—including pancreatic, breast, thyroid, and endometrial cancers.

And it’s not just about what we eat or how much we move. The root causes of obesity are complex and interconnected, often hiding beneath the surface. At its core, obesity can be categorized into five key drivers:

1. Lifestyle Factors – These include poor dietary habits and physical inactivity. While they’re the most obvious culprits, they are only part of the story.

2. Genetics – Our DNA can predispose us to store fat more easily, experience higher hunger signals, or have a slower metabolism.

3. Environmental Influences – We live in obesogenic environments, filled with ultra-processed foods, sedentary lifestyles, and harmful chemicals like BPA found in plastics that can disrupt metabolism and hormones.

4. Hormonal Changes – Particularly in women, premenopause and menopause play a huge role in weight gain, redistribution of fat, and insulin resistance.

5. Aging – As we age, our metabolic rate slows, and maintaining a healthy weight becomes more challenging without proper guidance and lifestyle adjustments.

From Disease Management to Root Cause Analysis

What makes obesity particularly difficult to treat is that it’s not just about willpower. Treating it effectively means going deep—understanding the metabolic dysfunction behind it, and using that knowledge to build a personalized, evidence-based plan that works long-term.

At Rache Clinic, this is exactly what we strive to do. Our approach isn’t one-size-fits-all. We provide a holistic, medically-supervised weight loss program that looks at the individual, not just the symptoms. Whether it’s evaluating hormonal imbalances, addressing emotional triggers, rebalancing the gut microbiome, or creating a sustainable nutrition and exercise plan—we are here to help you uncover the “why” behind your weight gain and guide you toward lasting transformation.

Medicine Over Beauty

This journey has reshaped how I see medicine. What began with an interest in aesthetics quickly evolved into something much deeper: the profound connection between metabolic health, longevity, and quality of life. The goal is no longer just to look better—it’s to live better.

If you’re ready to take that first step—whether for health reasons, mobility, energy, or self-confidence—know that you’re not alone. At Rache Clinic, we are ready to walk with you, support you, and celebrate every victory, no matter how small.

Because you deserve more than a number on the scale.

You deserve health. You deserve vitality. You deserve to thrive.

Rachel Ann Garcia, APRN, AGACNP-BC