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

In this episode, Dr. Evan Nadler challenges some of the most common misconceptions surrounding childhood and adolescent obesity—starting with the idea that it’s simply a result of poor diet or lack of willpower. Drawing on more than two decades of clinical, surgical, and research experience, he explains why obesity is a chronic disease, why BMI is an unreliable diagnostic tool, and how true risk should be assessed based on physical and mental health impact.

The conversation explores the powerful role of genetics and epigenetics, including how parental health and behaviors before conception can influence a child’s metabolic outcomes. Dr. Nadler addresses uncomfortable realities within modern healthcare, from non-reimbursable obesity diagnoses to institutional resistance, economic incentives, and the growing gap between scientific knowledge and actionable treatment.

From “skinny fat” and bariatric surgery outcomes to the misuse of compounded medications and politicized nutrition science, this discussion reframes obesity as a complex, multi-generational condition—one that demands earlier intervention, better systems, and evidence-based action. Dr. Nadler’s mission is simple but ambitious: prevent obesity early enough to make his role unnecessary.