GOLDEN VALLEY, Minn. - In this week's Real Men Wear Gowns campaign we're talking about losing weight.

We all know that diet and exercise are key, but when should someone consider weight loss surgery?

Dr. Jennifer Vesely is the Medical Director of the Medical Weight Management Program at HealthPartners. She says many of her patients have spent a lifetime feeling like they've failed when it comes to their weight.

“That's why we have Kleenex in all our offices because, as soon as patients hear 'It's not my fault' from somebody that knows, they all just break down because they've never been told that before,” Vesely says.

She says, what doesn't get talked about enough, are the physiological reasons some people have trouble losing weight and keeping it off.

A big part of that, she says, is a part of the brain called the hypothalamus, which regulates when we feel full.

“If you have a brain that's saying you're hungry all the time or you have a brain that is saying you are not full after a normal portion of food, then it's going to be really hard,” Vesely says.

She says people at or above a certain body mass index are eligible for medications that can help them lose weight. There are also procedures like vertical sleeve gastrectomy and gastric bypass.

According to Vesely, those things may be helpful for people who have already made lifestyle changes without success. She wants you to know that medication or surgery isn't cheating or taking the easy way out.

“It's a tool that's addressing the reasons why you struggle and, if we can address those reasons, then you can apply what you already know about healthy eating to be able to get the weight loss to come down,” she says.