July 2021

ENDOCRINOLOGY

REFLECTIONS ON THE GROWING FIELD OF OBESITY MEDICINE

Featuring: Robert Kushner, MD

As a passionate clinician, educator, researcher and advocate, I have dedicated my career to helping improve the lives of those affected by being overweight or having the disease of obesity.

I’m also a member of a group that is one of the fastest growing specialties in medicine – obesity medicine physician specialists.Though I appreciate the growing interest in the field of obesity medicine, I’m acutely aware that when I started almost 4 decades ago, things were quite different.

In my early days of practicing, there was:
  • no disease classification for obesity
  • no ‘obesity medicine’ physician specialty
  • no American Board of Obesity Medicine organization to certify physicians
  • no organization like the Obesity Society of leading scientists devoted to understanding and reversing the epidemic of obesity
  • no organization like the Obesity Action Coalition giving a voice to individuals affected by the disease of obesity
  • no anti weight bias movement
Though we’ve come a long way, we still have so much work to do.

Among the list of changes noted above, I take pride in knowing that with the help of my colleagues, we started the American Board of Obesity Medicine (ABOM) 10 years ago with the hopes of expanding the work force of dedicated and compassionate physicians who were knowledgeable and experienced in the care of patients with obesity.
Moving forward, I’m hoping that the 5000+ obesity medicine physician specialists certified by the American Board of Obesity Medicine can take the lead in the following areas:

1 – Model State-of-the-Art Obesity CareRather than setting up ‘quick fix’ clinics that use unfounded treatments that are either ineffective or designed for rapid weight loss, ABOM Diplomates must model credible standards of care.
What does that look like?
  • Optimal obesity care involves utilizing a comprehensive approach to helping patients manage their excess weight, incorporating lifestyle management that includes diet, physical activity, behavior change, stress and sleep, and when indicated, prescribing medications for chronic weight management and considering bariatric surgery.
  • It also entails employing an expanded group of other professionals including registered dietitian nutritionists, exercise specialists, health psychologists, nurse practitioners and physician assistants, along with commercial programs.
2 – Be a Resource to Colleagues, Local Health Care Systems and Medical SchoolsWith more that 2 of 3 adults being overweight or having the disease of obesity, we need primary care providers to be better informed about how to provide efficient and effective obesity care.

And with new medications becoming available for obesity treatment, this is an optimal time for ABOM-certified physicians to not only serve as a resource to their local health care systems but also become educators.

Whether it’s a local grand rounds conference, participating in continuing medical education presentations, or precepting trainees, ABOM Diplomats have an opportunity to inform and share their experience with other health care providers who are entrusted with the care of patients with obesity.

3 – Advocate to Fight Weight BiasWeight bias, the stigmatization and discrimination of people who are overweight, is rampant in health care, the media, and society at large. We have an opportunity to eliminate weight bias by taking the following concrete steps:
  • By using people first language (for example, saying “people with obesity” instead of “obese people”), we refrain from labeling people by their disease. This is important because we incorrectly ascribe attributes to people when we use labeling language. This is particularly common when we talk about obesity.
  • Obesity is not a covered benefit in many health plans. Lack of insurance coverage extends to office visits, referral to a registered dietitian, use of pharmacotherapy, and for some, bariatric surgery.
  • Advocating for change at the local and national levels is important for all of us. To become involved in advocacy, I encourage you to join the Obesity Action Coalition (OAC).
  • OAC is a 50,000+ member national non-profit organization dedicated to giving a voice to the individual affected by the disease of obesity and helping individuals along their journey toward better health through education, advocacy and support.
If you’re someone who struggles with weight and want to find an obesity medicine physician specialist in your area, you can do so here.
RK
Robert Kushner, MD

This article was originally published Dr. Robert Kushner's website on July 2021. 
Robert Kushner, MD is Professor of Medicine in the Division of Endocrinology and Professor of Medical Education. ​

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