Introducing…The Obesity Medicine Specialist: Who are they and what do they do?

Obesity is at an all time high. Its effects are wide spread across our nation and the world. The costs of obesity are staggering. It truly is a problem that requires all of our attention.

Management of obesity is tailored to a patient’s specific needs and it is widely agreed that it requires a multidisciplinary approach. There are different levels of overweight and obesity all of which merit intervention. Indeed, prevention of the condition altogether and the prevention of disease progression are important strategies in obesity treatment. The best practices will incorporate dietitians, behavioral health, exercise physiologists, Obesity Medicine Specialists (OMS), and surgeons.

OMS are licensed physicians, often board certified in internal medicine or family medicine who have dedicated their practice to the management of obesity and metabolic disease. They focus nutritional science, behavioral therapy, exercise and physical activity, pharmacotherapy, and sleep and stress management. They provide a sustainable model for the long-term management of the chronic disease of obesity.

Bariatric Surgery while highly effective is not available or appropriate for all patients who suffer from overweight or obesity. Class 1 obese (BMI 30-34) are not candidates for surgery under the current guidelines. This is the largest group of obese patients and it is terribly underserved. Within the groups who could qualify based on BMI (class 2 and class 3), most of these patients do not have access to surgery due to lack of insurance, poor candidacy, or other reasons. It is well known that 1-2% of patients who could qualify for surgery actually receive it in any given year.

This leaves a huge void for patients that are clearly suffering and need help or those that are on the cusp and need prevention strategies. It is here that obesity medicine specialists can have a tremendous impact in our unified fight against obesity.

Another major challenge in treating obesity is that long-term follow up is not good. In fact after five years it is rare to find a surgical practice who is seeing even 50% of its patients. We know that there is no cure for obesity and it requires long-term management. Why then do we see this drop off in follow-up if the disease is not cured?

One of the main reasons for this is the fact that many surgical practices do not have a system in place to insure long-term follow-up and to continue to provide support to patients more than 2 years after surgery. It is very common for surgical practices to only require annual follow-up after the first year. The length between appointments grows with the length of time since the operation. Patients need ongoing support in these years and an annual follow-up is not usually enough to help patients maintain their loss or to continue appropriate progress. I would argue that our follow-up visits should be more frequent the farther we get away form surgery. Many surgeons simply do not have enough time to allocate to patient support in this way and this is another place where an obesity medicine specialist can really make a difference.

We need to look at Obesity medicine specialists as our partners and not our competition in the fight against obesity.

In the spirit of this unified objective, ASMBS has partnered with The Obesity Society and The American Society for Bariatric Physicians to bring together top clinicians and scientists as we work together for our common goal of overcoming obesity .

More information can be found on our patient learning center: asmbs.org/patients

You can find more information about obesity medicine specialists at:
www.ASBP.org
www.obesity.org
www.ABOM.org