sarah ro, md
Sarah Ro, MD, is a Lead Physician for the University of North Carolina Physicians Network Weight Management Program. She is a UNC Institute for Healthcare Quality Improvement Scholar and an adjunct assistant professor in the Department of Family Medicine at UNC School of Medicine. She is a Diplomate of the American Board of Obesity Medicine and helped create community-based weight management clinics in seven different communities in central North Carolina. This program has increased access to evidence-based obesity care for socially vulnerable populations most impacted by obesity. Dr. Ro is passionate about decreasing health disparities and inequities in the treatment of obesity in children and adults.
Why did you pursue obesity medicine certification? As a primary care physician in a small town in NC, I observed enormous amounts of human suffering and premature deaths related to severe obesity. Just treating the comorbidities felt like putting a band aid on a bullet wound. That journey led me to the obesity medicine certification with one goal in mind: Improving our patients’ health by treating obesity.
Many doctors have told us about the “aha” moment that stimulated their interest in obesity medicine. Do you have an obesity medicine “aha” moment that sticks out in your memory? Years ago, I took care of a 22-year-old African American woman with a BMI 50 and severe cardiomyopathy. Her prognosis was very poor. As a last-ditch effort, the patient agreed to undergo bariatric surgery. When I ran into her a few years later, she had lost over 100 pounds and was attending a local community college studying to be a medical technician. This life saving and life transforming obesity treatment left a long-lasting impression on a young physician beginning her career in primary care.
How do you currently incorporate your obesity medicine training into your practice? In North Carolina and many other states in the US, obesity disproportionately affects the socially vulnerable population. For this group, one of the biggest barriers for accessing evidence-based obesity care is the high cost of copays and high out of pocket costs for specialty obesity clinics and the commercial weight loss programs.
At our institution, to increase access to evidence-based obesity care for this population, we embedded three ABOM certified PCPs within three primary care clinics in 3 different communities in central North Carolina in 2019. We decreased the financial barrier by billing primary care copay rates for weight management visits. All three physicians were seeing their primary care patient panel with dedicated time blocked to do weight management.
Within a year, the demand was so high for these services that we encouraged other PCPs at our institution to get certified in Obesity Medicine. We currently have 7 ABOM certified physicians in 7 different communities and in 2024, we expect 6-8 additional ABOM certified PCP’s to start the weight management clinics covering the rural areas of North Carolina. Our goal is to have a ABOM certified PCPs in each of our 80 primary care clinics at UNC Health.
For more information about UNCPN Weight Management program, please read: Impact of a Community-Based Weight Management Program in a North Carolina Health Care System (stfm.org)
Why do you believe obesity medicine certification is valuable? ABOM certification gave us the leverage to share our vision with the leadership at our institution. This vision challenges the status quo of just treating the comorbidities of obesity in the primary care settings and offers hope to all patients including the socially vulnerable population suffering from this chronic debilitating disease.
This partnership with our institution’s leadership paved the way for increasing access to evidence-based obesity care to many communities in North Carolina.
What is your greatest success story so far? We have seen over 200 children in our weight management program during the last five years. A typical child in our program is a 12-year-old weighing >280 pounds with multiple comorbidities who has experienced psychological harm due to being bullied for their weight. We now have many more FDA approved pharmacotherapies that are quite effective for these teens, and several are in the process of getting bariatric surgery. Low cost and geographic accessibility are the key in getting these kids and families into our weight program.
What is the biggest challenge you face in your practice? Many socially vulnerable patients do not have access to advanced pharmacotherapies. North Carolina ABOM-certified physician coalition group is advocating the North Carolina Department of Health and Human Services to include AOMs in the Medicaid formulary.
What do you wish other physicians knew about treating obesity?
- Watchful waiting in children with severe obesity is not acceptable when we have so many effective treatments options.
- Don’t forget lifestyle counseling! Anti-obesity medications help our patients re-establish their relationship with food and physical activity. It is a golden time to help our patients change unhealthy eating habits and sedentary lifestyle.
- Please remind patients not to lose hope when GLP1s are not covered or not available. Older agents and bariatric surgery are also very effective in improving their health.
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