MEET THE DIPLOMATE
madhu pamganamamula, md
Why did you pursue obesity medicine certification? Having practiced obesity medicine for many years prior to my certification, I wanted to reinforce my clinical knowledge of this area of medicine and update with the latest repertoire of tools available to physicians to fight this epidemic. It also provided a source and tools for me to transform myself into a more successful physician and offer treatments for my patients on a more structured platform.
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? A few years ago I saw a morbidly obese 30 year old young gentleman who was suffering from depression and sleep apnea. He was complaining of constant fatigue as well as excessive daytime sleepiness. He had seen many physicians before and they all stated that his symptoms were due to nothing other him being “fat.” His visits had made him further depressed and made him almost give in to his condition. This left him 40 pounds heavier and on the verge of losing his job. He had tried many times to implement a plan, which included better diet and exercise, but it was all to no avail. This was a man who did not realize that medicine had failed him in his attempts to lose weight. After hearing his experiences, I was sure that there were medical approaches to curing him of his predicament.
I immediately started him on antidepressants and had to fine tune his thyroid medication. I also diagnosed him with sleep apnea and provided the CPAP support along with appetite suppressants, dietary and exercise counseling. The patient lost more than 100 lbs and continues to follow me on a regular basis and is doing well.
This was evidence to me that exercise and nutrition plans should only be part of a more well rounded approach to treating the disease. Individuals can very much see drastic improvement in the efficacy of their plans with the addition of certain treatments from the area of obesity medicine.
How do you currently incorporate your obesity medicine training into your practice? Obesity medicine training has enabled me to take a more holistic approach to the treatment of the disease. Obesity is a disease resulting from various stresses on the body – be it psychological, physical or environmental. And the success of a obese patient to lose weight and sustain it greatly depends on the the initial evaluation and motivational interviewing that can result in establishing a strong physician-patient rapport. The evaluation involves piecing together the various components of the puzzle that makes up the individual’s health status. The aforementioned process identifies the particular deficiencies that contribute to the individual’s obesity. This helps us develop a more comprehensive and customized plan of care that includes both medical and surgical options available to the individual.
Why do you believe obesity medicine certification is valuable? I believe the certification expands the horizons of obesity management practice in a more structured manner. Many clinicians are often stuck in the trenches of current primary care complexity. This certification empowers the physicians to take a more creative and multipronged approach to achieve success in better treatment outcomes. Additionally, the certification identifies and distinguishes the physicians who practice primary care with an emphasis on obesity medicine.
What is the biggest challenge you face in your practice?
Empowering patients to come up with a viable plan in recognizing their own deficiencies in tackling obesity, adhering to the said plan, and educating them about the available tools and options in maintaining a healthy lifestyle.
What has been your greatest achievement so far? I recently received the “Community Statesman Award” in the field of Health and Science in my community for the year 2018. To me this stands as a testimonial to my efforts in developing a healthy community in and around the Midland/Odessa, TX area.
What do you wish other physicians knew about treating obesity? I believe that it is very important for physicians to recognize and treat obesity as a challenging syndrome or disease, rather than as a condition that should be looked down upon. I wish physicians would be more compassionate towards the obese and avoid humiliating them by calling them obese or fat.
Is there anything else you would like to share about your experience with obesity medicine? Given the scale of the current obesity epidemic, it is very important for any PCP to either acquire the required skills to manage the disease or consider referring to qualified obesity medicine physicians for better success and preventative health like they would to any other specialists (eg Cardiologists, Neurologists etc).
In fact, any patient that has experienced any improvement in the management of obesity becomes a free walking advertisement for that practice and a testimonial to the standards of care provided by that practice.
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