peminda k. cabandugama, md
Why did you pursue obesity medicine certification? I truly believe that battling obesity is the next great obstacle that is facing modern medicine currently. With its ability to impact all facets of life and pathology, this is the next global epidemic that needs to be addressed by all caregivers whether they know it or not. Therefore I feel that if I want to be at the forefront of that campaign, I need to equip myself with all the tools to do this and getting certified in the field of Obesity Medicine is the first step to doing so.
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? My “Aha” moment would actually be a string of them. Having contended with being overweight and obese myself, I have always tried to work out the intricacies of gaining and losing weight. Whether it be trying out a myriad of diets or experimenting with different work out strategies, it helped me gain an appreciation for the everyday struggle that people have to go through to lose weight against the body’s own ability to re-calibrate itself to an ever changing set point. I decided to pursue Obesity Management as a stand-alone specialty in my career when I was volunteering at a Weight Management Clinic (run by a mentor of mine, Dr Kevin Suttmoeller, who is also an ABOM diplomate) during my Endocrine fellowship.
How do you currently incorporate your obesity medicine training into your practice? I run dedicated Weight Management clinics, but do cross-consultation as needed during my endocrinology clinics and in the inpatient setting as well. Needless to say, being in the field of Endocrinology, with every patient visit, I feel that I can make a difference in a patient’s life, whether it means taking a couple of minutes to provide people with advice on diet changes and home exercises or giving the patient a meal plan. It is really eye-opening for me to talk to patients and realize that, contrary to popular opinion, it is not that they are purposefully ignoring the importance of eating healthy and regular exercise but they were just not afforded information on how to go about doing it.
Why do you believe obesity medicine certification is valuable? With close to a third of the US population already in the overweight to obese realm (and the numbers rapidly closing elsewhere in the world), I think that there isn’t a better time to be certified in the skills required to help this growing population of patients. The added benefit of getting certified in the field is it allows the passing on of knowledge I have gained during my certification. I currently run an Obesity Elective for Internal Medicine and Med-Peds residents at the University of Missouri-Kansas City. I believe this allows me not only to strengthen my own knowledge and keep up with the latest obesity medicine guidelines, but allows me to foster a new group of healthcare providers that will use these same techniques to empower their patients to lead healthier lives.
What is the biggest challenge you face in your practice? I think there are actually two big challenges that I face in my practice. One is the large amount of misinformation that is out there about weight loss in general, ranging from the abundance of unregulated over the counter weight loss supplements to patients being told that weight loss medications and even bariatric surgeries are “one-stop shops” to lose weight without the work. The other challenge is of course, time; with busy weight management and endocrine clinics, I feel that time is always an important commodity that I could use more of when educating these patients.
What has been your greatest achievement so far? I think my greatest achievement so far has been to restart the Weight Management clinic along with my partner here at the University of Missouri-Kansas City. This has allowed both of us to help countless patients head down the path to a better weight and more importantly, better health. There is no better feeling in the world than showing a patient how their weight loss has impacted their health, whether it is by showing their lipid panel or blood pressure and then showing them the scale!
What do you wish other physicians knew about treating obesity? I wish that all physicians can discern that being obese is not always a choice and that they should not just write patients off because of their weight. Unfortunately, multiple studies have shown that the sad truth is that most obese and overweight patients are just side lined as not being motivated enough to take care of any of their medical needs. Nothing can be further from the truth. These patients just need the correct guidance to help them lose the weight and a lot of them will surprise you with what they can accomplish if they receive the correct teaching!
Is there anything else you would like to share about your experience with obesity medicine? As I have delved more into the field of Obesity Medicine, I have realized just how complex the issue of obesity is, whether it is the hormonal causes of obesity to the socioeconomic reasons behind it. As such, my weight management patients teach me about dealing with obesity as much as I hope they learn from me on how to manage it. Therefore, I would like to request that if there are any destined obesity medicine specialists out there, please take the plunge into this rewarding field and make an enormous change in your patients’ lives and the lives of their families for decades to come.
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