robert ziltzer, md
Most of us were given little to no training in the treatment of obesity. As a result, most physicians today still give patients unhelpful advice such as “just eat less and exercise more.” Attaining obesity medicine certification allowed me to gain the knowledge to become an expert in the treatment of this pervasive disease. Local physicians can refer their patients with the confidence their patients are getting high quality, safe, evidence-based care. Patients feel more assured knowing they are getting state of the art nonjudgmental treatment for life.
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?
While practicing primary care internal medicine and pediatrics, I had spent much of my time prescribing blood pressure, diabetes and cholesterol medications. In many cases, obesity was the underlying cause of these conditions. I had said for years “When I can help people lose 50 pounds or more and keep it off, I’m going to stop doing primary care.” I learned those tools through training for obesity medicine certification and the accompanying CME. Within 6 months, I transitioned to full-time practice in obesity medicine. Now, over a decade later, I have a practice that is transformative for my patients and provides the career satisfaction that I am making a meaningful difference in the lives of my patients.
How do you currently incorporate your obesity medicine training into your practice?
Obesity treatment requires a comprehensive approach: nutrition, exercise, lifestyle change, appetite control, accountability, and a maintenance plan with long-term follow up. These are all elements I attained through the process of obesity medicine training.
Why do you believe obesity medicine certification is valuable?
Obesity medicine certification shows your patients and colleagues that you are a serious and legitimate expert in the treatment of this disease. It says you know how to talk to patients, know how to help them reach their goals, know what to do to reduce the chances of regaining, and know what to do when they do regain weight.
What is the biggest challenge you face in your practice?
Our patients believe that once they have lost weight, they are cured, and never have to worry about their weight anymore. Society perpetuates this myth; tens of thousands of diet books and quick fix weight loss tricks. It takes a long time for patients to understand obesity is a chronic disease. Sometimes, they have to regain several times before they realize they need to stay on their appetite suppressants, weigh themselves daily, check in our office each month, and remain active.
What has been your greatest achievement so far?
Through a partnership with my colleague, Craig Primack, we started with one office a decade ago. We have expanded to 6 physicians in 4 locations covering the Phoenix Metropolitan area. Our patients have lost a combined 204,000 pounds. Many could not walk a block, and can now run 5Ks, marathons, hike tall peaks, and enjoy playing with their kids again. It is these changes that most inspire me.
What do you wish other physicians knew about treating obesity?
When patients first see me, they feel shame, guilt, and embarrassment. They feel they have failed themselves. In many cases, they have lost all hope of regaining meaningful health and vitality. My hope is that physicians will learn how to help ready people for weight loss through motivational interviewing. Instead of telling them “If you don’t lose weight, bad things will happen,” ask them “Do you want help losing weight?” Then they will be much more receptive to change.
Is there anything else you would like to share about your experience with obesity medicine?
By 3 months, our patients reduce their blood pressure and diabetes medications by half. They improve physiologically long before they have reached their weight goal. Joint pain improves quickly and they start to appreciate the joy in being physically active. They start to see a glimmer of hope that they may able to turn back the clock! The change from primary care to obesity medicine has allowed me to regain the joy of practicing medicine. This is the kind of practice I had always hoped for!
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