vani prabhakar, md
Why did you pursue obesity medicine certification?
I am an endocrinologist with an extensive background and interest in clinical diabetes management along with other chronic medical conditions like hypertension, lipid disorders, and other endocrine issues. Most of these conditions have obesity as an associated issue, contributing to these conditions in the first place or as an effect of treatment such as insulin or oral medication therapy. Helping patients lose weight and see many of these conditions improve made me pursue the obesity medicine certification as I wanted a more focused and evidence-based approach to helping patients with their weight. I liked the certification process of obtaining obesity-centered CME, attending requisite conference or meeting and taking a certifying exam to become a diplomate of the ABOM. It is indeed an asset for clinicians like me in endocrinology to have this opportunity for additional certification in an important field like obesity medicine which is very much part of several chronic endocrine conditions.
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?
I would say it was a mix of several Aha moments !!! Many of my diabetic patients asked me to prescribe weight loss medication and I had to defer them as I did not have enough of a comfort level or experience to use them. It was very frustrating to my patients and myself to tackle weight gain from insulin and other oral antidiabetic medications and seem to be in a spiral of further need for more medication and more weight gain. I happened to come across the ABOM website after an Endocrine Society meeting and learned about the certification process and decided to pursue it further.
How do you currently incorporate your obesity medicine training into your practice?
I currently work in a medical weight loss program, so it is a very weight focused practice. I see several patients with and without endocrine issues and applying my endocrine and obesity medicine knowledge has been very rewarding. Patients are very happy that I am able to address several things for them. It gives me great satisfaction to be able to improve diabetes control and withdraw insulin or other oral agents with weight loss success.
Why do you believe obesity medicine certification is valuable?
Current certification pathway allows physicians to gain additional knowledge and apply evidence-based principles obesity medicine across a multitude of practice areas. If different specialists who see patients with health consequences of obesity are able to help their patients in their practices, it leads to a much more holistic and cohesive way to practice medicine. Prevention becomes a big part of one’s obesity-focused practice and I think this makes health care in associated chronic conditions cost-effective, and sustainable in the long term. Working with similarly trained individuals such as dieticians, diabetes educators and psychologists make for a wonderful team approach that seems effective.
What is the biggest challenge you face in your practice?
Insurance coverage for patients to attend a medical weight loss clinic and medication coverage. Not many hospital systems have caught on to dedicated obesity practices yet I think, but seems like this would improve with better insurance coverage for these services.
What has been your greatest achievement so far?
Seeing patients lives improve physically, mentally and emotionally with weight loss success. Being able to lessen need for medications, improve long-term health, reduce risk factors and having heard such grateful responses from my patients, reinforces my decision to certify in obesity medicine.
What do you wish other physicians knew about treating obesity?
It is very rewarding! Helping patients with chronic medical conditions is very challenging. But by treating obesity, one can produce positive and tangible results and make even more positive impacts on several associated conditions related to obesity. There is an extensive and growing science to the practice of obesity medicine, as an endocrinologist, it is even more exciting for me to gain further knowledge of complex hormonal pathways and apply that in clinical practice.
Is there anything else you would like to share about your experience with obesity medicine?
I am glad I decided to expand my knowledge into obesity medicine and am lucky enough to apply it in my current practice.
I hope that formal obesity training becomes a part of all endocrine fellowships and several other specialties too.
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