How an Obesity Expert Can Help You Pick the Best Medication for Weight Loss with Dr. Beverly Tchang

Curious about how an obesity expert can assist in selecting the optimal weight loss medication? 

If so, you're in luck!

In this episode, we're excited to have Dr. Beverly Tchang, a leading figure in obesity medicine. Dr. Tchang is an assistant professor of clinical medicine at Weill Cornell Medicine in New York. She is also a triple-boarded specialist known for untangling the complexities of weight management. As Program Director of the Obesity Medicine Fellowship and President of the Tri-State Obesity Society, her insights are incredibly valuable.

In this engaging conversation, we'll dive into the process of choosing the right weight loss medication with Dr. Tchang's expert guidance. We'll also unpack the science behind obesity and shed light on effective management strategies. 

Gone are the days of seeing obesity as simply a result of personal choices or willpower – we're realizing it's a complex medical issue that needs empathy and support for proper treatment. This shift is all about breaking down the stigma surrounding obesity and fostering a more compassionate understanding of those navigating weight-related challenges.

Redefining Obesity: A Compassionate Approach to Holistic Health

Let's dive into the complexities of obesity. While BMI is a common screening tool to show obesity risk, it fails to capture the full picture of an individual's health. This metric, with a cutoff of 30 or higher designating obesity, overlooks crucial factors such as gender, race, and body composition.

You may be surprised to find that the BMI scale is the same across genders, therefore disregarding inherent biological differences. To address these limitations, a holistic approach to weight assessment is essential. Incorporating additional pieces of the puzzle like waist circumference and body fat percentage, with gender-specific cutoffs, provides a more nuanced understanding of weight-related health risks.

The medical community is undergoing a transformation in how it perceives obesity. Rather than viewing it through a lens of judgment, there's a shift towards recognizing it as a treatable medical condition deserving of empathy and support. This change aims to destigmatize discussions surrounding weight and foster a more compassionate approach to healthcare.

However, the journey towards destigmatization and improved definitions is gradual. Despite the emergence of anti-obesity medications and growing awareness, the process of reshaping perceptions takes time. Our goal is to bridge the gap between information and education, ensuring patients understand the implications of their BMI within the context of their own health.

Ultimately, addressing obesity requires that we acknowledge how unique our health journeys are. By reframing the narrative around obesity and embracing a comprehensive approach to weight management, we can foster a more inclusive and effective healthcare paradigm. It's time to move beyond the numbers and prioritize holistic well-being in the fight against obesity.

Why It’s Important to Find Expert Support

When seeking guidance for managing obesity, look to connect with healthcare professionals equipped with specialized training in the field. One valuable resource is the American Board of Obesity Medicine (ABOM) website. Here, individuals can find practitioners who have undergone additional education and certification in obesity medicine.

Certified obesity medicine specialists have demonstrated a commitment to advancing their understanding of obesity through rigorous training and examinations. While the quality of care may vary among practitioners, this certification signifies a dedication to addressing obesity as a complex medical condition.

Given the staggering prevalence of obesity—impacting over one hundred million adults in the United States alone—access to specialized care remains limited. With approximately 6,000 certified obesity medicine specialists nationwide, the demand exceeds the available expertise. Therefore, it's crucial to recognize that managing obesity requires a collaborative effort across various medical disciplines - the disease of obesity is multi-faceted, so our approach to treatment should be too!

Every healthcare provider, whether in internal medicine, surgery, psychiatry, or obstetrics and gynecology, encounters patients affected by obesity. Thus, fostering a culture of obesity education and awareness is paramount in all medical fields.

Also, patients may benefit from consulting with specialists who offer a range of treatment options tailored to individual needs. While some individuals may find success with lifestyle interventions guided by primary care physicians and dietitians, others may require more intensive interventions, such as medications or surgery.

Similar to managing other chronic conditions like high cholesterol or diabetes, obesity care may follow a tiered approach. Primary care physicians can initiate treatment with standard interventions, but for those who require specialized care or have complex cases, consultation with an obesity medicine specialist may be beneficial.

In essence, navigating obesity care involves recognizing the needs of patients and accessing appropriate expertise to address them effectively.

Telehealth in Obesity Care: Access, Challenges, and Opportunities

The rise of telehealth programs, particularly accentuated by the pandemic, has ushered in both opportunities and challenges in the realm of obesity care. Dubbed as "obesity commerce" by Ted Kyle, founder of Conscious Health, this phenomenon reflects the evolving landscape of healthcare delivery, with a particular focus on weight management.

Telemedicine platforms offer a convenient avenue for individuals to access obesity care remotely, bypassing traditional barriers such as geographic limitations and lengthy wait times. However, amidst the growth of telehealth services, concerns regarding the quality and integrity of care have surfaced.

Many telemedicine companies heavily invest in marketing campaigns, promising easy access to medications like GLP-1 agonists for weight management. Yet, given reported shortages and sometimes exorbitant prices, many healthcare providers question the origin and authenticity of these medications.

Questions arise about the legitimacy of their product and about which is the priority - patients or profit. This further underscores the need for transparency and accountability within the healthcare realm, particularly in the telehealth sector.

Despite these challenges, telehealth holds promise in addressing the accessibility gap in obesity care, particularly for underserved populations in rural areas or those facing long wait times for specialist consultations. By leveraging telehealth platforms, individuals can receive timely interventions and support, potentially mitigating the burden of obesity-related health complications.

Yet! While telemedicine offers convenience, it should not compromise the quality of care or overlook essential aspects of patient evaluation and management.

Moreover, patients utilizing telehealth services for obesity management should maintain open communication with their primary care providers. Collaborative care ensures comprehensive oversight, including potential interactions with other medications and necessary adjustments to ongoing healthcare management.

Telehealth's inherent convenience and efficiency present opportunities to revolutionize obesity care, provided that patient safety and quality of care are first. As telehealth continues to evolve, finding that balance between accessibility and clinical rigor is the goal for best practice and best outcomes.

Crafting an Ideal Obesity Care Appointment: A Collaborative Approach

In an ideal world, an appointment for obesity care involves a holistic approach, addressing all areas within an individual's health. Drawing parallels to primary care consultations, obesity care appointments delve into medical history, family history, and social aspects of health, recognizing the pervasive impact of weight on every area of life.

Understanding what has worked previously, challenges faced, and environmental stressors encountered lays the groundwork for tailored interventions. Physical activity, dietary habits, and psychosocial factors help to develop a comprehensive understanding of the patient's needs and goals.

According to Dr. Tchang, her discussions often revolve around medication therapy. Providers utilize a mnemonic like the "Four Cs" (Contraindications, Comorbidities, Cost, Choice) to navigate treatment decisions in conjunction with patients.

First, addressing contraindications ensure patient safety, as this eliminates medications that pose risks due to medical conditions. Second, comorbidities are considered, exploring medication options that may offer additional benefits beyond weight management. Third, cost becomes a crucial factor, acknowledging insurance coverage and affordability to ensure long-term feasibility. Ultimately, personal choice is emphasized, with treatment decisions made through shared decision-making, honoring patient preferences and fostering adherence.

This patient-centered approach acknowledges the importance of including patients in their care. By tailoring interventions to individual needs and preferences, healthcare providers create meaningful partnerships with patients, enhancing the effectiveness and sustainability of long-term management.

From redefining how we perceive obesity to exploring innovative telehealth solutions and crafting personalized care plans, we've covered a wealth of information in this episode.

But if you want the full scope of this topic, be sure to listen to the entire episode! Remember, managing obesity is not just about “managing” the numbers on a scale; it's about embracing a holistic approach that considers individual health and challenges. By fostering collaboration between patients and healthcare providers, we can navigate the challenges of obesity care together.

We hope you've gained valuable insights and practical strategies to support your wellness journey. Stay tuned for more empowering discussions, and until next time, take care and prioritize your holistic well-being.


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