The Dollars and Sense of Obesity Medicine Certification

As the obesity epidemic continues, new groups are encouraging physicians to develop specialized knowledge about the problem.

More than one-third of adults (34.9%) were obese in the US in 2012, and every state had a rate of obesity that exceeded 20%. Three states—Arkansas, West Virginia and Mississippi—have rates above 30%.

But the good news is that there are now more full-fledged doctors who specialize in obesity medicine trained and ready to combat this growing health epidemic.

The American Board of Obesity Medicine reports that a record 429 examinees passed the certification exam administered in December 2015, bringing the total number of ABOM diplomats in the U.S. and Canada to close to 1,600.

“Obesity is the leading driver of more than 70 other illnesses,” says Louis Aronne, MD, board chairman for the American Board of Obesity Medicine. “We think that treating obesity effectively should be part of healthcare. That should be our role. And to do that you need people who have the knowledge of this area. We have the breadth of knowledge, the specialized knowledge to manage patients.”

Diverse Group of Specialties

Aronne explains that ABOM recognizes that obesity is a disease that affects people of many types and with many other health problems. He also points out that the American Board of Medical Specialties has recognized obesity medicine as a clinical specialty. As such, the goal is to have a wide range of physicians become familiar with the specifics of obesity medicine.

That’s evident when examining the diverse group of specialties from which the newly certified (December 2015) hail. The group includes 141 internists, 123 family physicians, 33 endocrinologists, 28 pediatricians, 24 obstetricians/gynecologists, 14 gastroenterologists, and 10 surgeons.

“A big role of ours is helping people in other parts of the institution to develop treatment programs in cancer, heart disease, and gastroenterologists who deal with liver disease,” Aronne says. “How do you manage all the women with breast cancer, for example, who have weight problems and need an oncologist? That’s the type of concept that is really revolutionizing healthcare.”

Aronne says that becoming certified in obesity medicine provides physicians with the same level of qualification and confidence any specialist would have. He explains that many healthcare professionals don’t fully understand what obesity medicine is. He defines it as managing people in a way that focuses on their weight as a central problem that may be causing the other medical problems that they have.

Monetary Factors

Wendy Scinta, MD, MS is medical director for Medical Weight Loss of New York, PLLC, and an assistant professor of family medicine at SUNY Upstate. She is also the president-elect on the board of trustees of the Obesity Medicine Association.

With obesity now recognized as a disease rather than simply a cosmetic issue, Scinta says there are several incentives for physicians to consider certification in obesity medicine. A key incentive is the shift to value-based reimbursement. Physicians are penalized if their patients are less healthy, incentivized if patients are healthier. Scinta says that’s something physicians just can’t ignore.

“It certainly makes sense if you're a practicing physician who knows anything about a business, that you start to think about learning how to care for your patients and keeping them healthy,” Scinta says. “Not only does it save healthcare dollars, it also helps your pocketbook in terms of what you’re bringing home.”

The Obesity Medicine Association is in the process of building a survey to collect more concrete clinical data about the way physicians across the US and Canada practice obesity medicine. The goal is to determine what approaches—the nuances that each physician has in the way he or she treats patients—are working, which are not, and what some clinicians may be doing that’s new and exciting.

“What we really want to is to be able to show that data, and have it published in a large-scale study,” Scinta says.

Getting Certified

Aronne recommends physicians who are interested in becoming certified in obesity medicine first secure a better understanding of what it is. He suggests exploring education programs offered online, and at some point attending a conference to get a feel for what the specialty is about.

Scinta says there are many reasons physicians should consider certification in obesity medicine, not the least of which is improving the health of their patients. But it’s also important to note that the healthcare costs of obesity range between $147 billion and $210 billion per year.

“Imagine what we could do with that money if we could put it back into healthcare and work on prevention,” Scinta says. “But if you want to look at it from a short-term standpoint, it’s going to help you be able to work less hard and be able to have better outcomes, and hopefully be more satisfied as a physician in terms of what you’re able to bring home in your paycheck.”