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Patients’ Health Not Improving? It’s Why I Treat Obesity



I think we are at a crossroads in medicine right now. Imagine the perfect storm. Life expectancy is decreasing for the first time in generations. Public health measures have gotten a hold of cigarette smoking only to have obesity rise up and surpass it as the leading cause of preventable death. Major attempts at curbing obesity and diabetes have failed. The final data on Healthy People 2010 outcomes showed obesity and overweight individuals worsened over the measured period. At the same time, health care costs are high, outcomes are poor, and there is a scourge of physician and provider burnout — there’s even a shortage in some areas.

Is this a coincidence? I can still practically taste my frustration of seeing my patients get worse and worse every three months when I saw them. Their blood sugar, blood pressure, and cholesterol got just a little worse each time. Heartburn, reflux, sleep apnea, depression, etc., would creep up on them. The medication list, the problem list, the referral list, the order list, all got longer and longer. The patients kept saying the same thing, “I want to get better.” I would manage their numbers effectively, for the most part. Their “ABCs” of diabetes met my quality goals for my bonus. But they did not “feel” better — they felt worse, and so did I. Was this why I went to medical school? I did not feel I was healing anyone; rather, I was only managing numbers with pharmacology. Something had to change.

When I first started offering obesity counseling, it was based on a Mediterranean type diet and food exchange. I started to see some exciting trends in blood sugar, blood pressure, and weight, as you would expect. I did not expect to see the changes I saw in the patients themselves. They became more engaged and optimistic about their health. For some patients, this program was all they needed. But, for many people farther on the spectrum of obesity, it was only the beginning.

That was when I quit my safe and secure position at a large health system and opened my own practice based on the program offered by Robard. And that was when the really exciting results started happening. That was June 2015.

At first, it was the ones who already knew me from primary care who trickled in. Then, it was their friends, families, coworkers, kid’s teachers, and anyone who saw them. Word got around, and the floodgates opened. They all said the same thing. The program gave them hope and then gave them their life back. They wished they had had it sooner. They wished they had known it was out there. They wished their doctor had told them about it. They wished more people could hear of it.

Since then, I have opened a second clinic and the patients have lost a combined total of 29,572 pounds. They report the program is the easiest diet they have ever done, most of them enjoy the taste of the medical foods and would like to be reassured that they will still be allowed to have one for breakfast or lunch once they reach their goal weight. They typically report that taking food away for a period made a huge difference in the role that food plays in their life, their relationship with food, their eating habits, and their cravings. I have learned that taking food away is one of the most important behavioral aspects of the program, even if only for a month. Since food can be addictive for some people, taking it away completely can be crucial for long term change, which is the opposite effect that you may be warned about by some critics of a short term rapid weight loss program that is “unsustainable.”

When patients come in the first time, they are sick and tired of feeling sick and tired. They have a hard time making it through the day, let alone going to the gym after work. I tell them casually not to worry, after the first 40 pounds comes off, they will feel much more like being active, they look at me like I am crazy. When I tell them that they will most likely not need any insulin after four weeks, they burst into a smile. When I tell them that after all the dozens of diets they have tried, with cabbage and lemons and meal prepping, all they have to do is drink a shake every four hours and the weight will come off, and they can go on with their lives of caring for their kids, parents, sick spouses and full time job, they are truly relieved.

And, for me, I now know why I went to medical school. Obesity is like lupus. It does involve every system in the body. You do have to treat the whole patient for the best outcomes.

So, for me, I honestly had some selfish goals. I wanted to feel purposeful and like I was making a difference. I mean, I get to cure diabetes, taking people off of 150 units of insulin who had been told they would be on it for the rest of their lives, freeing them from over one hundred shots of insulin a month. It is like curing cancer or chronic pain. Now, the biggest problem with my work is that I am so busy and I can’t seem to tell anyone “no” because I know the results they will get and they cannot get similar treatment anywhere else — at least at this point. So, I am working longer hours, but I love every minute of it, and at least I am not a helicopter parent and I hope my kids are learning “grit” and determination and non-normative gender roles by observation, but that is another talk.

So, I implore you to take bold action. In the name of decreasing life expectancy, plummeting quality of life, astronomical health care costs, physician burnout and sell out, turn away from the focus on HEDIS measures, patient satisfaction, quality bonuses, resource allocation and meaningful use. Before we turn into Wally World, stop missing the forest for the trees. Be the little boy who called out the Emperor’s New Clothes. Choose the path less traveled, operate at the sharp end of the sword, do what no one else can without those initials after their name can do, and fix the underlying problem.

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Want to save $30k? New Study Says Lose the Excess Weight



How would you feel about having an extra $31,447 in your pocket? Well, according to findings in a new John Hopkins Bloomberg School of Public Health study, that is the average savings in direct medical costs and productivity losses that a 40-year-old adult could expect to see by going from obese to normal weight.

But the study also found that cost savings is apparent for adults at any age group. A 20-year-old adult who goes from obese to healthy weight would see an average savings of $28,020 over their lifetime. After age 50, the largest cost savings occur when an individual with obesity moves to the normal weight, with an average savings of $36,278.

Think about what someone could if they lost all their unhealthy weight and re-allocated the money they would have spent on health care costs toward savings. They could buy a brand new car… a down payment on a house… a vacation around the world… college tuition for their kids. Why continue to allow obesity to hold our lives back?

There is already a wealth of research that illustrates how obesity and related comorbid conditions affects health care costs, workplace productivity, and job absenteeism. The estimated annual health care costs of obesity-related illness are a staggering $190.2 billion or nearly 21 percent of annual medical spending in the United States. This narrative really brings those numbers home to a more personal level when we take a look at what those costs look like for an individual.

“Most previous models have taken into account one or a few health risks associated with obesity. Subsequently, the forecasted costs may be unrealistic,” says Saeideh Fallah-Fini, PhD, a former GOPC visiting scholar who was part of the research team. “In our study, the model we developed takes into account a range of immediate health complications associated with body weight, like hypertension or diabetes, as well as all major long-term adverse health outcomes, including heart disease and some types of cancer, in forecasting the incremental health effects and costs to give a realistic calculation.”

Achieving a healthy weight provides financial benefits to any individual, medical practice, hospital, or company — it’s a win/win for any person, across any industry and population, and now it’s easier than one might think to put into practice. If you are ready to start reducing health care expenses by treating obesity, take a look at these two opportunities below to learn more and get started:


Related Article: Obesity Treatment Saves Time, Money, and Lives
Sources: Science Daily, National League of Cities

Blog written by Vanessa Ramalho/Robard Corporation


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Free On Demand Webcast: Updates in Obesity 2016-2017



Obesity treatment research is continuously updated. It can be challenging to stay abreast of new treatment protocols, pertinent nutrition information, and new solutions. To help health care professionals to stay ahead of the curve, Robard Corporation offers “Updates in Obesity 2016-2017,” a free, on demand webcast video featuring Dr. Christopher Case, a board certified endocrinologist in Jefferson City, Missouri, practicing at Jefferson City Medical Group.

During this presentation, Dr. Case reviews recently published articles in obesity management and the impact in clinical management; defines the role of macronutrients in weight loss and obesity through the examination of current published studies; and, advises you on how to implement practical weight maintenance techniques and applications through the assessment of current research.

Watch the video below. Then, be sure to check out how Robard can help you treat obesity.




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