A recent article on Medscape highlights the work and the opinions of Dr. Gitanjali Srivastava, a professor of medicine, pediatrics, and surgery, and the medical director of Obesity Medicine at Vanderbilt University, who had been practicing pediatric medicine for nearly a decade before completing an obesity medicine fellowship at Massachusetts General Hospital in 2013. Reflecting on that time, she recalls that there were no established guidelines or curricula for the specialty.
At that point, obesity was already a widespread issue, but there was still significant stigma both in the medical field and among the general public. After completing her fellowship, Dr. Srivastava spent months traveling and meeting with hospital executives across the country, explaining the importance and value of obesity medicine, covering details about its budget, business model, space needs, and revenue potential.
Specialized obesity treatment gains traction
Today, the field of obesity medicine is growing rapidly. More patients are seeking obesity treatment, and healthcare systems are actively recruiting specialists and building metabolic health centers. Since 2020, the number of doctors certified by the American Board of Obesity Medicine (ABOM) has nearly doubled, and fellowships have more than doubled as well. This year, over 2,100 doctors from various specialties will take the board exam, marking obesity medicine’s increasing integration with other medical fields.
The growing demand for obesity treatment has coincided with the U.S. Food and Drug Administration’s approval of GLP-1 injections, which have shown remarkable weight loss effects. Dr. Marcio Griebeler, head of the obesity medicine fellowship at Cleveland Clinic, explains that the recognition of obesity as a chronic disease, rather than a lifestyle issue, has been long overdue. Obesity treatment has shifted away from advice about diet and exercise to a more scientific understanding of the disease.
Dr. Kimberly Gudzune, chief medical officer for the ABOM Foundation, and others highlight that the brain functions differently in people with obesity, making it more challenging for them to lose weight through willpower alone. New treatments like GLP-1 have shown that obesity can be managed with medication, much like conditions such as high blood pressure or diabetes, but the disease often returns if treatment stops.
More obesity management and treatment training is needed
As more patients seek obesity care, doctors from various specialties are being asked about obesity treatment options, yet many feel unprepared due to a lack of education in this area. Medical training has historically neglected obesity and metabolic health, according to Dr. Nina Paddu, an obesity medicine specialist, who notes that her own training barely addressed these topics.
Dr. Srivastava explains that while the medical community has long sought to establish guidelines for obesity treatment, only recently has enough evidence emerged to create standards. Over the past five years, understanding of obesity’s underlying causes has advanced, with research highlighting the brain’s role and its connections to other diseases. This progress is transforming the way multiple specialties, including endocrinology and surgery, approach obesity.
In response to the growing need, more doctors are pursuing additional training in obesity management. The ABOM offers two certification pathways: completing 60 hours of continuing medical education (CME) credits or undertaking a 12-month fellowship. Dr. Srivastava points out that while the fellowship is more intensive, many physicians are choosing to immerse themselves in it to further their careers. Some return to their previous specialties, but many take on roles specifically focused on obesity medicine.
Despite the field’s growth, there are still not enough obesity specialists to meet the rising demand. With only a small percentage of U.S. physicians certified by the ABOM, many patients may not have access to comprehensive care. Dr. Gudzune emphasizes that while the field is expanding, it remains small relative to the number of patients in need.
Liraglutide is safe for kids as young as six, study finds
Speaking of weight loss medications, a new study shows that liraglutide, a drug already approved for treating obesity in adults and teens, is safe and effective for children as young as six when combined with diet and exercise. The results of the study were published in The New England Journal of Medicine. The drug was found to reduce body mass and slow weight gain in kids aged 6 to 11. Based on these results, the manufacturer, Novo Nordisk, has asked U.S. regulators to expand its use for this younger age group. If approved, it would be the first drug authorized for treating the most common form of obesity affecting over 20% of U.S. children in this age range.
The study involved 82 children, with those receiving liraglutide showing a 5.8% reduction in body mass index (BMI) after over a year of treatment, compared to a BMI increase of 1.6% in the placebo group. Nearly half of the children taking the drug saw significant health improvements. However, side effects, particularly gastrointestinal issues like nausea and vomiting, were common. While experts welcome the potential benefits of the drug, they urge caution in its widespread use due to the risks and lack of long-term data.
The study highlights liraglutide’s potential to treat the underlying causes of obesity in young children, potentially preventing serious health issues like diabetes and heart disease later in life. The trial will continue, with further results expected in 2027.
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Source: “Doctors Seek Additional Obesity Training in Wake of Obesity Patient Boom,” Medscape.com, 10/1/24
Source: “Weight-loss drug Saxenda effective for kids as young as 6, study shows,” MSN.com, 9/29/24
Source: “Liraglutide for Children 6 to <12 Years of Age with Obesity — A Randomized Trial,” NEJM.org, 9/10/24
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