The Multidisciplinary Approach to Managing Patients with Obesity [Interview][Transcript]

Dr_Glenn_Rich_Obesity_medicineGuest: Dr. Glenn Rich
Presenter: Neal Howard
Guest Bio: Dr. Glenn Rich is certified as a Diplomate by the American Board of Obesity Medicine. Dr. Rich has established the Weight Control Center at Fairfield County Medical Group. This center takes a multidisciplinary approach to managing patients with obesity, while providing evidence-based compassionate care.

Segment overview: Dr. Glenn Rich, MD, discusses the medical specialty of obesity medicine and the multidisciplinary approach to managing patients with obesity, while providing evidence-based compassionate care.

Transcription

Health Professional Radio – Patients with Obesity

Neal Howard: Hello and welcome, I’m your host Neal Howard. Thank you so much for joining us. Our guest in studio today is Dr. Glenn Rich, Endocrinologist, recently certified as Diplomat by the American Board of Obesity Medicine. Now this represents the highest level of achievement in medical specialty of obesity medicine. Dr. Rich has established the Weight Control Center at Fairfield County Medical Group, the center takes a multi-disciplinary approach to managing patients with obesity while providing evidence-based compassionate care. Welcome to Health Professional Radio Dr. Rich.

Dr. Glenn Rich: Thank you.

N: Thank you. A couple of years ago, I believe the American Medical Association recognized obesity as a disease affecting 33% of the population of the United States. Now you are a board certified specialist in obesity medicine, what was it that drew you to obesity medicine?

R: It’s…my journey. I have been an Endocrinologist for about 25 years and an Internist for 25 years and one of my biggest frustrations practicing medicine was seeing patients who are overweight knowing that in a couple of years they’re gonna be termed diabetics or other complications from weight limited illnesses and just recommending diet and exercising and realizing that it was not working. And I can predict the patient to be diabetic in 2 or 3 years and even though the patients were well meant and really try to do what I recommended, what I have to offer them was inadequate and they will develop diabetes after a couple of years so I wanted to go back and learn something new that I could be able to help my patients with.

N: In seeing some of these patients doing what you’re recommending that they do and they were still developing these problems associated with being overweight. Weren’t you offering what you were taught to offer them in med school, in research and what not? How was it that you had to dig deeper in order to be more effective?

R: In medical school when I trained 25 years ago, we had very little training in weight management and in most of our training was just for recommending healthy diets and actually… until a few years ago where really diet that recommended low-fat and more high carbohydrates and in retrospect I’ve really seen to have been the wrong diet for weight management. So even as an Endocrinologist I don’t believe my training was adequate to really address this much more specialized area right now and also over the last 5 or 10 years there’s been a lot of new information about obesity and I’m understanding that it’s a disease as much as a life choice and there’s physiologic and biological factors in the individual that makes it very challenging for them to lose weight.

N: Now let’s talk about the Center there in Fairfield County, when did this get started? When was it founded, The Weight Control Center?

R: This is a multi-specialty group and when I became board certified I hired a couple of nutritionists to work with me. I have a diabetic educated who works with me and I sort of reach out to the community for some of the other stuff that I’ve unable to offer here in terms of exercise, in terms of counseling if I need that so I’ve done what I can do in a small private practice in terms of making it a center for the patients right here and then it’s stuff that I can’t offer in my office, I have offered it by getting outside sources to send the patients to.

N: Does your specialty in obesity medicine lend any advantage to the person who is not obese or has not been genetically identified as a potential obese patient? Can some of these people who are not even identified as going to be obese, can some of these practices help them to not become obese? Just because you’re not identified genetically, it doesn’t mean that lifestyle won’t cause you to become obese.

R: Yeah, I think a lifestyle in the last 20 to 30 years really has driven the obesity epidemic and in the last number of years you can see the rise in obesity and now it’s considered about a 3rd of the population’s obese and a 3rd of the population is overweight and clearly our environment and our society has geared people, have sort of made it more difficult to people to stay healthy and live a healthy lifestyle. All stresses or the lack of sleep and other factors, so any person who was a risk for that or was starting to gain weight, I think some healthy lifestyle choices working with a physician is always helpful and working with a weight center if they’re starting to gaining weight, I think would be helpful for many patients.

N: Has the mindset about obesity as far as, from the stand point of physicians as well as the patient, has that mindset shifted in a more positive direction more conducive to effective treatment? Or are you still battling the mental aspect of being an obese person when someone comes to your center?

R: I think there still is a very large amount of weight related vices in the country and I think there’s also a huge amount of guilt in patients who are overweight in terms of blaming themselves for why they’re overweight. So I think one of my roles is to try to get away the stigma of weight from the patients, try to talk with them and explain to them that there are many factors that they don’t control that causes weight gain and things from genetics to changes in the brain hypothalamus to other factors in their life that makes them prone to gaining weight and I think this trying to take a guilt off the patient and tell them they have a disease. You wouldn’t blame a patient who had a cancer because of it, you wouldn’t blame a patient with diabetes because of it or high blood pressure and I think a lot of people with weight related illness have been blamed for generations that they just stop eating and exercise, that it’s for their own doing and the science does not support that. The science supports that this is a disease like any other disease with causes and effects and so I think taking that guilt away from people and having them understand that there are factors that we can work with to try and help them is very important.

N: We see and attempt in advertising in mainstream media to accept being overweight as just a normal part, there’s some people are overweight, some are not. Commercials are becoming very accepting of what they call plus-sized models and actresses and actors and what not. Do you find that that is either a non-issue or is it something that you see some of your patients saying “You know what, maybe I should just not try and work as hard at this since this is just the way that I am.” and you as their physician can see that maybe acceptance is not the way to go at all?

R: I think there is more acceptance these days in weight in some individuals, I think it’s very personal. But I also think even though there’s acceptance, there’s still a lot of biases in there in terms of…biases, even when…biases with patients and how they perceive them has actually a lot of biases in terms of weight management with those patients also. But I’ll like to try…the patient, most patients even though they may be more accepted by society, it still has many effects on their life in terms of health. That is very important, I consider it as unhealthy BMI and unhealthy weight… patients because… so many different diseases and so many life complications that even if it’s socially accepted, medically I think there are a lot of ramifications on many patients who are overweight or obese.

N: Now and where can our listeners see more information about the Fairfield County Medical Center and Weight Control Center at Fairfield County Medical Group?

R: Actually right now we’re in the process of redoing our website but it should be up and running hopefully within a couple of weeks and our website will be www.fairfieldcountymedical.com and we’re in the process of redoing that to include the obesity stuff in there, that hopefully that will be up to about 2 or 3 weeks.

N: Great. You’ve been listening to Health Professional Radio, I’m your host Neal Howard. We’ve been in studio talking with Dr. Glenn Rich, board certified Endocrinologist and board certified as a Diplomat by the American Board of Obesity Medicine, designations and represents the absolute highest level of achievement in the medical specialty of obesity medicine and Dr. Rich has been in here, in studio with us talking about his multi-disciplinary approach in managing patients with obesity while still providing evidence based compassionate and considerate care. It’s been a pleasure talking with you Dr. Rich.

R: Thank you.

N: Thank you.

R: It’s been a pleasure talking to you also Neal.

N: Thank you. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe through our podcast on iTunes.