A team of leaders from the MSU College of Osteopathic Medicine is evaluating ways to change the conversation about obesity — one doctor at a time.
Kim Pfotenhauer, assistant dean for clerkship education at the MSU College of Osteopathic Medicine, is a board-certified osteopathic family physician, a fellowship-trained diabetologist and is board-certified in obesity medicine. Here, she answers questions about her participation in a national project that aims to create and implement curriculum related to obesity education and how it might affect patients to have anti-obesity medications covered by Medicare and Medicaid.
How many people in the U.S. are affected by obesity and how does it contribute to other health conditions?
According to the Centers for Disease Control and Prevention, two in five adults have obesity, which means they also have a higher risk of developing diseases like type 2 diabetes, heart disease and some types of cancer.
Historically, there has been a stigma associated with obesity and overweight conditions and that has discouraged patients from talking with their doctors about their concerns. Since 2013, obesity has been considered a disease, not just a lifestyle concern, and that has changed the way people think about it from a medical perspective. In some ways, this is a really new science.
I think that patients who are overweight or obese feel a lot of judgement and bias. They often aren’t treated as if they have a chronic disease, and we need to shift that framework. We can treat this and now we have more tools to use than just lifestyle changes. While lifestyle changes will always be important, we recognize the complexities of this disease, and we are beginning to treat it holistically.
What’s happening at MSU to help prepare new physicians to work more successfully with people who have obesity?
Representatives from the MSU College of Osteopathic Medicine were chosen to work with experts from nine other colleges to develop and implement an obesity curriculum for medical schools. We’re about halfway through the two-year FORWARD Education QI Project which was initiated by The Obesity Society, a group of professionals who collaborate to overcome obesity.
Because obesity is newly categorized as a disease, there isn’t a lot of material in curriculums in many medical schools across the country, so we are implementing 12 free education modules about the comprehensive diagnosis and treatment of obesity into our curriculum. MSU is the only osteopathic medicine program participating in this QI research project, and part of our contribution is to develop curriculum specifically for osteopathic students.
Here at MSU, our students have studied some of this new material in their first-year biomedical sciences course and they’ll get more as they continue through the program. So far, I’m hearing that they appreciate having classroom guidance. No matter what area of medicine students choose, they will be treating patients with overweight and obesity. They need to know how to do that with compassion and the latest evidence-based approaches.
If medications to treat obesity are approved for coverage by Medicare and Medicaid, what could happen?
Well, this won’t be a change for everyone. In Michigan and 15 other states, Medicaid already covers anti-obesity medications. Although these medications have been used for years to treat type 2 diabetes, they are now being used to treat overweight and obesity, which is new. Insurance plans need to catch up. I don’t think anyone could have predicted how popular these medications would become, and we’ve had issues with shortages in addition to coverage. This change would be a big step forward.
I’m excited about the possibility of having Medicare and Medicaid coverage for anti-obesity medications. Many people benefit from taking these medications as part of a comprehensive treatment for diagnoses of overweight and obesity.
And we are seeing results.
Research reported in 2023 showed a decrease in adverse cardiovascular events, like heart attacks and strokes, in people who are treated with certain anti-obesity medications who don’t have type 2 diabetes. Obesity puts patients at risk for over 236 different diseases. If we are looking for the biggest benefit, this is a good place to start.
These medications also are changing the way we treat people who have this chronic disease. Some medications are approved for adolescents, who are also showing increased rates of diagnoses of overweight and obesity. There are also many more medications in development, some of which may help people lose an amount of weight that is equivalent to bariatric or metabolic surgery. Patients now have more options to manage their health, and physicians have more options to treat this challenging chronic disease.
