Building Your Dream Team: How to Find the Right Obesity Medicine Physician

Years ago, the standard approach to obesity in primary care was to “eat less and move more.” Now, we’ve come to learn that without intensive behavioral support, that approach is largely ineffective. What many people don’t know is that obesity medicine is actually a medical specialty on its own that focuses on the evaluation, treatment, and prevention of obesity.

If you're struggling with the physician you're currently working with, feeling they offer little guidance and understanding about anti-obesity medications, and offer no accountability, finding an obesity medicine physician might be the next step for you. 

When you're looking for a physician, one of the first things you need to decide is what kind of care you’re looking for. So in this episode, I’m exploring three different options to consider: in-person weight management clinics, telehealth practices, and direct primary care clinics. (You’ll also discover the red flags you need to look out for when making your decision!)

References:

ABOM.org

Finding a DPC (direct primary care) physician: https://mapper.dpcfrontier.com/

Audio stamps: 

02:12 - Dr. Rentea discusses the role of an obesity medicine physician and when you might need to look for one.

04:16 - We find out why most people are not going to get all of their help from one person.

05:28 - Dr. Rentea explains why you don’t need to have struggled with your weight to be a good physician in this space.

06:22 - It’s important to decide if you want to see someone in person or virtually. Dr. Rentea discusses the in-person experience and how to go about finding the right physician.

13:58 - We learn about telehealth options, like Dr. Rentea’s practice, and what to look out for when considering this option.

21:26 - We find out why direct primary care could also be a good, inclusive option to consider.

23:42 - Dr. Rentea shares some of the red flags to be aware of when finding an obesity medicine physician.

Quotes:

“Most people are not going to get all of their help from one person.” - Matthea Rentea MD

“Not everybody needs to have struggled with weight for them to be a good physician in this space.” - Matthea Rentea MD

“I really think that we've gotten a lot of this information wrong over time. We've really just thought about the scale going down in general, but we've not thought about what the body composition is and how you can best manage your blood sugar and how to bring this all together in a way that's not overwhelming.” - Matthea Rentea MD

“You need to like who you're working with. At least that's what I found is that if you don't like the physician, you don't want to listen to what they're saying, and you don't want to do anything.” - Matthea Rentea MD

“Everyone's different. You might not respond to what's being offered and all of us are unique.  - Matthea Rentea MD

And so if there are these really high guarantees, it's just a big red flag to me.” - Matthea Rentea MD

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Transcript

0:29

Welcome back to another episode of the podcast. I'm so excited to be with you all. How is everybody doing? I am In a phase where I have been increasing my movement, I'm doing a lot more strength training, and I had this magical moment the other day where instead of doing a modified move, so I'll do a lot of modified planks or modified push ups, things like that within the strength program that I'm doing, and the other day it just occurred to me, why don't I just try to do this normally, you know, with having the hands extended, and And it was actually easier to do it that way than it was to do it with the knee modification. And if any of you out there have been someone that You've really had a mental block for a lot of years leading up to you tackling that. For me, it's definitely been with movement. Certain things have always been certain body moves, not possible based on my body size or being able to do certain things based on being able to sort of, I'm really into functional fitness, meaning where you can really handle your own weight and do things like that. And so that was just a really. Incredible non scale victory for me, and that is slightly different than what we're going to talk about today. But just to remind you, no matter where you are in your journey, whether you are starting out, you are on the road, maybe you're at maintenance and you're just fine tuning things continue to look good. For things that are amazing every day because they exist, but we have to notice them. It was such a quick moment. It was this one second. I can do this. It wasn't even a profound thought, but I just had that moment. So I wanted to share that. And I'm wondering if you can sit here and think to yourself today. Was there a moment today, something that was amazing that you can just kind of hold on to that a little bit. So today I wanted to just very briefly talk about finding an obesity medicine physician. So a lot of people don't know, and probably this is not those of you that are listening to this podcast, but obesity medicine is actually an entire specialty. And the reason that this is, it's because Weight management, helping someone to manage their metabolic health, to potentially bring down their weight set point, it is extremely complex. We used to think that it was just, well, decrease your calories and move more. And we've just come to learn that there are, there were plenty of people that would do all of that. And the hunger that would come with losing weight and the obstacles that would come were just, much higher than you would expect. And most people would gain all that weight back plus more. And so this field of really helping with how can we strategically help with health in a way that's actually sustainable where things get better and we're not actually causing more harm. It's actually very complex. And so one of the things if you are struggling with the physician that you're working with, where you're working You feel like they're giving you actually very little guidance. They maybe don't really understand the anti obesity medications. I can't tell you how common it is that someone will join me where they actually have coverage for a med. They've been on the medication, but they're noticing that their physician has, maybe the primary care doctor has actually told them has straight up said to them. I can prescribe this, but I don't have any of the other supports for you. So they're not getting much help with nutrition, with mindset, with exercise. They just have no direction on any of it, very little accountability. And for some people, it really matters that they can get that accountability from their physician. So I wanted to talk today about looking at different options to be able to find an obesity medicine physician that you might've not thought of. And. We're going to make this a little bit more of an informal podcast because of course I could go, you know, through all these different companies. I don't think that's helpful. I think that opening you up to what you should be looking for or what you should look out for as a red flag, that those things might be helpful. Now, the first thing I want to say before we even get into where to look and what to do. It's that most people are not going to get all of their help from one person. It is extremely rare, the type of clinic setup that I have, that has so many different arms to it, where there's support in a lot of different areas. And even in my program, I am not, for example, I do not a hundred percent have a fitness program. I love who I suggest that people work with and I have the ability to kind of say where someone's at and what I'd like them to do and kind of help them on the arc. I know the science behind all the things, but as far as execution in a gym or with an actual program that I'm going to tell you where to look for. And so know that. It is not at all a failure if you are working with a physician, a clinic, something like that, and you find that okay, I get this help with the medication, but then I feel like I need more help with nutrition or exercise, or I just want to be in community with other people that are doing this so I don't feel so darn alone. There's nothing wrong with that. In fact, that's actually very normal. So I just wanted to start with that that most physicians it is. I do not find many physicians like me that themselves have lost weight. Actually, many doctors in this space do not have a weight challenge, and that's not a problem. So not everybody needs to have struggled with weight for them to be a good physician in this space. Now, if someone has, I find that often they have a they have a little bit of a different approach because they have some lived experience. And that's what I say with me, right? It's like I just have this This knowing it's like kind of with Play Doh, right? Like you've actually played with it. I'm actually trying to make these high protein recipes and I'm very conscious in trying to do these things. And it might be a little bit different, the energy coming across from that person for someone that hasn't. But of course, we can't hold that against a physician if they haven't struggled with their weight, right? Not all physicians are going to struggle with all problems. And That's why we have evidence based medicine, so that we can really be following those recommendations. When you are looking for a physician, I think one of the first things that you need to decide is what are you actually looking for? Some of you might be more limited because you might be in really rural areas where there are not big clinics set up or you just don't have the population that supports certain things. One of the first questions though, taking that out of the equation that you need to think about is, do I want to see someone in person or virtually? Now there are several areas in medicine where, and obviously I'm biased because my clinic is a virtual telehealth clinic, but I want to explain to you why the option was. a hundred percent available to do in person as well and why I decided to keep it virtual. So a lot of the time, some people just really want to sit across from someone and there is nothing wrong with that. You are going to be limited by geography and who is physically around you, but that is a hundred percent an option. The other option though, and it is just as great because we have so many health extenders that we can use, that you can use at home to make telehealth work. For example, body composition scales, measurements, there's so many things we can do. And there's so many different ways to track stuff that a lot of the time to me, for example, it makes no difference whether I'm going to see you in a virtual visit or whether I'm going to see you in person. And in fact, I've done both of these throughout my career. And what I actually found was that when I was. seeing people in person. The no show rate was a lot higher because people needed to physically cancel a lot of their day to get there. Even if someone lived close to the clinic, they would need to take time off of work. And then because I was seeing more people in clinic, I didn't have as much time blocked to actually be able to get back to people. Then the time to get back to people was longer. And so what I find found was it was a really clunky experience. It was also they were not able to see me monthly. And so it would be this experience where they would get started on a medication, unless there was like a law, like for example, with Phentermine where you had to see him again the next month, or there was some type of a requirement where you felt like you needed to physically lay eyes on them, listen to their heart again, things like that. After that, you might see them every three or four months. And what I would find is that. A lot of things had happened in between and I had no idea. I had no, no chance to intervene. I had no, sort of little mini opportunities to kind of re give them some hope and motivation and focus them and have accountability. A lot of my patients say that they just frankly love the accountability that they get to talk to me every month, right? So first I want you to think about if you are someone that physically wants to talk to someone in person, then that's going to be a very local search to you, right? It's going to be by city. It's going to be. A lot of the times I find a good way to find that is going to be to ask in these sort of neighborhood social groups. Like for example, on Facebook, if you are part of a community group that is maybe your, your, I'll give you an example, like our association where we lived in Indiana, there was a Facebook group that they had just for us. So you kind of know what's going on in the neighborhood. And that's a place where people might say, Hey, what primary care doctor do you guys like to see? And then Everyone would kind of weigh in. I remember getting so many referrals from that when I was in primary care because someone would say, Yeah, I asked on a neighborhood board and your name came up a bunch of times. And obviously, like people are geographically siloed where they're living. And so then if they're seeing that name pop up a bunch, you're going to know. So if you're keeping it local, I would be looking on Google is obviously a powerful search engine. And then I would be looking for recommendations from family, friends, and in those type of networking groups, I'm sure that Reddit, things like that. These are the times you actually want to get in the weeds with these things because you want to know what people's experience is. It's really hard to just read a website and know what's going on. I don't know that I have ever. had a patient that just found my website and then became my patient. They all either heard me on TikTok, heard me on a podcast, a friend or a family referred them, another patient referred them. No one is just finding my website and then signing up. So look for local things if that's what you want to do. Now, another really big option, and by the way, a second thing with those local things, and this applies to both local and telehealth clinics that you're looking at. I want you to check if the physician that you're seeing is certified by the American Board of Obesity Medicine. It's ABOM. So abom. org. It's a website that you can go on and you can see if that doctor has the board certification. Now, a lot of people can practice in the obesity medicine space without having that board certification. And I'm not saying that they might not still be excellent and great. But more times than not, when I have someone where they just got really insane recommendations thrown at them, it came from someone that has not had that additional training. And so what is ensured when someone has that training, it's not that everyone's going to practice the same medicine afterward, but it's that they have seen these different studies that show what the metabolic problems are, that show what the actual evidence based results are, not just thoughts in their mind from a patient or two that they've treated where they say, okay, Everyone's going to intermittent faster. Everyone's going to do this or that. Whenever someone has a very dogmatic practice, it's a problem because we are all individual. And so a lot of the time when someone has been through this board certification, they have the additional training to understand that. And I will also tell you that they know a lot more things to look out for. They are likely really screening you for for different eating disorders like binge eating disorder or night eating syndrome They are picking up on things that other doctors are not even though they might say that they're in the weight management space So I know that this is tricky and I just want to start with validating that it is so frustrating Even me when I was trying to find a physician It was like I had to wade through this pool of I remember I met with one And she was lovely, but I just felt her energy. I would never get along with this doctor. I felt very judged for my weight. This was years ago and the way in which she talked about it, even though she was certified with the American Board of Obesity Medicine, I just felt like this person I will not get along with. And that's okay because remember this is an area that's ultimately very intimate what you're talking about. A lot of people are very sensitive to this. You've been judged your whole life based on your weight and what you're eating and what you're doing. And now you're going to work with someone on it. And if you feel triggered by them, it's not going to work. Okay, so you can look on abom. org. You can see if the physician that you're contemplating seeing is certified by them. The one thing I always say when I talk about that website is that there are a lot of different specialists that are certified on there. So, for example, a gynecologist can do it, a surgeon can do it. And you want all these different specialties because we're all interacting with the same patient. But just because they're on that website doesn't mean that they have a clinic exclusively for weight management. They might have just done it as an extra just so that they can understand their patients better. In medicine, we're always continually doing what are called CME, continuing medical education. And so A lot of us, it will just be something that we'll spend a year learning a lot more about this because we want to help people more in this direction, but we don't go, we don't set out to make a weight clinic. And I think the last time I looked, gosh, I hope I'm remembering these numbers, right. I think there's only like 8, 000, board certified in the, with the American board of obesity medicine. And that's between us and Canada. And so every year I think it grows by, a thousand or two more, but you can see that no wonder it's really hard to find a specialist. Okay, so that we kind of hammered to death the, the in person experience. The other thing I want to go through are these telehealth options, and so there are many different options. So I'm gonna start with something like my clinic because then I want to kind of contrast how it's different to other experiences, and I'm sure that there are even more setups compared to what I'm really familiar with hearing about because it's really endless. This is an area of medicine where it can be done in different ways. So in my clinic, for example, I am a solo practitioner. So meaning you are seeing me, it's not like, okay, you're getting bounced around between different physicians or I lead the main groups, but then you're seeing someone else. So right now I am the doctor that you see, and then you can. Come to a monthly group nutrition call that we do. You can meet with the dietitian on your own if you want. We have in their, workshops that we do. There are question and answer sessions. There is a video series. There's a planner. There's a lot of support that goes into you talking to me monthly. There's a lot of additional education because I really think that we've gotten a lot of this information wrong over time. We've really just thought about the scale going down in general, but we've not thought about what the body composition is and how you can best manage your blood sugar and just kind of how to bring this all together in a way that's not overwhelming and a lot of my patients. This is really what I consider one of my areas of expertise. It's someone that's really struggled a long time with their weight. Maybe there's emotional eating brought into it. And so it's not just as simple as they got a med and they're losing 100. They, maybe they've done that, but they're actually still struggling with different things. So a lot of my patients will have had bariatric surgery in the past. A lot of them might have complicating things like depression or ADHD. So there are things that are getting in the way of them being able to really manage this easily. And so with us, it's really kind of visit to visit, figuring out what can we keep adjusting so they can keep going. So with a clinic like mine, it's really a highly. Personalized touch. What I mean by that is you're meeting with me monthly and you've heard all these resources. There's a lot going on, right? That's a very high touch clinic. Now, there are other clinics where you can still maybe even have a board certified physician that takes care of you. Some of these bigger telehealth clinics a lot of these are also a monthly charge to join, with a lot of these, what you need to look out for is that you might not actually either ever or rarely be meeting with a doctor. So, for example, you might initially do a video visit. Now, many of them, You don't ever even talk to someone, and that to me is a little scary because you can be filling out all these forms and doing things, but I don't know that everyone knows how to fill those forms out correctly, and so it scares me to think that you filled out a form and suddenly there's a prescription at the pharmacy, because I feel like stuff always comes out when I have a visit with someone, but some of them will be entirely written based. So, Some of them will be that you have a video visit very rarely. So I've heard of some of them where you might come in and have a video visit, but then you never again have one. Some of them require video visits more often so that the doctor can actually make sure to still be following up with you and seeing if there's kind of anything to catch along the road. And so you need to look at what are they actually offering? How often am I actually going to talk to this doctor? So with a lot of these services, it's basically a monthly charge and the doctor's refilling a medication, but there's really not much communication. And so you need to look at what this clinic is offering, whatever telehealth service it is, what am I actually getting for this? And so those are sort of more monthly ones. And then there are clinics that. that are telehealth that take insurance, where you just pay for the visits, but there's not as much other support in between. So all of them offer different things. When you're in the midst of this, it gets really confusing because there's different charges and they're all offering different things and stuff like that. So here's the reality. You have got to do your research because I have had patients come to me from, from all of these different services. And the reality is, Some of them were great and some of them not so much, and there's different reasons why people would come over to me, maybe some of them they just couldn't hear back from the provider. I remember one, I'm not gonna say what the company name was, it's one that since hasn't done so well, but they, I guess for months had not done the prior authorization. And I wondered whether they were kind of. Stringing the patients along because it was, I want to say like a six month period where they were still quote unquote, figuring out the prior authorization and that, I mean, that's kind of insanity because when you submit a prior authorization, they have 30 days to get back to you. So I don't understand how it could be six months, right? So that's just sort of being deceptive in your business practices, or maybe you're just so highly unorganized on the backend and then the patients don't know that. They can expect different and so they kind of stick around. But what you really need to do is look at the service that I'm thinking of going with. What are they actually offering me? And try to compare a few of these and see, does it meet my needs? One thing I really want you to look at is to think to yourself, What do I need? Maybe you're someone that you actually don't ever want to talk to the doctor. You just want the prescription and this sort of like peripheral care. Maybe that's enough for you. I think there are people out there like that. And then there are people that know, I do better when I have accountability and when I check in. I know for me personally, I do so much better. When I know what appointments are coming up and I have this accountability, it's not the day to day. I'm not still doing a lot, but it's like I get this feedback. I get this input. I'm someone also who for myself does a lot of coaching, meaning I have a coach, right? And so you can be doing all the things in the world, but it helps to get this outside perspective to be able to change what you're doing. So look into these different clinics. And when I say also what they offer, for example, a lot of the telehealth ones, it's a monthly charge. But then, for example, with my clinic, once you've gotten to maintenance or you feel like you don't need as much help. Then it just turns into you just having visits when you need it. So looking at, is there a succession plan within that clinic? Is it something where I move toward where it ends up being sort of quote unquote, like a regular clinic would be, or am I always going to have to pay that price and so that's something to really keep in mind. That what does it look like long term and there's nothing wrong with continuing to pay a monthly amount, but you might be someone where you want to kind of quote unquote graduate at some point, but still have the help there if you want to come back to it, right? So I'll give an example within my clinic. I had this vision where I thought, you What I see is that people need, and it's had proof of concept at this point, people need a lot of help when they first come in. And we're just going over all the things, all the time, and there's a lot. And then what ends up happening is, this is usually, Again, if someone's like brand new, brand new, it's usually like nine, nine to 12 months in, they usually don't need as many services. But let's say that you already were out of med and things like that, you come in within however many months, you don't need all the help. You're not needing the dietitian all the time. You're not needing to talk to me all the time. You're good. You've got your faculties about you. So then you can kind of go to a version and if the medications are not being titrated all the time It's always a high risk time when you're, when you're moving up the dose on things. But once you've been on it a while and you know, you're good and maybe you're at maintenance. then maybe you want to be able to drop down to something where you just see the person every three months, four months, six months, whatever interval that physician thinks is appropriate. And so just know that you can find clinics like that. The other option that I want to throw out there, this is the third thing. So we've talked about in person exclusively weight management clinics. telehealth options. And then the one that I want to throw in as well, and this is an in person option, but many of them are virtual as well, as long as you're within the state they're licensed in, would be a direct primary care clinic. I am a really big fan of direct primary care. This is a membership based model where you are paying the primary care physician monthly and you have a much closer relationship with the doctor and you can contact them when things are going on and their panels are smaller because they're not needing to deal with insurance. And the, the reason that I bring this up is that many of them are also American board of obesity medicine board certified. and they usually have programs where they will do weight management as well. And so you get the best of all the worlds where maybe you get a primary care doctor and they're also doing that. So I just wanted you to look out for that. There's a website called dpcfrontier. com and you can look For a locator based on zip code, and you can see if there's a clinic near you, a lot of them will do, for example, what my clinic does, a meet and greet where you can just talk to the doctor for a few minutes just to see, you know, do I like their energy? That's the only other word I can say. I mean, you just, you need to like who you're working with. At least that's what I found is that if you don't like the physician, you don't want to listen to what they're saying and you don't want to do anything. So that is another option to think about a direct primary care doctor where you Not only can they take care of your primary care needs and often I find with weight management it people are so stigmatized and they get such biased care that they stop wanting to engage with the health care system often when they're coming into my clinic. they will have rheumatologic conditions that haven't been diagnosed and other things because they just haven't been getting the correct amount of primary care. And so often if you find a clinic where you feel like it's inclusive, they're doing the primary care and the weight management, that can often be a really nice option as well. So hopefully today just got you thinking about what do I actually want out of my physician, whether it be that they're in network, that they're a local place I can go to. And if they're a telehealth service, what type of services do I want from them? And then you see if the fit is right. I also think that it's nice. A lot of these virtual services, my clinic included, I don't like when programs sort of pressure you into, Oh, you have to sign up for six months. I hate that. What if you don't like what you're getting? What if you, what if the fit isn't right? And so again, with clinics like mine, it's really monthly where you could decide. This doesn't feel right to me or, you know, I don't need this help, then you can get right out. I want you to look out for as a red flag. Let's talk about red flags for a second. One of the first red flags that I really want you to look out for is if they tell you, well, you need to sign up for six months to a year to even come into the program. I just find this to be a challenge. Now listen, anyone can sell however they want to. I find it to be a challenge because there is no amount. of confidence that you can have prior to going into something, if it's going to be the right fit or not. And so unless they're telling you, well, look, within the first month or two, if you don't like it, we'll fully refund, you know, you can be on your way. Otherwise, I find that to be a very scary approach. Hopefully, whatever clinic you're working with, It's either month to month or visit to visit, and it's not something where you need to do this huge commitment. I just find within the health space, this is so not done anywhere else, but within health and coaching, these huge upfront investments are just horrendous to me. So that's one thing to look out for. The second thing to look out for is If it's, well, everyone follows this protocol and it's, I remember one patient on a, well, this person did not become a patient. I had a meet and greet with someone and they wanted to know, well, what was my protocol that I take everyone through? And what was very clear to me was talking to this person was that, They had been to many clinics where, where it was sort of, you know, and we're going to put you on all these supplements and we're going to do all these things. And like, this is what everyone's going to have done. And how could that be true? You know, in your gut, that that can't be true, that everyone's going to respond to the same thing. And so if you're going somewhere where they say, well, this is our 18 week program and everyone does this amount of this amount of veggies and protein and this. Many ounces and everyone's doing the same thing. How can that be true? Just let it be like, just let it be a gut check for you. Does this sound like this can be right for me? Okay. And then the third thing is over promising things, guaranteeing that you're going to lose weight, guaranteeing this or that, that can't be true either. Everyone's different. You might not respond to what's being offered and all of us are unique. And so if there's these. Really high guarantees. It's just a big red flag to me. So anyway, hopefully this episode was helpful It was a little bit longer than I thought I guess I had more to say with you trying to find a team That's really supportive to you I hope that you can find someone that can help you either to start this journey to stay on this journey to refine things as you go along and that You really find a team where it's supportive because unfortunately, I really subscribe to the thought that obesity is a chronic, lifelong condition. And so there's going to be times when you're going to be doing amazing. You're going to need very little contact. And then there's times you're really going to struggle. And it might even be you get prescribed a prednisone, which is a steroid by a doctor. And suddenly some weight comes back on and you need a little bit more help to get that weight off. Maybe you had been at maintenance, but now there's that struggle. Or unfortunately, you go through other health conditions. Or just stress gets kicked up or suddenly your hunger goes up. I can tell you there are so many scenarios that my patients down the road encounter and then they're able to just right away let me know because I've always been in the loop and they let me know what's going on and we figure it out and it is not a long term problem for them again. I hope that all of you can find that because I really think that it makes a big difference in your long term health. Alright, I hope you all have a great rest of the week and we'll talk next week.