Obesity Medicine Board Exam

[GonnaBeADoc2222]

Which review book / question banks are helpful for this exam?

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[DrMetal]

Which review book / question banks are helpful for this exam?

MKSAP and your Internal Medicine residency, provided you did it in the United States.

Do we really need a new thread on this every month?

 

[rokshana]

MKSAP and your Internal Medicine residency, provided you did it in the United States.

Do we really need a new thread on this every month?

Apparently it’s popular… you don’t have to answer every post though.

 

[GonnaBeADoc2222]

What friendly folks!

 

[DrMetal]

Apparently it’s popular… you don’t have to answer every post though.

The over sub-specialization of our professsion (and the ridiculous 'board certifications' that ensue) deserve such satirical commentary.

 

[chessknt]

The over sub-specialization of our professsion (and the ridiculous 'board certifications' that ensue) deserve such satirical commentary.

This isn't ABIM endorsed. The board itself seems to think that physicians arent being trained to manage obesity specifically despite the fact that the majority of our patients have this condition.

I am still waiting on someone to create the American Board of Breathing and Pulse Detection. Once we hit that it has to be the bottom.

 

[scpod]

The board itself seems to think that physicians arent being trained to manage obesity specifically despite the fact that the majority of our patients have this condition.

You’re not. And you have no clue how little you know about managing obesity. I’ve practiced obesity medicine at least part time for over 10 years in a specific obesity clinic. But I learned more in 6 months of studying for the obesity boards than I did in 10 years of practicing on my own.

I would venture a guess that you don’t even know a whole lot about the laws governing obesity in your state. They are all different. I practice in three different states and each of them is vastly different.

Palliative care wasn’t a recognized specialty all that long ago either. Give it some time.

 

[VA Hopeful Dr]

You’re not. And you have no clue how little you know about managing obesity. I’ve practiced obesity medicine at least part time for over 10 years in a specific obesity clinic. But I learned more in 6 months of studying for the obesity boards than I did in 10 years of practicing on my own.

I would venture a guess that you don’t even know a whole lot about the laws governing obesity in your state. They are all different. I practice in three different states and each of them is vastly different.

Palliative care wasn’t a recognized specialty all that long ago either. Give it some time.

Laws governing obesity?

I'm going to need you to elaborate on this one.

 

[scpod]

All states have requirements on who can be treated and how. This is a small section from florida as an example.

https://www.flrules.org/gateway/readFile.asp?sid=0&tid=2413959&type=1&File=64B8-9.012.doc#:~:text=(2)%20Physicians%20in%20Florida%20are,use%20in%20weight%20loss%20management.

 

[DrMetal]

You’re not. And you have no clue how little you know about managing obesity. I’ve practiced obesity medicine at least part time for over 10 years in a specific obesity clinic. But I learned more in 6 months of studying for the obesity boards than I did in 10 years of practicing on my own.

So learn it, study it, preach it, and practice it. That's all well and good. As a physician, you're certainly allowed to take an interest in something and build your practice around it (provided that it's reasonably within the scope of your practice).

But do we really need to make a subspecialty out of it, with a board certification? Great, so go do an IM residency, then an Endocrine Fellowship, then an Obesity fellowship. You can be a PGY7++ before you start practicing.

I'm not suggesting we all start doing neurosurgery without credentials, but things like obesity (and for that matter, palliative care, since you mentioned it) we should all be well versed in. Wanna learn a little bit more and do more, great; do it on the job!

I would venture a guess that you don’t even know a whole lot about the laws governing obesity in your state.

What are we, lawyers now?

 

[VA Hopeful Dr]

All states have requirements on who can be treated and how. This is a small section from florida as an example.

https://www.flrules.org/gateway/readFile.asp?sid=0&tid=2413959&type=1&File=64B8-9.012.doc#:~:text=(2)%20Physicians%20in%20Florida%20are,use%20in%20weight%20loss%20management.

What in the hell is that?

Here's what my state has to say about it:

SCLLR

Basically "don't use off-label controlled substances for obesity treatment and try to follow established guidelines".

Also, no one has ever been sanctioned by the board for obesity related treatment.

 

[chessknt]

What in the hell is that?

Here's what my state has to say about it:

SCLLR

Basically "don't use off-label controlled substances for obesity treatment and try to follow established guidelines".

Also, no one has ever been sanctioned by the board for obesity related treatment.

Florida has weird medical laws like only respiratory therapists are allowed to obtain pulmonary function tests that don't exist anywhere else. I don't believe for a second there are any widespread laws on treating obesity. Don't know what you don't know but assume that all states are stupid as florida, the irony.

The medical board also doesnt write laws for whoever is keeping track.

 

[scpod]

I don't believe for a second there are any widespread laws on treating obesity.

I go to a few conferences per year. The largest are probably spring and fall Obesity Medicine Association, where hundreds of people come from all over the country. Always a huge topic is the antiquated laws in many states that hinder the practice. Lot of money spent lobbying to change laws. For many years Ohio law specifically prohibited using phentermine for more than three months. Just starting this year you can use it longer now if your patient loses at least 5% of their total body weight in 90 days.

I really challenge you to find me a state that DOES NOT have specific weight loss laws and regulations. I don’t think you can.

 

[chessknt]

I go to a few conferences per year. The largest are probably spring and fall Obesity Medicine Association, where hundreds of people come from all over the country. Always a huge topic is the antiquated laws in many states that hinder the practice. Lot of money spent lobbying to change laws. For many years Ohio law specifically prohibited using phentermine for more than three months. Just starting this year you can use it longer now if your patient loses at least 5% of their total body weight in 90 days.

I really challenge you to find me a state that DOES NOT have specific weight loss laws and regulations. I don’t think you can.

Phentermine is a controlled substance of course the country that invented the war on drugs is going to regulate that, has nothing to do with obesity but the obsession with drugs that the DEA decided can be abused.

Where is the critical mass of laws telling me I can't prescribe wegovy or consult surgery for a bypass or do anything else that is from this century of medicine that I am apparently so ignorant of? Go ahead and use the heavily legislated California--what laws have they passed? I asked chatgpt for you and it couldn't find anything.

 

[dozitgetchahi]

Phentermine is a controlled substance of course the country that invented the war on drugs is going to regulate that, has nothing to do with obesity but the obsession with drugs that the DEA decided can be abused.

Where is the critical mass of laws telling me I can't prescribe wegovy or consult surgery for a bypass or do anything else that is from this century of medicine that I am apparently so ignorant of? Go ahead and use the heavily legislated California--what laws have they passed? I asked chatgpt for you and it couldn't find anything.

I agree, a lot of the laws I’m aware of govern old school amphetamine derivatives for weight loss.

For instance, both Ohio and Alabama iirc prohibit using C-II stimulants for weight loss - e.g., Dexedrine and Desoxyn (the latter being prescription methamphetamine). However, in this day and age, it seems straight dextroamphetamine is rarely prescribed for anything anymore in favor of Adderall, and prescription methamphetamine is vanishingly rare (iirc there’s fewer than 1000 scripts written for it in the entire US per year, or something). So who cares? Also, at least in Alabama, it seemed to be very popular to prescribe Adderall for “ADHD” when it was really being used for weight loss and/or “fatigue”. Lulz. I never heard of the board coming after anyone about it.

Do they make you memorize a laundry list of state rules and regulations for the obesity boards? Because that would be really stupid, and indicative of all the board related nonsense we’re bitching about here.

 

[sloh]

For many years Ohio law specifically prohibited using phentermine for more than three months. Just starting this year you can use it longer now if your patient loses at least 5% of their total body weight in 90 days.

Is there even a point in entertaining phentermine now that GLP-1 agonists are available and more widely used so effectively for weight loss?

 

[rokshana]

Is there even a point in entertaining phentermine now that GLP-1 agonists are available and more widely used so effectively for weight loss?

Yes there is…it helps to have more than one medication in your armamentarium …while glp1a are game changers in the treatment of diabetes and obesity, there are pts that can’t take these medications or these medications are not effective.

 

[VA Hopeful Dr]

Is there even a point in entertaining phentermine now that GLP-1 agonists are available and more widely used so effectively for weight loss?

Given it's reasonable poor efficacy (and almost complete lack of long term efficacy), there never really was a point in using it much.

 

[ColonelForbin]

Obesity Medicine Board Review Questions by Dr. Kevin Smith is a good resource for the exam. It is available on Amazon.

 

[AlbinoHawk DO]

Obesity Medicine board is made for insecure FM/IM doctors that didn't do a fellowship and want to act like they have advanced training. Might as well get the lifestyle medicine and telemedicine board certifications too