73: The Limitations of Obesity Management in Primary Care with Chase Franks

As many of you may know, the Rentea Metabolic Clinic came about as a result of my frustrations in the primary care setting. Despite my passion for patient care, the brief appointments meant I couldn’t effectively tackle underlying metabolic challenges like insulin resistance, which are key for long-term health. 

I recently sat down with nurse practitioner and TikTok star Chase Franks, who faced similar challenges in his experience of primary care. Chase shares my passion for debunking myths about anti-obesity medications and his TikTok fans—over 118K strong—love his relatable approach and straightforward explanations.

In this blog, I share the challenges we both faced in addressing weight management issues in primary care, our shift into exclusive weight management roles, and why educating and empowering patients is at the heart of what we do.

Weight Management: Primary vs Specialized Care

In primary care, appointments were often a whirlwind of managing diverse health concerns like diabetes, hypertension, and mental health issues within tight timeframes—15 minutes for follow-ups and 25 minutes for new patients, if we were lucky.

Yet, despite its crucial role in health outcomes, weight often took a backseat due to these time constraints. Patients with complex health needs would come in, and while weight might contribute to their conditions, it rarely received the attention it deserved as a root cause. Bringing up somebody’s weight in a primary care setting could also unintentionally trigger discomfort or shame in patients due to the prevailing stigma surrounding weight in medical settings.

In primary care, one of the biggest challenges is balancing a wide range of health issues with the limited time and resources available. Many patients express a desire for weight management support, but it's often tough to provide comprehensive assistance. I tried to help by giving out educational materials, suggesting podcasts, and recommending programs outside of appointments. However, the level of support needed was usually more than what I could manage within the primary care system.

I also found that when I tried to collaborate with larger healthcare organizations to enhance weight management services, I often hit bureaucratic hurdles and organizational limits. Despite my efforts to integrate weight management into overall care plans, the resources and support systems were often not enough to consistently meet the needs of my patients.

In specialized weight management practices like ours, we can concentrate our resources specifically on helping patients with their weight-related challenges. Here, weight management becomes the central focus of our care approach. This allows us to have meaningful discussions, create personalized strategies, and provide ongoing support, all of which are crucial for long-term success.

At my clinic, patients benefit from a team approach that includes dietitians, behavioral therapists, and specialized medical professionals. This holistic approach ensures that patients receive the comprehensive support and tools they need to navigate the complexities of weight management effectively. Unlike in primary care, where time and resources are often stretched thin, our specialized setting allows us to empower patients with the knowledge and support needed to achieve sustainable health outcomes.

Transitioning to Specialized Weight Management

Both Chase and I have experienced how transitioning into specialized weight management allows for more in-depth conversations about weight and its impact on overall health. Unlike in primary care, where weight discussions might feel rushed or avoided altogether, in our specialized practices, patients come specifically for weight management. This means patients are more open to discussing their weight history and exploring sustainable solutions.

Conversations now revolve around empowering patients rather than just managing numbers. It's about understanding their journeys with weight, from childhood challenges to adulthood struggles, and guiding them toward achievable health goals. This approach not only enhances patient-provider communication but also ensures that weight management is integrated into comprehensive, personalized care plans.

Empowering Patients to Seek Specialized Care

If you find yourself seeing a primary care doctor who might not fully support your weight management journey, it could be because they lack the specialized education needed to address this complex issue effectively. It's important to recognize that not all primary care providers are trained extensively in obesity management. (If you do have a supportive primary care doctor who understands and helps you with your weight concerns, keep hold of them!)

If you are still seeking help in this area, don’t lose hope. There are compassionate providers out there who are well-versed in obesity treatment strategies and genuinely care about helping patients achieve better health outcomes. There are obesity management specialists, specifically trained in addressing weight-related issues as a chronic medical condition. Just as you would seek out an endocrinologist for thyroid issues or a cardiologist for heart conditions, it’s important to seek out healthcare professionals with expertise in managing obesity.