With the increasing popularity of weight loss drugs like Ozempic, Wegovy, and Mounjaro, it’s no surprise that more and more patients are asking their physicians about weight loss medicine. Accordingly, there has been a new focus on obesity medicine as a field, with increasingly, physicians looking to learn about obesity medicine and/or get certified in obesity medicine through the ABOM. This may be to better serve existing patients, develop ancillary private practice income streams within their existing practices, or to dive deeper into side gigs or even main gigs exclusively focused in obesity medicine. Many practices in this field are cash pay practices or offer an opportunity to practice medicine in a different way. In this article, we’ll discuss what obesity medicine is, the different career paths and options in obesity medicine, who tends to pursue obesity medicine certifications, and how to get certified.
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What is Obesity Medicine?
While many people hone in on the weight loss aspect of obesity medicine, the field of obesity medicine actually encompasses more than weight loss drugs. As physicians, we know that weight impacts so much of health and well-being, and yet we are not taught much about weight management and counseling during medical school. In 2013, obesity was officially declared a chronic disease. Obesity medicine aims to acknowledge that obesity is not a choice, and that there is biology, physiology, and more that contributes to the condition. Obesity medicine physicians help evaluate, treat, and advocate for patients in this context, with a focus on both the individualized treatment of obesity as well as related conditions. It aims to address nutrition, exercise, medications, behavioral therapy, and lifestyle changes, as well as surgery in the appropriate context, and obesity medicine physicians work with patients to address these things.
Is Obesity Medicine an official specialty?
Compared to many other fields, obesity medicine is a relatively new specialty, with the establishment of the American Board of Obesity Medicine (ABOM) in 2011, and ABOM certification not yet not officially recognized as a subspecialty by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA). That said, the ABOM is pushing forward towards this goal. In the meantime, an increasing number of physicians are choosing to pursue the certification established by the ABOM, with the number of diplomates certified at the end of 2023 reflecting an increase of 23% when compared to 2022. The ABOM is also working towards creating more dedicated standardized fellowship opportunities, although some of these already exist at individual institutions.
Which physician specialties tend to explore obesity medicine?
The majority of obesity medicine doctors are currently by far in the internal medicine and family medicine subspecialties. However, according to statistics on the ABOM website, there are also a large number of pediatricians, endocrinologists, surgeons, OB-Gyns, gastroenterologists, psychiatrists, emergency medicine, and cardiologists who have chosen to get certified. We suspect that as this field continues to grow, we’ll see others as well.
How is obesity medicine generally practiced by doctors in the field?
There are various different avenues that physicians practicing obesity medicine may choose to see patients. For many, it is simply done in the context of their medical practice, whether this be in a primary care practice, a clinic focused on obesity medicine, or in a bariatrics setting where surgery is also a part of the consideration. There are also dedicated telemedicine opportunities for those certified in obesity medicine, as well as opportunities for concierge or cash pay practices. Some physicians have elected to pursue this route through other methods, such as coaching or course creation. As the demand increases, more and more practice models are evolving. Several direct primary care practices offer weight loss services such as establishing fitness and eating plans, prescribing medications, and offering accountability services that check in with patients at a regular cadence.
How do you get the obesity medicine certification, and do you need it?
There is no official certification that a physician must hold to practice obesity medicine, though for many physicians looking to stand out amongst the competition when developing obesity medicine focused practices, a certification is a way to show patients you’re serious about the field when marketing your services, in addition to being an opportunity to learn more skills to help your patients.
Currently, there are two many pathways to get certified in obesity medicine, the CME pathway and the fellowship pathway. As fellowship spots are still pretty limited and many physicians are approaching this as an add on certification that they pursue while practicing medicine, most doctors on our physician communities are taking the CME pathway.
This pathway requires an active, unrestricted medical license in the U.S. or Canada, and you must be done with residency or fellowship. The residency must have been completed in the U.S. or Canada. It also requires that if you are a U.S. physician, you hold an active board certification in an American Board of Medical Specialties (ABMS) member board or Osteopathic Medicine equivalent.
There are a minimum of 60 CME (AMA PRA Category 1, AOA Category 1-A, or Mainpro-M1) credits about obesity required for certification, with at least 30 designated by the ABOM as Group One credits. These credits are generally offered by CME partners of the ABOM. There are also Group Two credits options, which come from non CME partners of the ABOM, and these must include the word “obesity” in the course title. All 60 or more CME credits must be earned within the 36 months prior to the application deadline.
Once you have net the criteria for credentials and CME, you can submit the application to sit for the certification exam, which is currently offered as a computer based exam at test centers in the US and Canada on an annual basis. It has 4 one hour blocks that consist of 50 questions each.
* Please note that this information is current from the ABOM website as of April 2024. Please check the ABOM website to confirm the most recent CME pathway requirements.
You can also do the fellowship pathway, which consists of completing an Obesity Medicine fellowship recognized by the Obesity Medicine Fellowship Council within the 36 months prior to the exam application deadline, and then sitting for the certification exam. You will also require a letter of attestation from the Obesity Medicine fellowship director.
How do you study for the Obesity Medicine certification exam? Is it hard?
Members of our communities on the whole say that the examination is relatively straightforward, and data supports that, with the pass rate in recent years being in the high 80th percentages and going as high as low 90s. There are several courses that have been recommended by members in our communities, as well as a book that appears to be regularly updated. The most recent book in this series is simply named Obesity Medicine Board Review Questions, by Ken Smith.
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For those that are looking to deep dive into the world of obesity medicine, there is also a pathway at the ABOM conference which includes an exam review course that runs a few days before the conference. Other popular courses are the OMA course, as well as courses run by Columbia/Cornell and Harvard (Blackburn). There are also sample test questions and other study resources linked on the ABOM website.
Does the Obesity Medicine certification increase your revenue? How much do obesity medicine physicians get paid?
This will vary a lot depending on the practice environment. If you are incorporating it into your regular practice, it may simply be an additional aspect to your practice and billed under insurance. However, given the high demand for these practices, we are seeing more physicians start side practices that are cash based. Many of these practices have scaled rapidly and can have high profit margins. Overhead in these practices is generally very low, also increasing your ability to spend more time with patients. Again, it’s all in how you want to shape your practice, but there are lots of opportunities to have a successful business model here while doing what’s best for the patient and helping them with their weight loss and lifestyle journeys. Bottom line is that it is currently quite possible to do only obesity medicine and make a decent living as a physician.
Conclusion
For physicians interested in obesity medicine, pursuing further education and/or a certification in this field offers a unique opportunity to build a practice which is generally less stressful and very fulfilling. There’s a reason so many physicians are pursuing it! Feel free to ask more questions about this field and setting up a related practice on our physician communities.