Obesity Awareness Education Under Review

October 23, 2017

By Jennifer Walker

How do obesity and overweight, which affects two out of three adults in the United States, fit into PA school curricula? That has not been determined, says Corri Wolf, PA-C, RD, an associate professor of physician assistant studies at the New York Institute of Technology.

Corri Wolf, PA-C, RD
Corri Wolf, PA-C, RD

The National Commission on Certification of Physician Assistants (NCCPA) has a blueprint—a simple list of diseases and conditions—that lays out the basic minimum that PA programs need to teach their students during the didactic phase to prepare them for the PANCE exam. Obesity, which the American Medical Association began to recognize as a disease in 2013, is on the list.

“But how much of that is taught and when it is taught is really unknown,” Wolf says. In other words, the amount of education PA students get around obesity could vary greatly by school.

Yet, with education around obesity, PAs could become leaders in treating this disease. Faculty buy-in and teachers with a background in obesity medicine will be necessary to expand obesity education in PA schools. But there are also several post-graduate resources available for PAs who are ready to make an impact on obesity now.

Streamlining Obesity Education at PA Schools
At PA schools, the first step to streamlining obesity education is showing faculty the importance of expanding obesity medicine in their curriculums. The Physician Assistant Education Association (PAEA), along with 23 other organizations, took a giant first step in this direction by publishing a paper that lays out provider competencies for management and treatment of obesity.

“That’s a big deal because it will help PA programs realize it’s incredibly important that they teach their students to become competent in obesity medicine,” says Wolf, who also works at a private gastroenterology practice on Long Island, New York. The next step would be to present the paper to faculty members at a conference.

The way obesity is categorized on the NCCPA blueprint could also be changed. Right now, it is listed as a psychiatry/behavioral condition under the category of eating disorders. While eating disorders can be associated with obesity, obesity is not an eating disorder.

“This categorization is likely having negative impact on [obesity’s] coverage in PA school,” Wolf says. It can also be problematic if PA schools are relying on psychiatry faculty members to teach obesity because they may not be as up-to-date on the disease’s pathophysiology, medical consequences, lifestyle interventions, pharmacology, and surgical interventions. Wolf, who is also a nutritionist, recommends classifying obesity under the endocrine category.

The next challenge is finding faculty members who have the background to teach obesity medicine. Ideally, the obesity portion of a PA curriculum would cover the epidemiology and pathophysiology of the disease, as well as diagnosis in terms of the physical exam and laboratory components, the associated medical conditions, and treatment, which varies from person to person. Finding teachers who have this background is going to take time.

But, once faculty members see the importance of obesity education and are prepared to teach it, expanding obesity medicine in PA curricula should be an easier task.

“The faculty of PA programs does have some degree of latitude,” Wolf says, adding that although time is a factor, there is little red tape, such as committee approval, associated with adding content to the curriculum. “Obesity really can be fit in if a faculty member wants it to.”

While there is hope for change, the bottom line is that PAs often graduate from PA school having learned relatively little about the diagnosis and management of this highly prevalent chronic disease. The situation is similar for our physician and nurse practitioner colleagues.

PAs Can Build Skills through Other Resources
The good news is that PAs can build a skill set in obesity medicine through other resources. Those who have a budding interest in obesity may want to listen to the first 18-minute episode of the Vital Minds podcast, which was created by the PA Foundation. Here, Larry Herman, PA-C, MPA, DFAAPA, Dean of Physician Assistant Studies at Gardiner-Webb University in Boiling Springs, North Carolina, and a past president and past chair of AAPA’s Board of Directors, gives a broad overview about what goes into diagnosing and treating obesity.

Then, PAs may want to attend the obesity track offered at AAPA’s annual conference. Last year, obesity topics included the underlying pathophysiology of the disease, pharmacology in obesity medicine, surgical approaches in treating obesity, medically-supervised weight loss programs, and getting paid for obesity care. Because AAPA is committed to addressing obesity on behalf of the PA profession, there will continue to be a similar amount of obesity-related content at the conference for the foreseeable future. The presentations are available here by purchasing the Thursday, May 18th package.

AAPA also has an online curriculum about obesity medicine, which contains seven modules. The curriculum covers diagnosing the disease, as well as treatment options such as lifestyle interventions, pharmacology, and bariatric surgery, and is a good fit for PAs who want to address obesity within their own specialties.

“This curriculum demonstrates very well how regardless of the area of medicine you work in, obesity medicine is relevant,” says Wolf, who was on the advisory board for the curriculum. She adds that the curriculum could also be used to prepare faculty to teach obesity medicine at PA schools.

Whatever method of education is used, it is important that PAs gain the skills to address obesity. “Regardless of the subspecialty or the primary care area they work in, whether it’s urban or suburban, PAs are going to see a tremendous number of patients who have this disease,” Wolf says. “They need to be competent because obesity is going to impact their care one way or another.”

Find more information about AAPA’s Obesity Leadership Edge program here.

Other resources: “AMA recognizes obesity as a disease”

Jennifer Walker is a freelance writer in Baltimore, MD. Contact Jennifer at [email protected].