Speaker 1:

Welcome to AACE Podcasts. Thanks for tuning in as we elevate clinical endocrinology by taking deep dives into trends and topics that can help us improve our patient care and global health. Find the latest episodes on aace.com/podcasts. And now let's meet the endocrine experts who will be talking with us today.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

Hi everyone. Welcome to the AACE Podcast. I'm Dr. Elizabeth Bauer, an endocrinologist, obesity medicine specialist, and a clinical associate professor of medicine practicing in San Diego.

In today's podcast, we're going to be talking about obesity care and what a patient journey of someone living with obesity may look like because, I mean, let's be honest, navigating obesity care, or honestly, a lot of medical care can be confusing, and people deserve clear, respectful information and practical tools to help them understand that obesity is a chronic disease, but also to help them know what questions to ask and what there may be to expect in upcoming visits. And that's why AACE, the American Association of Clinical Endocrinology, created the patient journey resources, which are patient-centered, easy to understand guidance designed to help individuals navigate their condition and treatment options.

I'm joined today by Michelle, who will share her personal experience living with obesity and how the AACE Patient Journey helped her feel more informed and supported in her next steps.

Michelle, welcome, and thank you so much for being here.

Michelle Mata:

Oh, thank you, Dr. Bauer, for inviting me to your podcast.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

So before we begin, I'd like to thank our sponsors, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and Amgen for supporting this podcast.

So Michelle, we connected briefly before the recording, and I'm really grateful you're willing to share your perspective. So to start, can you tell us a little bit about yourself and where obesity has shown up in your life?

Michelle Mata:

Yes. So my name is Michelle Mata. I'm 54, born and raised in Texas. I'm a mother of two adult children, Sean Alec and Kimberly Michelle. I have two grandchildren, Benjamin Sebastian and Mariah Rose. Also, I have two emotional support animals, Figgy, who's in my room right now, and Poppy Seed, who stays with my daughter, and my daughter lives with me, or I live with her. We cohabit the same apartment. I'm a quilter, I'm a crafter, I'm a volunteer, I love chocolate, and I know ASL.

Where has obesity shown up in my life? As a child growing up, I wasn't overweight. I wasn't overweight as an adolescent. I started gaining weight after I started my treatment on my journey for mental health, actually. So I started taking medications for depression and anxiety, and some of the side effects of those medications caused me to gain weight. So it was as a young adult that I actually started experiencing weight gain and being overweight.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

And when did you realize that it wasn't just about trying harder, but something was actually affecting your health and quality of life?

Michelle Mata:

I think it was after being diagnosed with type 2 diabetes, high blood pressure, joint issues, even fatty liver disease, PCOS, and even thyroid issues. I realized that a lot of these diagnoses I was struggling with and my quality of life just became difficult. It was difficult for me to become active due to the joint pain and struggling with the type 2 diabetes and blood pressure issues.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

And you just bring up such good points because obesity as a disease is so complex. There's so many things that go into the disease process, and medications are ones that a lot of times we just forget about. You do the medication rec when you come in, everybody asks you, but are we the providers looking through and being like, "Oh, we are part of the problem. There are things that we could do to help mitigate these side effects and stuff." And so that's always part of the evaluation. I'm so glad you brought that up.

And everybody's journey on how they acquired obesity is different, but then also the effects of it on your body. And so do you remember how long were you living with obesity before you made the connection, diabetes, PCOS, all these complications of it was actually a result of it?

Michelle Mata:

That's a great question. I think it was maybe 15, 20 years ago did I actually start making the connection that obesity was affecting me. I knew that I was struggling being active. I was struggling with my self-esteem. I wanted to exercise, but every time I went to the gym, people stared at me. And so it caused me to avoid public places and gatherings. Also, I live with several mental health diagnoses and other physical ailments. And I know that my mental health struggles contributed to my obesity as well. It's kind of like a catch-22. I want to do this, but I can't do it because of this, and I can't do this because of this. It's like I want to exercise, I want to go and use some of the equipment at the gym, but I have joint issues and I start feeling pain. And because of the pain, I stop exercising. I want to go to the gym, but my mental health tells me people are going to be staring at me, people are going to be looking at me, people are going to be judging me, and that prevents me from going.

So it's like, what do you want me to do? I'm trying to do what I need to do and you're making fun of me because I'm trying to lose weight. I don't get it sometimes. Society can be cruel. And I think that's another reason why I want to lose weight is so that I can stop people from judging me for being overweight. And we don't want to be overweight. It sometimes happens to us.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

What I'm hearing are these challenges that people living with obesity are experiencing physically, emotionally, socially, that people don't see. You're living with this, it surrounds you in everything that you touch. So thank you so much for sharing that.

Was there a moment where you felt dismissed, or conversely, finally understood by a clinician?

Michelle Mata:

There was a time when I had gone in to see my PCP for an ear infection. I also live with psoriatic arthritis, and my psoriasis for me shows up in and around my ears, and I often would develop what my doctors would call secondary ear infections. And so I would go in to get treatment for that. And I remember one time I couldn't see my PCP, so I had to make an appointment with the PA. This is the first time I've seen her, and I go in for the ear infection, and right away she says, "You need to lose weight. That'll help you." And I'm like, "But I'm here for my ear." And she says, "Yeah, and you need to lose weight." And I'm thinking, "Well, how much weight do I have to lose for my ear to get better? Is that the treatment? I have to lose weight in order for my ear infection to resolve. I don't get it." And she says, "No, I have to give you some antibiotics for that."

So I went in for one thing and she throws in my weight, which has nothing to do with my ear infection at all. And this is the issue we have with some healthcare professionals is that they assume that being overweight is the thing that contributes to all our ailments, I guess, for lack of a better word, but it's not. I think that's the dismissive part is going in for one thing and right away it's our weight. It's our weight. It's our weight. Lose weight and everything will be better.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

It's really how we bring it up. And I totally get it. I've learned the hard way as a clinician myself earlier when you're trying to say one thing, but it comes out differently. And so the clinician may or may not have known how the disease of obesity was affecting you and they might've just been saying it. Or they did know and they just weren't saying it right. And so things like increased inflammatory response, decreased wound healing, things like that that may have contributed, but it's not the cause and it sure is not going to be the treatment. And so, yes.

What about feeling understood? When did that finally happen by a healthcare professional?

Michelle Mata:

It was actually my weight loss surgery doctor. He was the one before I even had... Actually, it was my second surgery. But Dr. Patel, I remember going to him and I had already had my first weight loss surgery and was going in for a revision and I was struggling to lose weight. And he told me that I needed to lose at least 20 pounds before they could schedule the surgery. I had already done everything I needed to do prior to that, blood work, scans, exams, talking to a behavioral health specialist and all that. And I needed to lose about 20 pounds, and I struggled to lose those 20 pounds. I listened to the nutritionalist and did everything she told me to do, and I couldn't lose the 20 pounds. I couldn't.

And I remember going finally to the doctor again, and he said, "Don't worry about it. I know you're struggling. I know this is a struggle for you." And we scheduled the surgery, and that was a moment of he gets it. He gets it. Losing 20 pounds. If I could lose 20 pounds, I could lose another 20 pounds after that on my own. But I struggled to lose 20 pounds on my own. Well, with some assistance on eating healthy, doing away with some of the foods that aren't healthy and exercise and getting support, and even with all of that in place, I still struggled with losing 20 pounds. And he understood. He understood. He actually said, "Keep doing everything else that's helping you." And I did.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

Thank you for sharing that because when people are trying hard and still struggling, like what you're saying, they need clarity, they need support, not shame. And so it sounds like you finally saw, he understands, I am not just sitting here doing nothing. I'm trying hard and struggling.

So Michelle, I'd like to ask you about your experience using the AACE Patient Journey with obesity, which I had the privilege of volunteering as one of the obesity specialists who helped develop the resource. And I learned a lot from the process, especially how much patients benefit from the clarity, support options, patient language. It was a great learning experience. But I really would like to hear about your experience using this resource. So can you tell me how did you first find the AACE Journey for Patients with Obesity and what made you first explore it?

Michelle Mata:

That's a great question. I believe I first found AACE when I was at the Your Weight Matters Conference. It was last year. I believe it was in 2025. I was part of a focus group and we were asked about... It wasn't obesity, I think it was for the fatty liver disease, and that's where I first saw aace.com. And my first impression was, wow, it was so thorough. There was information in there that I had never thought about related to obesity and the other issues that I also live with. And it was there all at my fingertips. And I thought that a website that I can go and get some information about my obesity and everything about or related to it without judgment was there. And I just remember what a great experience that was for me to go onto the website and get all this information and not one person is judging me about all these diagnoses.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

What did it help you understand about obesity as a chronic disease that you either didn't know about or didn't fully appreciate before?

Michelle Mata:

That it's not my fault. I think the one takeaway from that, it's not my fault that I have some diagnoses that I have in my life that I manage or try to manage on a daily basis. This isn't my fault. I was trying so hard to take care of myself and taking the medications and doing the treatment that my doctors are telling me I need to do, and these caused me to become overweight. It's not my fault. And that there's help out there. I'm not alone in this. And I think that's what I got from the website, that there's help and that I'm not alone and it's not my fault.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

So great to hear. And it's also important too, knowing that there's support, knowing that this isn't your fault, that it is a disease process... Because it also reframes our thinking of it in that this isn't just a short-term problem. This is a disease, and we shouldn't be doing these fad diets or these interventions that are short-term. We need to think of this in long-term care. This is the rest of your life. And the changes that we make, we need to focus on the sustainment of these good changes over time.

And specific to the journey, because we have definitions, we have support resources, we have example questions you could ask your provider. Were there any parts that stood out specifically?

Michelle Mata:

There's a couple of things that really stood out for me. One thing was the list of some medications that are prescribed to people living with obesity, and they broke them down into pill form, injection and what they do. So that was something that really stood out. I thought a weight loss medication was a weight loss medication and it's supposed to help, but I didn't know that it's more than just it's supposed to help either decrease your appetite or it slows down the emptying process. And so knowing that some of these medications have a specific job and knowing that really did help.

Another thing was the questions, not only questions to ask my doctor, but questions to ask my health insurance provider because I remember the first time I went to try to get weight loss surgery, I was denied, and I didn't understand why they denied it. And they told me it was because it wasn't medically necessary. And I thought, that's strange because my doctor is telling me this is medically necessary. So who are they to tell my doctor and me that it's not medically necessary? My doctor's telling me in order to improve my life that I need to lose weight. And he's recommending weight loss surgery to help me. And so that portion of not just to ask what questions to ask my doctor, but what questions to ask my insurance providers, those were a couple of areas that I found very helpful.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

You're already describing some of those barriers. There's so many barriers that you have to go through, everything from cost of medications, coverage of the medications, finding the right clinician, all these different barriers that for the last 20 years, it sounds like, you've been working through.

After exploring the patient journey, did you feel more prepared for your medical appointments and did it help with asking questions and setting goals?

Michelle Mata:

I realized while I was going through the website, that on the website, I was able to get those answers to some of the questions I had, that I actually wanted to ask my doctor. And I thought, I got those answers from the website and the answers that I got eliminated a few minutes taking away from my medical appointments, asking about questions that I got from the website. So I can go to my doctor, talk to my doctor about things that I couldn't get answered from the website. And so I focused on that instead of asking all those questions that I got answered from the website. So I got the most out of my appointment. I would tell my doctor, "Well, I found this website and I got some clarity from there. What do you think about this?" And I actually had told her about it and she went looking for it real quick on her phone and she thought that that was an amazing website as well, knowing that I shortened the appointment time from spending... asking her questions and getting those answers and focused more on what I really needed from her.

I go to her and I pay my copay. I don't want to spend that money asking her questions and getting the answers from her that I got from the website. And so the energy spent talking to my doctor at my doctor's appointment was spent on my treatment and how she's going to help me instead of me asking her questions and spending the time just there listening to her and writing down notes.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

You're bringing up so many things. This is the reason why we created this resource. And I mean, full disclosure, you are not my patient.

Michelle Mata:

No.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

I live in California, you live in Texas. I met you right before this podcast. I specifically asked for this because I didn't want to bring one of my patients with spoonfed information. And so this is just so wonderful hearing this from you because this is exactly why we created it, both to help the patients, but also the providers too. You can use this, "Hey, here's a wonderful resource. Please read through this and then the next time we can talk about anything additional that, any questions that you have on this."

Michelle Mata:

Right. This reminds me of the time when I was first diagnosed with type 2 diabetes. I didn't understand a lot about it. And my doctor told me about it, told me I have type 2, and actually referred me to the Texas Diabetes Institute here in San Antonio. And I went there, took the classes there to learn about type 2 diabetes. And everything I learned there at the Institute really helped me in understanding that I don't have to get all this information that they taught me there from my doctor. My doctor's treating me and doesn't have the time to tell me how to eat, what I should do, exercise more, whatever. She sent me to a program that helps me with this. And aace.com is just like this, is my doctor tells me I have this and they tell me, "Go here to learn about this and then you have questions, come back and ask me."

And so that's what I get out of this, is that AACE was a place for me to come and learn about obesity. And then if I still have questions, I can make an appointment and talk to my doctor about it.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

Thank you so much for sharing that. So last tidbits, if you have any, but if there's someone watching who feels stuck or ashamed, what do you think is one small step that you'd recommend and where should they start when they're ready to learn more? What advice do you have?

Michelle Mata:

There's a couple of places. AACE is one of them. Come on there and just start clicking on tabs and go read. It's full of information, full of information, support groups, finding the resources that you need.

Probably another place is the OAC, the Obesity Action Coalition at obesityaction.org. That's a great resource. There's a conference coming up in July 2026, Your Weight Matters Conference. That's a great place for anybody who's stuck, who is overweight or living with obesity and you don't know where to go, you don't know what to do, you don't know what weight loss treatment options you want to pursue. The Your Weight Matters Convention is one where you can find some of those resources, whether it's medication or different kinds of surgeries, finding support there by just listening and meeting new people there. The vendor portion of the... The vendor hall where a lot of these organizations and places come and you can ask questions from them.

I think those are some first steps is AACE, I think it's .com, obesityaction.org, and the Your Weight Matters Convention. Those are some starting points. You're not alone in this. There's help out there. There's support out there. There's other people that are living with the same challenges you have. You're not alone. And the resources are there. You just have to take that huge baby step to want this for yourself. You matter, and the help is there. I know that's where I got some of my help. I know that the Your Weight Matters Convention helps because I've been there several times. I can't wait to go in July. The Obesity Action Coalition that sponsors the convention, they are a huge help. There's no judgment there. There's no judgment at all, and that's a great starting point.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

Michelle, thank you.

Michelle Mata:

You're welcome.

Elizabeth Bauer, MD, FACP, FACE, DABOM:

I appreciate your honesty and your practical takeaways. Anyone, if you're watching and you're not sure where to start, the goal is to take one next step, just one. Learn, prepare, bring your questions to your clinician. As Michelle said, you're not alone and effective care is available.

Thank you to our sponsors for supporting this podcast and thank you to everyone watching and listening. You can find other episodes of the AACE podcast at aace.com and help us in our mission to elevate clinical endocrinology together. Thank you, everyone, and see you next time.

Speaker 1:

Thanks for listening to another great AACE podcast. Join us for another episode at aace.com/podcasts and help us in our mission to elevate clinical endocrinology. Together we are AACE.