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Welcome to ACE 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.
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Hi, everyone. Welcome to the Ace 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 ace, 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 ACE patient journey helped her feel more informed and supported in her next steps. Michelle, welcome and thank you so much for being here.
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Thank you, Dr. Bauer, for inviting me to your podcast.
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So, before we begin, I'd like to thank our sponsors, Fehringer, 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?
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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 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, I love chocolate and I know asl. Where has obesity shown up in my, my life? I, you know, as a child growing up, I wasn't overweight, I wasn't overweight as an adolescent. I started gaining weight when I was 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, as a young adult that I actually started experiencing weight gain and being overweight.
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And when did you realize that it wasn't just about trying harder, but something was actually affecting your health and quality of life?
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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.
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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. Right. You do the medication wreck when you come in. Everybody asks you, but are we the providers looking through and being like, oh, we are, 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, you know, pcos, all these complications of it was actually a result of it.
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That's a great question. I, you know, I think it was maybe 15, 20 years ago. Did I actually start making the connection that, that obesity was affecting me? I knew that I was struggling being active, I was struggling with my self esteem. I didn't want to, 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. I also, I live with several mental health diagnoses and, and other physical ailments and I, I know that my mental health struggles contributed to my obesity as well. It was kind of, it's kind of like a catch 22. You know, I, I want to do this, but I can't do it because of this. And, 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, 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, and I think that's another reason why I, I, I want to lose weight is so that I can stop people from judging me from, for being overweight. And, and we don't want to be overweight. It, it sometimes happen.
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What I'm hearing are these challenges that, you know, people living with obesity are experiencing physically, emotionally, socially, that, that people don't see, right. Like you're living with this, it surrounds you and everything that you touch. So thank you so much for sharing that. Was there a moment where you felt dismissed or conversely, like, finally understood by a clinician?
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C
You know, there was a time when I had gone in to see my pcb, 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'm seeing her. And I go in for the ear infection. And right away she says, you know, you need to lose weight, that, that'll help you. And I'm like, but I'm here for my ear. And she says, yeah, and, 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? Like, is, is, is that the treatment I have to lose weight in order for my ear to, my ear infection to resolve? I don't get it. And she says, no, I have to give you some, 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, and, and this is, this is the issue we have with some health care professionals is that they assume that being overweight is the, the, the thing that, 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, 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.
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Mm. It's really how we, how we bring it up. And I totally get it. I've. I've learned the hard way as a clinician myself, and earlier, when you're trying to say one thing, but comes out differently. Right. And so the clinician may or may not have known how the disease of obesity was affecting you, you know, and they might have just been saying it or they did know, and they just weren't saying it. Right, 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.
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Right.
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Yes. What about feeling understood? When did that finally happen by a healthcare professional?
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It was actually my, My weight loss surgery. Dr. He was the one before I even had. Actually, it was my second surgery. But my, my 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, you know, 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 was, I listened to the nutrition list and, and did everything she told me to do, and I couldn't lose the £20. I couldn't. And I, I remember going finally to the doctor again, and he said, don't worry about it. I, 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, if I could lose 20 pounds, you know, 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, on, you know, eating healthy, doing away with some of the foods that I, that, that aren't healthy and exercise and, and getting support. And even with all of that in place, I, I still struggled with losing 20 pounds. And, and he understood. He understood. He, he actually said, keep doing everything else that's helping you. And I did.
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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 he, you finally saw, like, he understands. I, 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 ACE 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 ACE Journey for patients with obesity and what made you first explore it?
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C
That's a great question. I believe I first found ACE 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 ace.com and my first impression was, wow, it was so thorough. It was, 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, and I thought that a website that I can go and, and get some information about, about my obesity and, and, and everything about or related to it without judgment was there and, and I, 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.
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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?
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That it's not my fault that I, I think the one get takeaway from that. It's, it's not my fault that I have, I have some, some diagnoses that I have in my life that I, that I manage or try to manage on a daily basis. This isn't my fault. I'm, I was trying so hard to take care of myself and taking care of, and taking, taking the medications and doing the treatment that my doctors are, are, are, are, are telling me I need to, 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, that's, that's what I, I, I got from the website that there's help and that I'm not alone and it's not my fault.
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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, you know, our thinking of it and that this isn't just a short term, you know, problem. This is a disease. And we shouldn't be doing these, 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.
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Right.
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Changes that we make, we, we need to focus on the sustainment of these good changes over time and specific to the journey because we have, you know, definitions, we have support resources, we have questions that you could, example questions you could ask your provider. Were there any parts that stood out specifically?
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C
There's a couple of things that really stood out for me. One thing was the, the list of some medications that are prescribed to people living with obesity. And they broke them down into, into pill form, injection and what they, what they do. And so that was, 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, the questions, not only questions to ask my doctor, but questions to ask my, my health insurance provider. Because I, I remember the first time I, I went to try to get weight loss surgery, I was denied and I, I didn't understand why, why they denied it. And they told me it was because it wasn't medically necessary. And I thought, but that's, 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 is telling me in order to improve my life that I need, I need to lose weight and, and weight loss surgery. He's recommending weight loss surger to help me. And so that portion of, not just to ask my, 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.
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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, you know, 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?
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C
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, I could go to, 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, instead of like asking all those questions that I got answered from the website. So I got the most out of my, my appointment. I would tell my doctor, well, you know, I found this website and I got some clarity from from there. What do you think about this? And I told, 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, the, the, the appointment time from spending asking her questions and getting those answers and focus more on what I really needed from her. Like I'm, I'm, I go to her and I pay my co. Pay. 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 my, my, the energy spent talking to my doctor at my doctor's appointment spent was spent on my treatment and how she's going to help me instead of me asking her questions and, and spending the time just there listening to her and writing down notes.
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So you're bringing up so many things that this is the reason why we created this resource. And I mean full disclosure, you are not my patient. No California, you live in Texas. I met you right before this podcast.
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Right?
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I specifically asked for this because I didn't want to bring one of my patients, you know, and you know, with spoon fed information. And so this is, 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, read here's a wonderful resource. Please read through this and then the next time we can talk about, you know, anything additional that any questions that you have on this.
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C
This reminds me of the time when I was first diagnosed with type 2 diabetes. I didn't understand a lot about it and you know, 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, to, to tell me how to eat, what I should do, exercise more, whatever. Right. She sent me to a program that helps me with this. And this was, ACE.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 that ACE was a place for me to come and, and get, learn about obesity. And then if I still have questions, I can make an appointment and talk to my doctor about it.
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A
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's, what do you think is one small step that you'd recommend? And, and where should they start when they're ready to learn more? What advice do you have?
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C
There's a couple of places. ACE is one of them. Come on here, come on there and, and, and just start clicking on tabs and, and go ready. It's full of information, full of information. Support groups, finding the resources that you need probably in your. 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 and your weight Matters conference, that's a great place for anybod, anybody who's stuck, who is overweight or living with obesity.
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And
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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 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 ace. I think it's.com obesityaction.org and the your weight Matters convention. Those are some, some starting points. You're not alone in this. You, there's help out there, there's support out there. There's people, other people that are living with the same challenges you have. You're not alone. And 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 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, that sponsors the convention, they, they are a huge help. There's no judgment there. There's no judgment at all. And that's a great starting point.
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A
Michelle, thank you. 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.
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Learn.
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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 ACE podcast at ACE.com and help us in our mission to elevate clinical endocrinology together. Thank you, everyone and see you next time.
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Thanks for listening to another great ACE podcast. Join us for another episode@aace.com podcasts and help us in our mission to elevate clinical endocrinology together. We are ACE.