Dear Doctor: Rocio Salas-Whalen
The founder of New York Endocrinology on revolutionizing our approach to obesity medicine.
Dr. Rocio Salas-Whalen believes in treating the patient — not the disease. Her focus on preventive care shapes her Manhattan practice, New York Endocrinology, where she provides personalized care and empowers each patient with the knowledge required to drive beneficial outcomes and promote lifelong health. Specializing in obesity medicine, Dr. Salas-Whalen is a triple board-certified endocrinologist active in the continuing advancement of the field and a clinical instructor at NYU Langone Hospital. She’s a strong proponent of preventive medicine, advocating that obesity is treatable and that lifestyle and behavioral therapy (alongside pharmacotherapy) can work wonders in preventing obesity and its many complications.
“Ever since I was a young girl, I knew that I wanted to become a doctor. I’m the first physician on both sides of my family, so while I wasn’t necessarily exposed to it growing up, I still had a strong passion for medicine starting from a young age. I think I can trace my interest back to my insatiable curiosity as a child: I was always interested in how things work — especially the human body. I couldn’t understand why taking certain medications would help with some conditions but not others. I wanted to get to the bottom of how things worked and why.
Finding my specialty came later, during medical school. I’m originally from Mexico, where diabetes is very common. In fact, my grandfather passed away from diabetes, so you could say that it was the first disease I was exposed to. While in medical school, I discovered that there was an entire specialty dedicated to the study, treatment, and prevention of diabetes, and from that moment onwards I knew that I wanted to go into endocrinology.
On the common misconceptions regarding obesity medicine
The American Medical Association (AMA) recently classified obesity as a disease in 2013, so obesity medicine is still a brand new field here in the States. Being a leader in an emerging field like obesity medicine is exciting, but there’s still so much more work that needs to be done in terms of incorporating treatment and prevention plans into everyday medical practice.
Every specialist comes into contact with a patient who has obesity, since the complications of obesity can be multifactorial (heart disease, joint disease, PCOS, etc.), but many practitioners are still misinformed when it comes to diagnosing, treating, or even preventing obesity. That’s part of why I chose to specialize in obesity medicine — to combat the misconceptions that are still prevalent, even amongst medical professionals.
The most common misconception I run into in my practice is the belief that obesity medicine is somehow the patient’s fault. Of course, now we know that’s not true. Once the AMA accepted obesity as a disease, the community understood that it’s not a lifestyle problem, but a chronic health problem. Lifestyle and behavioral factors are one part of the pie, but there are also environmental and genetic factors of which the patient has no control that play a significant role in the development of obesity. Unfortunately, this misconception is still prevalent among patients and the medical community.
Another misconception is that obesity medication doesn’t work, or that using medication is representative of a patient’s failure to lose weight on their own. As practitioners, we need to broaden our vision to understand that a patient’s success is not solely dependent on what they do or don’t do when they leave our office, but that we have tested and effective medications at our disposal that can help.
Many patients assume that a visit to the doctor regarding obesity will result in the doctor saying, “OK, go home and eat better, exercise more, and come back in three months and we’ll see how you’ve done.” Understandably, a lot of people stop going to the doctor under this assumption. What’s more, a lot of doctors stop offering their help because this cycle is frustrating and ineffective. Now, we have so many tools to offer our patients, but the misconceptions around obesity medication (or obesity medicine in general) prevent many doctors from offering these solutions.
To understand the community’s aversion to obesity medication, we have to revisit its origins. Obesity drugs in the 1960s and ’70s were blacklisted because of serious complications, but recent advancements in obesity medications have changed the field completely. The newer studies are longer and broader, and the resulting drugs are safer and more effective. Every other year there’s a new drug that emerges that can work in a variety of applications. For example, GLP-1 receptor agonists have proven useful in obese patients with type 2 diabetes, and Belviq can be used in patients with depression and obesity. Excitingly, this variety of new drugs enables us to treat a wider spectrum of patients.
Why preventive care?
I believe prevention equals patient knowledge. The more a patient knows, the better they will do. In this way, prevention has to be a conversation. After opening my own practice, I now have the time and, perhaps more importantly, the control over my time to have longer and more informative conversations with my patients.
Previously, I’ve been in a practice with a preset schedule where I’d have twenty patients to see in a single day. There was never enough time to have the important conversations with each patient. That’s the main reason why I started my own practice. I wanted to have the time to talk with my patients about everything and listen thoughtfully to their questions and concerns.
There’s a lot of lifestyle and behavioral therapy that goes hand-in-hand with pharmacotherapy in obesity medicine, so having that time with my patients is crucial. When I see a new patient, I allot sixty minutes for our visit, and every follow-up visit after that is thirty minutes (though I do sometimes go over). This allows me ample time to speak with each patient about their condition and everything that may be affecting their health. I also guide them on how to make healthier choices that will have an impact on their overall well-being. Seeing how this approach has changed my patients’ lives for the better has been incredibly rewarding. It’s proof that obesity is treatable, and that medications work wonderfully alongside informative lifestyle and behavioral changes.
Vital Signs
My secret talent is…I’m a great travel research agent. I plan out my family’s trips from beginning-to-end!
Next getaway destination? Mexico, but not just to my hometown. I try to take my daughters back as often as I can, so they can learn about their heritage. Our next destination will be Colima, a beautiful state with old haciendas, volcanoes, and hot air balloons.
Any phobias? Dying, if that can be considered a phobia.
Favorite meal? Anything spicy. I love Mexican food, Thai food, Indian food — anything that serves up that hot, burning feeling.
The best advice I’ve ever received was… “The best publicity is a happy patient” has been great (and true!) advice for my medical career.
You can learn more about Dr. Rocio Salas-Whalen here.
Know a great female doctor in NYC? We’d love to meet her, introduce us here!
