Shownotes
What if bariatric patients could shift the narrative around obesity from shame and blame to biology and treatment?
Today, Dr. Ann Rogers, the current president of the ASMBS, joins us again to help us break down the stigma of obesity, challenge outdated measures like BMI, and openly discuss the truth: obesity is a disease, not a personal failure. This episode is your call to action—start the process, seek support, and share your story to empower others on their journey.
Tune in, and don’t forget to join the BariNation community to attend community meetups, watch exclusive bonus content and support the podcast for as low as $5 per month!
IN THIS EPISODE:
- (02:42) Dr. Rogers shares her background and discusses the mission of ending the stigma of obesity
- (04:06) Past ASMBS President Dr. LaMasters believes everyone is deserving of treatment
- (07:01) Is obesity a disease, and takeaways from the Obesity Summit
- (12:02) Dr. Rogers references President elect Dr. Richard Peterson comments about there being essentially no training on obesity in medical school
- (17:25) Getting beyond the concept of BMI and other associated medical problems
- (31:48) It is essential to educate yourself about the disease of obesity and the ramifications that are not weight-related
- (35:50) Stick with it, be your advocate, make the appointment with a provider and share your story
KEY TAKEAWAYS:
- Obesity is a complex, chronic condition that warrants medical treatment, yet stigma remains a significant barrier to care. Many still view obesity as the result of poor personal choices rather than understanding the biological, psychological, and societal factors involved.
- Improving obesity care requires collaboration among healthcare providers across specialties, including surgery, primary care, endocrinology, and more. Unified efforts are needed to enhance education, expand access to care, and prioritize compassionate communication.
- BMI alone does not accurately capture an individual’s health status. Alternative diagnostic tools—such as waist circumference, DEXA scans, and assessments of visceral fat—offer a more complete picture. These methods aim to identify obesity-related health risks better and move away from outdated, one-size-fits-all metrics.
RESOURCES:
- BariNation Website
- Join the BariNation Membership community meetups to support you on your journey with obesity treatment. https://barination.com/pages/join-our-community
- Want to see bonus content? Head over to the BariNation community to get more and support the podcast for as low as $5 per month!
OTHER RESOURCES:
GUEST RESOURCES:
Ep. 250 - Individualized & Innovative Approaches to Diagnosing and Treating Obesity
The Lancet Diabetes & Endocrinology Commission Report
BIOGRAPHY:
Dr. Rogers is the Director of the Penn State Health Surgical Weight Loss Programs. She is currently serving as the President of the American Society for Metabolic and Bariatric Surgery (ASMBS), with her term concluding in June 2025 at the National ASMBS Conference in Washington, D.C.
ASMBS MISSION: To enhance the well-being of individuals affected by obesity and associated illnesses through the progression of metabolic and bariatric surgical techniques and other medical interventions.
ABOUT:
If the BariNation podcast helps power your bariatric journey, become a monthly podcast supporter and help us produce the show! Visit www.barinationpodcast.com and help us support people treating the disease of obesity with humor, humility, and honesty.
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Transcripts
Jason Smith: [00:00:00] Hi. Welcome to BariNation, where we support the bariatric community with humor, humility, and honesty.
safe place that powers your [:Natalie Tierney: Our goal is you leave us today feeling hopeful, inspired, and ready to live your best bariatric life.
Hey, variation, it's April. [:Diagnose and define obesity. It's an extremely powerful shift and one that I think patients have been hoping for for a very long time. In many ways, it's [00:01:00] dethroning, BMI, not taking away completely, but it's opening up different ways that we can talk about and think about the disease of obesity. I. It's been an honor to get to know Dr.
at the A-S-M-B-S is doing to [:I. [00:01:45] We wanna extend a deep and heartfelt thank you to Dr. Rogers and the A-S-M-B-S for allowing us to have the time to sit down and interview Dr. Rogers and Herstein colleagues. All right, my friends, we know you're gonna enjoy this episode. Let's dive in. [00:02:00] Welcome friends. Today I have the honor of welcoming back, one of the most famous women in obesity medicine, Dr.
illed that you're joining us [:Will you take a moment and introduce yourself to people who haven't watched that first episode?
ell, like you said, I happen [:I'm passing the gavel to my dear [00:03:00] friend, uh, rich Peterson. Uh, but I'm staying around. I'm gonna be the immediate past president and I'm gonna continue to be involved. My, uh, theme for this year was ending the stigma of obesity, and we're not there yet, but [00:03:15] I'm gonna continue to try to make it happen. And we've been doing a lot of work to, to try to.
Carry that torch forward, however we can.
n that, and I know it's a, a [:Dr. Ann Rogers: I know,
April Williams: I know. Yeah, it's hard. It ain't easy. It is not easy. No. Patients carry a lot of guilt, shame and blame.
rselves living in, uh, helps [:We can feel that we can move forward and make progress.
ase. And my dear friend, uh, [:She made a great point. She said that, uh, obesity is something that can be treated. It should be treated, and it deserves to be treated, [00:04:45] and we really have to get that message out.
April Williams: That is a perfect place for us to maybe start this conversation, right? So exactly what you said, it, it deserves to be treated.
% of people who [:Dr. Ann Rogers: I think it's, it's, it's being hit from all sides because not only do, uh, a lot of doctors not necessarily believe that it's a disease, [00:05:15] but even if they kind of believe it's a disease, they think it's something that patients bring upon themselves.
g that, you know, it's, it's [:Mm-hmm. Patients are ashamed and they're thinking, oh, if only I could just stop eating. How do you [00:05:45] stop eating cold Turkey? Right. Right. No. No. You just can't. And you're hungry all the time and you're thinking about food all the time. So it's, it's just, it's terrible.
nt, I carried that guilt and [:Yeah, of course. And I was not. I was not. And, and
would choose. And to eat too [:April Williams: Yeah, of course not. And as you know, right with the disease of obesity. It's un hideable. You cannot hide no behind excess body [00:06:30] weight. No. It's there out there in the open.
not be seen. But yet you're. [:Dr. Ann Rogers: And imagine going to the grocery store, right? Yes. Everybody's judging you and they're looking in your cart and it's just, oh, it's terrible. Yes.
April Williams: It's a, [:Dr. Ann Rogers: [00:07:15] How do we all work together? Together? Yeah. And I can't believe how many people we got in one room Yes. To work together to get that message out. People who never would've gotten together before. Yes. Endocrinologists, [00:07:30] lipidologists, you know, uh, physicians, not just surgeons, you know, internal medicine doctors, you name it.
They were all there and they wanted to talk about how we all work together to treat this. Disease
April Williams: [:They [00:08:00] want their patients to be well and to of course to get healthy, of course. But they have to be frustrated by running into a wall when they're, when they tell their patients when less move more. Yeah. Their patients eat less. Move more. Right. And nothing happens. Right. They have to be, and they've been doing [00:08:15] it for decades, right?
Yes. Yes. For decades. So what, what were some of those big takeaways from, from this obesity summit? Well,
ked to have that we were not [:So, oh, they were not able to be [00:08:45] there. Oh. So that was deeply troubling. And similarly, we invited many of the big insurers and they were also concerned that they would get in trouble if they were to travel. So they were not able to be there either. And I think that's a [00:09:00] loss because we needed to have their voices present.
f our corporate council, uh, [:It's not clear. I. [00:09:30] Should have been there. And I think, uh, in retrospect, they wanted to be there, but they were not. But of the people who were there, and we, we probably had, uh, somewhere between 20 different organizations represented there. [00:09:45] Uh. There was great agreement that this is a disease and we need to tackle it from multiple angles and, and we had it professionally, um, moderated.
o, uh, a number of different [:April Williams: Oh, wonderful.
Dr. Ann Rogers: Yeah. So, [:April Williams: Okay. I've seen some of the infographics that have come out of that discussion. Yeah. Yeah. And I was surprised in [00:10:30] the best possible way to see some things on there that I. Wouldn't have thought from a patient perspective was there, like what there was, there was so much focus on education. How do we really change how we educate people not [00:10:45] only about the disease, but but treatment options.
endocrinologist with family [:I thought I saw, and I really had to zoom in on these pictures 'cause the infographics were amazing. They were huge. Yeah. They were huge. But it talked about how do we [00:11:15] really use patient forward or patient friendly language. Mm-hmm. Right? Mm-hmm. How do we invite people into this conversation without immediately, you know, triggering their defenses.
Dr. Ann Rogers: Yeah.
, look, I understand this is [:Dr. Ann Rogers: Yeah.
April Williams: But as your doctor, it's my job to help you. Mm-hmm. Live your healthiest life and your excess body weight is something that concerns me for all of these health reasons.
Not because, you know, I can [:Dr. Ann Rogers: Yeah. Yeah. My, uh, that was our president elect, rich Peterson. My friend made the point that, uh, when he was in medical school, and it's, it's true for all of us. We got almost no [00:12:15] education about obesity, and that's something that he would really like to see change. Yeah. And uh, even, even our, our colleagues in internal medicine and family practice and whatnot.
A lot of them are very far, [:April Williams: Yes. Yep. The other element that was on those infographics. Was speaking to the importance of connecting patients with other patients. Community connection. Mm-hmm. Uh, storytelling was a [00:13:00] huge part of what, what I saw on those infographics. Yeah. And I know. Right. This modern bariatric community is very modern.
ling with a disease that you [:We're learning to, to grow with one another. In [00:13:30] these communities and, and I saw that represented in, in this, why do we
s, it's down in Gainesville, [:Uh, the people working at A-S-M-B-S and they're, they're brilliant people. And, and we, I was talking to them about, you know, where do you think we should go? What else [00:14:00] should we do to try to stop stigma? And I heard some really heartfelt messages from, from people, some of whom are actually struggling with weight.
g that happens is they weigh [:You [00:14:30] walk in Yeah. And they get the information, but nobody has to stand there and move it and you feel bad and you wanna take off your clothes. It, it's like, mm-hmm. Yeah. Maybe they need to have that information in order to. Determine what dosage of a medication [00:14:45] they give you or whatever, but it's like, it's such a turn off.
It's such a deterrent. You don't even wanna go. It keeps people from even going to the doctor.
April Williams: Yes. You
Dr. Ann Rogers: know, that's
pril Williams: bad's bad. So [:And the, and that fear of the scale was the, one of the, the top things. And some of our [00:15:15] members are sharing, they are seeing shifts in their doctor's offices. So their doctor gives them an opportunity or an option. Would you like to, would you like to know your weight today? And that's a yes or no question that you, the patient get to get to, yeah.
[:Dr. Ann Rogers: Yep. I wanna know. I don't wanna know. No. If I choose to know, that's one thing. And if the doctor chooses to say, Hey, do [00:15:45] you wanna talk about weight? And are, you know? Yeah. Yeah. But oh, that is one of the things that came up in the, um, in the obesity summit, is we need some sort of clearing house where it's.
Easy for patients who [:April Williams: Yes. Oh, that would be phenomenal. 'cause this is not easy. It is not easy. We, we say [00:16:15] all the time on this podcast and, and anywhere that, that, that we have a presence.
is the doctor going to make [:Right. So we definitely un understand that as patients and to help provide a [00:16:45] more clear pathway or hurdles that are a little bit shorter, would be monumental in more people accessing care, I think. Yep. The, the, the thing that we were just talking about, the, the weight, remind me of the Lancet report, right.
The, this [:There are other factors that go into it.
t Commission really was that [:And so it's not applicable to a lot of other people. Mm-hmm. Right? Mm-hmm. People of [00:18:00] color, women, younger people, older people, blah, blah, blah. Asians in particular. Yeah. Um, and so it's a, it's a. It's a rough and ready way of looking at populations [00:18:15] maybe, but it's not particularly good when you're looking at an individual.
April Williams: Mm-hmm.
ey have the kind of visceral [:And I think when, when the paper came out in January, I think, I think a lot of people who. Take care of this problem. A lot of surgeons and a lot of [00:19:00] obesity medicine specialists were terrified by it and were violently opposed to it because they thought it meant that it was gonna classify certain people as, uh, having severe obesity but not having a disease.
And [:That basically. If you have a BMI of 40, you automatically by definition, are defined [00:19:45] as having a disease. Okay? Okay. Okay. So anybody who has A BMI of 40 is presumed to have enough visceral adiposity to qualify as having a disease. Okay? And so [00:20:00] everybody else in the world should probably have some other kind of.
d of visceral adiposity, uh, [:Mm-hmm. And then if, if by that, uh. Quantification. They decide that you have obesity, then, then they wanna look and see if it has started to affect, uh, organ function. Mm-hmm. [00:20:45] Right? Mm-hmm. So by organ function, it would be things like. Has it started to affect your kidney function?
April Williams: Mm-hmm.
Dr. Ann Rogers: Are you having joint problems?
breath? Are you having heart [:Yeah. And they wanna believe that they're healthy at any weight, but that just means that. Most likely it hasn't been [00:21:30] diagnosed yet. Yes. You know, yeah. They are bone on bone in their knees and they have knee pain and they don't wanna think about it, or they don't wanna talk about it or whatever. Mm-hmm.
a very high BMI or visceral [:April Williams: I would agree. I've actually read it. So I've read the complete 56 page. Uh, it's long. Yes, [00:22:15] it's long and it's a long paper. And I know that some of you listening are watching are wanna nerd out like, like I did as well. So we're gonna link it in the show notes if you would like The, the condenser, the phone, it's
Dr. Ann Rogers: strangely.
ind of is because what, what [:Right? But the report needed, you couldn't run a
Dr. Ann Rogers: marathon. It's a miracle. Exactly right.
t because you don't have the [:Absolutely. You still deserve help at at at that middle level and even at the beginning. Absolutely. [00:23:30] And at the beginning level as well. Uh, Dr. Ponse kind of walked us through this, you know, yes. No scenario. And there is a, a, a pathway for, for, for, for people who have excess body weight, who are just larger mm-hmm.
But [:Dr. Ann Rogers: you can have. High blood pressure and be skinny as a rail. Yes. Or have diabetes and be skinny as a rail. Yes. And you can still get [00:24:00] treatment, right? Yes. Same sort
rs that can go into a person [:Mm-hmm. And there were so many things to look at and as a patient who, for. 37 years. The only number that mattered in the eyes of my doctor was my weight. All of a sudden it gave me such a, a much more wider [00:24:30] lens that even I as a patient can now have discussions with my new PCP about. So I have, I've, I've had my RMR tested, I had my VO two max tested.
ned up so many conversations [:Oh, that number. [00:25:15] But I was giving, I was giving so much weight to it. Yes. But now my focus is on what can I do for my visceral fat? What, what, what can I do for bone health? What can I do for, uh, you know, for strength and conditioning and mobility? Mm-hmm. That's [00:25:30] what's really important here. I can do all those things with a little bit of excess tissue.
I just need to make sure that I'm pulling the right levers so that I can do the things that I wanna do.
at I watch on Instagram and, [:And he would go to doctor after doctor and they ignored him and they would say, ah, you just need to lose weight. You just need to lose weight. Just lose some weight, lose some weight. And he finally wound up in the hospital and it turns [00:26:15] out he had a, uh, stone stuck in his common bile duct and he needed a procedure, a couple procedures to get that cleared out.
is was, now I know what it's [:You know, maybe we need to stop saying, oh, it's your weight. It's your weight. Like, yeah, weight is an issue too, but we can't just say, oh, it's your weight. We have to delve deeper into Yes. These [00:27:00] other things that are associated with weight. Yes.
April Williams: Uh, I, right. I, and I have a very personal story about how weight bias has impacted the trajectory of my life, but.
s of my life, the get out of [:And yet nothing changed. Nothing changed and, and their, their solution didn't change. So for 37 years, I just Absolutely. And they kind of knew you wouldn't be able to lose enough weight to make that change. Right, right. The, the [00:27:45] one time that I was able, I, I was able to lose a significant amount of weight two times, and of course it came back with a vengeance.
disappointing. Try something [:Wasn't the case at all. [00:28:15]
Dr. Ann Rogers: And they didn't even investigate.
I can't on, I can't put that [:Dr. Ann Rogers: back in time.
April Williams: I can't go back in time. But what I can do is implore, encourage.
People to force or to ask their doctors to dig deeper. Just dig
Dr. Ann Rogers: deeper. Yes. Just in
illiams: case. Just in case. [:Mm-hmm. But not in, not in this particular, not in that, not in that. So that, that weight bias and that that weight stigma, that's upsetting. Hmm.
Dr. Ann Rogers: Because it's an easy out for them to do nothing.
April Williams: [:Thank goodness I, I attended so many variation support groups and, and in those conversations that I was able to have with the therapist that lead them, they helped me understand I was looking for somebody else to, to pay the price for [00:29:45] their negligence because I feel like. For 37 years of my life, well, for my entire life,
Dr. Ann Rogers: yeah.
I
ns. That makes me extremely, [:I can't quite drop that bag, [00:30:15] so to speak, but I can certainly say nothing is going to change this. But what I can do is have these conversations with people like you. We can, we can implore people listening and watching to dig deeper. Push back. Yes, exactly. Ask for something [00:30:30] different and realize that your weight is probably hindering an aspect of your life, or it hasn't yet, but it will.
oncert with whatever else is [:Treat multiple things with one. With one thing. It's one tool, but it is helping me with so many projects around my house. That's the right, like that's the power of surgery. [00:31:15]
Dr. Ann Rogers: That's amazing. Right? I mean, in, in all fairness, I, I hate to speak badly of my. My colleagues, you know, I hate to say, you know, that bum, you should have looked further.
y, very difficult to be a, a [:April Williams: PCP was 15 minutes.
. And what are, [:Jeez, Louis. Oh my God. You
um, but. It, it is a, a lose [:But I think that's kind of where we can, we can partner, we can work together. Mm-hmm. If, if our patients are really leaning into the [00:32:15] education. Right. That was really talked about at that obesity summit. Correct. And if we're, if we are taking the time to educate our ourselves, if we are, we're learning about the disease, we're learning about what this means, we.
n when we meet with our care [:Yeah, yeah, yeah. For the medical provider to then meet you where you're at and [00:32:45] say, wow, awesome. Yeah, let's talk about these things. Then you really can partner with somebody to move the needle
Dr. Ann Rogers: to, and then maybe say. I think I need to go to the gynecologist to look into this or whatever, so, you know, right.
Yes. Yeah. Like [:April Williams: it, it's a powerful way to kind of move forward and to meet your provider where they're at. And, and it also lets your provider know you take your health and your wellness very seriously. Yeah. And that you are interested in partnering with them. Mm-hmm. Right. Because I would've to be [00:33:15] your own
Dr. Ann Rogers: advocate because.
They may not have the hours in the day to do it.
to bat for the kids that are [:Dr. Ann Rogers: No.
April Williams: Right. Like I will pour, I will give all of my effort to those kids, but the the kids that are showing up for themselves and I can see them making the effort, I'm gonna stay late.
'm gonna join you on another [:Dr. Ann Rogers: more,
April Williams: they are invested in understanding this, man, whatever I can give you, I'm gonna give you.
Dr. Ann Rogers: Yep.
ams: And I think that's just [:Also with, with, with these care providers, they're, they're gonna give their best to everybody. But if I show up and I'm a heavy hitter and I'm like, okay, I know this, this, and this. I'm struggling with this, this, and this. I think this could be a pathway forward. What do you think? [00:34:15]
Dr. Ann Rogers: Well, if we can provide that for patients, I think it's great.
And I think our patient education stuff is getting very, very good on our website, so I hope people are able to make use of that.
te for patients, you guys is [:Uh. Because I really do think this is how we, we can help move the needle on [00:34:45] this. And that's kind of my final question for you, Dr. Rogers. As patients, what do you hope or what do you wish, what do you enjoy seeing patients doing that are not only helping themselves treat the disease, but are encouraging others to start [00:35:00] treatment for the disease?
enter this program and to go [:So I just stick with it. Stick with it. You. It's the only thing that people do for themselves, you know?
April Williams: Yeah.
ur patients are women. We do [:It's unbelievable. You just gotta stick to it. It's you, [00:35:45] you gotta do it. It's for you. Yeah. Nobody else is gonna do it for you.
your inspiration or if your [:Obesity treatment. Awesome. Wonderful. We, we know the most powerful way to to change is by listening and watching the stories of [00:36:15] others. Yep. And what we really realized, especially in the very nation community, we all understand what it's like to struggle with excess weight. We, we get that we know what it feels like.
we get it, we get it right. [:I can [00:36:45] do it. Yep. That's the power of, of telling stories
Talk about it. Yes. Be yes. [:April Williams: Be be proud. And it's hard to do because we understand how, how much shame and guilt and, and worry that, that we carry.
But the [:It is going to help somebody else. It absolutely is going to [00:37:45] help somebody else. Yeah. If you are watching or you're listening this episode and you think you are ready to make that next step, we, we applaud you. And that next step is go to the as MBS website. Search for, uh, treatment providers. Notice I [00:38:00] didn't say surgeries.
is excited to help you start [:So head to that link, go to the as mbs website, search for a provider and make a phone call. That that is, that is our call to action for you today. Start the process. [00:38:30]
Dr. Ann Rogers: Dr. Rogers, thank you so much for joining me today. It's been great. Thank you so much for having me.
April Williams: We, we just, we love, love connecting with you.
If people are interested in maybe reaching out directly to you, what's the best way to do so?
Dr. Ann Rogers: Uh, [:April Williams: Awesome. Wonderful. We will make sure that that is also, uh, late linked in our show notes. That's great. Thank you again. Thank you again Dr.
Dr. Ann Rogers: Rogers. Have a good one. Thanks.
All right. Bye-bye.[:April Williams: That wraps up another empowering episode of the Berry Nation Podcast. If you enjoyed today's episode, keep the conversation going by joining the Berry Nation membership community. Where you can attend live support [00:39:15] events, access on-demand resources, and find a caring community.
Natalie Tierney: Join us@barination.mn.co.
orter@barinationpodcast.com. [:Jason Smith: And just remember at the end of the day, you've got this. We've got you. And we'll see you next time. Bye everybody.