Dr. Jerome-Zapadka

I did all my training at the University of Pittsburgh including my undergraduate degree in Physical Therapy, medical school, internal medicine residency, and a gastroenterology/hepatology fellowship.?I have been out in clinical community practice for nearly 29 years.?I have always had a particular interest in obesity, and obesity related medical issues, particularly the variety of related gastrointestinal malignancies and fatty liver disease.?I have been speaking in the community for several years regarding this.

However, it was not until several years ago when my NAFLD patient with an unresectable hepatoma asked me "Dr., Did I eat myself to death?", that I began to deeply question my approach to this patient population.

This prompted me to pursue board certification in Obesity Medicine, through the American Board of Obesity Medicine.?I am also in the midst of pursuing certification through the Society of Metabolic Health Practitioners.

As community physicians, we realized that the majority of NAFLD patients do not require referral to a tertiary care center, and that we needed to be comfortable and thorough in our approach to these patients.?Our practice, Valley Gastroenterology Associates, was committed to this, and as such, we were the first community practices in our area to obtain the FibroScan technology.?We also began the VGA Center for Obesity Medicine where the vast majority of our patients have NAFLD.?They are offered a more structured program to improve not only their fatty liver, but their entire metabolic health profile, using the cornerstones of care including a thorough evaluation of their medical/metabolic health, detailed nutritional teaching with Lisa Lipp our dietician , an alliance with B Well Nation where they have formal resistance training with Chris Cosky, an exercise specialist, and behavioral/motivational interviewing.?We have seen multiple patients improve their fatty liver and other metabolic abnormalities, including Type II Diabetes/pre-diabetes, hypertriglyceridemia, central obesity and Insulin Resistance if caught early.

Through Heritage Valley Health System, we have developed a multidisciplinary Metabolic Task Force.?Though we have several goals regarding addressing metabolic health, one includes education regarding appropriate screening for NAFLD based upon the recently released AGA clinical care pathway.?I recently gave a lecture to the HVHS Family Medicine residency program about this. ???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

Because the need is so great to disseminate information about NAFLD,?I became involved with the Community Liver Alliance several years ago and now cochair the Fatty Liver Coalition.?I am proud of how this coalition has grown internationally, to now include not only provider and patient educational programs, but also the new Fatty Liver Journal Club where we hear from researchers presenting their original articles from the literature.

I also sit on the Board of NASH kNOWledge where I am the chair of the Education and Outreach Committee.?We have a strong focus on the pediatric population, and as such, with the help of our volunteer, Patty Kardambikis, we have already developed three educational teaching modules regarding fatty liver, sugar, and insulin resistance, to be taught in grade school and middle school, and are planning school assemblies based on fatty liver education.