Spreading the Word About Therapeutic Carbohydrate Restriction in Tennessee

Amanda Decker Purchases 4,000-Square-Foot Building for Her Growing Metabolic Health & Weight Management Clinic

When we last spoke with Amanda Decker, MSN, FNP-C, MHP–a nurse practitioner working for a respected medical group in rural Tennessee—she had recently become one of the very first to receive the Metabolic Health Practitioner (MHP) accreditation from the Society of Metabolic Health Practitioners (SMHP).

Amanda, who had recently turned 40, told us how she had used a low-carb way of eating to lose more than 40 pounds and improve her health. Her discovery of low-carb led her to start thinking more about how she could apply this knowledge to her patients, and she started trying the approach with some them.

“Low carb was not widely accepted in rural Tennessee where my practice is located,” Amanda explained. “I would suggest that my patients cut out the breads and starchy carbohydrates, and that they prioritize protein and focus on non-starchy vegetables, and see what happens.”

The results were astonishing. Her patients not only lost significant amounts of weight—she started routinely taking them off diabetes medications.

Amanda started working on her MHP accreditation shortly after the SMHP launched in December 2020, and she earned the accreditation in early 2021.

To say a lot has happened since then would be a huge understatement.

Amanda was working at Dickson Medical Associates in Dickson, Tennessee, and had stopped accepting new primary care patients so she could grow the metabolic health side of her practice.

“My practice was really focusing on metabolic health, but we were maxed out on space, and I had no room to grow or expand,” she said, “So I created a business proposal and presented it to my employer as a way to grow the medical practice, and grow my individual practice at the same time.”

The proposal involved Amanda purchasing a 4,000 square foot building that will give her room to expand her practice.

The new building gives me room to continue doing exactly what I’m doing, but I have the space we need to grow.”

“My goal is to add a health coaching program, so I can expand and offer that to all of my clients who come for weight management services. I’m also planning to bring in a registered dietitian or nutritionist.”

The clinic was remodeled from the ground up, and includes modern exam rooms, space for the health coaches, and a comfortable waiting area. It also has a complete kitchen and 1000 square feet of unfinished space she is contemplating turning into a small gym.

“When you have a large amount of weight to lose or if you’re just completely new to exercising, it’s very intimidating to walk into a gym and ask for help. I want to give patients the opportunity to learn without that intimidation.”

Amanda also has plans to put the kitchen to use outside of regular office hours.

“I would like to start offering classes on meal prep or basic cooking techniques on the weekend or on Fridays when I’m off of work.  We may even bring in some of the local restaurant owners that have started adapting their menus with more low-carb offerings.”

Amanda is enthusiastic about the growing interest in therapeutic carbohydrate restriction in her region, and is looking forward to continuing to spread the word to others.

“When I started doing low carb three years ago, it seemed nobody here in town was aware of its benefits,” said Amanda. “Now we have two low-carb restaurants, and one of my  patients recently started a low carb bakery delivery service. The interest is definitely growing. It’s catching on.”

Amanda says she refers patients to these establishments because they provide a safe place to eat where they’re not likely to get off track. And the business owners tell their customers about Amanda’s clinic.

“They know there’s a provider here in town who supports low carb and metabolic health, and they tell their customers, and the word continues to spread through the community.”

Amanda says she is frequently asked questions about her MHP accreditation, and she proudly displays her credentials on the front door of her clinic and on her business cards.

“My patients ask me about it all the time, and that often leads to a conversation about how changing your metabolic health and learning how changing your lifestyle can help conditions such as diabetics, heart disease, inflammatory conditions and other metabolic issues. Having that certification definitely gives me additional credibility.”

Amanda says the growth of her practice has been due to several factors, with word of mouth at the top of the list. She also receives a large number of referrals from physicians within the multi-specialty practice, which includes approximately 30 providers, including primary care, pediatrics, orthopedics, cardiology, allergy immunology, dermatology, and neurology. She also says she receives many referrals from her parents, who have themselves seen their health improve as a result of her lifestyle recommendations.

Amanda says the large majority of her patients have and use their medical insurance for their medical care.

“Most of my patients want to use their insurance. We have a whole lot of blue collar workers, and they all seem to have great commercial insurance, where they just have a copay to come see me. A lot of my billing codes are related to hypertension, diabetes, insulin resistance or metabolic disorders.”

Amanda said the decision to purchase her own building was intimidating, but she is enthusiastic about her decision.

“I think the biggest thing for me was overcoming the fear of growing. I was pretty comfortable doing what I was doing in the space that I was in, but I had this overwhelming sense that there was more that I needed to do because my community was suffering.”

Asked if she had any advice for other practitioners considering making a move, she said “Don’t be afraid to make your dreams happen. If metabolic health can work here in Middle Tennessee, it can work in other places, too.”

The only proof needed to illustrate the value of what Amanda is doing is the results her patients are seeing.

“Cardiologists are not going to refer to someone who advocates low carb unless they see the results. They literally see their patients getting better. The orthopedist is not going to send their patients to someone to lose weight for a surgery unless they’re seeing positive results. You just need to show the results because nobody can argue with that.”

Amanda is looking forward to traveling to the West Coast in August to attend the 2021 Low Carb San Diego Conference.

“I am attending Low Carb San Diego with two nurse practitioners from my area that I am good friends with. I’m very much looking forward meeting other people in this space who are supportive of what we’re doing. It will be great to be able to meet these people, have good conversations, and grow our knowledge. There are some great speakers coming that I can’t wait to hear in person. I’ve listened to some recorded presentations, but to hear them in person and then to be able to kick back and ask questions to over dinner  and taste some new naturally made low carb wines will be something.”

The new clinic officially opened on July 6, and Amanda says it’s already starting to feel like home.

“The patients have thoroughly enjoyed being here. It’s a calm and inviting space, and it feels more like a home instead of a sterile clinical environment.”

Among the special touches are some old church pews, that Amanda’s husband stripped them down and refinished them to provide comfortable and stable seating for people of all sizes.

“Patients don’t have to worry how large they are, there’s not an edge, so you’ve got room to sit. You don’t have to worry if it’s going to hold you. You know that it’s going to be okay.”