If I had to list the top 2 ailments where people come in to my office asking me to prescribe “something”, it would be “something” for WEIGHT loss and ENERGY. Of course, I’ve also been asked for “something” to help fix a range of ailments like insomnia/bloating/ hot flashes/body aches/you get the idea.
Every time I get these requests, it strikes me as very strange, and an insight into the nature of our culture. How have we gotten to the point where we think the solution to our physical ailment must always be some external treatment, some prescription med or supplement?
Why is it so surprising to people when they hear; what you actually NEED is not a Magic Pill, but to be mindful and purposeful about what food you’re putting in your body. You NEED to get up and get your heart pumping and your joints moving. You need to take care of yourself; body, mind and spirit.
I like to remind people that when we are not feeling well, this is usually a sign that something is awry in our bodies. And a Magic Pill may sometimes help improve certain things, but some changes have to come from US. When I draw labs on a patient and I see high cholesterol, elevated sugars, reduced kidney function…I can certainly whip our the prescription pad for a statin, a diabetic pill, an ACE inhibitor (which are all evidence-based medications), but the conversation should never stop there. At the same time I have to take a step back and say “but WHY are these things all out of whack?”
The answer usually has something to do with that patient’s weakness for white bread, pepsis, 11 pm binge eating when they’re stressed out. It usually has something to do with poor sleep, lack of exercise, sometimes depression. There is ALWAYS something about a person’s lifestyle that can be modified to help fix some of their health problems. And I love being able to help empower people to take control of their own bodies and health through education.
So why are you on 15 different drugs, instead of a weight loss regimen? Part of the reason is because as doctors, we are extremely well-versed in the use of prescription medications . We’re comfortable prescribing medications because we know the mechanism of action (mostly), we understand the pharmacokinetics, side effects etc. We learned a lot of cool things in med school about medications. What most of us DIDN’T learn a whole lot about is diet, nutrition, exercise. We know these “lifestyle modifications” matter, but we’re not so great in teaching our patients how exactly to modify their lifestyle.
And of course, when your blood pressure is 180/110 we’re worried about you having a heart attack or stroke, so we feel good about throwing you on blood pressure meds. They work, and we get measurable results . So you’re happy, I’m happy…until you end up on 10 medications to treat various problems, then one of those medications are making you dizzy, so I need to add another medication to counteract that…but then THAT new medication is making your mouth super dry….you get the idea.
So, what’s the purpose of this post? I think it’s just me throwing out my thoughts. It’s the beginning of a conversation we need to have as a society, as a culture. A conversation I have with my patients every day. Sometimes the answer is so simple. Sometimes the answer is helping that person lose 10% of their body weight, and voila! Lower sugars, better blood pressure and cholesterol, and less knee and back pain!! But no….there also isn’t a Magic Pill for that 10% of weight loss. Like I tell everyone, if there was a magic pill that works so well, everyone would be on it and we’d all be walking around looking like Naomi Campbell. And even Naomi has to work out, you guys.