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MD Musings: Why are we always looking for a Magic Pill?

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.

 

 

 

 

 

Cutting through the Fat: Weight Loss/ Healthy Eating (Part 2)

So you’ve read Part 1 of our weight loss clinic series, and now you know so much more about calories; how many are in foods you eat, how many LESS you need to ingest to lose weight. Great! But now you need to come up with an actual game plan to enhance healthy eating.

Like I said before, I’m definitely not here to endorse a particular fad diet. But the end of the day, all diets have something in common: tips on what to eat LESS of, and MORE of. Many diet plans can be super-restrictive (for example, although I know people who’ve been successful on a Paleo diet, I’m very wary of a plan that endorses a lot of red meat, and eliminates healthy foods like legumes). For people that don’t want to be on a DIET, but want to know how to to eat HEALTHY (which should naturally help cut calories), these are 4 things you can do.

EAT MORE WHOLE FOODS: That is, non-processed 1 ingredient foods you can look at and tell what it is. Example: an Apple is a whole food. An apple pie is not. Old-fashioned rolled oats is a whole food, Quaker Oats Fruit and Cream oatmeal packets are not. Following this rule will naturally lead to eating more fruits and vegetables, and maybe then you’ll get your recommended 5 servings a day. Honestly, if you just follow this one rule, and eliminate processed foods from your diet, you’ve already won half the battle.

EAT LESS RED MEAT/ PROCESSED MEAT: As a lover of beef and bacon this pains me to say. But the more I read the data that processed meats are known carcinogens, and red meat probable carcinogens. , the more resolve I feel about cutting back. Note how I said “eat less” and not “stop eating”. Just because I know cutting out altogether is hard, since these types of meat are staples in many cultures. I don’t know if there is a safe minimum amount of meat, but I would personally aim for once or twice a month at most.  My personal goal is to totally eliminate red meat from my diet in 2018. Let’s see how it goes…

STOP DRINKING YOUR CALORIES: Seriously, the amount of hidden sugar in juices and sodas is incredible. And thanks to smart marketing, many people think that a glass of Snapple Ice tea is healthy compared to a Pepsi. What if I told you that Ice tea has as much sugar as a pack of Milk Chocolate M&Ms? If you’re serious about losing weight, juices and sodas have to go. Yes, even no-sugar added orange juice. Just eat the orange instead, and get the added benefit of fiber!

CUT DOWN ON REFINED CARBOHYDRATES AND SUGARS: Very few diet plans don’t include this recommendation, and there’s a simple reason. Refined carbs and sugars are the devil. I generally don’t like to vilify an entire group of foods, but the vast majority of unhealthy foods contain loads of sugar and refined carbs (i.e.processed so the whole grain is no longer intact). I’m talking white rice, white bread, white flour. When you remove the whole grain, you remove the beneficial fiber and other nutrients, so it’s basically empty calories with a high glycemic index. Hello, high blood sugar!! Hello, inflammation! (remember my article about this?) Hello, metabolic syndrome!

At the end of the day, we can argue all day long about what it means to have the healthiest diet. Certainly, I haven’t weighed in on the healthiness of poultry, seafood, eggs, dairy, healthy vs unhealthy fats etc. These are all worth digging into later on for sure, but I truly believe that following those 4 tips alone is sufficient for losing weight, cutting down your risk of chronic medical diseases like diabetes, hypertension, hyperlipemia and a host of other benefits.

What do you think of the weight loss clinic so far? Any other topics you’d like to read about? Let me know, and tune in for part 3 (Reviewing your Food Diary, common Pitfalls!). Oh and don’t forget to subscribe at the bottom of the page 🙂 

[small disclaimer: this post is about eating healthily, and includes weight loss tips for those that need to get to a healthy weight. Always talk to your doctor before starting a new diet, especially if you have medical conditions or take medications]