Many patients want to lose weight, either for health or aesthetics reasons, and the question of “what’s the best diet?” is one I’m asked frequently.
I’ve evolved my thinking on this in my years in practice. When I first started out, I used to recommend low-carb diets very frequently. And indeed, low-carb diets can work amazingly well. Both in numerous studies and in my experience with patients, there are a wide variety of low-carb diets (Keto, atkins, paleo, etc) that often work wonders. I still think that these diets are a great way to go for many people.
But I’ve also seen plenty of countervailing studies and patients, with the most obvious example being those folks who go onto a high-carb vegetarian/vegan diet and also see terrific results.
Given this, when I’m asked about the best diet, my quickest answer is to advise people to follow the diet that they feel they are most likely to enjoy and be able to stick to. Even if, hypothetically, there was one particular diet that truly worked best with your unique biology, it would be of little use if you hated it and burned out on doing it after just a few weeks.
But my real answer goes even a step further: you don’t need to follow a rigid “diet” at all. Rather, it’s often easier and more sustainable to adopt specific lifestyle principles that you can stick to indefinitely. What are these principles?
Just before leaving office at the end of his second term, President Dwight Eisenhower gave a speech in which he famously warned of the “military-industrial complex.” By this he meant that having large military budgets year after year was creating a powerful class of business interests who viewed the American military not simply as an institution vital to national security, but rather as a source of their own financial profits, and would hence forever exert pressure on the US government to increase military spending, regardless of whether it was otherwise appropriate to do so. This critique – which was shocking at the time – in retrospect seems rather obvious. Most observers of the US government now agree that there is an important interplay between the congress, the military, and the armaments industry, and the idea of a “military-industrial complex” is widely taken for granted.
Sadly, I see many parallels to the military-industrial complex in America’s modern medical system. Such as the way that pharmaceutical companies give generous donations to congressional members, who then pass legislation that is favorable to those companies. Or how the regulators of the pharmaceutical industry often obtain plum jobs with the pharmaceutical companies once they leave government, thus giving them an incentive while in office to “play nice” with them. Or how a small cadre of doctors sit atop the leadership at places like the NIH, controlling where grant money for research will go, thus creating an environment in which research that counters those doctors’ preferred ideas or theories is much less likely to receive funding.
But I want to talk about one such “complex” that particularly irks me, which I hereby will call the “academic-media complex.”
This will be a VERY brief post. I just wanted to announce two things:
First off, our practice was featured this week in the local newspaper. Find a copy of the Sippican Week and turn to page 17, or else click here to read the story. Thanks to reporter Erez Ben-Akiva for taking the time to stop by the office and get to know us.
By way of reminder, this Sunday (June 30) we will be hosting an open house along with four other Marion businesses as part of the “Dose of Wellness” event. Feel free to drop by from 8am-12pm on Sunday to see the office, meet us, and have a complimentary body composition scan. You can read my prior blog post here for more details.
As I’ve often written on this blog, one of my motivations for leaving corporate medicine and starting my own boutique practice is the opportunity to work much more extensively with my patients on lifestyle and other “holistic” modes of care, rather than working in an environment where the time pressures and financial incentives are oriented towards treating every problem that comes my way with a pill. As I’ve also written, this is not because I think pills are always, and in all situations, bad, but rather because lifestyle is usually much more effective than pills for promoting health and longevity; because a healthy lifestyle has (unlike pills) no negative side effects; and because it gives me a more rounded set of tools with which to help my patients. But let me add another reason why it’s best to avoid pills when reasonably possible: medicine is a big business, and like all big business, sometimes prone to corruption.
So annoying, in fact, that I googled it, and found out that there’s a whole culture of people out there who find the ad equally repellent. Many, unfortunately, have commented on the size of the main actress, and the backlash against the backlash against the commercial (isn’t everything in America these days a backlash against a backlash?) is that the haters of the commercial are simply “fat shaming” the actress. So let me state right off the bat that indeed, fat shaming is a horrible thing, and my objection to the commercial has nothing to do with the fact that the lead actress is overweight.
Rather, what really irritates me about the commercial (other than the cloyingly obnoxious jingle) is that it perpetuates the great pharmaceutical lie about type 2 diabetes: namely, that it’s an incurable disease that is best controlled with medication. Nothing could be further from the truth. The fact is that type 2 diabetes is often curable, and almost always manageable, with lifestyle modification, and – provided they make the correct changes – many type 2 diabetics don’t require any medication at all.
In recent years, there has been an explosion of interest in healthcare related content on the internet. Podcasts by figures such as Peter Attia, Andrew Huberman, Rhonda Patrick, Ken Berry, and Gabrielle Lyon, to name a few, have become extremely popular. Typically these podcasts take a health issue and dissect it for the average person, often with a bit of a different perspective than is found in mainstream medicine. And while I don’t agree with every single thing that each of the above doctors says or touts, I think that overall these folks do a great service to the American (and global) public by empowering people to learn more about how to take charge of their own health.
