Obesity Week 2019: Why is it So Hard for Doctors to Admit Their Failure?

By Dr. Tro Kalayjian

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It’s Thursday night, and I’m sitting in an airplane, about to take off for New York. I’m heading home from Las Vegas after attending Obesity Week 2019, the world’s largest obesity medicine conference, a collaboration between The Obesity Society and The American Society of Metabolic and Bariatric Surgeons.

I don’t quite know how to express my feelings and thoughts about this event, but the words ‘anger’ and ‘hopelessness’ immediately come to mind. My anger and hopelessness are best exemplified by the first keynote speech, delivered by Dr. William Cefalu, who is chief scientific and medical officer of the American Diabetes Association.

After accurately describing our country’s spiralling healthcare costs, and the morbidity and mortality associated with diabetes and obesity, Dr. Cefalu went on to discuss the benefit of low-calorie approaches for diabetes reversal. He also highlighted bariatric surgery and medications. But ultimately, he harped on one point, that is frequently repeated at conventional obesity medicine conferences: 

“There is no best diet. The best diet is one that a patient can adhere to.” 

The above article by Dr. Tro Kalayjian the physician behind Dr. Troys Medical Weight Loss and Direct Primary Care is a discussion about why it is so difficult for the medical profession to accept fundamental changes in medical understanding about diabetes and current treatments for it. It is why patients continue to get contradictory advice from doctors who really ought to know better than to recommend any number of established and well known dietary strategies that simply don’t work. It’s not that they don’t work anymore, it’s that they never worked, and there is no scientific basis for any of them.

This sounds pretty revolutionary to me. The esteemed Canadian doctors is joined by a number of US based colleagues who are challenging the status quo in the treatment of diabetes, and sending a message to their profession. Just stop! Stop misleading the public! Stop lying to patients! Stop killing your clients!

Closeup on medical doctor woman giving a choice between apple and donut

Of course, they are doctors and they don’t quite put it that way. But what else can you say when so many health professionals and authorities continue to promulgate misleading information, such as “moderation is the best strategy” when clearly, based on current information that is simply not true. Moderation will kill you if by moderation you include relatively mundate advice about carbohydrates and sugar. What sciences know is that consuming carbs in excess of certain pretty limited amounts leads to metabolic syndrome, metabolic syndrome leads to insulin resistance. Insulin resistance leads to diabetes. Diabetes leads to lots of really bad stuff that can kill you, or at the least, make you really really sick.

Stop being so gullible. Doctors aren’t necessarily up to speed on the current information about your health.

If you or someone you love is fat, obese, or has diabetes or prediabetes follow the link on this blog entry to the above article and understand what is being said. Doctors are willfully ignoring solid medical evidence in favor of standing by old, disproved theories because they are afraid of rocking the boat. Read Dr. Fung’s book, the Diabetic Code.

Stop believing anyone who says that eating many small meals a day is ok. Stop following advice so far heard that has led you to being overweight and obese. If you want to live and healthy, long life, fire your current endrochronologist if he or she disparages the most recent research and tells you not to follow Dr. Fung’s advice. Run away from anyone who says that carbs and sugars are not the cause of diabetes, metabolic syndrome, and many many many other life threatening diseases.

My fasting journey has just begun.

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No matter how far we are going on a journey, each step is a new beginning. When I began intermittent fasting, back in July, I knew from the start that it is a long term project, and progress measured in weeks, months and even years. My incentives for giving it my best shot are huge – better health, a longer life and a more enjoyable and energetic present.

What I didn’t know, at least not in my heart, is that every day would require a new, fresh commitment to the plan. I sort of thought that my inertia would carry me along long enough to sustain me until I reach my goals, which are tangible, measurable and, hopefully, achievable.

Well, no such luck. Almost every day I fast I find myself feeling extremely positive about what I’m doing. Almost every day I’m not fasting I find myself haunted by doubts. I feel like I’m not losing weight fast enough, I’m not managing my insulin and medications well enough, and whatever I’m eating is working directly against my goals. I see a perfectly normal person walk by and I think to myself, “What a fat slob”. Because I’m afraid that somehow I’ll lose my commitment and indulge myself in foods that I don’t even really like or want anymore.

And I’m still less than a half the distance to my weight loss goal, and still unsure about how long it will take me to get to the point where I don’t need my diabetes medications and insulin any longer. I guess I’ll know when I get there, because both goals are measurable, and there is external evidence that I’m making good progress on both fronts. But in the meantime, I feel a little bit lost at sea, from time to time. The worst times are when I’m eating, and wondering if I can really afford this whatever.

I tried to pretend that I wasn’t obese. It didn’t work, and I still became more and more seriously ill with diabetes and its complications. Something had to change, or I would die of the disease and complications from the disease.

I also know that even when I reach my weight goal, and my ambition to defeat metabolic disorder, and eliminate my diabetes, that I will then have to undertake another journey. Maintaining my healthy body will require vigilance, and committing to a healthy low carb diet, not for a while, but for the rest of my life. So the change I am currently experiencing through intermittent fasting will only be sustainable if I commit fully to the change in lifestyle needed to maintain the results.

Intermittent fasting is a little like travelling through a very long tunnel, at the end of which is new territory I’ve never seen before. There’s also probably more intermittent fasting in the future, if I really intend to maintain my health gains and not go back to obesity and diabetes.

This doesn’t discourage me, but it does present me with a challenge in the present, which is that my level of commitment to a certain and achievable weight and health goals must be followed by an endless journey, if the effort being made now isn’t to be completely wasted.

At that’s just a little intimidating. Well, maybe not just a little. Maybe a lot.

Three Steps Forward…

For the first time since I started this new lifestyle and intermittent fast, I am feeling a little discouraged. My weight has been fluctuating up and down between 215 and 225 pounds for a week. I thought once it got down to 215 it would stay there, but no. So I looked back at the week, and realize that I haven’t actually done anything inconsistent with my program.

So what is going on? I also notice that my blood readings have been running much higher all week, on fasting days as well as on eating days. What’s with that? Maybe I reduced my insulin too much too soon…. I don’t know but it’s discouraging. A bit. From what I read in the literature about fasting, it is seldom a straight line downwards in weight, and adjusting my insulin every day and every night is a little hit and miss.

Necessarily so, since the body isn’t actually just a machine, but is indeed an organic whole system, which I’ve been messing with for the last three months.

Today was my first day of fasting for this week. And I’m sticking to it, even on the bad days. Tomorrow with be a better day. Maybe not. But a tomorrow will be a better day if I stick to my guns and follow the program.

Hang in there with me, folks. The ride’s a little bumpy!