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

By Dr. Tro Kalayjian

doctortro.com/obesity-week-2019-why-is-it-so-hard-for-some-doctors-to-admit-their-failure/

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 doctor 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.

The Diabetes Code

Prevent and Reverse Type 2 Diabetes Naturally

I’m reinventing myself again. My goal is to eliminate or radically reduce prescription medications for diabetes, and a whole host of inflammatory diseases caused by the same thing that causes diabetes. 

Change doesn’t come easily when one is used to surrendering autonomy to the medical profession and simply being the obedient patient. It is NOT SAFE to simply trust that doctors know what is best for us. We already know this, but it is no surprise when we obediently follow their advice. Like everything else in life, you need to check the information out for yourself, and ask a lot of questions.

It seems that diabetes is actually caused by the thing that is supposed to cure it – insulin. In his book, The Diabetes Code, Dr. Jason Fung has coined the word diabesity – combining the words diabetes with obesity, to indicate that diabesity is caused by excess glucose in the body stored as fat, particularly in the internal organs, particularly the liver. There is a cycle in the body, controlled by the liver, that triggers the production of excessive blood sugar and results in insulin resistance.

Too much sugar and the body develops insulin resistance because the body simply can’t absorb any more sugar into the cells. To make matters worse, the medical profession prescribes increased insulin, or even just metformin, which helps the body to try to consume even more sugar.

Dr. Fung’s prescription for the elimination of diabetes is contained in a book called the Diabetes Code. Read it and weep, but understand that it calls for regular fasting to reset the diabetes cycle. 

This week I’m seeing my endocrinologist, and am going to be seeking support to follow Dr. Fung’s program. I’m curious as to what he will say.

Will he continue to prescribe insulin, Janumet, and Invokana to address my extreme diabetes? Or will he support a major lifestyle readjustment along with a fasting program to eliminate the disease altogether, eventually? I have already started to substantially reduce my carbohydrates and sugars in preparation for the revised program, and have already lost over 10 lbs in just under ten days.

I started writing about my diabetes and this journey several months ago, when I decided to review the prescription medications and their side effects, as a result of finally getting fed up with being sick, and seeming to get worse and worse and the years roll by.

With the encouragement of my middle son, Don, I began to look at diet as a major issue in my illnesses, as well as my diabetes. Sure, I went to many diabetes dietician clinics years ago when I first became aware that I was a diabetic. They always talked about reducing carbohydrates and sugars, and using diet and exercise to control my weight, and therefore help control my blood sugars.

As noted by Dr. Fung in his book, diet and exercise programs have been a massive failure, all over the world, in controlling or preventing diabetes or obesity. There are many reasons for this failure, but the medical professional continues to support this old and tired cant, that doesn’t actually work. I think the real reason that nobody wanted to actually examine diabetes and obesity with new eyes is that the old views are very profitable, to the pharmaceutical industry, the vegetable oil industry, even the health and diet industry itself.

But you’d have thought that somebody would have noticed that it didn’t work. And finally somebody has.

Anyway. Wish me luck on this new direction in my journey to solve my diabetes, and eliminate the side effects of so many medications by eliminating my need for them at all.

Finally, my wife Katherine has been diagnosed with Type 2 Diabetes in the past month, and has begun the journey through this ugly territory as well. Hopefully we can solve the riddle of the disease for both of us, and she never has to go through the years of pain and agony I am experiencing as a result of having poorly controlled blood sugar for the past twenty five years.

Fit? OMG! Thriving or suffering in our bodies?

A couple of suggestions and questions.

  1. Don’t smoke
  2. If you smoke, quit!
  3. If you quit and still get COPD, what the hell do you do then?

Donald B Wilson 1959-60 a

I’m not exactly in the best physical condition, considering everything.  I’m a type two diabetic, dependent on insulin.  I’m way too heavy, as my lifelong personal physician put in my chart – obese! She was far too polite to say that out loud to me, so I found out only after she retired and sent me a copy of the charts for my next doctor to see.

Up until 12 years ago I was a heavy smoker, having nearly started in the cradle, with both parents chain smoking my whole childhood.  I stole my first smoke from my mom before going to elementary school!  By the time I was ten I was smoking pretty regularly, and spent high school pretty much hanging out in the smoke pit with the other addicts.  Both parents scolded me for smoking, but then doing what you do rather than what you say does not give parents a whole lot of credibility.  None, actually!

Still, although it might have been their fault that I started smoking, they didn’t hold the stick in my mouth, and force me to smoke for the next forty years.  That was my own doing, and there’s no getting around the fact that I smoked a lot! for a long time! and didn’t really think about the consequences much.

Actually that’s not true.  In my periodic journals and diaries over those years, I remember bitching and complaining about how much damage I was doing to myself by smoking, despite hating what it might doing to me long term, I still kept on smoking.  I was totally resistant to all efforts made to get me to quit.

I did try from time to time.  Once, in my forties I stopped smoking for almost a whole year, before giving in to the filthy habit. So I guess I did know how harmful it might be to me in the future.  And eventually I did quit.  Twelve years ago next January.  It wasn’t easy.  In truth I might still be smoking if I hadn’t ended up in hospital for near a month as a result of blocked colon surgery.

Part of quitting was about trying to be a better example of a human being to my grandchildren than I had been to my own children growing up.  Twelve years ago I didn’t have any grandchildren, yet, but I was encouraged by believing that it would be better if they never saw me smoking at all.

I really hoped that by quitting when I did that I would avoid the worst consequences of smoking, such as COPD or lung cancer.

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

Well, I hate to say it, but so sad, too bad.  I have COPD, having pretty much avoided it until I caught pneumonia in August 2016 which triggered it, with severe breathlessness and a pretty severe and sudden restriction in my lifestyle.  The following list of things I could do comes from the Mayo Clinic website:

Lung therapies

Doctors often use these additional therapies for people with moderate or severe COPD:

  • Oxygen therapy. If there isn’t enough oxygen in your blood, you may need supplemental oxygen. There are several devices to deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town.

    Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time. Oxygen therapy can improve quality of life and is the only COPD therapy proven to extend life. Talk to your doctor about your needs and options.

  • Pulmonary rehabilitation program. These programs generally combine education, exercise training, nutrition advice and counseling. You’ll work with a variety of specialists, who can tailor your rehabilitation program to meet your needs.

    Pulmonary rehabilitation may shorten hospitalizations, increase your ability to participate in everyday activities and improve your quality of life. Talk to your doctor about referral to a program.

Lifestyle and home remedies

If you have COPD, you can take steps to feel better and slow the damage to your lungs:

  • Control your breathing. Talk to your doctor or respiratory therapist about techniques for breathing more efficiently throughout the day. Also be sure to discuss breathing positions and relaxation techniques that you can use when you’re short of breath.
  • Clear your airways. With COPD, mucus tends to collect in your air passages and can be difficult to clear. Controlled coughing, drinking plenty of water and using a humidifier may help.
  • Exercise regularly. It may seem difficult to exercise when you have trouble breathing, but regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles. Discuss with your doctor which activities are appropriate for you.
  • Eat healthy foods. A healthy diet can help you maintain your strength. If you’re underweight, your doctor may recommend nutritional supplements. If you’re overweight, losing weight can significantly help your breathing, especially during times of exertion.
  • Avoid smoke and air pollution. In addition to quitting smoking, it’s important to avoid places where others smoke. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs.
  • See your doctor regularly. Stick to your appointment schedule, even if you’re feeling fine. It’s important to steadily monitor your lung function. And be sure to get your annual flu vaccine in the fall to help prevent infections that can worsen your COPD. Ask your doctor when you need the pneumococcal vaccine. Let your doctor know if you have worsening symptoms or you notice signs of infection.

https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685

It might seem obvious that I need to change my habits, if I’m going to improve the quality of the rest of my life.

Dr. Tsang, my pulmonary specialist, referred me to the Fraser Health Respiratory Rehabilitation and Education Program at the Physiotherapy Department at  Langley Memorial Hospital close to where I live.

It is a six week Pulmonary rehabilitation program pretty much as described in the Mayo Clinic Internet website.  A rehabilitation respiratory counselor provided lessons and counselling, and worked with a physiotherapist and dietitian to provide useful information.  The classes (my class had five COPD students) run for about three hours twice a week, and for me personally, were extremely useful.

There is really two different types of learning that goes on in the classes, both of which are useful but one of which is essential if a person really wants to get the benefits of the information provided in the handouts and lectures.

All the materials presented are readily available on the internet or at your Public Library.  You could find them yourself, read them, and then do what is recommended.  You’d think that as a adults we could do that, and save everybody a lot of money in providing these classes.  Hell no!  Because information without reinforcement and actual exercises is only a small part of the learning process.  In some ways the biggest thing I learned in the program was how to let go of my fears, anxieties and panic, when experiencing extreme shortness of breath.

It’s no party, not being able to breathe freely.  In fact, its terrifying when you discover yourself unable to catch your breath any time your do any exercise at all.  For me, even walking up a flight of stairs seemed beyond what I was able to do.  I thought I was going to die, and the more afraid I became, the more difficult I found it to catch my breath.

The doctor told me that it wouldn’t likely kill me to breath, no matter how short of breath I am.  Her advice was helpful, although I’m not sure I actually believed her when she told me.

What was more useful was sharing the experiences of the other students within the context of the classes, where we were encouraged to stretch ourselves and learn to manage our boundaries while improving our cardio vascular  health.  We walked, biked and did stretching exercise as a group, with the instructors monitoring our oxygen levels and pulse levels.

After six weeks I gained insight into better management of my health, and an improved sense of opportunity to control my future.

Before I started the class I had already begun to walk and do more exercise four or five days a week.  After completing the program I’m committed to walking and exercising more, as well as changing my diet to improve my weight.  I know that doing so will also improve my diabetes and blood sugar levels.

I no longer feel so dis-empowered by my COPD, and see it as somewhat similar to my diabetes, which I also resented like crazy when I was first diagnosed.  Just as I have learned to manage my blood sugar levels through a combination of medications, insulin, exercise and diet, over the past ten years I will get control of my cardio vascular health, and reduce to a minimum the impact of COPD on my life.

I have learned that just because it’s hard as hell to breath when I exercise is no reason to stop exercising.  In fact, the opposite is a fundamental truth.  Use it or lose it, as the old saw goes.

I now make real effort to get and walk every day, and to exceed the minimums recommended in the class.

Instead of taking the shortcut every time, I’m learning to take the longer road home