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 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.

Marriage can be heaven, or hell!

If only I was not me.

I should have learned to stay away from women outside of my marriages.  It’s not that I run around on my wife, but rather that while I am not sexually faithful to only one person she and I agreed to live together as husband and wife, with a specific agreement to provide her with some comfort that I would be sensitive to her feelings and not cause her to be confronted with my relationships.  We agreed that I would be discrete, stay away from anyone in our circle of friends, and not inflict disease or another child with a lover on our marriage. I was also to keep the details of my “affairs” to myself. She didn’t want to hear about them. 

It might sound unusual, and maybe it is, but it was a natural outcome of our situation, and how we became a couple in the first place.  She had been one of my lovers during my first marriage, who had become pregnant with our son.  The pregnancy had led to an ongoing relationship as friends and parents, as well as sometime lovers,  which meant that when my previous marriage ended, we were still involved with each other even if mostly as the parents of a small child. 

During my first marriage, my former wife and I had an explicitly open marriage.  It’s not very good training to being a successful husband. 

I don’t know for sure, but I think that a lot of marriages become virtually sexless after a long period of time together. Whether that’s true or not it may or may not reflect an underlying problem in the relationship. My marriage has been sexless for more than a decade and was pretty much very low sex from almost the beginning. My marriage is not typical, I’m sure, but the reasons for not having sex with your partner can be highly unique to the two of you.

The only real problem is not the lack of sex, it’s more likely the lack of real communication and trust between you, on this subject, if not on any other number of subjects, including this one.

My partner and I still live together in the same home, but the marriage (as a sexual relationship, that is) is largely over, although we live together.  We have five kids between us and more than 40 years of being involved with each other.
 
My previous marriage was already in trouble when I met and became involved with my wife. In the beginning, things were okay with us, and after my first marriage broke up we moved in together and ended up married after another child was born.
 
We both came into the marriage with unrealistic expectations. After explicitly agreeing to an “open” arrangement with me, she actually thought that I would change completely and become a different person and not have intimate relationships outside of our marriage. I thought that she would be as good as her word, and be willing to be open as long as I didn’t cause her to be embarrassed, or bring home any diseases.
 
We were both living a fantasy, with serious long-term consequences. I went along my merry way, living pretty much as I did during my previous “open” marriage, and she went on living in a belief that I had changed my behavior, despite our agreements to the contrary. Part of the deal we made at the beginning when we got married, was that would keep my external relationships to myself, and not expose her to the embarrassment of having to deal with them on an ongoing basis.

Well, that didn’t work out so well. She ended up feeling completely betrayed sexually and emotionally, which she more or less kept to herself for more than 30 years. She also withdrew emotionally more and more over the years, until it got to the point where sex would have been totally pointless since we no longer even shared emotional intimacy.

She, on the other hand, assumed that I was lying all along. In other words not telling her that I was faithful, when in fact I was not. I assumed that she was well aware of my other friends when she actually hoped that they didn’t exist, but she was always angry that they probably did.

She, however, wouldn’t now feel as though she has been living a lie for all this time, and so angry that it’s impossible for her to get over it.

The weird thing is that I really can’t imagine my life without her in it, and don’t want to.  But it’s far too late in my life to change who and what I am, or what I have always believed.  Same is true for her.  What can we do?

It has occurred to me many times that it would have been a lot better off if I were not me.  Or at least, made a life with someone who shared my desire for multiple partners rather than someone who really feels that I ruined her life.