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Why do doctors tell us to eat stuff that's clearly bad for us?

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  • #16
    The only expert on your health and dietary needs is you! Don’t blame the doctors for your own faults or lack of knowledge, but learn how you respond to different kind of foods, training and recovery etc…
    "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

    - Schopenhauer

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    • #17
      A stick save and a beauty from JoanieL in prevention of this thread taking the bullet train to crazy town. Well done.

      I will interject 2 big things that I think do play a factor for a lot of doctors. They are what I had to overcome to do what I do, which is to actually have "consult patients", or people that I spend a good deal of time just talking to, either through me or my nutritionist.

      1) Lack of time.....Joanie's story about getting told to lose weight with no idea how is typical, and the main driver is the simple economics of being a doctor. Many work in hospital or managed-care clinics, well over 80% are not private, so this means you are essentially a very well-paid employee. In the view of a hospital or clinic, you are the engine of the entire business, the producer. Everyone else is only there, from staff to patients to janitors, because you are there creating fees for services.....this means that you have a schedule that is often BUILT for you to fall behind, as the managers have realized that you will usually find a way to carry it out.

      2) The problem with telling the truth....the reality is that, just like most any other professional, a doctor wants his patients to LIKE him/her. You want to have a good relationship with them, and a big part of that is that many patients are looking for validation, not confrontation. I have seen a lot of patients that come to me after years of getting regular care, and they are constantly shocked by what I tell them. More so than that, a lot of them get very angry or defensive. I am used to this by now.

      What if all doctor's started telling people the truth?

      Here is a quick summary of what I tell people several times a week. I have a binder I give them which lays all of this out in more detail, but here is how it typically goes. My typical patient is upper 40's to low 50's, at least 40 pounds overweight, diabetic, and almost always only has an interest in making sure they don't go blind (I am an ophthalmologist). Once they realize that I am in for changing much more than that, and have often been given a Carte blanche by their overloaded PCP to do whatever I want, it is a big shock to them.

      Patient: "So where are we at doc?"

      Me: "It doesn't look good. All of your metabolic markers point toward worsening disease, and this combined with your cholesterol numbers show increasing risk for a heart attack. On top of this, you are carrying an extremely excessive amount of visceral fat which surrounds your vital organs. Your feet are bad from years of not enough walking or using Martian shoes, the disks in your back are collapsed due to years of carrying too much weight, with bad posture and no back strength. Your knees are bad because of the same issues, along with a completely sedentary lifestyle over decades.....your blood sugar is diabetic of course, but this is masking a much bigger problem of metabolic disease. It makes you feel hungry even when you have plenty of glucose in your system, feel lethargic and foggy due to the food that you eat, and your gut is perpetually inflamed, giving you acid reflux, constipation, along with your poor digestion.

      Patient has stunned look on his face. I wait for a question but it never comes.

      Me: "Given the fact that you have developed all of these habits, from poor eating to bad posture to no exercise, over decades, all combined with an appetite tuned for hyper-palatable industrial pseudo-food, turning this around will be incredibly difficult. Would you like to hear how?"

      Patient still has jaw down.....mutters "Uh, sure?"

      Me: "First, you need to go home and take all of the food in the house and give it to a homeless shelter. I want it empty, to the point that a mouse wouldn't find food there. Next, you need to go to the store and buy only 6 categories of food: Meat, vegetables, fruit, rice, olive oil, and buy some coconut oil or ghee. This will be all that you eat, even if you go out. This will be an overhaul of your entire diet that must happen at least 95% of the time......next, I want you to walk, run, or hike 4-6 hours a week. You will start a strength program, based on compound movements with a lot of compensations for your joint problems, and you will begin seeing a flexibility coach. You will lift 3 times a week, do the others 2 days a week. With me so far?"

      Patient now staring at my shoes. They are minimalist dress shoes that took an act of God to find, BTW.

      Me: "You will no longer eat breakfast, ever. At best you will not eat solid food until at least noon, but eventually we will be doing about 16 hours without food, every day. You will buy some BCAA shake to make before you workout, fasted. No alcohol but small amounts of wine, no sweets, no bread, no caffeine once you start your eating window. Set an alarm for when you will go to bed, and let the sun wake you up if possible most mornings. You sleep like hell, and that needs to change before any of this will be possible. I will see you in 3 months. If markers have not changed, I will no longer be seeing you and will be transferring your care to someone that is fine with letting this happen. Any questions?"

      Now, I operate with losing about 25% of the patients that are sent to me.....seeing as I am private and get more referrals than I could ever possibly handle, this is not a problem, but if were to work for a hospital or network clinic this would be seen as completely unacceptable. I am fine with what I say being too much for some people, and I see it as proof that I am not diluting my message too much.

      One could make an argument that #2 is the fault of individual doctors, but that is not entirely accurate. We are forced to operate in a system that SOCIETY setup, seeing patients using a food system that THEIR elected officials setup.
      "The soul that does not attempt flight; does not notice its chains."

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      • #18
        Laz, the sad part is that some doctors also give advice as strongly as you, but in the opposite direction. I know someone who has been a "healthy" CW follower for a long time. She is a tad younger than your average patient's age group. She is overweight, has increasing hypertension, her blood lipids are low HDL and elevated triglycerides, and she has recently been diagnosed with early stages of fatty liver disease. She was sent to a gastroenterologist, who told her to stop eating red meat and drinking alcohol. She told the doctor that she doesn't eat red meat (remember the healthy CW she's been following?) and does not drink. The doctor told her to keep doing it, and to also go on a fat free diet. Not even low fat, fat free. She was literally told to avoid all fat, with the only exception being a little bit of olive oil. She has also been prescribed numerous pills.

        The sad part is that I have had a long conversation with her about fats, cholesterol, seed oils, etc., and while she seemed surprised, like "really, you can eat fat?", it went into one ear and out the other. She is so scared of fat and cholesterol, that even the concept of ingesting eggs translates to heart disease in her mind, which is also supported by her "doctors".

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        • #19
          Lazarus I wish you were my brother's doctor. He's diabetic and is having all the problems you mentioned. He's getting ready to have surgery for glaucoma. I've tried to get him to eat paleo for the last 3 yrs. He knows he should but he still insists on eating baked goods, though he tells me he only does it occasionally. I've stopped talking to him about diet. I think if a doctor would tell him the same things I tell him it would make a world of difference, but that won't happen because the doctors he sees are through the VA.
          Life is death. We all take turns. It's sacred to eat during our turn and be eaten when our turn is over. RichMahogany.

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          • #20
            To be fair, while I have not really had many doctors I work with ever say to eat strictly paleo, I have also never once heard a doctor recommend a diet high in processed foods, added sugars and oils, to avoid excercise of any kind, to consume alcohol beyond limited moderation, or limit fresh fruits and vegetable intake, to avoid leafy green vegetables while not taking "blood thinners", or to sleep so little so as to rely on energy drinks like water. Whole grains are still part of the CW, and just like in so many other things, change will be slow. Doing your own research and testing your own diet and body are way better than simply relying on the recommendations of others.

            People believe medicine is cut and dry, but there is a fair amount of wiggle room and differences in treatments. I had one MD tell me they no longer cut out appendixes in Europe. They attempt a first treatment with medication before resorting to surgery. Without culture and sensitivity reports, some docs prescribe different antibiotics to treat the same type of infection; say Levaquin vs Rocephin for a Pneumonia. Sometimes they'll give you a rational of population susceptibility, but sometimes it is just personal preference.

            We're all going to die, it is the years before and the quality that matters. If you are healthy and happy eating grains, why change? If you're like us, then you might want to seek alternatives like paleo to improve your quality of life. You won't find a lot of PCPs or docs telling you to go paleo, because they already have a hard time getting people to make minor modifications to their SAD of garbage, or to even excercise a little bit. Being informed and making your own choices, is always the best so you can see what works for you, instead of just doing what you're told.

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            • #21
              Originally posted by quikky View Post
              She was sent to a gastroenterologist, who told her to stop eating red meat and drinking alcohol. She told the doctor that she doesn't eat red meat (remember the healthy CW she's been following?) and does not drink. The doctor told her to keep doing it, and to also go on a fat free diet. Not even low fat, fat free.
              My doctor is similar. He never said to go on a fat free diet, but he did say never eat red meat and don't drink more than 2 drinks a night. When my cholesterol test was high he said I probably eat a lot of red meat and fast food, right? I told him no, I never eat red meat, I can't remember the last time I went to a fast food restaurant and I (was at that time) a vegetarian. He said oh well then you must have familial hypercholesterolemia. My total cholesterol was 268. That hardly qualifies for that diagnosis plus I didn't have the other symptoms. He just shrugged his shoulders and said I could probably go a while longer before he gives me a prescription.
              Female, 5'3", 50, Max squat: 202.5lbs. Max deadlift: 225 x 3.

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              • #22
                i am acquainted with a woman in her early 50s. she is 40-50 pounds overweight and a few months ago started taking blood pressure meds. she is taking 2 kinds and her doctors still can't get her in a "safe" range. she was told if she lost weight and exercised (again, not a how-to, just a suggested result) she probably wouldn't need to be on ANY meds. her response? "eh. whatever." she'd rather be fat, lazy and increasingly sick.

                my employer forced me to have a "health and lifestyle" screening last spring. all my cw markers were fine, but the nurse practitioners went bananas over me not ever eating grains while also eating meat everyday. they simply would not believe that my health had improved dramatically by eating this way.

                it was very hard for me to dump cw mindsets when i revamped my eating habits. eliminating grains, consuming more animal proteins and saturated fats was upside down of everything i'd been told all my life. try imagining that shift by the tens of millions? it will have to be a very slow process. couple that with so many millions who either order take-out or microwave dinner and couldn't cook a pan of eggs or roast a leg of lamb? good luck. lol, in fact i have 2 friends who use their ovens as additional closet space because they never ever cook. one guy keeps shoes in there and another keeps boots and hats and such.

                very few doctors are in the business of prevention. they treat symptoms. it's gotten worse as medicine becomes more and more hmo'd and very few patients are willing to be proactive about their own health, either by questioning their doctor or making personal changes.

                insurance, big med, big ag are all for-profit. we CAN choose to opt out.
                Last edited by noodletoy; 12-24-2013, 12:06 PM.
                As I ate the oysters with their strong taste of the sea and their faint metallic taste that the cold white wine washed away, leaving only the sea taste and the succulent texture, and as I drank their cold liquid from each shell and washed it down with the crisp taste of the wine, I lost the empty feeling and began to be happy and to make plans.

                Ernest Hemingway

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                • #23
                  There is a popular opinion that words of experts have much more merit, that their ideas of things must be true of the things themselves; so people base their knowledge on this rather than empirical evidence. Would you trust a watch that only told time accurately approximately 50% of the time? Similarly, an "expert" opinion should only be trustworthy if their opinion turns out to be significantly more accurate. Accuracy of "expert" opinion is a matter of degree, and should be treated as such. Turns out many times their presuppositions have little more accuracy than taking a guess, and each person in that profession gets their truths objectively from another expert opinion. Even popular opinions such as the ones expressed by Lazarus are only popular because you're presupposing the conclusion that his word is infallible because it is the popular opinion here, like the medical field has popular opinions there. It is never guaranteed to be accurate, as, it can always be misdiagnosed. This is one reason behind the ignorance of the medical field causing so many deaths.

                  This isn't even touching on the matter of opinions being easily swayed by one means or another; so you are left with residues of unanswerable questions until you take matters into your own hands.
                  Make America Great Again

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                  • #24
                    I think doctor's are as much a victim of the current paradigm as we are. Most of them don't eat SAD but a lot of them do eat CW healthy and are overweight. Medical school doesn't train them in nutrition and what it does say is all CW. I think doctors genuinely want us to be healthy, they just have no idea how. And even when they do know how, it's hard to approach patients about their diet. Life can be rough sometimes.
                    Out of context quote for the day:

                    Clearly Gorbag is so awesome he should be cloned, reproducing in the normal manner would only dilute his awesomeness. - Urban Forager

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                    • #25
                      Originally posted by Wildrose View Post
                      I think doctor's are as much a victim of the current paradigm as we are. Most of them don't eat SAD but a lot of them do eat CW healthy and are overweight. Medical school doesn't train them in nutrition and what it does say is all CW. I think doctors genuinely want us to be healthy, they just have no idea how. And even when they do know how, it's hard to approach patients about their diet. Life can be rough sometimes.
                      i think the average hmo check-up is about 15 minutes. only so much can be covered in that amount of time. since so many people are some kind of sick, especially with what are commonly called age-related diseases, (but are mostly due to poor life habits) the doc has to hurry-hurry-hurry figure out how best to relieve the suffering. and that most often results in writing a prescription.
                      As I ate the oysters with their strong taste of the sea and their faint metallic taste that the cold white wine washed away, leaving only the sea taste and the succulent texture, and as I drank their cold liquid from each shell and washed it down with the crisp taste of the wine, I lost the empty feeling and began to be happy and to make plans.

                      Ernest Hemingway

                      Comment


                      • #26
                        By the way Dr. Laz, you are the meanest doctor ever. If I was that patient I would be hanging my head in shame and probably crying.
                        Female, 5'3", 50, Max squat: 202.5lbs. Max deadlift: 225 x 3.

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                        • #27
                          Originally posted by Derpamix View Post
                          There is a popular opinion that words of experts have much more merit, that their ideas of things must be true of the things themselves; so people base their knowledge on this rather than empirical evidence. Would you trust a watch that only told time accurately approximately 50% of the time? Similarly, an "expert" opinion should only be trustworthy if their opinion turns out to be significantly more accurate. Accuracy of "expert" opinion is a matter of degree, and should be treated as such. Turns out many times their presuppositions have little more accuracy than taking a guess, and each person in that profession gets their truths objectively from another expert opinion. Even popular opinions such as the ones expressed by Lazarus are only popular because you're presupposing the conclusion that his word is infallible because it is the popular opinion here, like the medical field has popular opinions there. It is never guaranteed to be accurate, as, it can always be misdiagnosed. This is one reason behind the ignorance of the medical field causing so many deaths.

                          This isn't even touching on the matter of opinions being easily swayed by one means or another; so you are left with residues of unanswerable questions until you take matters into your own hands.

                          All true, and as to opinions you know what might be interesting? Making continuing education public knowledge. That is you could see if your doctor has been getting his continuing ed from prescription drug manufacturers or working to expand his knowledge in the fields of nutrition, exercise, or other more functional capacities. Lets face it....10 years of education is a paltry tidbit when it comes to someone who has been working in the field for 30+ years. I don't care what they did in college/postgrad, what have they done lately? What makes them different from the fella down the street. And I do mean this for all health care providers... There is a huge continuum on which one can practice after you get any degree. The degree is only a starting point.

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                          • #28
                            My doctor looked SHOCKED when I told him I just started (about 1 or so months ago) eating Primal. He said it is a 'fad' and to STOP eating red meat and eggs and too much fruit. I indicated that I have never felt better (except I know I will feel better yet when I get statins out of my system) He said, 'It you want to ignore the advice of medical professionals... (Yes, he let it stop there). I know my next blood work will probably be better than the last but not 'good' (in his opinion) and may never be again but I will live longer and feel better.

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                            • #29
                              Preventive medicine is not good for the medical business and telling the truth will sooner or later only fall back on the doc himself! If I were a doctor, meeting ignorant overfat and pre-diabetic people face to face, I’d just tell the patients what they like to hear and treat their symptoms down the road! Dr Lazarus sound like a better doctor that I could ever have been though...
                              "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

                              - Schopenhauer

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                              • #30
                                How much of it also has to do with the fact that any small win is better than nothing? For example, if a patient with numerous health problems and a terrible diet is told to completely overhaul their diet and lifestyle, they may be very hesitant and even resistant to changing. But if that same patient gets merely recommended to lose the chips and eat fruits and vegetable instead then they may be more willing to do so. Are they still eating grains and other harmful things?... sure, but at least now that patient's diet has some fruits and vegetables in it as apposed to none at all. It may not be a huge change but it is still a small win nonetheless.
                                http://nickburgraff.com/

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