Friday, April 30, 2010
But the email said . . .
I am constantly amazed by the number of people who bring me copies of emails that they have gotten or been forwarded to them. These emails are usually warning of grave hazards in everyday things or that a new miracle has been found to solve all of their health care or weight woes.
Email is considered by many to have as much validity as our parents and grandparents gave the written word. It has gotten to a point where certain emails develop wide followings and have a cult like following. They have people believing that radio waves can be transmitted over a cell phone to open a car door, that magnets will cure arthritis, that diet drinks are akin to embalming fluid and so many more as to be to be overwhelming. The way a good email following is usually obtained is by starting with an, at least, partially true statement, expanding on all of the potential positive or negative aspects of this statement thus blowing it out of proportion, either finding someone with a title or reputation to have quoted something about it (making this up often helps), make it look real by adding a partially true tale to demonstrate the point and then sending it to thousands of the writers nearest friends (usually anonymously). Sometimes they are created by cultists spreading the word, sometimes for the pure enjoyment of watching them spread across the globe until it obtains urban myth stature, and frequently as a way to promote products.
I had a patient in recently, a very nice and sincere guy who wanted to lose some weight. He was like many of us and had several bad habits such as smoking and somewhat excessive drinking. However, his biggest concern was that diet drinks would kill him so he could not give up his regular sodas (no water did not seem to be an acceptable option either because of an email his mom sent him about fluoride). He did not see how silly this sounded. The point is that this new way of spreading news is not one that should be trusted or relied upon.
A few things to consider when reading anything from any source but especially the internet.
Ok now you have my opinion.
John
Email is considered by many to have as much validity as our parents and grandparents gave the written word. It has gotten to a point where certain emails develop wide followings and have a cult like following. They have people believing that radio waves can be transmitted over a cell phone to open a car door, that magnets will cure arthritis, that diet drinks are akin to embalming fluid and so many more as to be to be overwhelming. The way a good email following is usually obtained is by starting with an, at least, partially true statement, expanding on all of the potential positive or negative aspects of this statement thus blowing it out of proportion, either finding someone with a title or reputation to have quoted something about it (making this up often helps), make it look real by adding a partially true tale to demonstrate the point and then sending it to thousands of the writers nearest friends (usually anonymously). Sometimes they are created by cultists spreading the word, sometimes for the pure enjoyment of watching them spread across the globe until it obtains urban myth stature, and frequently as a way to promote products.
I had a patient in recently, a very nice and sincere guy who wanted to lose some weight. He was like many of us and had several bad habits such as smoking and somewhat excessive drinking. However, his biggest concern was that diet drinks would kill him so he could not give up his regular sodas (no water did not seem to be an acceptable option either because of an email his mom sent him about fluoride). He did not see how silly this sounded. The point is that this new way of spreading news is not one that should be trusted or relied upon.
A few things to consider when reading anything from any source but especially the internet.
- You really do not know who wrote the information. It is unlikely that this is the way that major breakthroughs or warnings are spread.
- If it talks about a conspiracy or something the government does not want you to know then watch your wallet because this is a great way to peak your interest and possibly get you to spend for something that does not work or you do not need.
- If the argument is based only on one case history or anecdotes then the odds of it being valid should be highly suspect. The placebo effect is powerful enough to create many of their claims without there being anything of real value in the information.
- If it sounds too good to be true or so bad as to be unthinkable then do not think about it anymore.
- PLEASE DO NOT FORWARD IT! Especially to me.
Ok now you have my opinion.
John
My New Site is Up!
Ok not really a great thing for most of you but a good day for me. Finally after working on it for weeks and making my wife very unhappy with me for spending to much time in front of the "one eyed daemon" it is running at The Carolina Weigh. It is far from finished but I think it is a decent start.
John
John
Monday, March 29, 2010
But isn't it supposed to be good for me?
One of the most common things that I get when talking to someone about their diet is that they are eating something because it is good for them. This includes honey, or natural sugar instead of refined sugar, large amounts of dairy, fruits, sea salt, red wine, chocolate and a huge variety of other things. While it may be true that these are good for you or less bad than something else, it does not mean that to consume them in large quantities is going to help you be healthier or lose weight.
Like so much else - when it comes to evaluating your foods you need to take a large number of things into account and you need to make the best choices for your health. That something may be beneficial to you is usually based on having a small to reasonable amount. A 5 oz glass of red wine with an ounce of high cocoa chocolate seems to be helpful but the same cannot be said for a bottle of red wine and a bag of chocolate.
Beware of all claims to the effect that the more you eat the better you will be. It is usually just not true. Also be aware that peoples testimonies or anecdotes do not mean that something works and if that is all that the makers of a product have and not some reasonable population based studies then their product may be great at stimulating the placebo effect. It may be the case that the product does no good at all but what is given with it is the effective part - consider HCG and the 500 calorie diet that you go on with it. Or the cereal box that says that it is a part of a healthy diet. It is but not the best part.
John
Like so much else - when it comes to evaluating your foods you need to take a large number of things into account and you need to make the best choices for your health. That something may be beneficial to you is usually based on having a small to reasonable amount. A 5 oz glass of red wine with an ounce of high cocoa chocolate seems to be helpful but the same cannot be said for a bottle of red wine and a bag of chocolate.
Beware of all claims to the effect that the more you eat the better you will be. It is usually just not true. Also be aware that peoples testimonies or anecdotes do not mean that something works and if that is all that the makers of a product have and not some reasonable population based studies then their product may be great at stimulating the placebo effect. It may be the case that the product does no good at all but what is given with it is the effective part - consider HCG and the 500 calorie diet that you go on with it. Or the cereal box that says that it is a part of a healthy diet. It is but not the best part.
John
Thursday, March 25, 2010
HCG Why?
HCG has gained a rising popularity with the diet clinics and thus the dieters in America. The interesting part is that it has been around for over 50 years and evaluated heavily with no proof of benefit in losing weight. Years ago it was used as a great way to keep a clinic in operation and profitable by providing these high cost injections that required weekly visits - no wonder bariatrics often gets a bad name.
Time and time again the public is battered by claims of instant cures and easy solutions. My feeling is that when this does happen we will not be finding in an obscure book by a master salesman or infomercial but it will flood the real news and medical avenues. As far as not putting out cures so people will continue to make money on the disease, it takes only a few seconds to realize that the real money is in a real cure and in obesity the designer will have enough money to build their own island. Be cautious about putting your hopes in the new miracle cure - it isn't. In this case new or a miracle.
I too want it to be easy, quick and painless but not yet. Even those with bariatric surgery have learned that old habits die hard and a large number gain their weight back after 3 or more years. I know they are starting to fill up my clinic.
The following must be included in all consent forms by order of the FDA in all labeling and advertising:
HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or "normal" distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.
The really funny part of the story is the way it was reintroduced to the United States. A book was written by Kevin Trudeau, who makes a living with infomercials, in 2007 claiming that this treatment was "suppressed" by the AMA and the FDA and "hidden from the public." He has no dietary or medical training. With our society having moved to complete distrust of the government this obviously proved he was correct even though he had done little studies or proof of concept. In September 2007, the FTC charged Mr. Trudeau with violating a court order by misrepresenting the content of the book and false claims in his infomercials which have been banned. However, he continues to play on the fears of the public vs the government. I assume that the income exceeds the risk and there are few concerns with a large number of people wasting their money and getting their hopes up.
Just Push Away from the Table
Many of us have gone to our physician wanting to lose weight (or they want us to). In my experience I get support and usually a prescription to push away from the table and start walking. I must admit that these are not bad ideas but for someone who has real weight to lose it is likely just discouraging and likely to send them to the nearest fast food drive-through after the appointment in frustration and defeat.
For those of us who have about 30 or more pounds to lose it is clear that we need more. It is not that we all will do well with the same approach - far from it - but that we need someone to help us and support us. What is little understood is that we need someone to be accountable to. Accountability is the thing that is most motivating for the individual who really wants to lose. It cannot be a spouse, coworker, neighbor or anyone that you feel too comfortable with. The will either be too lenient or to hard on you. The person to whom you are accountable must be understanding (to make it easier to come back to you when you make a mistake). compassionate and someone who wants to see you succeed. They must also be willing to be firm. This is why most programs include some level of accountability either through and part of individual counseling or as part of a support group.
The next thing we need to have is a plan or guideline. Dieting is not about perfection and any diet that only works if you stick to a rigid structure will ultimately fail because you will never learn how to manage the constant changing situation that is your life. You must learn how to bend and compensate for the food flood that we are all exposed to. Your plan must fit into your lifestyle and not push you into completely changing it. While change is important, long term success will be achieved through maintaining your comfort level and not changing your whole life at one time. The jumping in and changing everything until you reach your goal is one of the primary reasons that when this goal is reached most people fall back and gain their weight back.
Topics to come:
What does my physician know about weight loss?
Exercise and how it fits in.
Weight issues are lifelong and will not respond to quick treatments or challenges.
And so much more.
Tuesday, March 23, 2010
Hello and Welcome
Hello!
Thanks,
John
Welcome to my blog. I think this first article should tell you about me. I am a physician who works in a small town doing weight management. I am lucky to be self employed and fall outside of the insurance dominated health care system working with people who are excited about improving their lives.
I was born to an Air Force family and spent my years up through high school graduation moving from place to place. I graduated Washburn Rural High School near Topeka Kansas in 1973 (yes I am rapidly approaching senior citizenship). When my father retired we moved to my mother's home town in Greenville, SC and I went to The University of South Carolina in Columbia SC. After Graduation I then moved to Charleston, SC and attended The Medical University of South Carolina, graduating in 1981. After 3 years of pediatric residency in Charleston I was finally ready to go to work.
I moved to Greenwood, SC and joined a great pediatric group and stayed there for 5 years only leaving when my medical school debt became overwhelming. I joined the Department of Health and Environmental Control (DHEC) to continue my career and move to public health (besides they helped with my loan and I did not have to take call which my wife appreciated - that is another story). I directed the Greenwood County Health Department and the health departments in the surrounding five counties for seven years and loved it. I then was 'promoted' to supervise all of the health departments in SC as well as the Regulations Division of DHEC. This turned out not to be my dream job - I did not enjoy or fare well in the capital where politics is king and service is spoken of. I left after 3 years.
I was lucky enough to meet Dr. Johnson, an endocrinologist who had moved from teaching to helping with weight management. After working with him and his programs for about a year I wanted to open my own practice in Greenwood and thus Carolina Medical Weight Management, PA was begun in April of 2000. I have loved it ever since.
This was not meant to bore you and I know that it will get buried over time but thought you might want a sketch of who I am - it is unlikely I will ever put up a picture.
I will get into the most important part of my life soon and talk about a few things about my family. Most of the things I will write about however, will relate to my feelings about weight loss, health care, support and people in general.
Thanks,
John
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