I am on an Obesity Mission. I’m going to single handedly (with lots of great help) change the way we treat obesity. And the way we treat obese people. The following is an open letter to all the skinny doctors, trainers, dieticians and therapists in the world …
WITH ALL DUE RESPECT DOCTORS AND COLLEAGUES…YOU ARE WRONG ABOUT THE MEDICAL EVIDENCE!
Listen up. (That’s me BEFORE circa 2003). A fat doctor. Imagine. (Scroll down to see the AFTER).
Obesity is NOT simple thermodynamic imbalance. It’s not how many calories we eat and how little we exercise. That may be true for people who are overweight and have 20 or 30 or 40 pounds to lose. Any diet and exercise program that is basically healthy nutrition and movement will work for them; it’s just a matter of matchmaking – the right program for the right person.
For the rest of us, the obese…Eat Less Move More fails 95% of the time. Worse yet, severe restrictive diet and exercise may worsen, not improve, the obese person’s health. Emotional Eating and Behavioral Control don’t fare any better, but at least they don’t ruin someone’s health!
Here’s me with a recent 2010 AFTER (down 100 lbs). Winning an award because I figured out how to lose weight and how to apply that knowledge to every patient I see and how to teach to anyone who will listen. (Thanks Kaiser!)
Here’s what I know about Obesity. I’ll share it all with you in the hopes that you will go back to your exam rooms and order some labs for starters.
Obesity is a medical condition of serious inflammation, chronic pain, disordered endocrine function, changes in insulin metabolism, altered brain chemistry, food sensitivities, serious vitamin and mineral deficiencies.
Obesity is a psychosocial condition of depression and hopelessness and isolation and loneliness.
Obesity is a spiritual condition of broken hearts and broken souls and broken families. It’s not how we feel inside, but it’s how the outside sees and reacts to us. It hurts to be fat. Physically, psychologically, socially and spiritually.
Now…does that sound like gluttony to you?
Yet, if I go to any one of you, even the most esteemed physician or medical center, you will tell me Eat Less, Move More. Or you’ll send me to your behavioral health department because clearly there’s something wrong with me. There I will receive medication for depression and six weeks of therapy about how I’m a good person and I should love myself and not eat chocolate. Or you’ll throw up your hands and say I can have surgery, but I’m not sick enough to qualify yet. Wait a few years.
You can treat obesity, it’s easy. You already know how. But it’s not Eat Less Move More. And it’s not emotional.
It’s replacing Vitamin D, detecting Vitamin B12, A, Zinc, Iodine deficiencies, finding food allergies even when the lab tests are not sufficiently sensitive, treating pain and weakness with gentle movement therapy, jumping on that sleep disorder, correcting inflammation and insulin resistance, helping that sluggish thyroid, changing obesigenic medications to those with a more neutral weight profile. And yes, sometimes it’s sending us to behavioral health, but not nearly as often as you think.
You can treat obesity by understanding the many pathways and reactions that have been altered in response to excess inflammatory adipose and its causes. And one by one, correcting them. Just like you learned in medical school. Imagine that.
And I’m here to tell you, if you do that, your patients will lose weight. And feel better. And love you forever.
Announcing the opening of Stein Wellness Centers in May 2011, dedicated to comprehensive and integrative treatment of obesity. In person and distance.
Offering free consultation to any medical professional.
See one, do one, teach one.
Sara Stein, M.D.
Stein Wellness Centers (opening May 2011)
http://SteinWellness.com (under construction)