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Why you likely won’t lose weight Part 1 March 13, 2023

I have been practicing medicine for 20 years now, and I’ve learned a few things. First, people are always on their best behavior when they come to the doctor’s office. This is especially true for those who want to lose weight. Almost nobody comes into my office saying how horribly they eat (or anything else for that matter). I have not done an official study on this, but I would say somewhere around 92-96% of patients who come in to discuss weight problems tell me generally the same thing: Their diet isn’t to blame for their weight woes. 

Let me just give some very simple advice to those in the market to lose weight: Recognizing the problem is half the solution. This bears repeating: Recognizing the problem is half the solution. I have literally heard it hundreds of times over the course of my career: “But doctor, I eat very clean (or healthy, or whatever else sounds really skinny)”. Then they’ll usually start numbering off what they eat for breakfast (hint: it’s usually oatmeal, small cup of fruit, or 1 egg), lunch is almost always a meat portion without bread (of course), and dinner is a modest portion of veggies and meat. 

I want to stop here and make something very clear: My purpose is not to “fat shame” you or anyone else about your health. Not at all. What I am trying to do is hold a mirror in front of your subconscious mind to allow your conscious mind to see it. So you can start living a more congruent life. That is not fat shaming. That is being an advocate for you, even though you may not believe me. But you not believing me and continuing to label me as a fat shamer will do you no good if you’re really interested in losing weight and keeping it off over a lifetime. I am no more a fat-shamer than you are a truth-shamer. If you want to be triggered about facts, then there is truly no hope for you to ever lose weight and keep it off. I want to be as sensitive as I can possibly be here–I know this is a sensitive subject. 

OK, back to the storyline. A lot of people want to lose weight. A lot. So many in fact, that multi-billion dollar businesses are set up to cater to your weight loss dreams. There are apps, there are drugs, there are boot camps, there are cookbooks, there are diet centers, there are supplements and herbs, there are Atkins diet, Paleo diet, low fat diets, the Mediterranean diet, HCG, ephedra, phentermine, and Ozempic. There are many, many things out there that can supposedly help you lose weight. They all come at a price. 

The very first thing you need to know is that you are fooling yourself. Yes, that’s right, you are fooling yourself. Now, some of us come with a genetic makeup that makes it really hard to stay slim. It’s not your fault if you have an extra store of Ghrelin (a protein that promotes hunger sensations) or a deficiency in Leptin (a protein that promotes satiety). Or perhaps you have an underactive thyroid. However, weight gain is still simple math in the end. If you take in more energy from food or drink that you expend, your body will store it as fat. There is no other way around this, no matter how well you feel that you eat. Those who push the blame of their obesity onto other people or other external circumstances or things will inevitably fail sooner or later. Yes, weight loss requires a radical change in how you view yourself and your actions. 

Having said this, overweight and obesity may be a symptom of a deeper inner psychological dysfunction like depression, anxiety, and/or severe emotional trauma including Post Traumatic Stress Disorder. You may use eating as a coping mechanism to reduce emotional pain. While I understand that there is a lot to unpack in that, the dirty little secret is that it still comes out to an energy imbalance in your body, whether you eat to cope or not. 

The relatively rare number of people who acknowledge their unhealthy diet and those who reveal vulnerability and sharing of some of their concerns will do the best. There is no other way around it. These people are real people who recognize that we are not all machines or robots, but human beings, with all the messiness of living as a conscious, coherent, breathing person in this world. We all mess up. OK, great. Jump in. The water’s warm. 

Acknowledging that your diet is actually, not healthy, takes a lot of guts and courage. If you still believe I’m full of hot air, then allow me to track your activities for 24 hours. Your mind will be blown. Yes, we all do ignore things that we don’t want to consciously tackle. I do it too. So before you get too uptight, let’s track your diet choices, you know, all of them, not just the ones you tell me about in the office. 

No matter what you have heard in the past about how to lose weight, make these number 1 and number 2 in your mind:

If you take nothing else away from this today, remember, white flour, white sugar=Bad! What has white flour? All bread, bagels, donuts, cake, cookies, croutons, wheat flour tortillas, wheat flour tortilla chips, crackers, wheat flour pasta, pizza, anything breaded and deep fried, hamburger buns, most breakfast cereals, and a whole lot more. What has sugar? Any desserts, including donuts, cake and cookies mentioned above, ice cream, any kind of sodas (yes, especially “diet” sodas), any kind of fruit juice (even the natural sugar–unless you make it into a smoothie–much better), milk shakes, candy, chocolate, yogurt, granola (starting to get the point?) 

It’s not so much the calorie count as much as it is the type and quality of food. Let’s say you have a 500 calorie salad next to a 500 calorie milkshake. They are both 500 calories. Which one will put more fat on you? Yep, the milkshake. 

Stay tuned for part 2. 

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