By the time I turned 40, I had gained and lost 40 pounds at least ten times. It started with the “freshman fifteen” plus another twenty-five in college. In medical school, I was introduced to sweetened coffee beverages, and I snacked on pretzels and candy to stay awake while studying. I got through overnight call during residency by using my meal tickets to buy chocolate-covered ice cream bars. And once …
“Aren’t you happy for me?” asks the patient smiling from the exam chair in my office. I say yes, but that’s not entirely true.
Happiness isn’t the right word. Conflicted might be it. How do I reconcile my feelings when this patient, who I am not sure is deserving, reports that he was awarded Social Security disability?
Sure, he has severe arthritis, wildly uncontrolled diabetes, and a massive skin breakdown of his …
No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.”
It could be with another colleague, a client or customer. Even in your personal …
As medical professionals, one of the most challenging things to do is to motivate a patient to make changes in their lives. We passionately want the best for our patients, and it is sometimes so difficult for us to be able to connect with and inspire them to take the next step on a path to disease prevention and longevity. The solution? Enter Lebron James and Tom Brady.
It is no …
An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved.
Anyone who has ever tried to lose weight or keep weight off realizes that evening can be …
I cannot get behind fat acceptance, or better stated in medical lingo as “normalizing obesity.” As a physician and as someone who has been obese or morbidly obese my adult life, I know first hand what it’s like to hate my body and feel ashamed of it. I still do this very moment as I type this, that’s something I have to work on.
Funny thing is, I am much more …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with a behavioral therapist, and …
The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the diet to straddle the increasingly blurred lines between faddist snake …
Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no …
Most people reading this would love to lose weight, feel better and live longer. Doctors are a smart and motivated group of people. Unfortunately, that intellect and drive has not prevented us from avoiding an increasing incidence of obesity, diabetes, and hypertension identical to the general population.
While this article may have started out sounding like an infomercial, I promise it will not end like one. …
My nurse practitioner was pleased to see me at my annual physical this year. “So how does it feel to be 20 pounds lighter?”
“It feels terrible,” I replied.
Allow me to explain.
Weight has been an issue my entire life. Raised on a standard Midwest diet of complex carbohydrates and the best processed delicacies that government assistance could buy, I spent most of my childhood socially segregated by my peer group due …
Empathy is the cornerstone of quality patient care. It is no surprise that the fundamental moral code that has facilitated human kindness for thousands of years is what drives physicians to commit to their oath today: Treat others as you would have yourself treated.
When it comes to the disease that is obesity, I can empathize. I’ve struggled with obesity for as long a time as I can remember. There are …
Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke for a few minutes about diet and exercise, and she agreed to see the nutritionist.
A few months later, she came back to check her progress. She had lost weight, about …
A patient of mine brought donuts in yesterday for the staff, and I confess! I had the one with sprinkles.
But with the study published in JAMA reporting that 35 percent of U.S. men and 40 percent of U.S. women are obese, I felt the need to talk a little about obesity and reproduction.
The endocrine system is tightly regulated by hormones which provide feedback to the brain to control their …
No matter how early I rise with the intention of getting my workout done before my children wake up, I’m rarely able to do it alone. Most days my 3-year-old daughter climbs out of bed and comes straight down to our home gym and watches me do my workout.
Often times she’ll sit quietly in the corner, but sometimes she’ll join in and follow the trainer on my workout DVD and …
Have you ever eaten a healthy meal, maybe some brown rice and stir-fried veggies, and found yourself ready for another meal just a short while later? Or, more often couldn’t overcome a hankering for a satisfying dessert to top off (and undermine the healthiness of) that meal?
As it turns out, this lack of satiety is not merely a function of the …
There is, of course, stuff we can chew and swallow that isn’t food. Play-Doh comes to mind. As does Silly Putty.
My thoughts turned to those substances, among others, when my friends at Time magazine asked me recently to opine on the suggestion that junk foods should carry warning labels. My first inclination was: No, that’s too much. But then it dawned on me: Is anything that …
Stephanie wrote in about a very common problem:
My daughter is 4 years old. She isn’t the tallest cat in town (she is about the 15th-25th percentile for height), and her BMI always ends up being in the high range (like over 85%). I worry about it. I am very health conscious for myself and my family. We live by all of the “rules.” And yet.
The family doctor doesn’t worry — …
The recent concentration of misleading media hooey about health has been excruciating, but the problem is perennial. I trust I needn’t make the case that you are under constant assault by distorted, contorted, titillating, and insipid headlines. This is certainly true in my domain of health and medicine; it may well be true more generally, but I tend to limit my commentary to the realm of my actual expertise. But to …
Weight is not a behavior, and weight is not a choice. Nobody wakes up and decides what to weigh today. In an age when healthy and unhealthy behaviors are increasingly subject to incentives and disincentives, respectively, this is all too easily forgotten.
Of course, weight is largely the byproduct of behaviors and choices, namely what and how much we eat, and what and how much we do: calories in and calories …
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