Eating SUV

A tank of gas will only take you so far. A bigger tank will take you a little farther. A hybrid a little father. Driving a gas-guzzling SUV won’t take you quite as far.

The same applies to food, except the gallon is the calorie and the vehicle is you. You will only have as much access to energy and basic building blocks of your cells as the food you take it. On the other side of the spectrum, you will only gain as much weight as the food you eat. Limit your calories enough and you will lose weight. Limit your total caloric in take to 1500 - 1800 calories and you will lose weight and maintain that weight loss.

We are in the middle of an epidemic. The majority of the population in this country you love are obese. The vast majority are overweight. The physical and mental health consequences are staggering. Billions of dollars are being spent on treating complications related to obesity. Billions of dollars are spent on drugs to reduce risks for the most common causes of death, when dropping weight would be just as effective and with less side effects.

You are sick and tired of all your patients whose life would be so much better if they would only drastically drop the pounds. Every day you see patients complaining of problems related directly or indirectly to their weight. Beyond that, the vast majority of problems you see could be easily treated (or have as a first line treatment) by quitting smoking and drinking and losing a lot of weight.

Frequently you listen to people who weight over 300 pounds (and are less than 5′8″) reporting that they have knee pain. Complete exams from multiple doctors and specialists reveal that they have osteoarthritis, which is a mechanical problem. Their poor knee joints are being crushed to death and the pain is the agonal screams. A simple answer is to reduce the amount of force being applied across that joint. Oddly enough, you get patients requesting hardcore narcotic medications, acupuncture (for pain control, not weight loss), surgery, miracle pills and all sorts of strange concepts. Sadly, most doctors do attempt those possibilities long before, they timidly suggest weight loss.

Sadly, political correctness of “cultural competence” has resulted in doctors rarely addressing unhealthy lifestyle choices as if it would be equivalent to racism. While we will sarcastically mock those who present from problems related to sex, drugs, alcohol etc. you have not recently heard another doctor actually call a patient on it (except you Dr. Ta) and say “Hey, that’s your problem genius. You need to stop that.” Yet, that’s exactly what we do with blood pressure, diabetes, cholesterol, colonoscopies, mammograms, pap smears etc. “What do you mean you haven’t gotten a pap smear? Are you crazy?”

Smoking remains the only exception to this because 1) a study came out saying that patients were continuing to smoke giving the excuse that their doctor never said anything about it and 2) it is politically correct to bash smoking.

You hear all sorts of excuses about why patients can’t lose weight.  The most common are related to other medical issues that hinder their ability to exercise or that cause them to gain weight or familial slow metabolism.  You don’t need to exercise (but you highly recommend it) as your plan is purely diet based and it doesn’t matter how slow your metabolism is or what medical issues may be working against you because if you limit your calories enough, you’ll lose the weight.

To continue the really bad metaphor, if you want to keep a car that gets 10 miles to the gallon (SUV) from driving more than 100 miles you would need to fill the tank with less than 10 gallons.  If the car gets 50 miles to the gallon (hybrid), then fill it with less than 2 gallons.  Fill your stomach with less calories than your body needs and you’ll lose weight.  If you are gifted with the metabolism then you can eat up; if not, don’t.

Disclaimer: I am a doctor and the above constitutes professional medical advice covered by my malpractice insurance. For the love of God, take it.