Why Your Doctor May Not Be the Best Source of Nutrition
Your doctor is one of the most important people for your well-being, and rightly so. While you should trust their advice on certain issues, it is also important to understand the boundaries of their learning and understand when you should seek outside help.
I grew up obese, despite the fact that both of my parents were healthy doctors. The few conversations we had about my weight were essentially lectures about moderation (or just “eat less, move more” ).
I always believed that hands-off was possible because they thought I would grow out of a chub. In addition, it is not easy for someone to become both a parent and a diet coach.
Fast forward two decades and the story will be completely different. My dad is now overweight and takes countless (medical) pills for breakfast. He knows nothing about losing weight and does not want to study. On the contrary, my mom is in great shape thanks to the fact that after my transformation she became an avid consumer of information about fitness.
Looking back, I understand that their silence was not caused by the fact that they hesitated or did not want to help me lose weight. Because they didn’t know how to help me lose weight.
My parents are only n = 2, but in my coaching experience, many clients have reported a similar knowledge gap in their own therapist. Of course, their doctor can tell them when to lose weight, but they will give bad advice to help them achieve it. No wonder.
What Doctors Know: Disease vs. Health
Most doctors spend at least 11 years in school: four years in bachelor’s, four years in medical school, and at least three years in residency (depending on the field of study chosen). In fact, doctors have learned a lot about a lot of things over time. But over the years and in all these textbooks, very little has been said about nutrition – the most important factor in weight loss and, undoubtedly, one of the most important factors in overall health.
Of the 40,000 hours physicians spend on training , usually only 19 hours are devoted to studying nutrition . According to the Chicago Tribune , that number has been steadily declining:
On average, doctors receive 19 hours of general nutrition training at a medical school; According to a study by the UNC Nutrition in Medicine Project, in 2004 the average was 22.3 hours. In 2009, 27 percent of schools met minimum nutritional education standards, up from 38 percent in 2004.
So, unsurprisingly, a study published in the Journal of the American College of Nutrition shows that only 14% of interns in internal medicine believe they can adequately talk to their patients about nutrition, while 94% believe it is their responsibility. so. However, if Dr. Oz’s popularity rating is an indicator, society still views doctors as authorities on weight loss.
To be clear, this is a systematic failure of the medical education system, and not the fault of our doctors. Between seeing the patient and securing them with something that they are incredibly knowledgeable about – there isn’t much time to make up for their educational shortcomings. Nevertheless, it seems silly to just look to medicine to reduce morbidity when dietary intervention can prevent some of them in the first place.
The problem of refusing to go to doctors for nutritional advice
The food and fitness industry is full of shea … uh … incredibly confusing , which is in no way helped by the apparent paralysis of the relevant regulatory bodies. Case in point: Despite decades of protest from the scientific community, the FDA is only now weakening its message about the dangers of dietary cholesterol .
Because of the abundance of conflicting information, people deal with confusion in different ways. Some are self-taught or self-taught who read voraciously until they learn to navigate the noise. However, most people naturally default to someone they trust to tell them what to do.
Human beings are subject to so-called bounded rationality – the idea that in the face of complexity, people sacrifice purely rational choice by making mental contractions. For most people, doctors are the custodians of health information. They know that doctors are professionally trained and generally trustworthy. Hence, it seems to follow that the advice of a physician must be reliable.
The problem is that too many people think that “curing the disease” is the same as “preventing the disease.” In fact, these are two completely different areas of knowledge. As my friend Dr. Joseph Lightfoot once told me, “In medical school I learned about disease, but not health.”
Regardless, it’s hard to imagine that typical nutritional advice from a physician can be harmful, after all, how dangerous can an abundance of cruciferous vegetables be? However, the usefulness of their advice is undermined by one of the most basic principles of medicine: “Do no harm first.” In other words, they must make sure that any treatment does not worsen the patient’s situation. When it comes to nutrition, this often translates into standard dietary guidelines.
For example, suppose a doctor is faced with a choice: make a status quo recommendation, such as limiting sodium intake, or go against the accepted convention by saying that you shouldn’t worry about your salt intake. In the eyes of a doctor, what is most likely to “do no harm”?
Most doctors would avoid controversy and simply advise their patients to limit their salt intake, because that is what everyone has always said. They believe that advice is “not harmful.”
The problem is that it is harmful. This increases their patient’s chances of failure. Simply put, research shows that the best diet is the one you can eat . By creating false limits and limiting choices, you are claiming that there is only one path to success (the doctor’s path) – low sodium, low saturated fat, low cholesterol, and no alcohol – when in fact there are many.
According to Dr. Spencer Nadolsky, obesity specialist and frequent contributor to Lifehacker:
Unless trained through ABOM (American Council on Obesity Medicine), ABPNS (American Council of Nutritional Physicians), or similar training / experience, the typical physician is not well equipped to help with dietary advice. This does not mean that the doctor is bad, it just means that it was not in their training. They can direct you to the right place and can certainly help with medication changes if they are associated with weight gain.
In fact, physicians who do not have a solid nutritional foundation probably should not undertake dietary intervention at all.
How to find a doctor who can help you
Of course, there are many doctors with extensive nutritional knowledge, such as Dr. Nadolski or Dr. Yoni Friedhoff , another frequent participant in the Vitals study. In fact, thanks to their multidisciplinary experience, these doctors have unique knowledge in the field of health and disease prevention that few have. However, the danger is that assuming that all doctors have the same experience.
Here’s how to find out if your doctor can help you with your own nutrition and fitness:
- Explore the latest data on topics such as saturated fat, protein intake, and dietary cholesterol. Frequently Asked Questions Examine.com is a good place to start. Ask your doctor questions about these topics, for example, “Is a high protein diet right for me?” or “Are eggs bad for my health?” If they stick with outdated wisdom by default without batting their eyelashes, you might want to look elsewhere for nutritional recommendations.
- Pay close attention to whether their advice is specific and actionable. Are their recommendations vague, such as “eat healthy foods” and “do things in moderation”? or they include specific guidelines such as “keeping a food diary and tracking calories.”
- Look at other credentials besides “doctor”. in front of your name. You can use this handy PDF to search medical certificates in any state. Are they being trained by the American Board of Obesity Medicine, the American Board of Dietary Physicians, or something similar?
- Be realistic about how well you get along with your doctor. Knowledge is not everything. Your doctor may be the most knowledgeable in the world, but his advice can backfire if you feel like he is overly judgmental or unsympathetic.
Ultimately, you need to make sure you have the resources you need to become (or stay) healthy and fit. Stay on top of the latest nutritional research. Don’t expect your doctor’s knowledge of medicine to apply to other areas. After all, like you, they are only human.