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Saturday, December 01, 2007

Biggest Loser and Why Can't Everyone be So Successful


The reason I really like this show is that it demonstrates that people can become healthier by losing weight, exercising, and eating healthfully.

On the most recent episode, the remaining seven contestants met with the show's doctor. One contestant's cholesterol dropped by 100 points. Another who was pre-diabetic no longer was glucose intolerant. And, one contestant who had hypertension no longer needed to take blood pressure medication after his large weight loss.

These feats were all accomplished by a change in lifestyle -- not with medications.

Why can't I get my patients to do the same? Many of my patients are overweight, eating terribly, with risk factors for heart disease -- diabetes, high blood pressure, abnormal cholesterol. They're often fortunate that they have not had a heart attack or stroke YET.

I try to give them the knowledge to eat well and exercise on their own. Most are receptive to my advice and willing to make changes. But invariably, they come back a few months later.... HEAVIER!!!

Sometimes, I liken it to my high school cheerleading coach, who when she would get annoyed at us not listening to her, would turn around, face the wall, and continue to talk, until we all noticed and started giggling. I feel the same way -- I might as well be talking to a wall.

But, I think a lot of it is our society. Sedentary is acceptable. Restaurants serve non-healthful foods -- they really don't care how healthy their food is for the most part, as long as it tastes good. And when you're hungry on the run, what do vending machines have? Junk.

The Biggest Loser contestants are sequestered on "The Biggest Loser Campus". They aren't exposed to negative influences of society. They have personal trainers. They have healthy food.

I have had one successful patient who I cared for during cardiology fellowship. He was hospitalized with a heart attack. He was a smoker, overweight, with a history of high blood pressure and high cholesterol. I gave him my usual talk -- quit smoking, eat better, consume more fruits and vegetables and less meat (most doctors won't say this, but it's true, meat is not good for you), exercise and lose weight. He quit smoking, lost 50 pounds, and as a result, dropped his cholesterol and blood pressure. In the two years that I cared for him after his heart attack, he did really well, without any angina (heart-related chest pain), and lower blood pressure and cholesterol levels.

Lifestyle change is possible. It takes a motivated person. When successful, these people can live longer, healthier lives.

6 comments:

CJ said...

Hi Shenkman!

Have you seen the specials on Discovery Health with Drs. Oz and Roizen? They are often on Oprah as well. My mom got me hooked on them. The specials (there are 3) show some really motivating footage, and their books are written really well for their target audience - ordinary people. (Books available on zooba.com for $10 each.)

My doctor wants me to bring my cholesterol down, I keep trying. It's been tough working full time and taking 3 classes...I've decided to take only 1 class on campus next term because of that. My overall is 205, 54 hdl, 135 ldl, and 82 triglicerides. Sticking to my oatmeal and trying to eat more fruits and veggies! Do you have any tips for single people? I hate going to the grocery store all the time, but fresh fruits/veggies go bad so quickly...

Nicole said...

I'm a PT and work with tons of overweight patients w/ LBP, knee pain, hip pain, etc.
I talk to them about diet and exercise (obviously). I have found that really working with a dietitian helps them. It reinforces what I say plus she sees them on a more regular basis till they are at a place where they are changing.
At least you are trying to help them make positive changes rather than just giving them medications.

Veg*Triathlete said...

Great post, Doc! Even though the changes may not be made right away, I'm sure you're having a great impact on your patients. Sometimes it takes people a longer time to make changes... I really admire the work you do!

I'd like to send you a blogger invitation to a vegan athlete group blog, if you're interested... I'm thinking it could be a forum to chat & share training & nutrition info in a more specific setting. E-mail your e-mail address (click on the e-mail button on my "about me" page.

Alec said...

Hi Heather,
I just came across your blog from the Vegan Triathlete Jen. I really like your blog and am glad to hear you're spreading the vegan gospel to your patients. I always love reading about people who are big time athletes who are also vegan- proves that you can really compete at a high level without eating dead animals!
I agree with you that it sometimes seems so hard to understand why people won't listen to advice about eating healthy, quitting smoking, exercising, losing weight, etc. They don't realize that when you eat healthy and exercise, other health issues work themselves out as well. I've got a few friends who have put on a lot of weight since college. One goes on these all-tunafish diets every so often to lose weight. I tell him it's crazy, that he should focus his diet on eating lots of fruits and veggies, but he doesn't listen. I guess it's better than not trying to convince others of the wonders of a whole foods plant based diet, but I often wonder about what I can tell them to convince them. I don't want to be the crazy stubborn friend who won't shut up about it, but I really want them to be healthier at the same time. They can see that I am really healthy and athletic, but I guess it doesn't do the trick. Ah well, we can try.

ahmed said...

"Lifestyle change is possible. It takes a motivated person. When successful, these people can live longer, healthier lives". I am with you. If I can just find a way to get my pts to stop eating salt, I will be very happy.

eeka said...

Hey, I love your blog!

You're right; I've only had one doctor commend me on my choice of diet*. This was a GI doc whose immediate reaction was basically "good for you, that's generally the healthiest diet." I've had several others tell me that I'm most likely protein deficient and then attributed any complaints to that. A previous GI doc told me that a vegan diet consists entirely of carbohydrates, which would be causing all of my GI issues (he didn't bother to take labs -- I'm slightly overweight but very active and my cholesterol and triglycerides and everything are great). This was particularly intriguing, for 2 GI docs within a month to tell me that my diet is harming me and that my diet is great for me.

*no meat ever in my life, alternating phases of completely vegan with phases of minimal dairy and eggs in stuff other people've cooked