Trust Me, I’m a Doctor

I recently reposted a blog about my issues with weight loss to my various sites, and as it often happens a response came in with the usual “it’s all about calorie deficit, simple math, burn more than you take in and you’ll lose weight”.

Those of you who read my blog, and/or listen to the podcast, know that I have many issues going on internally that this is not the case with me, and you know that this kind of thinking bugs the crap out of me. I was in a nice mood though and simply responded “that is assuming a calorie is the same across food types, so are you telling me that 2000 calories of spinach is the same as 2000 calories of a big mac?”

There answer was, amazingly, “yes”.

Andrew answered that response very eloquently so I will not repeat it, and it really has no effect on me because I know it’s not the truth. What kind of got under my skin was the condescension when they posted “I have a Masters in physical therapy and an MD”.

Oh, so that makes a difference?

The reason that line of thought bugs me is this … I have a Maters in Public Administration and a Masters in Business Administration, so using this writers line of thought, the very fact that I have those degrees means I know EVERYTHING there is to know about business, both public and private, and everyone should listen to me because I am always RIGHT.

Just not the case is it?

I would really like it explained to me how a Master’s degree in Physical Therapy somehow makes you an expert in nutrition, and while I admire most anyone who can complete the rigorous training it takes to become a doctor, it is well documented how little training they receive in nutrition (especially since this particular MD is a radiologist … something needed of course … but not someone I would go to for nutritional advice). According to the National Center for Biochemical Sciences, on average, students received 23.9 contact hours of nutrition instruction during medical school (range: 2–70 h). Only 40 schools required the minimum 25 h recommended by the National Academy of Sciences.

So out of, what, 8-10 years of medical school and training, 24 hours are spent learning about nutrition?

OK …. you’re an expert.

This goes beyond the basic “I’m a doctor, trust me” answer. This is the cookie cutter belief of “I did it this way and it worked, so it will work for everyone, and if it doesn’t that means you are not doing it right or are not being truthful about your intake”.

And you have been reading me for any length of time you know how much I LOVE being called a liar.

Tom Barbieri, of Tioga Wellness and the Tioga Wellness podcast, summed it up pretty well in a response:

I’m not an MD, nor have my Master’s in anything , but I’d argue and do believe ‘a calorie is a calorie’ and that the value of a certain number of calories of one food is the same as a certain amount of calories of another food. It’s very simplistic but true. Like, what weighs more? A ton of bricks, or a ton of feathers. Calorie is a value of energy expenditure. It’s the ‘economy’ of GETTING to that calorie that really matters. This is where MDs, nutrition ‘gurus’, and some other experts get it wrong. Some folks end up like Thomas Dolby and get blinded by science. So think of it like this: calories have no nutritional value themselves. So, they really don’t matter regardless of your age. It’s what’s “around” those calories that really matters. Calories are just great scapegoats of our obsession around nutrition. And mean nothing.

The fact that he, the MD, used the tried and true “3500 calories = one pound” was also brought into question by another responder who sent me an article by Zoë Harcombe (found HERE) that chronicled her attempts to find out where that belief comes from, i.e. what scientific basis does it have. No one knew. Not the British Dietetic Association, the NHS, the National Obesity Forum … in fact the closest she got was an answer from the Association for the Study of Obesity who sent her this response:

Basic biology tells us that 1kg pure fat, converted to energy = 9000 kcal, 1lb pure fat = 0.453 kg = 4077 kcal. The approximation to 3500 kcal is made on the basis that ‘adipose tissue’ is not 100% fat (some water and some lean tissue). Hence to lose 1lb pure fat = 4077 kcal deficit, or 1lb fat tissue in the body = approx 3500kcal deficit. This equates to 500kcal per day to lose 1lb in a week. This has been supported by numerous studies using whole body calorimetry.

Her follow-up asking for links to the “numerous studies” went unanswered. I won’t go into the full article, but it is a good read and evidence of just how clueless the establishment has become. False science leads to common knowledge. It is no wonder we are all confused. On the show this week we spoke with Dave Jimenez of Octane Athletics podcast, and owner of YurFit, and spoke quite a bit about how the enormous amount of information is available and the need for a good coach, or mentor, to help you weed out the bad information. The thing is that most of it is not bad information in of itself. Where it goes bad is when people assume one thing works for everyone.

If I can give just a piece of advice, be careful about who you hitch your wagon to. Just like in all areas of life, there are good and bad doctors, nutritionists, and coaches. If you are interviewing a coach and they tell you “yes, I can help you lose weight. All you need to do is buy these products, which I sell, and you’ll drop it like water” … run … run as fast as you can … away from them. It is not a bad thing for a trainer or coach to be an ambassador, or distributor, of health products, especially when they believe in their worth, but if they offer it up as the ONLY method that works (you know, because it worked for them) that be very leery of said product and coach.

And READ ..read everything … and make an informed decision as to what is best for YOU.

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