Do Fruits and Vegatables Prevent Cancer?

The answer in one word is "unproven." A large study involving 500,000 Europeans over a multi-year basis failed to show a definitive correlation between cancer development and fruit and vegetable consumption.

So if that's the case, why is it important to eat such whole foods?

Before I give you an answer, I want to point out the trap that you may have fallen into by even considering this question. If you've been reading this blog for some time, then at this point you should realize that when it comes to your health, X usually does not cause or prevent Y.

Yes, there are some notable exceptions like cigarette smoking causing lung cancer, trans-fats causing heart disease, etc. but it's almost never so simple.  True, we also know that sufficient levels of Vitamin A prevent night blindness, of niacin prevent pellagra, of Vitamin C prevent scurvy, etc. In other words, there are known cause and effects for certain diseases, but it's usually not one thing alone that causes the major killers such as heart disease, cancer, etc.

Why? The human body is a very complicated machine that is usually able to handle many imperfections (like autoimmune diseases, etc.) and environmental assaults (unhealthy foods, etc.) before it breaks down and stops working completely. It has many built-in mechanisms such as the immune system, the complement system, etc. that fight to fix problems before they wreak havoc.

Even in the case of really harmful things like smoking, not everyone develops lung cancer, one of the known consequences. Sometimes smokers die from the heart damage that smoking does and sometimes they die from something completely unrelated. (Many smokers who don't develop cancer from smoking do develop other lung diseases like emphysema and Chronic Obstructive Pulmonary Disease (COPD), the fourth highest killer of Americans.)

The point here is that it would be a mistake to think that anything, including fruits and vegetables, considered in isolation would prevent major diseases such as heart disease, the leading killer of Americans, and cancer, the second leading cause of death.

It is the sum of the parts that ultimately make a difference. If one eats lots of fruits and vegetables but simultaneously eats lots of processed sugar and other known carcinogens, the fruits and vegetables are unlikely to yield a high preventive effect.

So now let's come back to my question of why it is important to eat fruits and vegetables in regards to cancer.

The answer is that while no study has distinctly proven a cause and effect relationship between the amounts of fruits and vegetables one consumes (once above the deficiency threshold and below the toxicity level) and the development of cancer, there are certain factors that have proven to be strong risk factors for cancer development. One is weight. Overweight and obese people appear to have a markedly increased risk for development of a variety of types of cancer affecting both men and women. It is also a strong risk factor for cancer recurrence. For most people, their weight is a direct result of the types of foods they eat. People who typically eat more fruits and vegetables usually eat less processed foods like breads, crackers, pasta, etc. and weigh less. (See my previous posts 'Why You Get Fat?'  and the two part 'Why You Stay Fat?' for a more exhaustive discussion.)

As I previously wrote about a close relative that was recently diagnosed with cancer, I have taken a keen and deeper interest in the subjects of cancer prevention and survivability so that I may offer this relative the best guidance.

After review of hundreds of cancer prevention studies, I have reached some very tentative conclusions.

Fruits and vegetables alone (and clearly supplements including vitamins, minerals, antioxidants, etc. naturally found or synthetically produced to mirror such chemicals) do not alone prevent cancer.

However, as part of an otherwise healthy lifestyle that includes avoidance of known carcinogens such as smoking, drinking lots of alcohol, being overweight, exposure to environmental hazards such as asbestos and numerous other substances and chemicals such as acrylamide that develops on the surface of french fries during the frying process, nitrites used to preserve cured meats, certain food dyes, pesticides, and other chemical additives, etc., eating fruits and vegetables is likely to cut down one's risk of both developing cancer and dying from it.  As I previously wrote, the risk of men developing cancer is 1 out of 2 and of dying from it is 1 out of 4. For women, the numbers are slightly better with the risk of developing it being 1 out of 3 and of dying of it being 1 out of 5.

Cancer remains mostly a disease of random mutations instead of genetics.  What causes these mutations, why some get it versus others, and why some survive the exact same cancers while others die from them remains an issue of scientific debate. While science continues to try to figure it out, do yourself a favor and shift the odds in your favor. Substitute fruits and vegetables in place of processed foods, in addition to making many other known healthy lifestyle choices such as regular exercise, getting proper sleep, etc.  By doing so, you will give your body every opportunity to function at the optimal health level and to continue functioning for many more good years.

Waiting for cancer?

Let me tell you a very personal story. About three weeks ago, I got a phone call in the evening from a close relative. During the call, I was informed that this person had been diagnosed with cancer. A week later the person called again and notified me that a second cancer had also been diagnosed.  I was devastated and I am still reeling from the news. I love this person very much and can only imagine how dreadful it is for someone to be diagnosed with cancer and what fear it must invoke. Of course, when a close relative develops a serious illness, other family members are surely also concerned about the risk to their own health of developing a similar disease.  Such news brings pain to all quarters.

According to the American Cancer Society, the risk of a man developing cancer is 1 in 2 and of dying of cancer is 1 in 4. The risk of a woman developing cancer is 1 in 3 and of dying of cancer is 1 in 5. You have to be a Luddite not to be concerned about such odds and the personal risk to you of developing this horrific illness.

Although there is clearly a genetic basis for some people to develop cancer, most cancers are random mutations.  In general, it is now believed by credible scientists that virtually all people have cancers cells of one type or another in their bodies at all times due to such random mutations. However, their properly functioning immune system is often capable of dispatching with most of these fledgling cancer cells before they develop into life-threatening tumors.

At this point you may be thinking that if it's only a question of odds, then why not just hope that you will be lucky because what else can you do?  Well, I am here to tell you that there may be a lot to do.

It's well known that professional gamblers using a variety of techniques are able to improve their odds in casinos. For example, counting cards while playing the card game black jack shifts the odds in one's favor over the house. Such subtle shifts can make the difference between vast losses and gains.

In life, can there be any greater loss than the loss of health?

As with gambling, certain human behaviors shift the odds in favor of avoiding or even curing cancer.

Dr. Dean Ornish, in a landmark experiment, demonstrated that a change in diet could stop the expression of prostate cancer. In a limited study, he showed that with certain men, he could arrest the progression of the disease.

It is well established that breast cancer survivors who are overweight have a much higher rate of recurrence of their cancer than comparative normal weight ladies.

There are countless credible studies that support the role of diet and lifestyle in cancer development and death and at this point, almost all doctors agree that lifestyle, including diet, plays a major role in one's health and risk of dying from cancer.

Let's get back to my painful story. After researching the specific types of cancers that my relative had developed, I offered directed recommendations regarding changes in diet and lifestyle that offered hope for improved health and survivability.  After sharing a number of suggested changes, my close relative suddenly uttered that he/she was not prepared to go crazy about his/her diet.

What prompted this response?  My suggestion to eliminate all processed sugar products from the diet.

There has developed a growing body of evidence that sugar stimulates the growth of cancer. It does so by causing the release of insulin which binds to insulin receptors on the surface of solid tumors and stimulates them to grow faster.

When I shared this with a friend yesterday, she asked me why she hadn't heard about the role of sugar in cancer before?  She said her father had died from cancer and one of the country's leading oncologists had never mentioned the need for her father to avoid the sweet stuff.  Unsure of how long it had been since her father passed, I queried and she said that it was about ten years ago.  My response to her question was that scientists did not have as clear an understanding ten years ago as they do today about the dangers of sugar and other dietary intakes on their role in cancer development, progression, and survivability.

As fate would have it, a patient gave me an article two days ago that recently appeared in Mother Jones magazine chronicling the efforts of the sugar industry to suppress the alarming facts regarding the dangers of sugar not only for cancer development, but for heart disease and diabetes as well. Like Big Tobacco before it, the sugar industry has been very successful in confusing the general population into being unalarmed and apathetic about the dangers that sugar poses.

It's gotten so bad that most people actually believe that eating sugar 'in moderation' (however they define moderation) poses no threat to their health. Yet, our country suffers from an epidemic of obesity, heart disease, diabetes and dementia, with a rising tide of metabolic syndrome in which people have elevated blood pressure, sugar and cholesterol.

It may be unfair to single out sugar and its precursors (high glycemic index carbohydrates) as the worst culprits, but the label may actually be accurate. Clearly there are numerous other protagonists responsible for our health problems, including trans-fats, saturated fats, food additives, etc., but sugar laden products such as those containing High Fructose Corn Syrup, deserve special attention.

There are many ways to die, but I can't imagine a much worse way that wasting away from cancer. I still vividly remember as a medical student when I was asked to see a patient in the hospital.  As I entered the room, I saw a very jaundiced looking man with the outlined remains of what I could only imagine were once extremely good looks, who had wasted away and was now close to death from cancer. After addressing his immediate concern for which I had been summoned, I asked if there was anything else I could get him. I still get chills thinking about his response. He answered softly, but assuredly, that I could give him back his health. Then he smiled at me, apparently resigned to his fate.  He died a few days later.

As scientists now know about the major role that food plays in the cancer story, it would be a shame not to take heed of preventive measures that could very well save your life and allow you to enjoy many more years of disease-free living.  I wish I knew in medical school what I know now and I wish I had been able to do more for this stranger. He is long gone, but there are many more than can be helped now.

Let me start by suggesting some basic rules of staying healthy. The top rule is to eat mostly foods that have no labels, such as fruits and vegetables.  Enjoy large amounts of beans, lentils, chickpeas, nuts, and seeds. Consume whole grains on a regular basis particularly the ancient grains such as spelt, quinoa, and millet. Make Wild Salmon a staple of your dinner table, consuming it even every other day if possible.

Of course, you can ignore this advice and gamble with your life and the increased risk of developing cancer.  Or maybe, you now understand the risks and aren't willing to play the odds.

In addition, make sure that you stay physically active by walking at least 7,500 steps (3.75 miles) per day with at least 15 minutes of more intense exertion each day. Get at least 7 hours of sleep a night with at least 3-4 hours of uninterrupted sleep. Manage your stress by learning techniques to deal with life's inevitable stressors such as relatives informing you that they are ill.

The great American poet Robert Frost once wrote that "two roads diverged in the woods" and he "took the one less traveled by, And that has made all the difference."

Are you going to stay on the road traveled by most people of eating whatever they want blinded to the dangers of developing cancer and other horrible diseases that prematurely shorten their lives or simply make life far more difficult OR will you take the road less traveled by, by eating healthier and see if that makes all the difference?

Are you waiting for cancer? Please don't. It's not worth the wait.

Vitamin D Takes A Hit

Faithful readers of this blog (May 18 and August 29) have read my railings against Vitamin D for some time now. It never made sense to me that so many Americans were deemed to be Vitamin D deficient nor did it make much sense that as people got heavier that their blood test for Vitamin D would report lower levels although they wouldn't develop any deficiency symptoms. I even raised the question if it was possible that fat stored Vitamin D (fat soluble) is available to the body when needed.  While this question remains unanswered, the question of what defines a Vitamin D deficiency just got a new answer and I think it makes sense.

The Institute of Medicine (IOM) just revised the guidelines for what defines a Vitamin D deficiency.

First, a little about the IOM.  The Institute of Medicine (IOM) is an independent, nonprofit organization that

works outside of government to provide unbiased and authoritative advice to decision makers and the public. 

Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as the National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM.

Under the new IOM guidelines, you are considered to have adequate Vitamin D levels if your level is above 20 ng/mL. The previous level was 30 ng/mL. In one fell swoop, the IOM has essentially removed almost all Americans from the category of being Vitamin D deficient. 

You will no doubt hear push-back from those quarters that make money peddling Vitamin D and related advice, but you should essentially ignore them. The IOM is trustworthy.

So if you didn't have enough reasons yet to push aside your multivitamins and Vitamin D supplements, perhaps this one will do the trick for you.

For the umpteenth time, eat whole foods including a wide variety of vegetables, fruits, beans, nuts, seeds, whole grains and Wild Salmon and you will consume all the vitamins, minerals, antioxidants and all the other health promoting nutrients you need for a healthy mind and body. Get 15-30 minutes of sun each day (earlier or later in the day and avoid reddening) and Vitamin D is also well covered. (You also get it from Wild Salmon.)

The key to a healthy life is to eat healthy every day.

Do Multivitamins Prevent Cancer? Part 2

The media is having a field day with the recent study titled Physician Health Study II (PHS II) which claims that multivitamins may slightly decrease cancer rates among men.  If you simply read the headlines and you are a man that wants to decrease your risk of developing cancer, you would think that you should immediately run out and buy a multivitamin, and if you are taking one, you should keep taking it.

Don't!

The results are not quite living up to all the hype.

According to the study, after 11.4 years of taking multivitamins, only men, predominantly older than 70, showed mild decreases in certain cancers. In fact, this study included men who had previously been diagnosed with cancer, among whom for some unknown reasons were found the best results.

This study, paid for by the multivitamin manufacturers, including Pfizer, actually showed the following:

Slight increases in prostate cancer (662 placebo takers versus 667 among multivitamin users) and melanoma (89 increased to 100).
Slight decreases in total cancer (1253 to 1195).
Slight decrease in colon cancer (95 to 88).
Total mortality (death) slightly decreased from 1,134 to 1,092. That means for over 13,000 total men in the study, there were still over 2,200 deaths and only a decrease of 42 total deaths.

Get this. By my calculation, over 26,000,000 (million) pills over 11 years were taken by 6,660 men to spare 42 deaths. Ouch!  No wonder the drug companies want to push the results of such a study.

Basically, the men who took a daily multivitamin for over 11 years so no improvement in prostate, colon, and bladder cancer and no change in their overall cancer mortality. Also, a careful review of the study shows that the multivitamin users were also slightly less likely to smoke and slightly more likely to eat fruits and vegetables.

Finally, the study did not identify if any of the men had vitamin deficiencies prior to the start of the study. As they focused on physicians, who generally work long hours, there is a high probability that these men spent little time in the sun and therefore had an increased risk of Vitamin D inadequacy or deficiency.

Ladies and gentleman, overall, this study and the numbers presented basically prove nothing. With the overall cancer rate decreasing from 18.4 to 17.6 for every 1,000 years, there remains no reason to believe that multivitamins offer any benefit in the absence of deficiency.

The bottom line is that most importantly, despite taking a multivitamin every day, about 20% of the men still developed cancer and about 20% died.  Save your money!


So once again you are chastened to remember, Caveat Lector! (Let the reader beware).

Do Multivitamins Prevent Cancer? Part 1

If you are tuned in to health news, you may have heard about the new study that showed that among older men who took multivitamins, the incidence of cancer was reduced by 8%. Just like the studies that showed increased death rates in women who took multivitamins, this study failed to control for overall health.  

Therefore, when considering the relevance of these findings one does not know if the results were due to cause and effect or coincidence.

Undoubtedly, almost everyone, including the authors of this study, agree that foods that contain such multivitamins in their natural form as those studied have value in cancer prevention. Therefore, without controlling for the diet of the subjects of this study, one cannot reach conclusions whether the moderate reduction in non-prostate cancer rates (there was no reduction in prostate cancers, which represented half of the cancers that developed) we're due to pills or food.  Also, the study did not identify those who had nutritional deficiencies that can impair proper immune system functioning that can lead to cancer growth. 

Furthermore, this research was paid for by companies that provided the vitamins used in the study, which always raises red flags. 

So what's the take-away?  Eat whole foods like vegetables, fruits, nuts, beans, whole grains and wild salmon that contain all the essential vitamins, minerals, fatty acids, and amino acids our body needs that exist in a presumed synergistic relationship with hundreds of other nutrients and avoid synthetic pills of isolated chemicals.

But don't take my word for it. Tomorrow I will give you the actual numbers from the study and you can reach your own conclusions.

Why You Stay Fat...Part Two

This is Part Two. Please read Part One from yesterday first.

In the next step of my initial encounter with a patient, I always share a personal anecdote about my children and college. It starts with my denoting the perceived value of a great education. I believe there are few equals, in terms of value gained in knowledge, future employment possibilities, and self-esteem, compared to an excellent education. Today, college is a necessity for most, but an increasingly expensive proposition, and the more rigorous, higher vaunted and sought after private and public colleges are no exception. Accordingly, I confess to a bias that all teenagers should strive to get the best possible college education for the money (or their parents' money for the fortunate ones) spent.

To gain admission to the more intellectually challenging schools, a high school candidate most usually presents an exceptional academic record (except if you are a gifted athlete or have legacy).  What does such a record entail?  Mostly As.  How does one get mostly As?  By studying to get A pluses. You see, when you study for an A minus, you may and can often end up with a B. Study for a B and failure becomes an option.  Studying for an A plus offers no guarantees, but it does increase the likelihood of success.

Suffice it to say that my three, now adult children, were exposed to this philosophy early in life, and I am glad to say they all made it their own. Effort, diligence, attention to detail all paid off for them as it usually does for most people. (Just ask my children the three personal traits that lead to success and each will independently rattle off "persistence, perseverance and tenacity." I began to share these ideas with them when they were barely out of diapers.)

Regardless of one's mental capacity and education acumen, there is no substitute for motivation and effort when it comes to any level of success.

Likewise, people who want to change their weight status and health, most also strive for similar excellence. Even if you didn't go to college or an A was not your usual grade (or you never even saw an A), the pursuit of excellence is inherent in all of us. You must believe as much if you are to make changes in your life. I have yet to meet a regular person incapable of making changes. I know you can, but you must believe in yourself as well.

How does this rah-rah cheer-leading apply to your life and what does my excellence-in-school example have to do with anything? For that, you need answer, as my patients do, the next question.

What percent of food in your house would you deem unhealthy? To qualify as unhealthy, let's include the following: bread, crackers, cookies, cakes, chips, pasta, yellow cheeses, creams, margarine, butter, ice cream, fruit yogurts, fruit juices, etc.  What ever number comes to your mind that is less than 20% should be doubled as you probably missed a few.  Now think back to my school example. If there is any unhealthy food in your house, what is the probability that you will not consume it at some point, any point? Are you aiming for an A+ or are you aiming from the get go for a B or C?  Are you setting yourself up for failure before you even start?

If the unhealthy food is there, regardless of your excuse that it's for your spouse, your children, your guests, etc., you are rationalizing trouble ahead. The reason is because if you are depending on willpower to save you from devouring the food, it will eventually fail you.  Willpower almost never does well against constant temptation. In fact, according to scientific studies (see the book Willpower by Roy Baumeister), willpower gets depleted as you repeatedly make decisions to spurn temptation. At some point, mistakes, weakness, if not disaster looms. It is said that the average person makes about 200 food related decisions per day. With so many decisions to make throughout the day, isn't it likely you will make a few bad choices? That's just one of the reasons you can't rely on willpower. The best approach to willpower is developing a process, such as food shopping when you are not hungry, but that's a topic for another day.)

So what's a person to do to avoid the trap of eating unhealthy foods and snacks at home? Remove in their entirety (donate to homeless shelter or just discard) such unhealthy foods from your house and replace them with health promoting foods like vegetables, fruits, beans, seeds, nuts, whole grains and wild salmon. This is the FIRST step towards taking control and reinventing YOU.

So the first reason people stay fat is that they deceive themselves into believing that they can control their urges at all times and they don't need a process in place to make good choices consistently.  This is true whether they eat at home or at restaurants.

But I'm not done with the analogies just yet.

Have you ever owned a car, or know someone who has, that required premium fuel only. If you or they owned (as opposed to leased) the car, did you or they put anything, but premium gas in the tank? The common answer I get to this question is "no" and the reason I'm given is that the person believes that the car will not function as well with inferior quality gas.

But more importantly, most would agree that the engine of a car that requires one level of gas and receives an inferior level may ultimately fail. So what's the big deal? Can't you replace the car if the engine fails? So you are out of pocket a few bucks, but who doesn't like to get a new car once in a while? Cars are replaceable!

Well by now you probably get the point. Your body is not replaceable and yet many people, particularly those who eat poorly, treat it like they can swap it out anytime. (Maybe when science fiction collides with reality that may become true, but don't depend on that happening any time soon.)

Therefore, the secret to losing weight for health reasons is not to focus on losing weight, but to focus on getting healthy. To borrow again from the car analogy, if you feed the car premium gas, the engine will run better and last longer. Just like premium gas helps maintain the value of your asset, health promoting foods enhance the vitality of your life.

Accordingly, the second reason people stay fat is because of the type of foods they eat far more than the amounts of foods they eat. Premium foods like whole foods mostly promote health without weight gain; processed foods do the opposite.

Therefore, although I am not a psychologist, I know if people can't wrap their minds around the notion of changing their behavior and are not fully committed to make critical changes to their food selection, they simply aren't going to succeed. BUT... if they can light the candle of inspiration so it shines bright...if they can flip the switch and make the connection in their minds...if they can follow the label that says 'Premium Fuel Only"...and they are willing to work for the A...wonderful things can and will happen.

I often ask my patients if they are religious and the answer is usually no. They always have this immediate look of concern as they wonder if I am a proselytizer? I am not. In which case, I tell them that losing weight will require them to find religion. I am not referring to the religion of believing in a sovereign being (as I do); rather, I am denoting the religion of faith and conviction in one's own actions. I tell them, using a wide variety of references to holy war such as "crusades" and "jihad," that it's time to take up the battle against their fat-craving bodies and regain control. (I mean no offense to anyone that thinks such terms should not be used lightly given their historical consequences. I use them because they strike powerful images in people's minds and I am prepared to go to great lengths to help people get healthy.)

The battle of the bulge is as great a fight as any human being can ever be expected to fight on their own terms.  It takes that level of consciousness to win this war of attrition and claim back which is rightfully yours--your health and waistline!

As partners with my patients, I help them help themselves realize their aspirations, whether to look and feel better, or for whatever reason they are motivated to do so. Together, we take the first steps to a higher quality, healthier life. Yes, the process begins with what feels like a psychological intervention. But this is merely the first step of a method proven to work without drugs, supplements, and surgery to improve health and lose weight.

We teach how to eat right at all times without ever feeling hungry: No tricks, just a changed attitude that results in changed needs.

You can change your life, improve your health, and have more energy today if you are clear about your motivations. If you are not, let's speak.


www.mdprevent.net
www.myMDPrevent.com
(561) 807-2561

Why You Stay Fat...Part One

In my previous blog "Why You Get Fat...," I explained that there are five factors that contribute to weight gain (medical, diet, physical activity, sleep and stress). Of course, to lose weight you must address these factors. But once you have gained weight, to shed the unhealthy excess pounds becomes more complicated than just confronting the factors that caused you to get fat in the first place. That's because your body actually doesn't want to give up it's fat stores. It sees fat as energy storage and is invested in the rainy day theorem that you can never have enough fat for difficult times.

(In fact, according to a recent study dealing with diabetes, as the disease progresses, the human body begins to waste away. Therefore, the study showed that those with more body fat actually fare better because they survive longer. Diabetics take note: Just because extra fat can sometimes have perverse benefits, please don't let your disease get to that wasting away stage because there are ways to prevent such progression.  Nevertheless, for most people excess weight actually causes problems like the metabolic syndrome with elevated blood sugar, cholesterol, triglycerides, and blood pressure.)

So, why you stay fat has a lot to do with why and how you try to lose the weight.

The most simplistic, albeit meaningless, answer as to why must people stay fat is because as Albert Einstein once gave as the definition of insanity, they do the same thing over and over again and expect a different outcome. They bounce from one diet plan to another. Or they look to miracle cures, magic pills and quick fixes, offered by the likes of Dr. Oz and thousands of other pill-pushers. They know such approaches never offer permanent solutions, but they are so desperate, they will  try anything. (I make this point in the hope that by sheer dint of repetition it will eventually sink in.)

They try diets that include cookies, low-carb and high fat, hCG injections, appetite suppressants, calorie restrictions, gluten free, vegan, etc. and still inevitably end up around the same weight or worse.

The real problem is that most people never truly understand why they got fat other than thinking they simply ate too much. In response, they spend their time and money floundering around in search of ways to control their appetites, chasing the latest and greatest fad.

Everyone knows and many have tried diet programs with names like Atkins, The Zone, South Beach, Weight Watchers, Medi-fast, etc. and yet.... if it was only that simple. Diet programs fail for most people.

I think, based on now treating hundreds of patients with weight problems, that there's a much more profound reason why people keep their excess weight. Please read on to learn what I hope will be a new, life-changing perspective.

Patients who come to me for treatment of a weight problem often ask me during our first encounter if I am a psychologist or a physician. (I am the latter.) The reason is that our first meeting often begins with a discussion about their motivation.  When someone has gained a lot of weight, even reaching a point where they are defined as obese, the road back can be difficult and challenging.  In order to succeed, one has to have the right attitude and be optimistic, if not confident that if he or she does the right things, success will follow. Most importantly, they must be motivated to do so.

In order to gauge such motivation, I often ask a simple question, "Why are you here?" If they answer "to lose weight," I counter with "Why do you want to lose weight?" Some look at me puzzlingly when asked such a question as if the answer is obvious. Others chip right in with answers that range from the aesthetic, "because I want to look better" to the practical "I want to feel better." Some proceed to elaborate how they are sick and tired of feeling sick and tired.

But virtually all patients pause to answer my next question which is a variation of "Why do you want to look or feel better?" They puzzlingly ponder how I could ask such a question, so much so that I often have to repeat it to get an answer.

After a few more iterations of my probing deeper into their answers, we eventually settle on that aspect of their life which is what they label as their number one priority. We identify that aspect of their life for which they are motivated to make sacrifices to succeed. While I encounter a wide variety of ultimate answers, with most often including reference to grandchildren and spouses, we also sometimes settle on what appear to be mundane core statements such as "I truly enjoy life and just want to keep going" or "I have a fear of death and want to delay it as long as possible." These actually reveal a far deeper motivation as they strike to the essence of one's perspective.

With a candid answer finally in hand, my questions turn to how much do they want to succeed on a scale of 0 to 100.  Any answer that is less than 100 is met with further probing questions about why they are not 100% motivated to succeed. There is no right answer and 100 may simply never be in the cards for some, but it is very important for both the patient and I to know exactly what their motivation is to lose weight and how motivated they truly are to succeed. (The spouse sitting next to them and prodding them usually doesn't work.)

Take a moment and ask your self the same questions. Challenge yourself to find YOUR truth. Keep asking yourself the question until you reach past the easy, cheap answers. Dig deeper until you are absolutely certain you fully understand your motivation(s) and how deep they run.

Everyone's reasons are different. One poignant example illustrates this point.  A patient once shared that although she was married, she loved another man. Although she longed to be with this other person, she was committed to her husband and was steadfast in her fidelity. However, she believed that if she outlived her husband (of course, dying from natural causes and not foul play), then she may eventually have the opportunity to spend some time with her true love.  Her commitment to increase her health and lose weight was based on this single desire. It is difficult as a physician to hear about a patient's torment, but I was delighted to help the woman articulate her ikigai (Japanese for purpose in life) that would lead her to make positive life-altering changes to her health.

(By the way, it is never my place to judge, but it is always to help. I respect the diversity in people and recognize the very different lives they have lived. No one can, or should ever presume why someone does what he or she does. Studies show that some people gain weight because it offers a protective shield around them from the cruel world in which they suffered childhood adverse events.  Some studies have shown a direct linear correlation between the number of vices, such as binge eating and alcoholism, and the number of adverse childhood events, like the loss of a parent, living with an alcoholic parent, or experiencing some form of abuse before the age of 10.  In such cases, identifying such traumas and dealing with them is vital to changing eating habits. So the next time you see a heavy weight person, please hold back judgment. You certainly have no idea what led to his or her weight gain.)

End of Part One. See next blog for Part Two.


www.mdprevent.net
www.myMDPrevent.com
(561) 807-2561