DoctorTro Profile picture
Sep 17, 2020 5 tweets 1 min read Read on X
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These naive little med students & personal trainer PhDs don’t have to call families of patients who die from diabetic complications like sepsis, MI

They have never seen an amputation

If they had they‘d likely change their tune about their oreo &poptart inclusionism

1/5
These people often med students, dietitians and trainers...
who come on twitter, bombastically call for higher forms of evidence, calling people charlatans

& yet, they never truly observed the system fail. They dont even understand the problem. No experience.

2/5
If you want regurgitated vegan agenda, detox plans, supplements, or a fairy tale approach to macros or some nonsense/koombaya feeling of food inclusionism... you’ve come to the right place... twitter (im looking at you #rdchat ), not that the LC echo chamber is much better

3/5
It’s a wonderful place actually and yet a terrible place.

Its where brilliant minds can be reached within seconds. But also a place of complete ignorance.

4/5
I love twitter, it has taught me more than many CME lectures! But at the same time, particularly as followers increase, it can be a very dark place.

RANT OVER

5/5

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More from @DoctorTro

Mar 30
When I entered medicine, it was deeply personal. My family’s struggles with obesity and metabolic disease were my driving force. I watched my brothers reach 400 to 500 pounds, and our family was plagued by diabetes, hypertension, and more. I thought becoming a doctor would give me the tools to help, but what I found was a system that often prioritized profit over patient outcomes.
In the early 2010s, I began noticing issues with the CMS reimbursement structure. The payment model seemed designed to incentivize procedures and chronic disease management rather than prevention. Spending time with patients to address root causes wasn’t valued. Instead, quick fixes like medications were prioritized.
My skepticism grew as I delved into public health issues. Water fluoridation, for example, was accepted without question. Yet, when I examined the data, I found no significant difference in dental outcomes between fluoridated and non-fluoridated countries. This revelation made me question other unquestioned practices, like the push for flu shots without considering individualized risk-benefit analyses.

I marveled at people like @gorskon who claimed that herd immunity was an efficacious endpoint for mandatory mass flu shots… for a product with 10-60% match rate 🤔

To make this simple, it’s the equivalent of making the false claim that we can keep out mosquitoes with a chain link fence.

These people were liars, plain and simple and now post COVID we know this even better than ever.

Just look at the exaggerated claims we had to endure.Image
Image
Image
Read 5 tweets
Mar 14
If you want to tackle your weight or diet-related disease, you need to pick a side.

Let’s talk about food addiction!

🧵 /thread
2 paths, you much choose one:

One path: Acknowledge that your identity is shifting and that your relationship with food needs to change. If you recognize that certain foods are addictive and damaging, then commit—either abstain or harm-reduce with intention. If this is your path, you must fully own it.
The other path: Accept that you are choosing food as a psychoactive substance and a source of pleasure. Own it. Radically accept this choice without guilt or shame, and stop punishing yourself for it. If you take this path, fully embrace it—savor every bite, eat slowly, actually taste your food, and enjoy it. If this is your choice, then let it be a true choice, free of internal conflict.
Read 8 tweets
Feb 14
🚨 NEW PAPER 🚨

Making America Healthy and reversing obesity, without drugs & injections

By focusing only on metabolic health, patients lost 15.5% of their weight while STOPPING unnecessary medications

👇🏻👇🏻

50 patients
⬇️43lbs on average ‼️
💥~15.5% weight loss at one year💥
🤔 Majority of patients KEPT losing weight even after stopping GLP1
🤔 Even at 1 year, 76% of patients were STILL losing weight - BUSTING THE MYTH that “patients can’t adhere to diets longterm”

I’ll walk you through why some of this is REALLY important

This paper looks at the 1 year weight loss results from our virtual metabolic health program with CGMs, smart equipment, an app and virtual coaches.

Paper linked:
frontiersin.org/journals/nutri…

Please RT, bookmark & share this link 🔗 to spread awareness so doctors know the power of metabolic health and lifestyle changes NOT only pushing medications 💊

🧵/THREADImage
🤌Allow me to set the stage.

The current accepted truths in medicine is that GLP1 meds have unprecedented results and there is no other options because “all diets fail”

But have medical teams actually tried to help patients adhere ? 🤔

They haven’t. Why? Because it’s easier to prescribe injection weight loss drugs than to promote & inspire lifestyle change

But the sad reality is many patients cannot tolerate the injection drugs due to side effects while many others don’t actually need it.

If every patient with obesity and diabetes goes on these injection drugs corporate America and Medicare will go bankrupt from the trillion dollar burden it would cost.

So our clinic aimed for better.

A completely new care model called TOWARD

And how did we do?Image
We created a multi-modal approach to metabolic health leveraging telemedicine, convenience and real-time access to doctors and coaches who actually care because they have lived it!

We created a unique app
We leveraged smart scales, CGMs and remotely monitored blood pressure cuffs to help predict weight loss and intervene in real-time before weight regain occurredImage
Read 13 tweets
Feb 4
🚨 THREAD 🚨

GALLSTONES & GALLBLADDER DISEASE

Everything you need to know about gallstones as it relates to diet and dietary composition.

👇🏻👇🏻👇🏻👇🏻👇🏻
In the obese during rapid weight loss from a very low-calorie diet, a relatively high fat intake could prevent gallstone formation, probably by maintaining an adequate gallbladder emptying, which could counterbalance lithogenic mechanisms

nature.com/articles/08006…
On the basis of a meta-analysis of randomized controlled trials, during weight loss, UDCA and/or higher dietary fat content appear to prevent the formation of gallstones.

sciencedirect.com/science/articl…
Read 5 tweets
Jan 25
🚨We are officially changing the name 🚨

Have you heard of “lean mass hyper-responders” or LMHR… it may soon be called “Lean Mass Hyper-ABSORBERS”

Cc: @AdrianSotoMota @nicknorwitz @realDaveFeldman

🤯

Let me present some data from our clinic that we shared at @TheSMHP - that you may find interesting

🧵
Several weeks ago I put a poll asking people to guess what caused this?

So let’s dig in and find out:

We presented this case series of ~10 patients Image
Roughly 10 patients presented to our clinic who had elevated cardiac risk

Many of whom had evidence of plaque on CCTA or CAC

These patients wanted to hedge their bets but didn’t tolerate or didn’t want statin treatment

Some of them tried carbohydrate reintroduction or fiber supplementation with no improvement in lipids
Read 6 tweets
Dec 31, 2024
I have a serious problem with the term “pre-diabetes.”

The prefix “pre” is used to describe what comes before something.

In reality, “pre”-diabetes is actually AFTER or “post” 15 years of the high insulin levels & inflammation associated with the modern lifestyle.
Prediabetes is usually diagnosed by checking an a1c level, which is the percentage of hemoglobin that binds to sugar as a percentage of normal hemoglobin.

If you a1c is between 5.7 and 6.4, you are considered to have “pre-diabetes”
To achieve this level of pre-diabetes, you must sustain enough carbohydrate/glycemic excursions & weight gain where your average glucose rises sufficiently above normal levels.

The a1c describes your speed, your are past your speed limit.
Read 12 tweets

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