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Dr. Tro

@DoctorTro

15 Jul

There are 5 types of hunger that ideally should be taught to all patients with obesity

Without cultivating an awareness of appetite, hunger and cravings, a patient with obesity will not know what they are fighting against

So Let’s start!

We are going to start with some easy ones…

The Cephalic phase response aka food cues - this is hunger stimulated when in presence of food.

These signals are deeply ingrained

Think of Pavlov- these aren’t going away

Second up is appetite triggered by Social cues to eat

our social lives, wether they be business meetings, family dinner or birthdays

Unless you are going monk mode - this cue to eat is also not going away & requires attention to manage

Read 20 tweets

Dr. Tro

@DoctorTro

14 Jul

I saw a recent patient who came to me for weight loss & diabetes remission… he lost a significant amount of weight & his sugars improved but his lipids did not improve, an ensuing CAC showed a score of ~10, the patient was in his 3rd decade… I recommended a statin

I rarely prescribe statins in primary prevention but a confluence of factors leads me to believe this patients underlying dyslipidemia including high TG, low HDL & high LDL will not improve with lifestyle alone

Why do I bring this up?

🗣I believe the pharmaceutical industry is profit driven & wants the widest possible base to sell to
🗣I don’t trust medical organizations & verify guidelines myself including primary data

/contd

Read 4 tweets

Dr. Tro

@DoctorTro

13 Jul

@gorskon

So @gorskon is on a mission to weed out anti-vaxx sentiment.

Great.

But what about the countless doctors were RECOMMENDING vaccination BEFORE an EUA approval and BEFORE ever seeing FDA briefing docs or a label & then recommended to children BEFORE testing in their age group?

Everyone is after the anti-vaxx people

I think we should be going after THESE lemming parrots of doctors.

The doctors who would mandate EUA vaccination by law, the ones who believe everyone should get an EUA vaccine without outcomes studies

I’m worried about our profession’s ability to think.

Doctors believed they understood the vaccine, and yet we discovered myocarditis & VTE afterwards

Being cautious is quite reasonable for some

While still many others can’t afford to wait & should get vaxxd

Individual choice

Read 4 tweets

Dr. Tro

@DoctorTro

6 Jul

@okalayjian

My parents came to this country with nothing in their hands, from a generation of people literally slaughtered and robbed of everything.

They worked two jobs each as young immigrants, going to college at night.

I remember being a kid w/ @okalayjian @aramazto hungry w/o food

Literally we had to eat mayonnaise and pita sandwiches b/c my parents were out working.

To ensure we had food, my family literally bought fast food sandwiches when on sale & froze them so we could eat if they couldn’t cook dinner.

I know my parents did their best for me. They worked tirelessly and they have done the amazing service of being an amazing example of sheer tenacity & hard-work

But this was the food environment that kept me trapped for years to come

Read 22 tweets

Dr. Tro

@DoctorTro

4 Jul

Why am I so passionate about convincing armchair scientists that glycemia is mediated by carb intake & not weight loss?

There are HUGE implications for every patient w/diabetes on insulin, pre-surgical patients, & those embarking on lifestyle change who want quick biofeedback

The fact that SO MANY medical organizations are wrong speaks to serious problems with our ability to understand and interpret science on a SYSTEMIC level

The fact that low carb diets were only recently added to the ADA supposed healthy eating patterns is a testament to this

While I take great pride in questioning authority, thinking independently & challenging status quo, my motivation here is to JUST correct what is wrong

B/c of this I have been forced to publish research which I have little desire to actually do & in the face of great criticism

Read 4 tweets

Dr. Tro

@DoctorTro

1 Jul

@whsource

"DIABETES IS IMPROVED ONLY WITH WEIGHT LOSS"
❌Guyunet:@whsource
❌Guess:@Dr__Guess
❌Layne:@BioLayne
❌Bass:@kevinnbass

ME:
✅YOU ARE WRONG, carb restriction accounts for 80% of excess glycemia, a1c of 12➡️6.7 w/minimal weight loss in our patients
doi.org/10.3389/fnut.2…

Follow along as we go through more:
We took patients interested in both weight loss but there primary goal was management of diabetes.

We counseled them on literally NOT tracking calories, NOT controlling portions and just lowering carbs.

And the results speak for themselves

Look at the massive glycemic changes on CGM

Read 4 tweets

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