First of all, love @mackinprof work on protein

The love stops there m… THREAD
To equalize diets to some concept of “whatever works” is a lazy approach to obesity. FULL STOP.

Diets work for very specific reasons in certain individuals, not understanding those reasons needs to be states and it wasn’t

What happened instead?
Some koombaya nonsense that the efficacy of diets is based on adherence. Besides that being circular reasoning it again shifts the blame to the disenfranchised people with obesity & not the dumbfucks who portend to be experts
It’s just a way of blaming people with obesity. Full stop 🛑

Diets works for different reasons in different people.

The fact that the professor can’t articulate them in a simple blog post is a joke on our profession.

With that said, I still love his work on protein

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More from @DoctorTro

28 Oct
I met a person in the gym who went to a bariatric surgeon, was evaluated by a psychotherapist, psychiatrist and then had bariatric surgery.

She lost some weight but gained it all back several years later. No one reached out to her, nobody followed up.

/thread
When I asked her why she thinks it happened, why she gained weight, she said “it’s my fault”

She said “she ate too much, maybe she was emotionally eating”

And this is basically where I lost my shit (keep reading)
They cut out her stomach, forced her to “eat the size of her palm”… they cleared her for surgery and provided no support, no clear vision of what she is up against… but they did collect fact check$

THEY did this to her, SHE WANTED HELP… and yet she says “it’s my fault”
Read 5 tweets
10 Oct
I have patient who is an 18 year old male who recovered from documented COVID & is being mandated to take 2 (?3🤔) mRNA vaccines

Can we as a profession appreciate our amazing tools & therapies (like vaccines) but still acknowledge the need for an individualized approach?
As a profession we need to be able to have honest and open discussions about the balance between population health and individualized approach.
YOU CAN STILL SUPPORT & APPRECIATE VACCINES & DO ALL OF THESE:
- acknowledge rare side effects
- acknowledge ideal populations/exceptions for a vaccine
- stand up for patient-physician shared decision-making
- not support coercive measures

Vaccines are STILL an amazing tool!
Read 5 tweets
29 Sep
🚨THREAD

Why calories NEVER mattered...

1/n
We have known as far back as 1982 that tracking calories, food logging is inaccurate & doesn’t predict weight loss

10.1093/ajcn/35.4.727.

2/n
Meta-analysis in 2008 by Harnack and French, then follow-up in 2014 from Eblel, Kiszko reviews and assesses the evidence on the effectiveness of calorie labeling at the point of purchase

"Concerns on the effectiveness of calorie labeling policies"

10.1007/s10900-014-9876-0

3/n
Read 15 tweets
20 Sep
If you haven't read my thread on how fear and anxiety are driving off-label use of drugs...

I now want to talk about how fear and anxiety are leading to inappropriate assumptions about the vaccine and witch-hunting anyone who disagrees with you as being "anti-vaxxer"
In our practice we have recommended many patients get the COVID vaccine despite unknown unknowns and unclear adverse event profiles like clots with JNJ and myocarditis with mRNA.

These discussions and decisions are between patients and us as their advocates...
In any case, what I have noticed among the pro-vax, pro-mask, pro-mandate crowd is that they have let FEAR and ANXIETY drive there decision making.

Its like the flip side of the same coin regarding people using alternative treatments
Read 8 tweets
20 Sep
I am getting countless calls for ivermectin and I want to discuss some of the common issues I see with this

/rant 🚨
Most of these patients are highly invested in their health & are generally disenfranchised from traditional medicine

They see the medical reversals that have happened over the years and are cautious (thalidomide, vioxx, pharma fraud, right heart caths, unnecessary stents, etc)
Many of these patients don’t trust the pharmaceutical industry, medical organizations and question everything they hear (MSM, gov, etc)

Many of these people are HIGHLY intelligent but some common issues I have seen are as follows.
Read 12 tweets
17 Sep
It’s very difficult to help children under 13-15 with dietary change

They are still not fully developed, can’t drive, don’t buy their own food, don’t cook their own food, school lunch is a disaster, so is their friends house

But also many just aren’t ready to make the change
My best advice to parents with children who have obesity is to be as supportive as possible. Help them out without their knowledge

Replace the chips W/ @QuestNutrition chips

Buy nuts & fresh vegetables & berries

Get rid of ALL caloric drinks

And do it all w/o saying a word
Make their environment filled with satiating foods so that at least the food doesn’t make them keep eating

PLEASE. Don’t push them!

For every 10 parent that signs up their kids for our program we turn away about 8-9

Why?
Read 7 tweets

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