🔔 10 woke takes from the world of Modern Medicine in 2024 🔔

1) climate change is more important than human nutrition
2) obesity is genetic disease that requires drugs
3) obesity is healthy & should be embraced
4) diets don’t work, carbs are good, meat is bad
5) masking kids prevents death & causes no harm
6) any living thing needs 9-10 COVID shots, especially pregnant women & young children
7) COVID shots prevent long COVID & myocarditis
8) DNA & chromosomes don’t mean much, they are fluid, so is biology
9) the AMA covering the ethics of banning meat & NEJM covering climate change is more important than the diabesity epidemic
9) take drugs for every chronic disease
10) luck charms is healthier than eggs People wanted context - lie 1

1) “Meat is unhealthy”

Meanwhile it’s associated with improved mental health, improved bone and muscle health and newer studies like that from PURE show that excluding it is bad for mortality

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 and can be conditioned

Think of Pavlov & commercials - these aren’t going away quickly or ever

How statisticians and researchers arrived at the conclusion that the BlueZones are a FRAUD. 🤔

🔑 Thread with key excerpts

1/n “When these states transition to state-wide birth registration, the number of supercentenarians falls by 80% per year“

2/n

THREAD: 🧵

CGMs - continuous glucose monitors

Having looked at 10,000+ CGMs let me tell you what you will learn...

1/9 Lesson 1: Hidden carbs are everywhere
- you will find hidden sugar & carbs everywhere.

You didnt know you could find carbs/sugar but you will:
hotdogs, sausage, beef jerky, spices, condiments, sauces, soups, broths, basically everywhere you didnt look.

2/9

THREAD ALERT 🚨

I love the curious & creative thinkers, the patients who question everything, b/c answering these questions makes me a better educator & confirms my commitment to lifelong learning & shared decision-making

1/10 I don't “kick patients out” for presenting difficult questions… a cruel, yet common, practice among paternalistic/authoritarian doctors... I instead embrace the questions

I use them as an opportunity to dig deeper, understand more and understand better.

2/10

🧵 Thread on why low carb diets should be first line for obesity, hypertension, diabetes & metabolic syndrome ✅Diabetes:

In a randomized study he demonstrated that a 🥩 ketogenic diet was superior to a Mediterranean diet 🌱 at lowering the need for diabetes medications 💊

pubmed.ncbi.nlm.nih.gov/35641199/

Thread🚨

Let me take you through some examples of how medicine has 🛑 STOPPED becoming about getting people healthy & more about 💩 politics

Chronic disease like obesity, metabolic syndrome & diabetes continue to explode

Mental health is a crisis & your doctors care about👇🏻 “Meat is unhealthy”

Meanwhile it’s associated with improved mental health, improved bone and muscle health and newer studies like that from PURE show that excluding it is bad for mortality

How to INCREASE your low testosterone?

Thread 🧵 Testosterone is a steroid, anabolic hormone made in the testes and ovaries

🚨THREAD

Why calories NEVER mattered...

Summary:
Poorly calculated
Don’t quantify hormonal effects on appetite
Labels/Tracking don’t effect intake
Worse outcomes vs. dieting

Follow along with this fully cited thread 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

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 and can be conditioned

Think of Pavlov & commercials - these aren’t going away quickly or ever

Many people may not know my whole story so here is an synopsis for my new followers

My journey into medicine started at age 13.

I was a chubby little kid and remember sitting in the doctors office for my 13th annual physical We waited for 2 hours to be seen. I sat with my family who were all obese.

I remember getting on the scale after waiting for 2 hours and weighting the exact weight I way now -
210lbs

The doctor told me to exercise or I will end up like my 350lb brother.

How to INCREASE your low testosterone?

Thread 🧵 Testosterone is a steroid, anabolic hormone made in the testes and ovaries

After helping thousands of patients lose weight, here’s my advice for those looking for lifelong, sustainable life changes. These are the “5 MUSTS” anyone trying to lose weight lifelong NEEDS to do.

🧵/Thread Before you understand my “5 musts”, simply ask yourself -what are the side effects of your prior weight loss attempts- NOT your reasons, NOT what you want to happen, what went wrong, what made you stop?

🚨 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…

We have seen countless patients with HALTING of coronary artery calcium over multiple years

Key characteristics:

Thread below

https://twitter.com/budoffmd/status/1654280161381195776

They all exercise, including Zone 2, HIIT 1-2x/week, and RT

From 1999 to 2004 doctors witnessed & reported the harms of Vioxx. In 2004, Vioxx was pulled off the market and in 2007 pharma agreed to pay $5 billion settlement for liability From 2001 to 2007 doctors saw & reported the issues with Avandia. In 2010, Avandia was pulled off the market and in 2012 pharma was fined $3 billion for fraud

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”

The upcoming Fasting (No Lunch) Small Group with @AMKSmith12 is ONE WEEK away. Mark your calendars for May 4th.

We've prepared an article called "Fasting in 5 Steps" that outlines essential steps to assist you in getting started. Read thread👇 Step 1: Get advice 💡
Before you start an intermittent fasting or time-restricted feeding schedule you should talk to your doctor. You may have medical conditions that need close monitoring. Likewise, you may be on medications that may need to be adjusted.

We have used GLP1 in our clinic for 5 years

I can say with 100% confidence the effects on hunger wane between 1-2 years, after 2 years weight gain occurs

The nausea & vomiting drives muscle loss

It DOESN’T change behavior similar to how Lap-Bands didn’t change behavior

/1 It will not address emotional, psychological or mindset issues around food

If you feel angry & stubborn when people tell you to not eat junk, you will still be angry & stubborn

/2

I am so proud to have worked with the dream team of nutrition scientists on a paper titled: “Elevated LDL-cholesterol with a carbohydrate-restricted diet: evidence for a ‘lean mass hyper-responder phenotype." Our paper in CDN highlighted Dave Feldman's model for lipids in a low-carb state. We pooled his database to demonstrate the model in a systematic fashion.

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 and can be conditioned

Think of Pavlov & commercials - these aren’t going away quickly or ever