Obesity is everywhere. Lipid disorders are everywhere. A high percent of people take lipid lowering agents daily. People are obese.
Good news. The smartphone is democratizing medicine just like the printing press led to more knowledge and reformation. Revolutions followed the printing press. Suddenly things we did not know are made known. Similarly with medicine, the internet can help, the smart phone can help, and the tougher questions can go to your healthcare team to help you.
Bad news. Addiction has not changed. People have not changed. Education does not change behavior but effective communication can (http://www.paragonrx.com/experience/white-papers/effective-education-leading-to-behavior-change/). Today we have no markers of pleasure eating or how to block markers that lead to poor healthy eating choices.
Naltrexone is an opioid blocker. It has been shown to effect addictive eating (greater food-addiction symptoms and reward-driven eating) and less mindful / awareness of eating. Naltrexone-induced nausea has been shown to be mildly associated with reward-based eating. What that means to you simply is you think you need a reward, you go for that donut, but if you were on a heroin / opioid addict blocker like naltrexone, you would get sick just like the addict who went for heroin while on naltrexone. In a recent study, those who embraced mindfulness with eating, those who endorsed naltrexone-induced nausea, these tended toward reduced reward-based eating. See Acute responses to opioidergic blockade as a biomarker of hedonic eating among obese women enrolled in a mindfulness-based weight loss intervention trial. From Journal Appetite 9:311-20, 2015 August. You can also read Journal of Neuroscience. 35(9):3959-65, 2015 Mar.
Recently, I was found to have obesity, metabolic syndrome, elevated blood glucose and triglycerides nearly leading to pancreatitis. My healthcare team was awesome. My oncologist contacted the lipid clinic. The lipid clinic had me come in right away and I met with a great PhD nutritionist. She carefully went over my panel, she explained to me what each value meant. She told me how, even attempting as a physician to self correct, I was wrong. She pointed out key facts: food is an addiction, you must eliminate high glycemic foods, you must follow the rule that half the plate is broccoli or other equivalent vegetable (not corn for example), 1/4 of plate must be lean protein (grass-fed lean beaf, skinned chicken, tuna, salmon, etc), and finally 1/4 could be low glycemic carbohydrate (such as 1/4 of a yam, small amount of brown rice with beans, etc), low salt, no dressings, no transfats or monounsaturated fats (see recent article on the topic in JAMA Intern Med. Published online July 05, 2016), small amounts, low calorie, and very interesting, 40 minutes exercise per day to protect and lower lipids for 24-36 hours.
Amazing that you must exercise every 24-36 hours or lose benefit. Key factor.
We also discussed the importance of weight, waist measurement, and body percentage fat. The data is clear. Men are to be 110 # for first 5′ of height and 5 # thereafter per inch. Women are to be 105 # for first 5′ and 5 # per inch thereafter.
That is not me and I doubt that is you. But a fact is a fact, just like no one makes it out of this world alive.
So how did it work for me, a case example? My nutritionist advised but did not do it for me. My lipids went from 1493 to 135, blood glucose normalized, liver markers lowered, as well as other beneficial numbers; all in 2 weeks. I also lost 19 pounds with great effort. My blood pressure improved.
It does not stop at two weeks. It must be daily.
The blog began with a question to me: “How did you improve your lipids so quickly?” I changed my diet, I exercised, I ate steel rolled oats with flaxseed, I ate small portions, I fasted, I did not drink any sugary products, I eliminated anything possible to raise lipids and blood glucose (milk, sugar, sodium, cheese, meats except salmon / fish, high glycemic foods, plenty of water, exercised daily, and more). I did not stop even when addiction called me. It must be ongoing.
It was difficult. My cravings are ongoing and similar to attempt to get off pain medications. Guess what? I have the same feeling toward food when forced to go on a special diet as I did for my pain medication when I attempted to stop the pain medication. I crave subs, hamburger, fries, cheese, sugary drinks, high glycemic foods, white rice, salty foods, and on and on. We ALL have addiction. Let’s stop looking down our noses at the addict, the drunk, the abuser of prescribed medications, etc. Let’s be an example, starting at home. Teach yourself, then your family. Set goals.
You can do it but it is daily. You are an addict, you do need food anonymous. No one is going to take the food out of your hand. No one is going to exercise for you. Practice discipline.
All notes are personal and you can not be taken as medical advice. This is my opinion and experience. You have to consult with educated and qualified people in your realm. Yes, use the smart-phone, health apps, internet sites (WebMD, Mayo, etc), educate yourself, and practice democratization of medicine (see Eric Topol’s book The Patient will see you now, Jan 2015).
I am an ENT surgeon. I treat disorders of the head and neck. I am not a nutritionist, psychologist, internal medicine physician, etc. I can talk with you about your head and neck cancer, thyroid cancer, skin cancer, tonsil / sinus / salivary gland, etc in a controlled medical setting. You can call to speak with me or my great partners. But, do think about the topic, do educate yourself. Be proactive.
For your better health,
Philip Harris, MD FARS
Special thanks (editorial review):
Amy Lynn Clifton, Clinician Lindamood-Bell Learning Processes, Ann Arbor, MI