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Mr. Williams is a 52-year old male who has been with me for some time. He has just been started on metformin for newly diagnosed diabetes. Lisinopril is his only other medication for high blood pressure. When he had his yearly physical, he was also found to have a high LDL cholesterol of 150. His body mass index (BMI) is 29 -- significantly overweight and touching obesity levels.
I sat down with him for a long time to talk about his lifestyle habits. He was a college athlete, but from his 30s onwards, like so many people, had become extremely busy with work and family -- letting his health slip. He stopped regularly exercising and ate whatever was put in front of him. His brother had recently suffered a non-fatal heart attack, which had really shaken him. He wanted to improve his current health situation and expressed great motivation. I talked to him about his everyday habits and referred him for more intensive dietary and exercising coaching. So began his journey. He joined the local gym and started eating more thoughtfully.
Williams began a calorie-controlled healthy yet tasty well-balanced diet. He moderately restricted carbohydrate intake (carbs are the devil of modern-day society, and cutting back on them is the quickest way most people lose weight!), ramped up whole natural foods including vegetables and fruits, cut back on processed packaged foods and sugars, and controlled portion size and cut back on snacking.
He strictly blocked out an hour a day for exercise, no matter how busy he was. Nothing would come before his own health (yes, not even family), and he would have this "me time" each and every day (occasionally throwing in meditation too). As well as burning calories, this also quickly resulted in other noticeable amazing benefits including improved energy levels, mood, stress, sleep -- and also better focus and productivity for the test of the day.
When I saw him again 3 months later, he had already lost several pounds. Six months later he was down over 10 pounds. Today at the 1-year mark, he is down 25 pounds! He sits in front of me telling me how great and energized he feels. Compliments are flying his way and his BMI is now exactly 25. He is performing better at work and feels like his personal and family life has improved in leaps and bounds too. Best of all though, his HbA1C has normalized and his blood pressure is also low (110 systolic). We are giving a go at stopping both his metformin and lisinopril.
Williams is, of course, a fictional character made up for the purposes of this blog post. His story, however, is not uncommon -- I've seen dozens of such success stories in my outpatient preventive medicine practice. At a time when 70% of the country is overweight or obese, with all the associated comorbidities and staggering healthcare costs, Williams is the best! He has reversed his decline into chronic illness by seizing control of his health, and taking care of his most precious gift, his body. The more folks like Williams we have, the more healthy and happier our population, combined with billions of dollars in healthcare savings.
I have always considered myself a conservative minimalist physician.
Prevention is better than cure, and empowerment is better than treatment. The less you need to see me, the better news it is for you. There is no better feeling for me as a doctor than those occasions when I get to stop a patient's medications because they have made sweeping positive changes to their lifestyle. Good riddance to those prescriptions. These stories, albeit currently the minority of patients, make my job worth it.
, is an internal medicine physician, author, and co-founder of . He can be reached at his self-titled site, , and on .
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