Let me start by saying I don’t agree 100% with everything on Dr. Arya Sharma’s blog. For example, I think his Best Weight Practical Guide to Office Based Obesity Management (which he co-authored with the venerable Yoni Freedhoff and from which he regularly draws material for reposts) is a gross oversimplification of what is required of doctors and patients if they really want to have an impact on weight. In this most recent repost, for example, he suggests
“. . . it is safe to assume that a patient who is unable to commit to 30 minutes per day of combined dietary and fitness effort will be unlikely to succeed with weight management using a purely behavioural strategy. Asking patients whether they feel they can find 30 minutes a day for their weight management effort will help to assess their readiness and willingness to change.”
To that I gasp, THIRTY MINUTES?! No wonder the mythology persists that it’s all just a zippy “lifestyle” change, when our wise doctors promote this kind of crap. Thirty minutes devoted to a less toxic diet and some exercise may marginally improve someone’s health, but it is nowhere near enough time to have ANY permanent impact on weight.
On the other hand, the man, Arya, on another day can be brilliant. I’ll say it: genius. For example, on Friday he talked about the complexity of calorie intake as related to weight.
Clearly, he respects his own field of specialization, and yet he has not dropped the notion that General Practitioners can and should press patients to manage their weight. He is disappointed that they are “unenthusiastic,” but maybe he should hear that as a clarion call. His Practical Guide presses GPs to make behavioral prescriptions in the name of weight management (as opposed to mere health improvement), but the GPs know, intuitively, that those prescriptions are hollow, at best. They may even be damaging, because their dismal results can foster disillusionment and depression. To my thinking, asking GPs to help their patients with weight management is ludicrous. You might as well suggest that the GPs should be performing routine brain surgeries too.
Tomorrow or Monday, I will post my response to his brilliant Friday post. I’m still letting it ruminate (ferment?). How can I not adore him when he agonizes over weight issues as much as I do, and he applies his considerable training and expertise? I bow to his dual doctorates. His work, taken as a whole (and ignoring his simplistic “Practical” Guide), to me suggests a whole new model of medicine as it may apply to weight and health maintenance.