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Thursday, April 30, 2009

Your Nutritionist: Too Fat to Fish?

By Dr. Bill

This morning, like every morning, I tried to avoid reading my email first thing, because if I get hooked on a good story, I can easily lose track of time and I don't end up getting enough done. But I couldn't resist this morning, and I read an email from someone I know who was just diagnosed with Type II Diabetes

John loves to eat and loves to drink beer. He is in his mid-fifties and weighs about 20-25 pounds more than he should, so he's not exactly fat, but he's certainly not thin either. With this new diagnosis of Type II Diabetes, he is going to have to make some lifestyle changes, if he knows what's good for him.

John told me in the email that his family practitioner had sent him to a nutritionist after she told him about his diabetes diagnosis. John is 6' 1" and weighs between 255-230. I think it's entirely possible that John could get in shape within about 90 days.

He took the appointment with the nutritionist, and showed up for his appointment at the prescribed time. He checked in with the receptionist, who weighed in about 250, and couldn't have been a hair over 5'5". What we used to call "as wide as they were tall," behind closed doors.

You would think that a nutritionist would not want to have an obese person be the first thing a patient sees when they walk through the door, but John thought that maybe they had to hire her because she was qualified and they didn't want to break any discrimination laws.

John waited in the waiting room and after about 20 minutes they called him in. When the nutritionist arrived, he was just flabbergasted. She was tall, but she could not have weighed less than 300 pounds, according to John.

The nutritionist began to talk to John about his health and the ways he could improve it thought diet, but John could barely concentrate. He just kept wondering, "Why on earth are the receptionist and the nutritionist so incredibly fat?"

The nutritionist got to the part where she was displaying plastic food to show John about correct portion sizes, but John could not keep silent. Finally he blurted out, "If you know so much about nutrition and the rules of dieting, why are you so overweight?"

There was absolute silence on the other side of the desk, and then she said, "What did you say?" like she hadn't heard him correctly.

John played along and repeated his question. "How can you be so overweight, when you know all these rules about dieting and nutrition?"

This is when the nutritionist just lost it and started screaming at John. She ordered him out of her office. John left, but even with all the histrionics, he still thought his question was valid. On the way out the receptionist asked if everything was okay, and John muttered something about people who shouldn't give advice if they are not willing to follow it themselves.

He went back to his family practitioner and told her the story. She kept a straight face on for a minute or two, and then couldn't stop her own laughter.

After that, John was told of some rules that he really had to pay attention to.

I recommend, as John's doctor does, supplementation with pharmaceutical grade fish oil, especially for patients with Type II diabetes. Diabetes really ups the risk for cardiac issues, and although John does not have heart problems right now, his risk level is high. The pharmaceutical-grade fish oil is useful in the treatment of diabetes because it can help control lipid levels, particularly triglyceride levels. These levels are often elevated in patients with diabetes.

And diabetes is not the only thing the pharmaceutical grade fish oil is good for. This type of fish oil has been shown to have a positive effect on reducing the risk of some cancers and cardiovascular disease, and also has been linked to better joint health and improvement in mood and behavior.

It's really important for people with Type II diabetes to do what they can to elevate their mood, because many of them suffer from depression that is brought on by the disease.

I think John was absolutely within his rights to ask that question of his nutritionist. How is his situation different from taking health advice from a pulmonologist who thought nothing of smoking?

Nutritionists need to listen to themselves and follow through on what they are talking about, not just hand out diet advice with one hand and eat junk food with the other.

John told me that when he was in the nutritionist's office he had noticed cases of Diet Coke, which, if you didn't know, is the number one beverage that fat people consume.

Don't hesitate to get another opinion, especially in a situation like this, where you have reason to doubt the validity of what your practitioner is telling you, based on his or her own habits. - 17268

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