- "I really want to like Dr. Mike on YouTube,
"but he really has some fatphobic tendencies.
"He's actually a fan of intermittent fasting,
"which is unbelievable to me
"considering he's a medical professional.
"In his most recent video,
"he talked about gastric bypass surgery
"being good for long-term weight loss.
"And just in general,
"he's talked about obesity and,
"quote-unquote, 'watching what you eat.'
"He's done videos where he tried
"certain fat diets for 30 days,
"but I've never watched them.
"So I don't know where he stands on keto, for instance.
"Anyway, it just goes to show that even doctors
"can still learn a lot in their own fields."
I have to respond to this
as well as many of these comments.
Let's get into it.
(light music)
Honestly, I was really disheartened, disappointed
when I read this post.
I'm not one usually to get upset
when I read controversial posts
about something that I've said,
but this one touched me.
You know, I have a lot of patients
who are overweight and obese,
who are struggling to lose weight.
Know that they need to for their health
because they don't want to die young,
they don't want to have
a heart attack at age 40
or a stroke at age 50.
They want to live long, fruitful lives.
And it's my job as a physician
to help them do that.
That doesn't make me fatphobic.
I'm against fat shaming wholeheartedly.
I've said it on Phil DeFranco's podcast last year,
that fat shaming is a form of destructive criticism.
That only works to break someone down
instead of building them up.
As a physician, my job is to help a patient
get from Point A to a healthy Point B.
Not to make fun of them
while they're at Point A
in hopes that they get to Point B on their own.
No, we're a team
and we have to do that together.
In fact, I want to go through this post line by line
and really take it apart
so we can figure out what's what.
"He's actually a fan of intermittent fasting,
"which is unbelievable to me considering
"he's a medical professional."
I frankly, don't understand this critique.
I like intermittent fasting for myself.
Never did I say it's something
I recommend to all my patients
or as a piece of universal nutrition advice.
Universal nutrition advice doesn't even exist.
If you've seen any of my videos,
I said that time and time again.
"In his most recent video,
"he talked about gastric bypass surgery
"being good for long-term weight loss."
Yeah, evidence shows that
gastric bypass for those who are morbidly obese
has better long-term outcomes than dieting
or just medical treatment with medications.
That being said,
it's not the only solution.
It's not the right solution for everybody
and there's also different types of bariatric surgery.
There's many options
and you have to discuss them with your doctor
to find out what's right for you.
But just poo-pooing the entire industry is wrong as well.
Because not only does bariatric surgery
help you lose weight,
but it also gives you
better control of your cholesterol.
Better control of your blood sugars
so much so that in patients
who've had bariatric surgery,
we've put their diabetes into remission.
I mean, that's huge.
"And in general, he's talked about obesity
"and 'watching what you eat.'"
I mean, I've definitely talked about obesity.
It's well proven that
if your BMI falls under
the obese or morbidly obese range,
you're facing extra risks to your life.
You are gonna have more illness.
You're gonna have a lower quality of life.
And, frankly, a shorter life
than someone who is not obese.
Does that mean that it will be true all the time?
No, these are risk scores.
These are averages.
Also, many people are quick to point out
that the BMI scale is super flawed.
It's not a perfect system
and the BMI number alone should never be used
as a sole indicator of someone's health.
Remember, we don't treat lab values.
We don't treat numbers,
we treat patients.
So you look at the BMI number
and then look at your patient.
So if I see a very strong gentleman in front of me
with big muscles and a six-pack,
and his BMI falls under the obese category.
No, I'm not gonna think he faces serious health effects
because his BMI number is high.
We have to use some logic there.
"He's done videos where he's tried
"certain fat diets for 30 days,
"but I've never watched them.
"So I don't know where he stands on keto, for instance."
I mean, I would love for you to have watched them.
Because in my videos that have covered
Whole 30, keto, intermittent fasting, even vegan.
I've done these for 30 days
simply to show how they affected my body,
but I also talked about the science.
What we know, what we don't know.
Because, honestly, the field of nutritional science
is an absolute mess.
There's way more that we don't know
than we do know.
And I think understanding this level of humility
is a first step for many experts.
Whether you're a registered dietitian or physician.
"Anyway, it just goes to show
"that even doctors can still
"learn a lot in their own fields."
Facts, I agree.
This is the one sentence of this post
that I completely agree with.
Being in medicine is a field
where you're gonna learn
for the rest of your life.
In fact, there's a reason
why we have to retake our boards
we have to continually have updated education
'cause guidelines change.
In fact, that's what makes medicine special for me.
That's why I fell in love with the field.
You constantly are learning,
you're curious,
you want to know the most up-to-date information.
That's powerful.
that's good stuff.
And I'm sad that it came
at the end of a really angry message against me,
but it's true.
Now, let's take a look at some of the most upvoted comments.
"I felt the same way, too.
"I love all of his videos
"on other areas of science,
"but I take his health and nutrition videos
"with a grain of salt.
"Don't forget that much of the research within medicine
"comes from a fatphobic stance.
"so I feel it can be difficult
"for medical professionals
to move away from that."
I don't understand, like, what fatphobic,
how it's being used in this given example.
You know, many years ago we sort of viewed
those who were overweight
as perhaps people who wanted to be overweight,
who didn't care that they were overweight.
That may have been true for a small portion of people,
but there's individuals who have medical conditions
that make them more susceptible
to being overweight
and we have to address those in the medical community.
So it's not about being fatphobic.
It's not about fat shaming people.
It's about addressing true health risks
in a constructive way
to help people become
the healthiest version of themselves.
being overweight is not just a problem
for heart attack, stroke risk.
It's a problem for your entire health.
Cancer risk, sleep, happiness,
everything suffers when disease goes up.
"Most doctors also believe
"that obesity is a disease
"and that BMI is a good predictor of health.
"Sadly, most medical professionals are living
"in diet culture and fatphobia
"as much as the rest of the population.
"It's wild that doctors tell patients to lose weight
"when diets have a 95% failure rate
"and often leave people in worse shape
"than when they started.
"Can you imagine if doctors prescribed
"any other treatment or medication
"with 95% chance of failure."
This is a good point to talk about.
When we prescribe a diet plan or nutrition plan,
the reason that it fails
is because adherence is low.
Changing someone's behavior is quite difficult
and we haven't mastered that art as physicians.
As a health care system really,
but it doesn't mean that we're failing
because we're fatphobic.
I do think it's important to say
that I wish doctors spent more time studying nutrition
and understanding how weight loss works,
how cholesterol works.
If you're a doctor
and you're not up-to-date on this type of information,
it's really wise to use a teamwork approach here.
Get a registered dietitian on board,
a behavioral counselor,
perhaps even a consultation
with a bariatric specialist.
We have obesity and metabolic programs
across the country
that are doing great work.
"I have only ever seen one doctor in my life
"who didn't mention losing weight to me.
"So this is really not surprising to me.
"Show me a doctor who isn't fatphobic
"and I will be shocked."
It sounds like the person writing this
is going through a lot of pain.
So it's not about being judgmental here.
If doctors aren't immediately bringing up
someone being overweight or obese,
that could be okay
because maybe that person
isn't ready to have that conversation.
But if I'm gonna be giving you
an honest assessment of your health
where you can do better,
where your risks are,
we have to talk about weight.
It's like me having a patient who's a smoker
and completely ignoring the fact that they smoke
when I'm trying to optimize their health.
I would be doing a disservice to them.
So, yes, when I have patients
who come in for a checkup,
for a preventative visit
so that they can stay being healthy,
part of that discussion is weight management.
Not 'cause I'm fatphobic,
but it's 'cause I'm patient-focused.
"Capitalism thrives on people,
"especially women, feeling inadequate
"and needing to buy something.
"Either diet books, coaching, gym memberships,
"new clothes to show off that bikini body."
I don't want to blame this on capitalism.
I kind of want to blame it on rogue marketing.
You know, I talk badly of detox teas and miracle cures.
I've never sold any of that stuff, never will.
I think it's horrible for my patients
'cause it actually derails them
from true treatment plans that work,
but also take some work.
You know, it's a lot easier to take a pill
than get up, eat healthy, sleep well, go to the gym.
So, yeah, people are sort of excited
with these shortcuts.
But, honestly, these shortcuts don't exist.
It's not capitalism,
it's rogue evil marketing.
This one's actually in support of what I said.
"He's always advocating for preventable care
"because it's cheaper for the patient to lose weight
"than spend thousands of dollars
"on heart surgery and diabetes care.
"He's not fatphobic,
"he just doesn't want you in debt."
I'm a huge fan of preventive care.
I mean, that's why I love
family medicine and what I do.
Because I want to prevent the heart attack
rather than just simply
treat it when it's there.
Saving someone money,
saving someone having to take medications
long-term for the rest of their life
'cause they have a stent.
I want my patients to live
the highest quality of life
with as least medications as possible
and part of that means lowering your weight naturally.
If you're overweight or obese, of course.
Look I completely disagree with fat shaming.
I'm not fatphobic.
I want my patients to live happy and healthy lives.
And many of the times,
if they're obese or morbidly obese,
I want to help them lose weight
so that they can reach their goals
and have a high quality, long life.
That being said,
if you want more information,
I have a whole nutrition playlist
for you linked down below.
If you want to watch a really funny video
to take your mind off of things,
quarantine, right now
click here for a Memes video.
Or if you want to see what started this whole thing,
check out my Responding To Tweets video right here.