Why I traded in Family Medicine to become a Weight Management Physician

 
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1-50 minute lecture. 1 lecture was what I had in medical school training devoted to nutrition. I remember it so vividly today – we were taught about the benefits of dietary plans on diabetes, cholesterol and weight management by Dr. David Jenkins – Toronto’s very own endocrinologist and researcher who coined the term Glycemic Index. I wanted more! How could it be that of the hundreds of lecture hours in our medical curriculum, we could only afford to give just one lecture to lifestyle modifications to prevent so many of the chronic disease conditions that plague our population?

My desire to focus my practice on weight management stems from my observations that most family physicians are superstars at providing sound medical advice for diagnoses of conditions related to weight (ie high blood pressure, high cholesterol etc), but that we’re limited in our ability to provide lifestyle counseling to patients about how to reduce the risk of progressive weight gain that leads to those conditions in the first place. This isn’t new information – Lifestyle recommendations for chronic disease prevention is skimmed over in the North American medical school curriculum; consequently, many family physicians lack confidence in counseling on lifestyle interventions despite its recognized importance according to Stats Canada (reference below). I performed my own pilot study in residency which was consistent with this – 80% of residents felt that they were inadequate at counseling patients about nutrition and exercise.

It’s not the fault of physicians – the root of the problem is a system that doesn’t permit time or a foundation of knowledge about nutrition, exercise or medication counseling regarding progressive weight gain. It also stems from the fact that society deems overweight and obesity to be a lifestyle condition, that can be simply fixed by a commercial weight loss diet alone. That couldn’t be farther from the truth. Obesity is a chronic, progressive, medical condition that is rooted in complex pathophysiology.

In medical school, we are taught the ins and outs of chronic disease, and we learn to a great depth the medical approaches that we can use to treat. For instance, a patient who presents with high blood pressure: diagnosis requires repeated measurements, prescription of an antihypertensive, and brief counseling of dietary measures. Commonly documented lifestyle tips are “150 minutes of moderate to vigorous exercise per week, DASH diet, weight loss”. Despite the ease of briefly informing a patient to “eat less, move more”, it can be extremely daunting for a patient to demotivating for a patient to digest in the absence of real support.

Lifestyle recommendations for both prevention and management of chronic disease are skimmed over in the North American medical school curriculum; consequently, many family physicians lack confidence in counseling on lifestyle interventions despite its recognized importance according to Stats Canada (reference below).

A pilot study I performed in my residency program demonstrated that family medicine residents regard lifestyle counseling education such as nutrition to be lacking, and desire this to be taught in training. One of the very foundational pieces to longevity and good health (irrespective of genes, environment, etc) is under-taught!

My transition from Family Medicine to Obesity Medicine is my attempt to bridge that gap. My aim is to distill preventable and actionable tips for weight control, whether its nutrition, exercise and mental strategies that I share with my own patients – from both evidence-based research and my personal trials.

It is my hope that you find this site to be pleasureful, helpful and inspiring for weight control for everyday living!

In good health,

Dr. Sandy

 
Sandy Van