Physician pushes back against simplistic ideas about diet and exercise
PHOTO BY DR. SPENCER NADOLSKY-WWW.DRSPENCER.COM
Spencer Nadolsky, D.O., is the kid every dad wants his son to grow up to be: a star athlete (as a heavyweight wrestler at North Carolina, he was at one time ranked fourth in the country) who was also a star student (academic all-American) and is now a doctor who constantly tests his own limits, jumping from bodybuilding to triathlon and from vegan to ketogenic diets. (He details his experiments at drspencer.com.)
He’s also a family-practice physician and obesity specialist, which means he spends a lot more time with overweight and obese patients than the average guy with sub-10 percent body fat.
The first thing he learned? “Those with obesity aren’t inherently lazy,” he says. “Losing weight and keeping it off are actually really tough. Only a small percentage is able to do it.”
Which leads him to a crucial insight: Telling people who struggle with their weight to “eat less and move more” is absurd. In fact, check out the cartoon he created to hammer home this point.
PHOTO BY DR. SPENCER NADOLSKY-WWW.DRSPENCER.COM
Dr. Nadolsky contends that if this is really all it took, we wouldn’t have an obesity problem. Instead, he’s learned to look beyond what people know they should do, and what they’re already trying to do, and figure out why it isn’t working for them.
Genes are a consideration. So is their upbringing—how they were raised, and what they grew up eating. The combination of those two factors might predispose a person to simply be hungrier than the rest of us.
“I’ve had patients swear they’re only eating 1,200 calories,” he says. Just by looking at them he can tell they’re underreporting. But when he digs deeper he learns the patient’s hunger overrides any attempt to cut back.
“You put them on an appetite suppressant and all of a sudden they have an easier time adhering to the diet. These aren’t anti-lazy pills. They allow them to not feel miserable when eating less.”
But prescription drugs can be expensive, which brings up another common problem: money. The less of it you have, the less you can spend on medicine or gym memberships. Individual coaching is out of the question. Life is more stressful, and when you’re feeling that kind of pressure day after day, it’s hard to cope with the added stress of exercise and a lower-calorie diet.
Related: The Lose Your Spare Tire Program
That’s why one of his key recommendations is to find an online support group, where you can benefit from others’ experiences, or just vent about your own with people who can relate.
What never works is fat shaming, or accusing people of not having the fortitude of someone who’s been in shape his entire life—someone like Dr. Nadolsky, for example.
“They aren’t lacking willpower,” he says. “We have to realize that not everyone is the same, and telling someone just to ‘eat less and move more’ is awful advice.”
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