Eating out on low carb diet
I was 27 years old, living in Palo Alto, California with my best friends, I had a wonderful girlfriend, I was working hard to prepare for my application to a surgical residency, and I still found time to work out like a wannabe Olympian. Of course, not everyone (fortunately) was born with my level of genetic susceptibility to insulin resistance (stated another way, not everyone is born with my level of carbohydrate sensitivity). Dr. In my experience, about 10-20% of the population (my lucky wife included) seem resistant to carbohydrates and maintain exquisite insulin sensitivity, almost independent of diet. Remember, I was one of those doctors in the mainstream once upon a time. As my third year of medical school was winding down, and I was just about to embark on a bold fourth year curriculum of back-to-back-to-back-to-back surgical sub-internships, I was on top of the world. After struggling for some time I had to call my roommate to get me out of bed and help me to the bathroom. A few days later I managed to limp my way into the hospital for rounds and with the help of the residents and nurses who were kind enough to give me intramuscular injections of a potent drug called toradol, I was able to survive, just barely. S. I iced my back, took some ibuprofen, and went to bed. Within a few more days, not only was my back hurting, but I was also experiencing profound sensory pain in my left leg and left foot. , it must sound crazy to think that a patient could have a MRI scan so quickly). Within about 3 weeks of this back and leg pain, I was starting to worry that something very serious was going on. After a thorough exam, the physician sent me to the MRI scanner (for those of you reading this outside of the U. Bray is generally regarded as one of the most erudite authorities on obesity in the United States, while Ms. In other words, overweight people are not the lazy, constantly grazing, weak-willed individuals many in the mainstream have led us to believe.
I find myself getting asked this question, or some variant of this question, with increasing frequency as I speak and write about the Alternative Hypothesis I find most compelling surrounding obesity and chronic disease. Only when I realized, despite my diet which rigorously adhered to formal recommendations and my 3 to 4 hours of exercise per day, that even I was getting too fat for comfort, did I begin to question the Conventional Wisdom of why we get fat. Beyond being asked this question, personally (and frequently), one can see the same logic in the academic literature (see comment by George Bray in Obesity Reviews ) and in the press (see comment by Gina Kolata in the New York Times ). I realize this may sound hyperbolic, but I am not exaggerating at all when I say it felt like the skin was being torn off the bottom of my left foot. Bray and Kolata are both smart and thoughtful people who have devoted much of their lives to thinking about this problem. They just eat the wrong foods (rather than simply too much food). While I always tried (and hopefully succeeded most of the time) to treat overweight patients with respect, I silently judged them. When the ice melted, I would wake up in pain and need to repeat the routine. The next morning I woke up only to realize I literally could not get out of bed. The only way I could sleep was to tie my left foot in a plastic bag of ice to numb it and take 100 mg of Benadryl (enough to put a horse to sleep). Roughly 30-40% of the population are, conversely, very sensitive to carbohydrates and appear to be quite insulin resistant until nearly the last gram of sugar and most carbohydrates are removed from their diets. One sunny, June afternoon I got out of the pool after a good workout and felt a very strange pain in my lower back. Nor was I fine the day after or the day after. Then there is the rest of population, which includes me. I never made the connection until this week when a reader asked an unrelated question about lower back pain.
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