Frustration: A Tale of the “Good” Doctor

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by PAUL KLEIN, Co-owner of CrossFit 77

Allow me to start with an edited scene from the hit movie Pulp Fiction:

Vincent: I got a threshold, Jules. I got a threshold for the abuse that I will take. Now, right now, I’m a racecar, right, and you got me the red. And I’m just sayin’, I’m just sayin’ that it’s dangerous to have a racecar in the red. That’s all. I could blow.

Jules: Oh! Oh! You ready to blow?

Vincent: Yeah, I’m ready to blow.

Jules: Well, I’m a mushroom-cloud-layin’ mother******, mother******! Every time my fingers touch brain, I’m Superfly T.N.T.; I’m the Guns of the Navarone!

That is me right now, I feel like Superfly T.N.T., the Guns of the Navarone, a racecar in the red, ready to blow. For the first time, I had to part ways with a personal programming client. The reason is so appalling that I need some time to vent my frustration.

Evaluating the Client

Evaluating the Client

What this guy needed was a diet that will help control his hunger, stimulate his metabolism and at the same time help balance his hormone deficiency. For workouts, he needs to lift heavy weight and walk.
I will spare all the details, but it starts with a male weight loss client. In his initial evaluation, he weighed over 300#; the fat caliper score was alarming with his pec site being more than double the tricep site (an indication of low testosterone); and his tape measurements at the waist and hips were both over 50″. What this guy needed was a diet that will help control his hunger, stimulate his metabolism and at the same time help balance his hormone deficiency. For workouts, he needs to lift heavy weight and walk. That is it. The goal should be to build muscle, which will help increase his testosterone levels and increase his metabolic rate. He doesn’t need to run, jump, or anything with intensity. And he especially doesn’t need to be on an extreme starvation diet with zero fat. His body is already stressed. Why add to that stress?

Enter the family physician. After a check up with his family doctor, blood work revealed just what we had suspected: he is pre-diabetic and has low testosterone. Here is where my anger starts. The doctor decides that the best thing for this guy is to be on an extremely low-calorie, zero-fat diet. And by “low-calorie” I mean 500 calories per day. Think about that!: 500 calories a day for a 300-pound male with low testosterone. When I asked about how hungry he would get, he said it wouldn’t be a problem because the “good” doctor also prescribed an appetite suppressant.

A Prescription for Failure

Along with 500 calories, this starvation diet also has a whopping zero grams of fat, despite the fact that studies have shown low fat diets lower testosterone.

I told this client that if he chose to follow this protocol, I wouldn’t be able to sleep at night if I programmed workouts for him.

500 calories a day, with a macronutrient breakdown of:

  • 50g of protein,
  • 0 grams of fat
  • 50 grams of carbs.

This isn’t enough fuel for him to get an erection! Much less build muscle.

I wouldn’t even be comfortable asking this guy to walk around the block. I promptly told him that he needed to FIRE his doctor and find one who wasn’t completely ignorant to nutrition and its affects to the body. When I voiced my concerns, he informed me that he respected my opinion but that he was going to listen to his doctor.

So we parted ways.

What angers me the most is that this guy ISN’T being put on a path to success. A 500-calorie diet with appetite suppressants is a recipe for failure. In more ways than one. My prediction for him is as follows:

The list could go on and on. Before long, this poor guy is on a list of prescriptions that need a little daily pill organizer box. And this is all assuming that the Dr. hasn’t put this guy on a statin, which could send him down a rabbit hole of side effects that may be impossible to recover from. Does a doctor like this ever consider these scenarios? We can even forget the list of pills for a second. How do you transition a guy from a 500-calorie a day diet back to a normal life? It is a doomed scenario for this guy: he will most likely go from this starvation plan right back to a diet of chips, diet soda, and Jiffy peanut butter. Only this time, he will have no muscle mass to help with the metabolism. Which will make gaining back the fat a very likely situation.

Nice job leading your patient to success, Doctor!

Does Doctor Really Know Best?

Does Doctor Really Know Best?
Here at 77, we work our tails off promoting lifestyle changes as the answer to long-term health and fitness. We live what we preach. This may make us sound conceited, but it’s the truth and it shows.

Looking for an answer: Despite all our success with clients, we will always be trumped by the recommendations of a doctor. Even if it is a ludicrous as a 500-calorie a day diet with appetite suppressants.
I never ask a client to do something that I don’t or haven’t done myself.

I can only wonder what this doctor looks like. Is he practicing what he preaches? Is the “good” doctor sub 15% body fat with stellar blood work? Or is he reflection of his clients?

I would love to know how many lasting weight loss success stories he has versus how many yo-yo dieters he has created. The odds are good that all he can show is a list of patients who are a tax on the health care system because he never took the time to show them a correct and healthy path to success.

Despite all our success with clients, we will always be trumped by the recommendations of a doctor. Even if it is a ludicrous as a 500-calorie a day diet with appetite suppressants. So what do we do? We have an army of people that we feel 100% confident in referring clients to for help. Want a good massage? We have two of the best in the business. Need a chiropractor that does the best soft tissue work in the area? We will give you his card. Got a baby on the way? We have an ob/gyn who won’t steer you wrong. But if you need a family doctor…damn it. I have nothing for you.

How bad is it? I have been referring people to a place in Reno, Nevada that I trust will give sound advice. Think about how crazy that is — there are family doctors on every corner here in North Carolina, and I would rather send someone to do a Skype call with a doctor on the other side of the country. What is the answer? More patient education? More nutrition education for doctors? Less pharmaceutical sales influence in the doctors’ offices? Or maybe, someone reading this knows of a family doctor who is not just a pill pusher and will email us his contact information? God, I hope that is the case, because I am out of ideas and I am running in the red. And we all know what results from running in the red.

Paul Klein is the co-owner/head trainer at CrossFit 77 in Mooresville, NC. 

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