How to Lose Weight

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Dennis, a miniature dachshund, was up to 56 pounds because someone had fed the dog a diet of White Castle burgers, pizza, ramen noodles and other human foods.  Now he loves to chase squirrels and birds, play fetch and is a spunky little spitfire.  Why? Because Dennis went on a strict diet of dry dog food and long walks.  Now he weighs 75% less.  So is this an issue of neglect?  Yes. Is this an issue of the food we eat and the lack of exercise we get.  Yes!  Though the article didnt say, I guarantee that the original owner was just as obese and unhealthy from eating the same crap.  And that is what most Americans do.  Instead of being on a strict diet, playing outside and being spunky spitfires, we are instead just couch potatoes who are nature deficient and mope all day in front of some technology (TV, XBOX, computer or smartphone).  Dennis gave us the roadmap to fix all this.  And he didn’t have gastric bypass or any expensive weight loss drugs.

 

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  12 comments for “How to Lose Weight

  1. Mark
    March 20, 2015 at 6:36 am

    Even though I saw a photo of an over weight dog along with the heading “How to lose weight”, I still expected some reference to the sport of wrestling. I always told my wrestlers the average person must run/jog 35 miles to lose 1 lb of fat. I didn’t expect them to run that distance when cutting to their desired wt class in a given week although many did. The safe answer was and still is what you put in and what you put out. Signed …..a Greyhound for life

    • Doug Farrago
      March 20, 2015 at 7:33 am

      You are still one of the best wrestling coaches I ever met. Thanks for the comment!

  2. Cat
    March 15, 2015 at 5:32 pm

    Wow Doug. I see an awful lot of over simplification and assumption compressed into so few deficient sentences with your post.

    I would love to see some pictures or supporting evidence to confirm your statements that the PREVIOUS owner was likely an obese, techno addicted slug. What was done to that dog amounts to abuse, which in my experience (vet tech, shelter volunteer, and dog trainer) is usually the result of a very misguided pet owner, thinking they love their pet and are giving them what they want. I’ll let the vets and other experts say if my impression that more often than not such owners are seniors or people where reason is compromised is valid.

    For myself, I will tell you that I am obese, with a variety of contributing health issues and I have NEVER, EVER in my entire life had an obese pet. Despite your “guarantee” I am not a techno addict, American Junk food junkie, sofa slug. At the point that I could no longer afford the assisted membership at the local YMCA where I used to swim and exercise 3 times a week it became progressively difficult for me to walk my service dog. We adjusted. More indoor play and I now have a mobility scooter that I use to exercise my dog, and I got a walker for exercising myself. Do I need to loose weight? Absolutely. Is the solution for me, as simple as getting back to nature, eating kibble, taking long walks and chasing squirrels? If only.

    Your over simplified statements paint with a broad brush of monumental proportions that must indeed be heavy to lift. How you read the article and jumped to conclusions of such limited perspective and understanding on the subject you address is stunning. All the more so, since as an educated and intelligent person and MD, you surely know that there is so much more to any of the many facets that are indicated.

    Furthermore, the life saving changes for Denis the Dog, is directly related to the fact that he no longer lives in the same home and is cared for by another person entirely. Not a simple shift, but an uprooting, complete life changing experience that I “guarantee” included some amount of grief at being separated from his previous owners, intensive efforts at retraining and correcting the problems, included at least one vet or more providing support and guidance and as clearly stated in the article, included surgeries after the fact to deal with the excess skin and accompanying infections.

    • Doug Farrago
      March 15, 2015 at 6:45 pm

      I am sorry you took this personally. That was your choice. I was talking about this case and I will still stick to my assumption. The owner had to be eating the same stuff and hence, the dog suffered consequences. Yes, obesity is multifactorial and not a laughing matter. I made no jokes in this blog post. This dog was GROSSLY obese. And no, losing weight is not easy but is eating better, eating less, taking long walks and playing outside healthy for people? Yup. And as far as being a techno addict…we all are and it is probably killing us more than we know.

      • Melinda
        March 15, 2015 at 9:02 pm

        Actually, Cat has some good points. Not every owner of an obese animal is obese, and vice versa. I recall a client who used to bring in her Springer Spaniel that was seriously obese and gaining. She, herself, was slender–and single with grown children that did not live at home. After having the weight discussion a few times and frustrating the owner immensely, I started to think the owner was going to leave our practice over it. It came to light that the owner had taken her mother in to live with her, and the mother had mild dementia. The mother had bonded with the dog as her best friend, especially since the owner was at work all day. The owner had had numerous talks with the mother about not feeding the dog treats and table food, including “HER VETERINARIAN SAYS…”, but the mother would not stop. The owner tried only keeping smaller treats in the house, but the mother would just give more. Finally the owner started putting limits on treats rather than saying 100% no, and leaving out the allowed number per day, but the mother kept getting out more, finding them even when the owner hid them or buying more herself at a nearby store. She couldn’t remember having given the dog a treat 1 minute after giving one and so would give another and another, then share lunch leftovers, etc.…. The dog reached 85# and the owner and I had a long discussion about the fact that we were on the same side of the problem, not enemies; nothing could be done about the mother, the dog could not go to another home because the mother needed the companionship, and the mother was more important than the dog. If the dog had a short life, at least it was enjoyed and kept the mother happy; in short, the dog’s health was being sacrificed to the needs of the mother, as other animals are used for human purposes, too. After a few years the mother died. The dog got back down to 42# and lived a normal rest of her life–with the same owner. Although veterinarians have had an adage since at least the 80’s of “Never tell a fat person their pet is fat,” owner and pet obesity are not always coupled together.

      • Cat
        March 15, 2015 at 9:18 pm

        Sorry, you are mistaken that I took your post personally. I use myself as a verifiable example that your assumptions on various levels are broad and lacking perspective. Clearly as an MD you focus on people. I get that. I get why you would assume that the dogs previous owner is eating the same craptastic fare as they were feeding their dog. However; that assumption is flawed in that you seem to be saying Obese dog = obese owner and by correlation would equate to obese owner = obese dog. My own example serves to prove the reverse is not true and I offer the perspective that in my experience your assumption is flawed. I quite simply have seen far too many owners of obese pets that do not fit with your assumptions. That yes, indeed, owners of obese pets do feed their animals things they do not eat.

        It is far too easy for misguided pet owners to allow their pets to train them. Just like the many contributing factors for human obesity, onset can stem from a variety of issues and circumstances. Too often, a finicky eater is accommodated and before long the owner complains that the animal will not eat anything else, and they love their pet and can’t bare to see them suffer… And yes, they will literally accommodate the pet with foods the pet prefers. Situations of a senior that can barely make ends meet at the end of the month, but feed their pets specially cooked chicken or steak, take the dog to a drive through to order only for the dog.., are well documented.

        Does it also happen the way you assume? No doubt, but I am suggesting it happens far less than you might think. Enough to skew the validity of your assumed relation in the matter.

        No, you did not make jokes about issues surrounding obesity. I did. Partly a jest because well, I live with a sense of humor that I freely express especially when so much in life is laugh or cry. Apologies if it seemed in poor taste. The jest is also in part, my expression of dearly wishing the answers were so simple. Certainly eating better, eating less, taking long walks and playing outside is healthy for people. Just as proper feeding, care, training and understanding of our pets is important. But again, I use myself as example, not as in taking it personally; there is so much more to each of those aspects. Hence I opine that your stated solution is over simplified and fails to consider the reality of the situation for a significant majority in both pet ownership/guardianship and being a healthy human being.

        Yes, the technology is here to stay and evolve. Yes it makes it far too easy to exercise our fingers and our minds rather than our whole bodies. (the fact that too many fail to exercise their minds on the internet aside) 😉

        In terms of that technology and my opinion of your stated opinion, your post appeared on FB, posted by another Dr, I know and respect. I freely admit that I have a respect for doctors and perhaps an unfair assumption or expectation that doctors have a greater social responsibility, that should extend to the use of the written word that is publicly available. In that regard, I found your post over simplified and your stated rational flawed.

        I have looked at your website, and read other posts. I don’t disagree with you on many things. But, in this instance, and the very public nature of the shared information, I think the over simplification and edited presentation of the issues is a disservice to the issue of obese pets, people and yourself. Perhaps unfair and judgmental on my part, but it was very public, you do invite comment and even dissent and I feel strongly enough on the multiple subjects to take you up on your offer.

        Thank you for being open enough to allow comments and intellectual exchange.

        • Doug Farrago
          March 16, 2015 at 1:45 pm

          I am not always right. 🙂 This blog is just random thoughts from an idiot (me)
          “The only true wisdom is in knowing you know nothing.” – Socrates

  3. Doug Farrago
    March 15, 2015 at 1:01 pm

    LOL

  4. Pat
    March 15, 2015 at 12:05 pm

    Doug, I’m calling BS. Your comments are incredibly insensitive, given the virtual epidemic of fat shaming that US pets are documented to suffer. Non-human family members’ self-perception, and the growing rates of body dysmorphic disorder being reported by veterinarians is no laughing matter. Moreover, with the tightening airline economics, certain animals are being singled out for discriminatory rates based simply on weight, leading to further cycles of stigmatization and mandatory crate-upgrade fees which are simply beyond the means of some ticket purchasers.

    Moreover, your assumptions that a dog would want to “chase squirrels” and be a “spunky spitfire” propagate typical, but unnecessarily restrictive stereotypes that do not allow for a non-human family member’s greater potential range of expression. Dennis’ case deserves a mature, compassionate, team-based approach that looks beyond the mere simplistic input/output paradigm, and can more properly assess the psycho-social stressors and possibly disparate influences that may have led to this problem, if indeed it even is one. While surgery might ultimately be unnecessary, it is callous of you to so quickly remove that option from the table, as well as stimulants in order to help Dennis to endure the least discomfort possible. Moreover, those potential additional expenses could appropriately meet the threshold for state assistance in the form of mechanical ambulatory devices, home modification improvements, and disability subsidies, not to mention any additional tax ramifications for the home’s bill payer. Further, Dennis may still be suffering the chronic pain and inflammation that would suggest an ongoing relationship with pain management, and possibly social and/or spiritual support.

    This case should not represent yet another opportunity for fat shaming, as you have seen it, but a way to illuminate an often unfortunate reality, and begin a national conversation on the best way to help the other Dennis’es of the world. Before it’s too late.

    • Melinda
      March 15, 2015 at 4:26 pm

      Oh, dear Lord! That is so funny! What’s even worse is knowing that we veterinarians have clients that would take all of that seriously and want to start all that up for their pets!!!

      • Steve O'
        March 16, 2015 at 9:19 am

        I am struck by the sentence ” Non-human family members’ self-perception, and the growing rates of body dysmorphic disorder being reported by veterinarians is no laughing matter. ”
        I am a pet owner, but I do not see that level of cogitation in my pets. I unashamedly admit that much of the complexity of our relationship lies in my own imagination. I do enjoy them immensely; we greet each other eagerly after a long separation, and enjoy relaxing togetherness on the couch after a long day. My pets are animate, sapient and they mentate. They do not have complex inner lives to the degree that humans do.
        As we anthropomorphize animals, we disparage other humans.
        “Moreover, those potential additional expenses (for Dennis) could appropriately meet the threshold for state assistance in the form of mechanical ambulatory devices, home modification improvements, and disability subsidies, not to mention any additional tax ramifications for the home’s bill payer.” At this point, I beg that the writer is spoofing us with irony. The generous gift of all to everybody is the gift of nothing to anybody. That concept merely projects one’s own guilt onto others. We feed our narcissistic fantasy of goodness with a, abundant helping of paranoia – “All the world would be GOOD if it weren’t for the BAD people!”
        I ask Melinda’s thought on the direction of 21st century American healthcare. Do you see human medicine as racing towards large-animal commercial veterinary medicine? I certainly do. As so few animals live independently, or have the financial means to underwrite their own care, their care is “rationed” by the owner’s choice. Are we not pretending to invent the same approach to human medicine? Some greater and wise MIND ought to decide what care we will receive, based upon rational best practices. However, unless some greater alien civilization comes to Earth to run our human zoo, we are stuck running it ourselves. As the science fiction stories often warn us, if another species sees how we run our human zoo, they might shut us down for gross negligence. So be it.

        • Melinda
          March 16, 2015 at 11:36 pm

          You are exactly right, Steve O’, when you said, “I am a pet owner, but I do not see that level of cogitation in my pets. I unashamedly admit that much of the complexity of our relationship lies in my own imagination.” The statement you were responding to, “Non-human family members’ self-perception, and the growing rates of body dysmorphic disorder being reported by veterinarians is no laughing matter.” was made in complete jest, and my comment, “What’s even worse is knowing that we veterinarians have clients that would take all of that seriously and want to start all that up for their pets!!!” was about exactly what you expounded upon–the fact that pets do NOT have that level of cognition but so many owners anthropomorphize them to believe that they do and these owners (fortunately a small percentage, but very noticeable) would want exactly all of the pertinent services for their pets as a human would have available to them! You make my point precisely!

          As to where human medicine is going, well, I’m certainly no expert on human medicine. (In fact, I’m currently being treated for stage IIIC ovarian cancer and, although a lot of human medicine is similar enough to veterinary, I really know what’s going on with my own care, there is one heckuva lot of difference between human and animal medicine!) I don’t think I can fully predict where veterinary medicine is going right now, between super-high indebtedness for new grads (hundreds of thousands) with poor starting salaries (around $50-60K) that don’t rise much and pet stores and online sources offering cheap veterinary services suggesting the future is lousy vs. increased spending on pets with specialists in every discipline at fees worthy of their specialties, and pet insurance becoming more common, offering people some ability to pay these higher costs yet potentially heading toward controlling veterinarians as human health insurance controls MDs.

          I constantly feel great sympathy for MDs with all of the EMR issues, administrators, reporting, restrictions, control by insurance companies, etc–all the stuff Doug is constantly helping MDs be aware of, rather than just having that sinking feeling that “something is rotten in Denmark but I’m not exactly sure what it is.” I fear that it is heading where you suspect, but optimistically hope something will “give”, or perhaps aging legislators will start to have aging issues themselves and start to realize that “aged lives matter, too”, and even with decent insurance, not all is well, and if some go on Medicare or have close friends and relatives that go on it, and they can’t find doctors who accept it, and have lousy care coverage, and pay a premium if they delayed going on Medicare because they had better insurance for awhile, etc. etc. Perhaps somewhere along the way the camel’s back will break and the system will be forced to have some changes that are acceptable to doctors, lest we end up with the LEAST qualified and least smart in our population being the only ones willing to become MDs because it is all work and risk and no pay.

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