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Your Primary Care Physician Is Not Qualified To Give You Fitness, Nutrition, or Supplementation Advice: Here’s Why

By: Taylor Empey ISSA – CFT, SFN, SET, Elite Trainer Level I
Over the years patients have been conditioned to believe that in order to get proper advice on how to engage in fitness, adopt a healthy diet, and understand the depths of dietary supplements, they need to consult with their primary care physician (PCP). However, as more recent research has exposed, it is becoming shockingly clear that many PCPs are far from qualified from giving any advice related to these aspects of health.
The range of PCPs and their various areas of specialization vary greatly so the exact number of these individuals who may have been fully qualified to help overweight, obese, or unhealthy patients is not entirely known.
However, to justify the claim that not all (in fact many) PCPs are not qualified to be counseling their patients in areas of fitness, nutrition, and supplementation, here are some interesting findings about the education that many physicians receive in the realm of nutrition as found in a survey that was conducted among many accredited medical schools nationwide.
“During the 2012/13 academic year 141 US medical schools were fully or provisionally accredited by the LCME. Only information about the 133 schools with a fully operational four-year curriculum at the time of the survey is included in this report. A total of 121 (91%) medical schools responded to the survey.”
The questions in the survey addressed specifically how many hours of nutritional education did medical students receive, as well as how many minimum hours were required (if any) specifically dedicated to nutrition.
“The responding medical schools reported that they provide on average 19.0 hours of nutrition
education with a standard deviation (SD) of 13.7 hours and a median of 17 hours. Over a third of the responding medical schools (43/121, 36%) reported requiring 12 or fewer hours of nutrition instruction; twelve of those institutions (9%) required none. Less than a third (35 of 121, 29%) of the responding medical schools reported that they provide at least 25 hours of nutrition education across the four-year curriculum.”
Though some schools reported higher numbers of hours for some medical students these numbers seem to be low given the amount of responsibility that is placed on doctors to provide patients with nutrition and healthy weight management advice.
“Primary care physicians overwhelmingly supported additional training (such as nutrition counseling) and practice-based changes (such as having scales report body mass index) to help them improve their obesity care. They also identified nutritionists/dietitians as the most qualified providers to care for obese patients.”
The PCPs that participated in the study ‘overwhelmingly supported’ that Licensed Nutritionists and Registered Dietitians should be who these patients should be referred to.
So, it seems the next best step for a patient to take, regarding addressing at least their nutrition behavior to begin living a healthier lifestyle, would be to consult a Registered Dietitian if studies are showing that PCPs are not qualified to be giving such advice. This seems to be the most logical professional patients should be seeking out to receive more credible education and training than from the average doctor. However, there are in fact issues with seeking out even a Registered Dietitian for nutritional counseling as well.
According to a study that was conducted surveying undergraduate students studying nutrition and dietetics it was stated that, “several studies have indicated that college students majoring in dietetics have more problems associated with food than do students majoring in other disciplines. If this is true, dietetics students may need more counseling and education on eating disorders, especially because many will eventually be counseling others professionally.”
The abstract continued and clarified that there were some students who did show positive responses and psychology oriented around their views of nutrition and their nutritional habits in relation to the questions in the survey. However, it was also found that “the results of the second survey, however, indicated that dietetics majors had significantly more negative eating patterns than did students from other majors.”
It should be noted that the study did indicate that with more experience students showed a more positive understanding and psychology oriented around nutrition behavior.
However, other research findings have revealed that individuals who have a preexisting unhealthy relationship with food are more likely to pursue education and a career in dietetics. Evidence Suggests that people majoring in dietetics have a notably higher tendency to develop or suffer from eating disorders or disordered eating behaviors.
It seems that even if a patient seeks out, or is referred to, a qualified Registered Dietitian they may still not be receiving adequate, accurate, or healthy nutrition counseling.
People then often seek out Certified Personal Trainers or Nutrition Coaches who are more prevalent in the fitness industry. However, those many individuals in this space can be highly qualified, there is no significant regulation of education and services offered in these industries.
With so many conflicting diets and protocols available on the internet, a lack of regulation in the fitness industry, unqualified primary care physicians, and registered dietitians who suffer from disordered eating patterns themselves, we as a nation are in a serious predicament when it comes to properly seeking out appropriate, healthy, personalized, and long-term sustainable nutrition advice.
Fitness and Healthcare professionals, and their prospective regulatory organizations, need to take action to remedy this problem so consumers can get the help they need safely, effectively, and from the appropriate professionals.
Bleich, S. N., Bennett, W. L., Gudzune, K. A., & Cooper, L. A. (2012). National survey of US primary care physicians’ perspectives about causes of obesity and solutions to improve care. BMJ Open,2(6).

Adams, K. M., Butsch, W. S., & Kohlmeier, M. (2015). The State of Nutrition Education at US Medical Schools. Journal of Biomedical Education,2015, 1-7.

Reinstein N., et al.  Prevalence of eating disorders among dietetics students: does nutrition education make a difference? J Am Diet Assoc. 1992 Aug; 92(8): 949-53.

W.V. Strauss, et al.   A Comparison of Dietetics Career Choice Motivators and Prevalence of Eating Disorders in a College Female Population. Journal of Academy of Nutrition and Dietetics. September 1999.

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Chronic Dieting and Focusing On Rapid Weight Loss Sets You Up For Failure

By: Taylor Empey ISSA – CFT, SFN, SET, Elite Trainer Level I

I have discussed this topic with numerous clients and individuals over the years when discussing the negative impacts of chronic dieting and unhealthy, unsustainable dieting techniques.

It is not uncommon that chronic dieters have a higher likelihood to regain lost weight after undergoing dieting techniques as compared to a non-dieter.

Studies have shown what happens when undergoing a specific dieting technique and how some individuals suffer from lower resting energy expenditure (REE) after engaging in certain unhealthy dieting techniques. This essentially means that as the participants lose weight, they may be losing some of the weight from muscle mass, which requires more energy to sustain the tissue than fat mass. Essentially, the more muscle you lose, the lower metabolic rate you will have. If you lose more weight from muscle than from fat tissue your REE will decrease further than those who lose more weight from fat vs muscle.

“In one study, three years after participants concluded a weight loss program, only 12% had kept off at least 75% of the weight they’d lost, while 40% had gained back more weight than they had originally lost.”

I have encountered many individuals who have suffered from these or similar outcomes when attempting to lose weight. Individuals are more likely to gain unhealthy weight and some gain more unhealthy weight than they originally had before they began their diet.

Our society is so heavily transfixed on focusing on ‘weight loss,’ and doing it as quickly and easily as possible. Because of this motivation, people make poor health choices in order to reach their weight goals including disordered eating behaviors, fully engaging in eating disorders, adopting poor nutrition habits, participating in numerous short-term unsustainable diet programs, engaging in excessive high intensity exercise and workouts, all while failing to address the real issues in their lives that lead them to be unhealthy in the first place.

We as a society (especially fitness companies and marketers in the industry) need to stop focusing on ‘weight loss,’ and start focusing on healthy sustainable fat loss, lean muscle development, behavior change, healthy lifestyle practices, and a healthy psychological and emotional relationship with fitness, food, and supplementation.

Grodstein F., Levine R., Troy L., Spencer T., Colditz G.A., Stampfer M.J. (1996). Three-year follow-up of participants in a commercial weight loss program. Can you keep it off? JAMA Archives of Internal Medicine. http://archinte.jamanetwork.com/article.aspx?articleid=622054

Spritzler, F. (2016). Do “diets” really just make you fatter? Authority Nutrition. https://authoritynutrition.com/do-diets-make-you-gain-weight/


Medical Treatment in the Healthcare System is Incentivized To Keep You Ill; and They’re Profiting Off It

By: Taylor Empey ISSA – CFT, SFN, SET, Elite Trainer Level I
It is apparent, given the current state of the obesity epidemic in America, that efforts to treat obesity, and other related diseases, is not working to reverse the problem. Currently the rate of development of both obesity and type 2 diabetes is still on the rise. Though some of the efforts that have been made to help treat and reverse these conditions post-diagnosis may have positive impacts, it is clearly not an effective long-term solution.
Prevention, not just post-diagnosis based treatment, is a more effective and healthier approach. This approach should be adopted in order for us to get a real handle on the situation. Medical and health professionals need to figure out more effective forms of preventative measures vs only helping patients with post-diagnosis based treatments.
However, due to the fact that the healthcare system is set up in such a way that there is no substantial financial incentive for healthcare providers to give preventative counseling (since they only get paid when patients are ill), the state of health nationwide in the United States continues to get worse overall while the healthcare system continues to make money off of treating ill patients vs keeping their patients healthy from a preventative standpoint.
It is hard to say whether a specific method of obesity prevention advice will be effective or not until the proper long-term research has been conducted, but it is clear major changes need to take place in the health care industry if we as a nation want to reverse this epidemic.
Some areas where greater improvement is needed are school lunch programs, school physical education programs, food labeling and nutritional education for children and consumers, and looking into how to approach issues like food deserts and government policies oriented around food, nutrition, and supplementation. Though some of these areas have already been addressed recently or in the past, more changes in these areas may be required to help shift these health-related epidemics in the United States.
Medical and health professionals need to start shifting their focus towards prevention, not just treatment, but due to the way these professionals are paid and incentivized this may not be as likely as ideal; doctors simply don’t make money off of healthy patients and that is the reality of the situation when it comes to the healthcare system in the United States.

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