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Karl Popper (1902 - 1994; regarded as one of the greatest philosophers of science of the 20th century)

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    Sunday, May 28, 2017

    STRESS

    ​Compromise and Lowering Stress

    I have read, but seen no scientific proof, that emotional stress itself can make people gain weight. The proposed mechanism is that stress makes the adrenal gland produce more cortisol. Cortisol causes the liver to release more glucose. Elevated glucose triggers insulin. High insulin causes  obesity.


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    Posted by Michael Anchors, MD, PhD on Sun, May 28, 2017 11:36 am | [0] comments

    Tuesday, May 09, 2017

    BREAD

    Dave’s Bread

    Late last year I changed order #3, which used to read “Eat less starch and sweets”. I was embarrassed about that order because I knew it can’t be right. In China and India, the two leanest nations, people eat lots of starch in the form of rice and potatoes. They just eat few sweets. So non-sweet carbs by themselves must be okay. 

    The thing to really avoid is (1) sugar and (2) sweeteners regardless of calories and (3) white bread, because these things vigorously drive up insulin without satisfying hunger. Fatness is not about calories, friends; it is about insulin. Read The Obesity Code by Jason Fung MD.


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    Posted by Michael Anchors, MD, PhD on Tue, May 09, 2017 2:24 pm | [0] comments

    Tuesday, May 02, 2017

    DIETING

    ​Yo Yo Dieting

    Last week an article in the New England Journal of Medicine furnished evidence that yo yo dieting increases the chance of a heart attack or stroke. You should not believe this right away because the data were epidemiological, i.e. there was an association between yo yo dieting and heart attack, but association does not prove causation. It might have been for instance that yo yo dieters ate more sugar than no yos or did less exercise. The “dieters” may not have even been dieters at all; the study wasn’t even about yo yo dieting; the data were extracted from a study of Lipitor’s effect on heart disease. The authors merely remarked that people in the study whose weight varied a lot were more prone to heart attack. But weight can vary for many reasons other than dieting.

    Nevertheless, it is beyond doubt that each time you lose weight and regain, it is more difficult to lose weight the next time. Yo yoing leads to insulin resistance. 

    Sometimes patients, returning many times, complain that the phen-pro medicines aren’t working like they used to. Usually the problem is not the medicines; it’s yo yoing.


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    Posted by Michael Anchors, MD, PhD on Tue, May 02, 2017 1:23 pm | [0] comments

    Sunday, April 23, 2017

    ​The Parable of the Two Dogs

    I have two dogs of the same breed, Sam and Lulu. Sam is 8 years old, Lulu 3. Sam weighs 88 lb. He is overweight by the charts. I can’t feel his ribs, a standard way to tell if a dog is overweight. Lulu weighs 50 lb, normal by the charts; I can feel her ribs. Sam gets more exercise than Lulu. I feed Sam 50-70% of the amount I feed Lulu at each meal, using the same food. They have no other source of food. Their relative weights are not changing. Neither dog is sick, and their blood tests are normal.

    What can you learn from this true story? The answer is not a trick, and you ought to understand it after reading the two previous MOWs.


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    Posted by Michael Anchors, MD, PhD on Sun, Apr 23, 2017 12:56 pm | [0] comments

    Thursday, April 13, 2017

    DON’T JUDGE PEOPLE

    ​Judge Not

    The books I’ve recently read have made me aware, again, how complex obesity is. My god, there are viruses that may make you fat, genes, bacteria, ethnicity, age, gender. Most of my patients lose some weight and keep it off, but there is variation. Some lose a lot, some lose a little, a few lose none. Some keep it off, some regain. Some are not following my Ten Orders, others are. Some ‘fess up, others lie. Some think they are not following the orders even when they really are. They assume that if they are not losing weight, THEY must be at fault. 

    They might be. They may not be. It may even be MY fault. It’s just all so darn complicated.


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    Posted by Michael Anchors, MD, PhD on Thu, Apr 13, 2017 12:12 pm | [0] comments

    Wednesday, March 22, 2017

    FAT

    ​New Thinking

    When people walk into my office wanting to lose weight, almost everything they know about fat is wrong. Their first article of faith is that fat is bad for you, either as a food or on your body. WRONG. The second article is that to lose weight you must either eat less or exercise more. WRONG. If you gained weight back, it was because you ate more or stopped exercising. OFTEN WRONG. The whole matter is so much more complex. Read The Secret Life of Fat by Sylvia Tara or The Obesity Code by Jason Fung. Read something. Your doctor hasn’t read anything, because they are not paid to study, don’t expect to, and don’t know how to. The drug companies rule.


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    Posted by Michael Anchors, MD, PhD on Wed, Mar 22, 2017 1:13 pm | [0] comments

    Tuesday, February 21, 2017

    COFFEE

    Coffee

    ​While on phentermine, patients should not drink regular coffee. Phentermine is a stimulant and caffeine is a stimulant. Taken together, they increase the chance for nervousness, palpitations and poor sleep. Besides that, people tend to put a lot of sugar or sweetener in coffee, and we were trying to cut down on sugar. That’s was the main point these days.

    I don’t care about the caffeine in tea or chocolate. There is so much less caffeine in brewed tea. Interestingly there is just as much caffeine in an ounce of tea leaves as in an ounce of ground coffee beans; but you use so much less tea leaves to make a cup of tea than beans to make coffee.

    You may drink decaff coffee. Here are some things I have heard patients say.


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    Posted by Michael Anchors, MD, PhD on Tue, Feb 21, 2017 11:59 am | [0] comments

    Tuesday, February 14, 2017

    FAST FOOD

    Fast Food

    ​When asked to give examples of fattening food, most patients list “fast food” first, meaning things such as KFC and McDonalds. I bet most of my patients have a fast food meal once or several times a week. When I pass such places on the road, there are always long lines of cars in the take-out lane. I assume most of these meals are eaten in the car.

    When I ask patients why fast food is fattening, their first answer is because it contains so much fat. Even people coming for a fourth visit, people who have been told many times that it is sugar, sweeteners and refined (white) flour that cause obesity, they still make the mistake of blaming fat. Old (mental) habits die hard–if ever at all. All of you should be reading The Obesity Code by Jason Fung MD.

    I don’t know of any prospective studies testing whether fast food is fattening, but assuming it is, I lay the fault to the following...


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    Posted by Michael Anchors, MD, PhD on Tue, Feb 14, 2017 7:24 pm | [0] comments

    Monday, January 16, 2017

    Beverages Are Food Too

    Many people who have trouble losing weight don’t think to count beverages when they total up the amount they consume each day. Losing weight is all about keeping the insulin level low between meals. Anything sweet, solid or liquid, drives insulin level up and prevents weight loss.

    You have to be aware of how many sweet drinks you take in.

    And how big. All our sodas and coffees are obscenely huge.

    Between meals you must find something to do to entertain your hands and your mouth, other than smoking, eating or drinking. Try reading a book or talking to a friend or playing a game.


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    Posted by Michael Anchors, MD, PhD on Mon, Jan 16, 2017 8:32 am | [0] comments

    Monday, November 28, 2016

    PHEN-PRO

    Phen-Pro No Longer Means Phentermine-Prozac

    A weight-loss doctor in Texas has acquired the trademark to the word "phen-pro" so I will no longer use that word. His product contains neither phentermine nor Prozac. I have no direct knowledge whether his "phen-pro" named product works. 

    For many years I had the use patent for the phentermine-Prozac combination, but I never acquired the trademark because I was not producing phentermine-Prozac pills. There is published evidence from me and other doctors that Prozac enhances the weight-loss action of phentermine, but the most important thing is not the pills--it's the Ten Orders.


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    Posted by Michael Anchors, MD, PhD on Mon, Nov 28, 2016 6:22 pm | [0] comments

    Thursday, November 03, 2016

    OBESITY MYTHS

    Eating And Exercise Are Strongly Linked

    Last week I read Gary Taubes’ wonderful book How We Get Fat and What To Do About It (2010). The book taught me nothing new, but I admired the clear way Gary expressed things. In particular he reminded me that it is impossible to lose weight by eating less or exercising more. Because of insulin, if you exercise more, you WILL eat more. If you eat less, you WILL move less. You cannot overcome it with willpower.

    Pause for a moment to consider how much of what most people and doctors “know” is bullcorn.  I continue to be amazed by it. Science and math, reading, are the only things on which you can rely. What people only tell you is worthless.


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    Posted by Michael Anchors, MD, PhD on Thu, Nov 03, 2016 9:32 am | [0] comments

    Monday, September 12, 2016

    KIDNEY STONES

    ​Colas and Kidney Stones

    For years I have been telling dieters to avoid “diet” sodas because the artificial sweetener in them is too sweet. Sweet flavor itself raises insulin, blocking weight loss. Dieters would be better off with the high fructose corn syrup in regular Coke than with the aspartame in Diet Coke, or so I thought.

    Now I must modify that advice. Overconsumption of cola-type drinks increases the occurrence of kidney stones, and that fact is especially true of the type sweetened with high-fructose corn syrup. The intake of fructose increases the urinary excretion of calcium and oxalate. Ninety per cent of kidney stones are composed of calcium oxalate. Moreover cola-type sodas, diet or non, contain phosphoric acid. Phosphate contributes to starting stones. Fresca and Sprite don’t have phosphate, but they are still fraught with the fructose issue. 


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    Posted by Michael Anchors, MD, PhD on Mon, Sep 12, 2016 11:39 am | [0] comments

    Wednesday, August 17, 2016

    WEIGHT LOSS TIPS

    ​French Fries Aren’t French

    Americans combine french fries with many things. For a dollar extra Dunkin Donuts will give you an order of fries with your donut! As far as losing weight, I don’t care if you eat fries as part of a meal, as long as you don’t eat a lot of them and you don’t eat fries as a snack. They strongly raise insulin; we are trying to keep insulin low between meals. 


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    Posted by Michael Anchors, MD, PhD on Wed, Aug 17, 2016 3:14 pm | [0] comments

    Wednesday, July 06, 2016

    Meaningless Words

    Patients use a lot of meaningless words, as though mere talking is enough. For example they are eager to tell me they eat “healthy”. I have no idea what they mean. The word “healthy”, an adjective, means ‘not sick’. So are they saying they eat not-sick? What does that mean?

    When pressed on the “healthy” issue, they used to tell me they ate low-fat foods and avoided red meat. Now they have absorbed enough news media to know that red meat is okay (TIME magazine June 23, 2014 and November 9, 2016); carbs are the real problem. But recently they have started telling me they avoid “processed” food. Other than a few fruits, aren’t all foods processed before being eaten? I’m confused.


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    Posted by Michael Anchors, MD, PhD on Wed, Jul 06, 2016 11:54 am | [0] comments

    Tuesday, April 19, 2016

    HEALTHY WEIGHT

    ​Lowering Standards

    In the office I often say, “Late last year I took an important step that tremendously improved my rate of success. I lowered my standards. I decided I am not trying to make women skinny anymore. There is no reason to do it. Men don’t want women to be skinny. GI Joe doesn’t want Barbie to look like this.”

    I show off a Barbie doll.


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    Posted by Michael Anchors, MD, PhD on Tue, Apr 19, 2016 9:16 am | [0] comments

    Saturday, April 16, 2016

    What Dogs Have Taught Me

    My sister is my main helper, taking the initial history on new patients, and she is a dog lover. When I get the chart, it always has information on the patient’s pets. I didn’t ask for this, but it has had a useful result–I have noticed that all the dogs and most of the cats of obese patients are themselves obese. This confirms that animals presented with an excess of food will overeat. I suppose we should not have expected the majority of people to be any different. 


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    Posted by Michael Anchors, MD, PhD on Sat, Apr 16, 2016 10:30 am | [0] comments

    Thursday, April 07, 2016

    BMI

    ​BMI Should Not Be Used For Individuals

    Body mass index or BMI is the weight in kilograms divided by the square of the height in centimeters. To calculate BMI using pounds and inches, multiply the product by 703. The BMI was invented by Belgian statistician Adolphe Quatelet in the 19th century for use in population studies. He never intended it to be used for individual people, because it says nothing about body shape or composition.

    ​Before 1990 doctors and insurance companies used tables of weight versus height, one for men and another for women, based on simple actuarial statistics, to determine who was at risk. In 1998 the NIH went over to BMI in order to present info on both sexes in the same brightly colored diagrams. You saw then, too, the beautiful food pyramids that were also BS supreme. 


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    Posted by Michael Anchors, MD, PhD on Thu, Apr 07, 2016 10:06 am | [0] comments

    Thursday, March 24, 2016

    STRESS EATING

    ​The Most Common Cause Of Stress

    Hard to explain why stress is such a cause of obesity–when I am stressed, I lose my appetite–but among the people who fight obesity, stress is a major cause of snacking and overeating. So it is worthwhile to look at the causes of stress. Cognitive neuroscientists do.

    The major source of stress in most people is: being given responsibility without sufficient power.


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    Posted by Michael Anchors, MD, PhD on Thu, Mar 24, 2016 4:32 pm | [0] comments

    Saturday, March 05, 2016

    Methuselah ate what he found on his plate

    Methuselah ate what he found on his plate,

    And never, as people do now,

    Did he note the amount of the calorie count;

    He ate it because it was chow.

    He wasn’t disturbed as at dinner he sat,

    Devouring a roast or a pie,

    To think it was lacking in granular fat

    Or a couple of vitamins shy.

    He cheerfully chewed each species of food,

    Unmindful of troubles or fears

    Lest his health might be hurt

    By some fancy dessert;

    And he lived over nine hundred years.

    —Anonymous


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    Posted by Michael Anchors, MD, PhD on Sat, Mar 05, 2016 10:32 am | [0] comments

    Thursday, February 25, 2016

    SPORTS ILLUSTRATED MODELS

    ​Reflections on the cover of Sports Illustrated

    The cover of Sports Illustrated swimsuit edition this year features plus-size model Ashley Graham on all fours in the surf. I’m not sure which sport this photo is intended to illustrate, but my first guess is . . . swimming :)

    I had to get that joke out of the way. In fact I use the magazine the following way. Next to the Sports Illustrated, there are copies of Self magazine and a Barbie doll. I tell female patients there is no reason they have to look like Barbie. None of the models in Self magazine has visible breasts or buttocks. I point out that the women in men’s magazines have those features. Witness buxom Ashley. Women don’t have to be skinny to be attractive.


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    Posted by Michael Anchors, MD, PhD on Thu, Feb 25, 2016 4:42 pm | [0] comments

    Monday, February 15, 2016

    CLEAN THE KITCHEN

    ​To Lose Weight Clean The Kitchen

    Years ago a population study showed that obese people have more cluttered homes. You can imagine many reasons for that. You might think it’s a character or personality thing. You might think, spending more time eating, the overweight people have less time to clean. It could be a genetic thing–who knows? But here is a controlled study on the matter.

    In the study a hundred randomly chosen subjects were invited into a clean kitchen or a cluttered kitchen to write a report. In both kitchens there was an equal amount of snack food they were invited to eat. In the cluttered kitchen the study subjects, fat or lean, ate twice as much snack food as in the clean kitchen.

    The report written by the subjects had nothing to do with the study; it was just an excuse to get them into the kitchen. The subjects were not even told the true purpose of the study. They had no idea it was about food or clutter, or that there were two kitchens.

    I conclude that if you are trying to lose weight, it is a good idea to keep the kitchen neat.


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    Posted by Michael Anchors, MD, PhD on Mon, Feb 15, 2016 10:49 am | [0] comments

    Friday, January 15, 2016

    ​What I Wish I Had Said

    The other day a nurse working at a weight loss clinic called me on behalf of the doctors running her clinic to find out what I do that makes me so successful with the group I am so successful with, i.e. motivated smart people mostly women with a BMI of 25-35. This group constitutes the majority of the people coming to my clinic. Of course my view is that the people with a BMI of 25-30 don’t need help at all, since that group has the longest lifespan, lowest mortality, NOT the skinny people (Flegal 2005). My other view is that we should not be using BMI, but instead some measure involving abdominal girth, waist-hip ratio or body fat percentage.


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    Posted by Michael Anchors, MD, PhD on Fri, Jan 15, 2016 12:17 pm | [0] comments

    Wednesday, December 23, 2015

    NON-CELIAC GLUTEN SENSITIVITY

    FODMAPs

    If you have abdominal bloating and discomfort after eating, you may have non-celiac gluten sensitivity. This syndrome has only recently been described. It will soon be renamed for it has nothing to do with gluten.

    When you eat too much carbs and sweets, you may start to grow the wrong type of bacteria in your colon. The bacteria may even extend up into the small intestine where bacteria do not normally grow. The bacteria cause the wall of the bowel to become leaky, leading to bloating, discomfort and alternating constipation & diarrhea–I am sure about all that–and perhaps to arthritis, "brain fog" and depression. I am not as sure about the latter claim. Google "leaky gut syndrome". 


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    Posted by Michael Anchors, MD, PhD on Wed, Dec 23, 2015 12:41 pm | [0] comments

    Wednesday, December 02, 2015

    OPINION

    ​Train Your Dog

    Everyone of you has a dog, and that dog is you. You have to train your dog. One of my patients complained that she could not lose weight because of poor sleep. She would lie awake for hours in the middle of the night, then get up and get something to eat figuring that "she was awake anyway."

    But I pointed out that she was not eating because she was awake, but rather staying awake so she could eat. Picture her as a dog, I said. Stay awake, girl. Stay awake... stay awake... good girl. Now you can have a treat.

    When she looked at the problem in this way and stopped putting treats in the refrigerator, she returned to sleeping through the night.

    You can think of many ways in which you train yourself to do things you don’t want to do. Take control. Especially parents. You can’t train your kids if you make no effort to train yourself.


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    Posted by Michael Anchors, MD, PhD on Wed, Dec 02, 2015 12:28 pm | [0] comments

    Wednesday, November 11, 2015

    OPINION

    ​Health and Wellness

    While I was growing up and even when I was in medical school, the word "healthy" meant simply ‘not sick’. It was the opposite of "sick". Now and unfortunately, the word has evolved to mean a zen-like state of wellness. Another funny new word–wellness. The reason this is all bad is that it gets people to think badly about themselves, to worry, reducing the quality of life and spoiling the fun. For no benefit to the person. The idea only makes money for doctors, drug & insurance companies and lawyers.

    The mutation of the word "healthy" began with the idea that real disease could be prevented by doing the right exercise, taking the right vitamins and supplements and getting an annual check-up at the doctor. All this began in the sixties on the basis of no studies at all. Please don’t think American doctors have anything to do with science; they are interested only in money.


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    Posted by Michael Anchors, MD, PhD on Wed, Nov 11, 2015 10:14 am | [0] comments
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