The most frustrating thing in my practice is the tendency of patients to make bureaucratic changes rather than radical changes. The bureaucratic process is the process by which government agencies change, i.e. making a small change and waiting to see if the change makes a positive difference. If so, they make another small change and wait. This process is very safe–especially for the bureaucrats–and also very slow. The social need usually outruns the response.
In the office I present compelling evidence why exercise, low-fat diet and calorie-counting do not work and the only effective means to lose weight is the Ten Orders. Too often patients respond bureaucratically, with a half-hearted effort to do some of the Orders, never bothering to learn the rest. And they hedge their bet by continuing to exercise, restrict fat and count calories. Result? They lose only 2 or 4 lbs between visits, and sometimes gain.
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