M.D. of Clinical Nutrition?

BU Medical Sciences
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
C

chattkis

Senior Member
10+ Year Member
5+ Year Member
15+ Year Member
Joined
Mar 12, 2005
Messages
160
Reaction score
0
Does anyone know a doctor who specializes in Clinical Nutrition? I am interested in obesity (specifically curbing it) and other nutrition topics. Is this a popular specialty? What do they usually do? Private practice, hospital?? TIA
Members don't see this ad.
 
My dad has a friend who is a nutritionist (MD).

He has a private practice.

I hope this helps!

Angel
 
I haven't heard of it nor is it a popular specialty.

If you want to deal with nutrition, save the schooling and become a dietician.
If you want results for curbing obesity, become a bariatric surgeon.
 
Members don't see this ad :)
I disagree, we need more doctors who know a lot about nutrition. Is there any other lifestyle factor that affects your health as much as what you eat? It's quite strange that doctors hardly know anything about nutrition, hopefully that is changing. With the obesity epidemic, that kind of speciality should be in great demand.

Dietitians often end up planning school lunches and such, that's probably not what you're interested in.

Check out this guy:

Dr. Furman

He's a family physician who focuses on nutrition. His books/blog are really interesting.
 
chattkis said:
Does anyone know a doctor who specializes in Clinical Nutrition? I am interested in obesity (specifically curbing it) and other nutrition topics. Is this a popular specialty? What do they usually do? Private practice, hospital?? TIA
Click to expand...

I do 🙂

They may be involved in private practice, government work, or academics. Some examples of the best-known and most highly respected physicians who focus their work on nutrition and obesity are listed below. There are any number of pathways to this career. A common route include pediatrics or internal medicine followed by specialty in GI. Specialty in other fields is certainly also possible, with endocrine, neonatology and renal perhaps among the more common combinations.

http://main.uab.edu/ipnec/show.asp?durki=37725 will be of help in understanding certifying requirements.

This is, to date, a small specialty, but I expect it to grow. Almost all physician's who work primarily in nutrition do so together with registered dietitians. They are complementary, not competing, specialties. Those who wish to know more could PM me as well.

Regards

OBP



Dr. Gordon Jensen:
http://www.mc.vanderbilt.edu/root/vumc.php?site=vchn&doc=4516

Dr. William Dietz
http://www.esi-topics.com/obesity/interviews/DrWilliamDietz.html

Dr. William Klish
http://www.amazon.com/exec/obidos/tg/feature/-/151551/103-5032455-0077446
 
If you're interested in the molecular aspects, there is some overlap with endocrinology. I know an endocrinology fellow who is doing some research on overexpressed receptors associated with obesity. From what I've heard, this is becoming a hot topic. Obesity has rapidly become one of the major health care problems in the US. Also, the sentiment that obesity is the result of laziness or poor character is now being challenged.
 
what an excellent thread! the nutrition route is exactly the direction i want me MD career to go in, and until now, i haven't really heard much about it at all. i've been a health nut for the last few years of my life, and i'd love nothing more than to help a lot of people live healthier lives by simply monitoring what they eat and engaging in an effective exercise program. thanks for all the useful links!
 
neovenom said:
what an excellent thread! the nutrition route is exactly the direction i want me MD career to go in, and until now, i haven't really heard much about it at all. i've been a health nut for the last few years of my life, and i'd love nothing more than to help a lot of people live healthier lives by simply monitoring what they eat and engaging in an effective exercise program. thanks for all the useful links!
Click to expand...

Me too! I'm also thinking about sports medicine, but with plenty of nutritional counsling thrown in as well to help athletes perform their best. 😍
 
Clinical Nutrition is a fellowship under the specialty of internal medicine.

In the US, almost every physician will have to deal with different diseases related to obesity, as obesity is a risk factor for many things such as diabetes, which itself is a major risk factor for cardiovascular disease. Obesity also leads to many issues dealing with arthritis, degenerative joint and disk disease, etc, etc. The question is what aspect of obesity do you wish to deal with?

If you want to deal with the nutritional aspects, then you might be interested in clinical nutrition, which has been a fellowship under internal medicine, but may also be approached through pediatrics. If you want to deal with the diabetes aspect, you can look into endocrinology, also approached via internal medicine and pediatrics. (There is also a combined Med/Peds which is a four year program with dual boarding in both.)

The options are many. Once you get into medical school, start exploring in the first year so you can have a better idea of all the options available. Most students make the mistake of waiting until the third year and then having to decide without knowing what's out there.

I hope this helps. PM me if you have more questions.
 
BooMed said:
Dietitians often end up planning school lunches and such, that's probably not what you're interested in.
Click to expand...

Just an FYI regarding Registered Dietitians (Source: American Dietetic Association www.eatright.org)


EDUCATIONAL AND PROFESSIONAL REQUIREMENTS
Registered dietitians (RDs) are food and nutrition experts who have met the following criteria to earn the RD credential:

-Complete a minimum of a bachelor's degree at a U.S. regionally accredited university or college and course work approved by the Commission on Accreditation for Dietetics Education (CADE) of the American Dietetic Association (ADA).

-Complete a CADE-accredited supervised practice program at a healthcare facility, community agency, or a foodservice corporation, or combined with undergraduate or graduate studies. Typically, a practice program will run six to twelve months in length.

-Pass a national examination administered by the Commission on Dietetic Registration (CDR).
Complete continuing professional educational requirements to maintain registration.

-Some RDs hold additional certifications in specialized areas of practice, such as pediatric or renal nutrition, nutrition support, and diabetes education. These certifications are awarded through CDR, the credentialing agency for ADA, and/or other medical and nutrition organizations and are recognized within the profession, but are not required.

-In addition to RD credentialing, many states have regulatory laws for dietitians and nutrition practitioners. Frequently these state requirements are met through the same education and training required to become an RD.

COLLEGE COURSE WORK Dietitians study a variety of subjects, ranging from food and nutrition sciences, foodservice systems management, business, economics, computer science, culinary arts, sociology, and communication to science courses such as biochemistry, physiology, microbiology, anatomy, and chemistry.

EMPLOYMENT OPPORTUNITIES Registered dietitians work in a wide variety of employment settings, including health care, business and industry, public health, education, research, and private practice.
Many work environments, particularly those in medical and health care settings, require that an individual be credentialed as an RD.
RDs work in:
-Hospitals, HMOs or other health care facilities, educating patients about nutrition and administering medical nutrition therapy as part of the health care team. They may also manage the foodservice operations in these settings, as well as in schools, day-care centers, and correctional facilities, overseeing everything from food purchasing and preparation to managing staff.
-Sports nutrition and corporate wellness programs, educating clients about the connection between food, fitness, and health.
Food and nutrition-related businesses and industries, working in communications, consumer affairs, public relations, marketing, or product development.
-Private practice, working under contract with health care or food companies, or in their own business. RDs may provide services to foodservice or restaurant managers, food vendors, and distributors, or athletes, nursing home residents, or company employees.
-Community and public health settings teaching monitoring, and advising the public, and helping to improve their quality of life through healthy eating habits.
-Universities and medical centers, teaching physicians, nurses, dietetics students, and others the sophisticated science of foods and nutrition.
Research areas in food and pharmaceutical companies, universities, and hospitals, directing or conducting experiments to answer critical nutrition questions and find alternative foods or nutrition recommendations for the public.
 
Members don't see this ad :)
i know that there are some chiropractors that only practice clinical nutrition. they graduate chiropractic school and then get their diplomate in clinical nutrition; this takes about three additional years. boomed that sounds like a great idea, you'll be a busy doc.
 
PMR TX MS said:
In the US, almost every physician will have to deal with different diseases related to obesity, as obesity is a risk factor for many things such as diabetes, which itself is a major risk factor for cardiovascular disease. Obesity also leads to many issues dealing with arthritis, degenerative joint and disk disease, etc, etc. The question is what aspect of obesity do you wish to deal with?
Click to expand...

I agree with this post to the extent it suggests that obesity is largely a non-"nutritional" issue, (it's more a genetic than a diet issue) and that physicians of all types will perhaps deal as (maybe more) frequently with obesity and its complications than nutritionists. If you want to curb obesity, your best shot is going into genetic research.
 
There are a number of physicians working in this area. A few that come to mind are David Katz, Robert Kirshner, F. Xavier Pi-Sunyer.

http://publichealth.yale.edu/faculty/katz.html
http://www.uchsc.edu/core/chicago.htm
http://www.nyorc.org/XPCVframe.html

All are internists and academics; Katz is also a media star (ABC, Oprah). There are certainly pediatricians who specialize in the care of children with obesity.

There is board certification in nutrition for physicians (and other holders of doctoral degrees).
http://www.cert-nutrition.org/CertificationProcess.htm#Eligibility
 
BrettBatchelor said:
If you want to deal with nutrition, save the schooling and become a dietician.
Click to expand...

I agree 👍. Dieticians are the nutrition experts... there is no need to pursue medicine if you wish to deal with nutrition primarily.
 
Law2Doc said:
I agree with this post to the extent it suggests that obesity is largely a non-"nutritional" issue, (it's more a genetic than a diet issue) and that physicians of all types will perhaps deal as (maybe more) frequently with obesity and its complications than nutritionists. If you want to curb obesity, your best shot is going into genetic research.
Click to expand...

If obesity is mainly a genetic issue, why weren't one third of Americans obese twenty years ago?

Answer: Americans eat at least 200 more calories per day then they did in the 1980s (which will add about 20 pounds of weight per year) and 40% of us are now completely sedentary.

We are now raising the first generation of children who will have a lower life expectancy than their parents!

Most people in the hospital are there because of problems caused by being overweight and out of shape. We are literally killing ourselves with food.

I think is it very important to have doctors who know about nutrition.
 
BooMed said:
If obesity is mainly a genetic issue, why weren't one third of Americans obese twenty years ago?

Answer: Americans eat at least 200 more calories per day then they did in the 1980s (which will add about 20 pounds of weight per year) and 40% of us are now completely sedentary.

We are now raising the first generation of children who will have a lower life expectancy than their parents!

Most people in the hospital are there because of problems caused by being overweight and out of shape. We are literally killing ourselves with food.

I think is it very important to have doctors who know about nutrition.
Click to expand...

Yes and no. Weight gain is caused by high caloric intake and less activity, no question. But obesity is not caused by people's lack of knowledge that certain foods are bad, or that portions are too big. Most heavy people know that they should be thinner, attempt a variety of diets, to no avail. Virtually every heavy person knows that they should eat less and exercise more, and what foods are considered healthy versus not. But yet the problem increases year after year. Thus, to address this problem, you need to address the chemical signals -- see why some people feel full while others can eat themselves into oblivion, why some people are fast metabolizers while others store fat more readilly. And that, my friend, is all genetics. If obesity is to be cured, it will have to occur on that level.
 
For those interested in nutrition, here are a few good titles:

Food Politics: How the Food Industry Influences Nutrition and Health by Marion Nestle

Fed Up!: Winning the War Against Childhood Obesity by Susan Okie


Cheers.
 
i don't necessarily agree with Law2Doc's post. i believe eating habits are taught...pure and simple. These behaviors develop over time which is what makes them hard to change. If one didn't develop these detrimental behaviors and instead grew up learning the correct way to eat, the problems of overcoming "chemical signals", as you put it, would be much reduced.

it is a fact that certain people store fat (location and amount) because of genetics. But, this will only occur if that person eats too much and exercises too little. This could all be prevented by positive behavioral patterns. Thus, I believe MUCH of the rise in obesity is caused by parents because they are responsible for shaping our eating and activity patterns.
 
(Oldbearprofessor, maybe you can answer this)


Okay, so for those of us who are interested in nutrition, what do you think is the BEST route to get the info that we need (most relevant, most efficient)?

Do a Master's in Nutrition (a la Columbia or another program)?

Do an Internal Med nutrition fellowship?

Do an MPH with a nutrition emphasis?

Independent study? 🙂

I'm planning to do Internal Medicine but I'd like to incorporate more preventive care/ nutrition than the norm. Maybe become involved in a "wellness center"...

Thoughts, anyone? What's the best route?
 
oblivious said:
i don't necessarily agree with the above post. i believe eating habits are taught...pure and simple. These behaviors develop over time which is what makes them hard to change. If one didn't develop these detrimental behaviors and instead grew up learning the correct way to eat, the problems of overcoming "chemical signals", as you put it, would be much reduced.
Click to expand...

But everyone KNOWS what are the good and bad foods. Many folks still grow up being told to "eat your vegetables". Lots of folks who are obese don't achieve that state until later in life (when they become more sedentary, have babies etc.). And most heavy people make attempts to lose weight -- to no avail. The proliferation of diet books on the best seller lists and the fact that weight loss has become a billion dollar industry is a testament to this. But even if, as you suggest, the bad habits are initially taught, then the nation's inability to wean off the habit, even knowing it is bad (based on most obese persons various failed attempts at dieting), is akin to an addiction. No one is going to listen to a nutritionist about eating right and losing weight if they cannot even listen to themselves. Addictions sometimes are most effectively addressed chemically (eg. nicotine patches, methadone). And this once again puts us back to genetically created signals. I continue to posit that obesity will be cured, if at all, via genetic research. In 20 years we will see if I am right.
 
Law2Doc said:
I agree with this post to the extent it suggests that obesity is largely a non-"nutritional" issue, (it's more a genetic than a diet issue) and that physicians of all types will perhaps deal as (maybe more) frequently with obesity and its complications than nutritionists. If you want to curb obesity, your best shot is going into genetic research.
Click to expand...
This is ridiculous. Obesity is not a result of genetic problems. It is a result of lifestyle. Same with heart disease, diabetes, HIV, most cancers... nearly all the major health problems in the US are entirely preventable. Granted, there are a VERY small proportion of people who do have genetic defects that inevitably lead them to some of the above conditions. Claiming that obesity is genetic is shameful to me.

Certainly the environment that we grow up in and live in influences the way we conduct ourselves. But it certainly doesn't create an impenetrable barrier to a society where people make their own health decisions and become personally responsible for preventing personal illness. Scapegoating bad genes is a ludicrous proposition because it neglects the fact that most Americans are simply to lazy or too apathetic to control their own indulgences in an unhealthy lifestyle.

The worst part of it:

We subsidize health care so that no matter how people treat themselves, the government still picks up the tab when we see the old-age results of years of unhealthy lifestyle decisions.
 
Of course genetics influence who gets obese, but that doesn't mean that because you have bad genes you are destined to become obese. We need to make personal and societal changes to help everyone be healthier.

Case in point: Most everyone in my mom's family is morbidly obese. It didn't happen all at once, but (like most Americans) little by little they have gained huge amounts of weight over the years. They've suffered from diabetes, heart disease, cancer, strokes, etc. My mom moved to Oregon and became a hippie 30 years ago. She started eating really healthy and exercising, and raised me to do the same. Despite our genetic tendency towards fatness and diabetes, we are both a normal weight and very healthy.

The solution to obesity will not be found in a pill or a genetic treatment. We already have the solution! Lifestyle choices. But we need to make it easier for people to be healthy. It is nearly impossible not to be fat in the U.S. We feed kids complete crap at school, build our cities so that we're unable to walk places, and allow the food industry to wield huge power over the government with financial contributions.

There's no mystery to solve as to why people are so fat here, the mystery is why we put up with it.
 
BooMed said:
Of course genetics influence who gets obese, but that doesn't mean that because you have bad genes you are destined to become obese. We need to make personal and societal changes to help everyone be healthier.

Case in point: Most everyone in my mom's family is morbidly obese. It didn't happen all at once, but (like most Americans) little by little they have gained huge amounts of weight over the years. They've suffered from diabetes, heart disease, cancer, strokes, etc. My mom moved to Oregon and became a hippie 30 years ago. She started eating really healthy and exercising, and raised me to do the same. Despite our genetic tendency towards fatness and diabetes, we are both a normal weight and very healthy.

The solution to obesity will not be found in a pill or a genetic treatment. We already have the solution! Lifestyle choices. But we need to make it easier for people to be healthy. It is nearly impossible not to be fat in the U.S. We feed kids complete crap at school, build our cities so that we're unable to walk places, and allow the food industry to wield huge power over the government with financial contributions.

There's no mystery to solve as to why people are so fat here, the mystery is why we put up with it.
Click to expand...

Not sure your case in point is a good one. Just because a lot of people in your mom's family are obese, diabetic or even genetically predisposed to obesity or diabetes does not mean your mom, or you was passed the same gene or set of genes. You don't get all your genes from a single parent or lineage, and to the extent things are recessive, they may skip many generations. And levels of expression of genetic symptoms may vary over generations. (There are many cases where fat parents have skinny kids and vice versa.) Thus you may not have any genetic tendency towards obesity and diabetes, and may have the ability to keep thin because you are not even combatting the same set of chemicals/signals as the rest of your mom's familly. What seems like the obvious easy solution to obesity and diabetes may prove as big a hurdle for some as quitting heroin cold turkey.
 
About the genetics issue, I don't think it's the primary cause of the obesity program right now. We're progressively getting more and more obese over time, but there's been no change to the gene pool to explain it. Also, obesity seems to be spreading from country to country as more people adopt American (ie fast food and tons of snacking) eating habits. For goodness sakes, obesity's a problem in China now.

To the OP, there are physicians who focus primarily on nutrition in their practice. The examples I'm thinking of just because of familiarity are all in the vegetarian community, but I guess there are lots that aren't. Check out Joel Fuhrman, John McDougall and Dean Ornish (my favorite!).
 
exlawgrrl said:
About the genetics issue, I don't think it's the primary cause of the obesity program right now. We're progressively getting more and more obese over time, but there's been no change to the gene pool to explain it.
Click to expand...

One of the articles I linked earlier in the thread addresses your point, and suggests that our current diet is causing the obesity genes to come into play -- the genes have always been there, lurking in some folks' genome, but supersizing (the ready easy availability of high caloric foods) is what has changed, and kicked them into gear. The logical next step in biogenetics is how do we turn them back off, or otherwise inhibit them.
 
Law2Doc said:
One of the articles I linked earlier in the thread addresses your point, and suggests that our current diet is causing the obesity genes to come into play -- the genes have always been there, lurking in some folks' genome, but supersizing (the ready easy availability of high caloric foods) is what has changed, and kicked them into gear. The logical next step in biogenetics is how do we turn them back off, or otherwise inhibit them.
Click to expand...

What you are talking about are genetic predisposition combined with environment. IMHO this is going to be the hot research area of the 21st century for all sorts of diseases.
 
busupshot83 said:
I agree 👍. Dieticians are the nutrition experts... there is no need to pursue medicine if you wish to deal with nutrition primarily.
Click to expand...

But dietitians do not prescribe medications and some will not even recommend a particular diet for a patient, they will only help patients/clients in following a diet order that has written by a physician. (e.g. the doctor orders a low cholesterol, low fat, 2 gram sodium diet and the dietitian helps the patient figure out how to translate that into a menu plan and how they can use strategies to make food taste better and still adhere to dietary restrictions).

Most dietitians work in conjunction with physicians. Telling people who are interested in nutrition to become dietitians is like telling those who are interested in sports medicine to become physical therapists. Yes, physical therapists work with injured athletes but the physician is always the team leader.
 
Law2Doc said:
Not sure your case in point is a good one. Just because a lot of people in your mom's family are obese, diabetic or even genetically predisposed to obesity or diabetes does not mean your mom, or you was passed the same gene or set of genes. You don't get all your genes from a single parent or lineage, and to the extent things are recessive, they may skip many generations. And levels of expression of genetic symptoms may vary over generations. (There are many cases where fat parents have skinny kids and vice versa.) Thus you may not have any genetic tendency towards obesity and diabetes, and may have the ability to keep thin because you are not even combatting the same set of chemicals/signals as the rest of your mom's familly. What seems like the obvious easy solution to obesity and diabetes may prove as big a hurdle for some as quitting heroin cold turkey.
Click to expand...

Well I don't want to be mean but my mom was a pretty fat teenager, and I got pretty chubby for a couple years during high school when I discovered fast food. Also, my dad's family is really fat too, maybe even fatter than my mom's. Anyway, for the sake of the argument (although I find this unpleasant to admit) if I did not work out and eat healthy (which I'm not saying is easy for me!) I would probably be pretty overweight.

Hmm. I am really embarressing myself here, but I had to counter your argument. People often assume I am just naturally thin, but I work out almost every day and eat crazy healthy.
 
Law2Doc said:
One of the articles I linked earlier in the thread addresses your point, and suggests that our current diet is causing the obesity genes to come into play -- the genes have always been there, lurking in some folks' genome, but supersizing (the ready easy availability of high caloric foods) is what has changed, and kicked them into gear. The logical next step in biogenetics is how do we turn them back off, or otherwise inhibit them.
Click to expand...

Stop eating huge portions of junk food.
 
LizzyM said:
What you are talking about are genetic predisposition combined with environment. IMHO this is going to be the hot research area of the 21st century for all sorts of diseases.
Click to expand...

I agree, which is why I suggested the OP (who asserted a desire to work on combatting obesity) might want to consider a more genetics oriented field rather than a nutritionist one.
 
Law2Doc said:
Clearly not everyone seems able to do that or the billion dollar weight loss industry would be gone. More is at work here than mere gluttony.
Click to expand...
It's interesting, the CDC even came out a few years ago and said that the poor in the US actually suffer more from obesity than the rich. It's really backwards from the historical model (or the model in the developing world): wealthy people would showcase that wealth by over-indulging in everything, especially food. Girth would translate into impression that you have enough money to buy all of the least healthy pastries, sweets, etc., as well as hired help to do your manual labor.
I guess now big mac and fries is a lot cheaper than a pound of apples and asparagus.
Here's just a short link: http://depts.washington.edu/uwcphn/research.html
 
Law2Doc said:
Clearly not everyone seems able to do that or the billion dollar weight loss industry would be gone. More is at work here than mere gluttony.
Click to expand...

I know, I just think it's funny that people are always wanting to do huge, complex research projects when the answers aren't really that complicated. Of course it will be amazing to discover all of the intricate working of our genes and I'm really excited to learn about that stuff, but in the meantime I'd like to work towards practical solutions to get our society healthier.

I predict (or at least I hope) that fairly soon people are going to get really sick of being so fat and of having their kids be so unhealthy and we will make some collective choices towards healthier living. For example, people can demand more sidewalks, public transportation, bikepaths, better school lunches, putting P.E. back in schools, and better food choices at grocery stores. Those are just a few things that could make a huge difference.

I think it's a tragedy that the weight loss industry prays on peoples' insecurity and hatred of themselves, and that $33 billion is wasted each year on stuff that doesn't work.

Would creating a pill that slightly decreases weight but comes with a host of terrible side effects be all that much different?
 
BooMed said:
Would creating a pill that slightly decreases weight but comes with a host of terrible side effects be all that much different?
Click to expand...

Kind of like the olestra potato chips that remove the fat but gives people the runs. There's always a market for vanity. Hopefully genetic research can unlock better solutions, though.
 
Law2Doc said:
Yes and no. Weight gain is caused by high caloric intake and less activity, no question. But obesity is not caused by people's lack of knowledge that certain foods are bad, or that portions are too big. Most heavy people know that they should be thinner, attempt a variety of diets, to no avail. Virtually every heavy person knows that they should eat less and exercise more, and what foods are considered healthy versus not. But yet the problem increases year after year. Thus, to address this problem, you need to address the chemical signals -- see why some people feel full while others can eat themselves into oblivion, why some people are fast metabolizers while others store fat more readilly. And that, my friend, is all genetics. If obesity is to be cured, it will have to occur on that level.
Click to expand...
Knowledge is only the first step in changing behavior. And it is, in my opinion, 80% behavior. As a previous poster mentioned, the generations before us did not have nearly the amount of obesity related diseases as do exist right now. Therefore, merely knowing which foods to eat will not facilitate health behavior change; skills must be learned and practiced and the environment (such as the junk food cabinet) must be altered.

As far as blaming the obesity epidemic on genetics, IT IS DANGEROUS TO DO SO. This totally defeats the purpose of empowering individuals to change their lives! Research must go on considering genetic factors related to obesity, but until we can pin point the "obesity gene" and actually manipulate it, there is no reason whatsoever to tell overweight individuals that's "it's genetic." It may be, but it doesn't help them to know this, and eventually they'll find out on their own, if their problem is largely genetic, as they try to lose weight (properly) and they don't succeed.

As far as the poster who stated that there is no need for an MD degree if wanting to specialize in nutrion: I DISAGREE! Primary care physicians are in the front line of duty, so to speak. How many of us can afford to hire a nutritionist to help us with our eating problems??? We will go to our primary care physician to address our health concerns. And the truth of the matter is that many people expect their physicians to know about nutrition (as they should). This is a great area of specialty that I had not even considered, and I thank you all for the wonderful links. Sorry about the soap box. I shall step off now.
 
dragonmate said:
Knowledge is only the first step in changing behavior. And it is, in my opinion, 80% behavior. As a previous poster mentioned, the generations before us did not have nearly the amount of obesity related diseases as do exist right now. Therefore, merely knowing which foods to eat will not facilitate health behavior change; skills must be learned and practiced and the environment (such as the junk food cabinet) must be altered.

As far as blaming the obesity epidemic on genetics, IT IS DANGEROUS TO DO SO. This totally defeats the purpose of empowering individuals to change their lives! Research must go on considering genetic factors related to obesity, but until we can pin point the "obesity gene" and actually manipulate it, there is no reason whatsoever to tell overweight individuals that's "it's genetic." It may be, but it doesn't help them to know this, and eventually they'll find out on their own, if their problem is largely genetic, as they try to lose weight (properly) and they don't succeed.

As far as the poster who stated that there is no need for an MD degree if wanting to specialize in nutrion: I DISAGREE! Primary care physicians are in the front line of duty, so to speak. How many of us can afford to hire a nutritionist to help us with our eating problems??? We will go to our primary care physician to address our health concerns. And the truth of the matter is that many people expect their physicians to know about nutrition (as they should). This is a great area of specialty that I had not even considered, and I thank you all for the wonderful links. Sorry about the soap box. I shall step off now.
Click to expand...

No need to step off the soap box -- this discussion is interesting. I agree that telling obese folks to "give up -- its genetic" isn't the right move. And as a profession we cant do that. But I also think that if the OP and others really want to cure obesity, the answer is going to be in the genome, not diet. That so many people want to get trim, and have health reasons to do so, and know exactly what a good diet consists of (versus a bad one) and yet still cannot stick to diets long suggests to me more than a matter of an internal struggle of gluttony versus willpower. It suggests chemical signalling gone awry. (I also point to those many who get various gastric surgeries and still manage to eat through staples and bands). And anything that's broken can be fixed (or at least shut down)-- its just going to be a matter of time.
 
But we never had a genetic solution before, and we were thin.

I do think it's important to think about how different types of food affect the brain and body and I'm excited about research in this area. But people don't have to wait years and years to find out that eating vegetables is good and eating french fries is bad! Have you ever noticed how if you eat a lot of junk food you feel totally crappy and tired and you always crave more? Well I find that when I'm eating healthy and filling up on good stuff, not only do I have tons of energy, I don't really crave junk food or sweets. It's really not that hard. It's not about depriving yourself from stuff that you really want, but rather choosing foods based on what they have to offer and adding treats in small quantities.

It's hard to start exercising too, but once you do your body feels so much better that you want to keep doing it!

I think the real solution is teaching our children to live in a healthy way, because it's easier to keep living well than to break bad habits.
 
dragonmate said:
Knowledge is only the first step in changing behavior. And it is, in my opinion, 80% behavior. As a previous poster mentioned, the generations before us did not have nearly the amount of obesity related diseases as do exist right now. Therefore, merely knowing which foods to eat will not facilitate health behavior change; skills must be learned and practiced and the environment (such as the junk food cabinet) must be altered.

As far as blaming the obesity epidemic on genetics, IT IS DANGEROUS TO DO SO. This totally defeats the purpose of empowering individuals to change their lives! Research must go on considering genetic factors related to obesity, but until we can pin point the "obesity gene" and actually manipulate it, there is no reason whatsoever to tell overweight individuals that's "it's genetic." It may be, but it doesn't help them to know this, and eventually they'll find out on their own, if their problem is largely genetic, as they try to lose weight (properly) and they don't succeed.

As far as the poster who stated that there is no need for an MD degree if wanting to specialize in nutrion: I DISAGREE! Primary care physicians are in the front line of duty, so to speak. How many of us can afford to hire a nutritionist to help us with our eating problems??? We will go to our primary care physician to address our health concerns. And the truth of the matter is that many people expect their physicians to know about nutrition (as they should). This is a great area of specialty that I had not even considered, and I thank you all for the wonderful links. Sorry about the soap box. I shall step off now.
Click to expand...
as one of our biochem profs ( a guest lecturer from temple) stated: People weren't nearly this fat 100 years ago, 50 years ago, or even 15 years ago.....Genetics don't change that fast.....
 
Taus said:
as one of our biochem profs ( a guest lecturer from temple) stated: People weren't nearly this fat 100 years ago, 50 years ago, or even 15 years ago.....Genetics don't change that fast.....
Click to expand...

I like these ideas (did someone mention these already?):

* It's in our nature as human beings to overeat because in the olden days :laugh: (caveman days) food was scarce and we had to expend a lot of energy to get it. Now, of course, food is abundant and we simply have to go through the drivethru.

* Anyone seen the recent study about "supertasters"? A percentage (ooh, I forgot the number-- 25%??) of us humans have vastly more tastebuds than others. We have a greater response to food and may be prone to overeat. A similar study showed that some individuals salivate much more than average when given food cues-- they apparently "enjoy" food more than the average joe. I believe I am one of those people. (I battle my cravings to be a size 4, so no need to think I'm making excuses for being overweight).

Just some ideas, not meant to add to or subtract from any of the discussion above.
 
So in relation to the OP, it has come to light that being an MD in Nutrition would be best for planning nutrition for those with certain food allergies rather than the obese.

Psych in Behavioral Medicine might be more applicable.
 
As the OP: I don't want to focus on the genome. While I agree that genes might have a little something to do with the issue, that in no way predestines people to be overweight.

I want to teach health living. To show people that they actually can be healthy and fit. I don't want to cure obesity. I want to encourage those who are overweight and unhappy to change. And I want to increase these people's quality of life. I just didn't know if there were doctors who focused on nutrition and obesity.
 
Great discussion though. 👍

I think an M.D. degree will give me a great advantage. Using my knowledge of medicines, the body, and the human psyche.
 
Without question obesity is the key nutrition problem in the developed world and is rapidly increasing in developing nations. Furthermore, I agree that the area of nutrient-gene interaction as related to obesity and the relative roles of genetics, activity, metabolism and diet in the global obesity epidemic are important areas of work for physicians with expertise related to nutrition.

However, that is not to mean that undernutrition is not important throughout the world and that physician's with expertise are not involved in investigating and treating this as well. Undernutrition can refer to protein-energy malnutrition, either related to diet or chronic illness. It can also refer to micronutrient malnutrition, which, on a global basis is thought to affect almost half of children in developing countries. Again, the causes are primary - low intake of these and excessive intake of mineral inhibitors (e.g. phytates inhibiting zinc absorption). They can also be secondary to things like parasitic infections causing blood loss and chronic infections such as HIV. It is by the way, quite possible to be overweight and simultaneously have micronutrient malnutrition (e.g. iron deficiency).

In pediatrics, nutrition expertise is useful in a range of areas, including things like fortifying human milk for preterm infants, cow milk protein allergy management and of course, management of almost all chronic illnesses in growing children, but especially problems like cystic fibrosis and eating disorders.

In terms of research, there is tremendous interest these days in aspects of the Barker hypothesis and the increasing evidence that early life nutrition affects metabolic processing throughout life.

Bottom line is that many physicians involved in mainstream research, education and patient care benefit from nutritional training and from learning enough about nutrition to work together with dietitians and others in enhancing the nutritional care of their patients. This importance of nutiriton in clinical practice is not just related to obesity and the debate about whether or not obesity is primarily a dietary, physical activity or genetic problem. Gaining respect for those who understand the role of nutrition in managing many types of disease processes might be a good start for many. Enhancing ones medical education with specific electives, etc in nutrition is an even better idea.

Regards

OBP
 
BrettBatchelor said:
FYI: Documentary on TLC about a 750 lb. Man. They show him seeking treatment in an obesity clinic in Ohio.
Click to expand...

Funny you mention that, I watched the last few minutes of that last night. Wow. :scared: Can you imagine being so fat you couldn't even lift your arms?
 
You must log in or register to reply here.

Similar threads

2026PreMed
  • Locked
How much of a Big Deal is it to just have clinical volunteer hours instead of Clinical employement hours
Replies
3
Views
625
chilly_md
chilly_md
O
Does clinical volunteering count as clinical hours?
Replies
4
Views
426
Goro
Goro
D
Another: Is this clinical experience? question about clinical research
Replies
1
Views
226
LizzyM
LizzyM
M
Clinical Research Roles
Replies
7
Views
591
AJS59
AJS59
D
Lack of volunteering, good hours in research, leadership, and clinical
Replies
4
Views
935
Med Ed
Med Ed
Top