Intensive Dietary Management

Dr. Jason Fung: More and more physicians are starting to recognize the crucial importance of diet in the treatment of chronic metabolic diseases. Recently, I asked Stanford University’s Dr. Manny Lam about his experience using intensive dietary management for the treatment of metabolic disease. Reading his story reminds me powerfully of my own journey toward realization that diet is the cornerstone of good health.

Dr. Lam studied computer science at Brown University before receiving his medical degree and masters in medical sciences from Brown’s Alpert Medical School. He trained at Stanford for internal medicine then worked as a hospitalist phsyician as well as teaching at Stanford. Patients present with conditions, such as heart attacks, strokes, kidney problems, liver problems, blood clots, lung infections, cancer, and bleeding. and he noticed that almost every one of my patients had high blood pressure, high triglycerides, high blood sugars, and obesity. He thought, “Man, I wish I saw you years ago…”

This was metabolic syndrome due to insulin resistance and carbohydrate intolerance. The solution was LCHF and intermittent fasting, but there was a lack of doctors in my area who was practicing this. That’s why he started the Metabolic Health Clinic in sunny California.

Dr. Manny LamLooking at the meteoric rise of our obesity epidemic. I wonder, what would the world be like without obesity? I always thought that obesity and diabetes was inevitable, a given. We are doing all we can, and we are telling our patients all the right things, right?? I first heard about the low carbohydrate high fat (LCHF) or “ketogenic” diet in 2011. I reunited with one of my good friends in college. I still remember it, because he weighed 250 lbs in college, and had slimmed down to 150 lbs. He lost 100 lbs! I asked him, “Eric, what did you do?” He said: “I cut out sugar and starches. I eat a lot of fat, and the fat melts away.” When I first heard him, I felt repulsed. “What? You are crazy. Butter, are you kidding? Bacon, are you kidding? Watch out for your coronaries, because that fat is going to clog up your arteries.”

At that time, I was a resident in internal medicine. My mentors taught me that saturated fat was bad; obesity is as simple as calories in and calories out. It was as obvious to me as the sky was blue and the sun shines. We learned about medicines, not nutrition, so I believed that medicines were much stronger than lifestyle changes. Why would we challenge some of the oldest givens in medicine, or even our mentors? Little did I know, nutrition was more dogma and culture than fact or science. Little did I know, nutrition was foundational to all medicine.

I did not revisit this issue until early 2016. One of my friends was practicing “intermittent fasting”. He was eating within a small window and fasting the rest of the time. Of course, my gut response when hearing anything foreign to my own medical training: “What kind of fad diet is this? How is this different from calorie restriction? You are going to mess up your metabolism!” But, I respected Mike, so I decided to practice it too. Within one week, I noticed my body starting to change. I had more energy. I was more focused. I stopped having cravings, and I was not hungry. It was a sensation of calm that I never felt before.

I looked into it more, and I came across Dr. Jason Fung’s website. I read his book “Obesity Code”. I bought Berg’s Biochemistry, and I read the chapters on fast vs. fed states, carbohydrate and fat metabolism, and ketosis. I read Gary Taubes ,”Good Calories Bad Calories”. This challenged my intellectual foundation about nutrition, and it came crashing down. Dietary fat is not the cause of obesity, heart disease or chronic disease. It was all the sugars and starches in our diet which leads to elevated insulin, hyperinsulinemia and insulin resistance. Obesity is a hormonal disorder. Our own government and medical societies have been telling our universe the opposite of what we should be doing. As a physician, I went through the 5 stages of grief. Is there an alternate universe out there where the obesity epidemic did not exist, and all this could have been prevented?

I became fully convinced when I saw it first hand in patients. A member of the WeFast Facebook support group had been struggling with obesity and type 2 diabetes, on 100 units of insulin. Together, we kept her accountable with intermittent fasting and low carb high fat nutrition. She lost 30 lbs in one month, and  most impressively, she completely stopped her insulin because her blood sugars had normalized. All her blood work improved, and she came off her medications. Together we did what no medicine in the world could do – reverse her type 2 diabetes. I felt proud to be a doctor, and I found myself enjoying it so much, I had to open my own clinic that specialized in fasting and LCHF.

I travelled to Toronto to meet and learn from Dr. Jason Fung and Megan Ramos at Intensive Dietary Management. I was hooked. A few months later I pulled the trigger and took the plunge. I started the Metabolic Health Clinic, a clinic that supports patients on a LCHF nutrition and intermittent fasting. I Most importantly, I wanted to share with my patients that there is an alternative to more medicines, more insulin, more weight gain and more complications. There is natural cure for their obesity, their diabetes, their chronic disease. Food is our medicine.

What is your program?

I started “The Metabolic Health Clinic” in Menlo Park, CA. My clinic focuses on screening and treating insulin resistance and optimizing metabolic health. This includes obesity, high blood sugars, polycystic ovarian syndrome, high triglycerides, high blood pressure, and all downstream effects. My approach combines conventional medicine, nutritional sciences and laboratory diagnostics to find the root cause of disease. I use strategies, such as intermittent fasting and ketogenic nutrition, to lower insulin and lose body fat.

Living in the Silicon Valley, many of my patients like to see data. Additional services include body composition analysis, ketone checking and continuous glucose monitoring. Body scans monitor fat loss and muscle gains. Monitoring blood sugars for biofeedback helps patients understand the impact of food, exercise and sleep on blood sugars.

I wanted to see my patients 25 years before they came into see me in the hospital, to stop or reverse chronic disease. I incorporate the philosophy that “food is the best medicine”, and I enjoy talking about nutrition and lifestyle before going to medications. I thank Dr. Fung for helping to open my eyes about the root cause of obesity through the Obesity Code.

Dr. Jason Fung: Thanks so much, Manny. I know you will help thousands of people with your skill as a physician. It’s interesting to note that the ketogenic diet and intermittent fasting has really caught fire in Silicon Valley. Literally, the very smartest people in the entire world have become interested in their health and realized, as Dr. Lam did, that nutrition is mostly dogma and not science. Now, those living in Silicon Valley will be able to get the medical supervision as well as the proper nutritional knowledge. Great job, Manny.

For those people not in the Silicon Valley area, there are other options. I want to introduce our new Intensive Dietary Management website – www.IDMprogram.com. We’ve made a number of changes from the old site and I don’t want readers to get confused. We’ve made things much more organized to find all the free resources available online. The weekly blog is still easily found along the top right of the website. 

Resources

Let’s face it- losing weight is no easy feat. It’s difficult even with all the support in the world. Without this support, it is virtually impossible. There’s a lot of great information out there and we’ve listed some of our favourite websites under the ‘Resources’ tab.

One of the best resources on the internet is www.dietdoctor.com, which has recipes, meal plans, news, and educational videos relating to low carb diets and weight loss. Most of it is free, but even a subscription is only a measly $9/ month with 1 month free. There’s the free Low Carb program at www.diabetes.co.uk delivered via email which has been used successfully by over 250,000 people. There are great cookbooks, and podcasts for low carb and ketogenic diets.

Megan Ramos and Dr. Manny Lam

IDM Program

Yet, the fact still remains that many people would like a real person to work with them. As a physician, I understand that. Dr. Google is great for many things, but when you get really worried or sick, most people will go to a real doctor – somebody who has the knowledge, but also the experience to guide you. It’s like trying to rewire the electrical in your house based on a few videos from YouTube. You can do it, but it’s kind of risky.

The same applies to dieting. Losing weight is hard, and having somebody there to guide you can be a vital asset. There are many programs to do this if you want to follow the standard calorie restriction advice of ‘Eat Less, Move More’. You can join Weight Watchers, or Jenny Craig or any number of other commercial weight loss programs. You can also visit a dietician, who often work in hospitals and community centers alongside the physician. But where can you go for a low carb diet? Even harder – where can you go for intermittent fasting?

I’m excited to be able to offer the Intensive Dietary Management (IDM) Program to clients anywhere in the world. We provide the education, support and guidance necessary to succeed at low carb diets and intermittent fasting. The website provides links to much of the free educational materials I’ve written over the last few years. There are links to the weekly blog, as well as the archives going back several years. In the Resources tab, there are links to some of the more popular lectures/ videos/ podcasts I’ve done. There is also the new Obesity Code podcast, which will also give listeners insights into obesity and how to treat it. We feature real life IDM client stories and the lessons to be learned including expert commentary from Gary Taubes, Nina Teicholz, Prof Tim Noakes, Dr. Peter Brukner, Dr. David Ludwig, Dr. Gary Fettke, Zoe Harcombe, Dr. Aseem Malhotra as well as Megan and myself.

We hope that everybody is able to use the free resources to take control of their own health. But I recognize that there will be those who need more personalized attention. For them, we offer the online IDM program of personalized coaching and support, providing a nutritional counsellor to help you with your own specific questions and problems. We have detailed online training videos to help you transition to  Low Carbohydrate, Healthy Fat diet and offer suggestions as to what type of fasting regimen you may benefit from. Fees and other details can be found at www.IDMprogram.com

In addition to the personalized attention, all our session are delivered in a small group format. While many people may initially feel that one on one sessions are better, I don’t believe that true. The peer support and opportunity to learn from and teach other people in your exact same situation is very powerful. In school, we recognize that while the teacher is an important influence, peers are even more important. This is why peer pressure is considered so strong. In a supportive group setting, we turn this peer ‘pressure’ into peer support – a powerful source of encouragement and strength.

In fact, when I first started incorporating nutrition into my medical practice, I started with one on one sessions, since this is the medical model I was used to. I quickly found that failure rates were high. People felt isolated. People felt alone in their struggle. Once I switched to a group setting, there was a noticeably higher success rate. In my office, people always think they will hate the group sessions. Once they start, they love them. Other support groups like Weight Watchers and Alcoholics Anonymous have always recognized this important truth and used it for client’s benefits.

Whether or not you are interested in joining the IDM program, we welcome all to visit and take advantage of all the free resources available, including our brand-new podcast.

 

 

2017-10-18T15:29:09+00:0027 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

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Tracey
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Tracey

Is there a way to find a doctor like Dr. Fung in my area?

Aharon
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Aharon

Naturopathic Physicians (ND) found listed at http://www.naturopathic.org
also Functional Medicine physicians found at http://www.ifm.org

Florence L
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Florence L

If you can’t, it would not be uncommon. I was in this situation. you can do it yourself using the free info from Jason. Jason encouraged me to do it myself after I emailed him. I had been wanting it join his Dietary Management program, but was not able to because I was blocked by not having access to to neccesary blood work to enter the program. My medical team would not order it. I also found Dr. Eric Bergs YouTube video helpful. You can still use your regular physician for some blood work. Though I had huge opposition from… Read more »

glib
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glib

for those who can not do blood work… it is not expensive to do it online. They cost a few tens of dollars each.

Siffair
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Siffair

IF was my answer. I was shedding weight and all my crazy cravings went away (like you wouldn’t believe) and then I started noticing high cortisol (sore neck and shoulders) which then lead to me not ovulating and getting very heavy menstruation. I went and off IF testing my theory over 4 years. I can confidently say it affects ovulation because of the stress it puts on the body particularly 23:1 (which became so easy for me after 2 weeks). Even us older women want to ovulate because of how bad it feels when we dont and how good delicious… Read more »

Michelle
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Michelle

I agree!! I’m pregnant at 41 with my 9th child. My husband and I were thrilled with working on IF and keto. I’ve had a history of PCOS but when pregnant again, I wish there was more common sense approaches to our bodies’ glucose changes. I hate the propaganda pushed toward women during all these important seasons of fertility, pregnancy, and postpartum. It seems like all common sense we’ve learned goes out the door when we need it the most!

Your Pal
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Your Pal

please provide transcripts for the podcasts. Not everyone can hear them and not everyone can subject others to noise

corrie
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corrie

I hope that someone by now has seen my prior comments (and facebook message) regarding the new website and the corruption of the older blog posts thereon… No graphs or diagrams or other visual aid have transferred !! What a loss!! I hope someone else thinks so too and is trying to correct this!!

JR62
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JR62

I consider Weston A Price’s book ‘Nutrition and Physical Degeneration’ to be one of the most important book to read if you want to understand how important diet is to human health. You can read it free from online:

http://journeytoforever.org/farm_library/price/pricetoc.html

Rich
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Rich

GREAT BOOK!!

Kurt
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Kurt

Love all the videos, books and podcasts. Love the new look on the website except for one thing. When ever I tell someone about your program, I always tell them to go back to the first of the blog and read them in order so that they don’t miss anything. Unfortunately, one used to be able to navigate around the blog by page. Without that feature it is truly a pain to keep going back to the last blog you read. If you could return the page navigation feature of your blog, it would be greatly appreciated.

Abhay Jajoo
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Abhay Jajoo

Dr Fung. I am part of the IDM and follow this blog religiously. One thing I noticed that your blog posts on this new platform do not have any published date. I am hoping this is a “bug”. The published date allows me (and I am sure other regular blog readers) to track the articles. Would really appreciate if you could put the publish date for each blog post on the blog. Thanks. Abhay Jajoo

Kurt
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Kurt

Do you also have to monitor your patients’ hypertension medication as well as their diabetes medication? Do your patients ever come off of their hypertension medications? I did a search for hypertension to see if any of your earlier blog entries covered this, but I did not get any hits on the search.

Jenny
Guest

Have read both your books and seen all 6 parts of “Aetiology of Obesity’ on YouTube. I’m considering trying fasting and reduction of processed carbs to lose a needed 50-75#’s but over the past 2 years I’ve had a hysterectomy and a thyroidectomy. While my TSH/T4 levels are back in range due to Synthroid I wonder if the IDM approach will be fruitful or am I doomed before I start? Any advice?

Poha
Guest
Poha

News today about Diabetes out-of-pocket costs, in Canada. In comments, nomention of LCHF IF. https://globalnews.ca/news/3818585/liberal-tax-plan-hurts-diabetics-critics-say/ comments As a mother of a type 1 diabetic child I can tell you that the disease is all consuming for parents and management of the disease comes at a cost of more than 10k annually to our family. Unlike type 2 diabetes there is no way to prevent type 1- it is an autoimmune disease with no cure. The disability tax credit, while a drop in the bucket, is a big help for families who are devastated by this disease. I find it particularly… Read more »

Jay Howard
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Jay Howard

I am a bit hesitant to wade in as I know this is a potential minefield. However, I respect Dr. Fung and it appears many of those who follow him are seeking truth with regard to dietary practices, so I will throw my two cents in and see what others have to say. I think one could switch to eating manure and would be healthier than eating the standard American diet (SAD). However, based on the best research I can find, LCHF may not be the healthiest diet for heart and artery health, and currently, heart disease is the leading… Read more »

Kurt
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Kurt

LOL. Who is this, Dr. Joel Kahn? You are a complete fraud. Yes, if I was a Tsimane of Boliva I would continue eating whatever it is that they are eating, but I’m not. Let’s feed the Tsimane diet to the inuit and see what happens to them, but of course we have already seen what happens when you give inuit a large load of carbs. If you want to eat this way, fine. Do it, but why come over here with this garbage? This is the exact same pig of a diet with a little lipstick thrown on it… Read more »

Jay Howard
Guest
Jay Howard

Not sure if you are here to deal with diabetes only, but you might also look to seek out some help for your emotional issues. You seem to be seething over with anger; not good for healing, whatever reason you might be here for. For one, I am not “promoting” anything. I have no gain, financial or otherwise, in what you do or don’t eat. I am engaging in an exchange of views, which I thought was the purpose of an open forum. I feel sorry that your current mental condition makes it impossible to be willing to engage in… Read more »

Kurt
Guest
Kurt

It does make me feel better. Your idea of fair exchange of ideas is laughable. The marketing machine for the keto/low carb and fasting approach pales in comparison to the marketing that your side spews out. Nina Teicholz and Jimmy Moore both rip apart the propaganda movie What the Health and the garbage science that is cited. If you have the research, cite it, but we both know you don’t. Since you respect Dr. Fung let’s look at what he has written on this blog about your “truth”: “The United States Department of Agriculture’s food pyramid would guide food choices.… Read more »

Jon
Guest
Jon

I have also been inspired by Jason Fung’s work with fasting. I have come from 248 to 188 lbs as a 56 year old man, and am now experimenting with using fasting as a weight maintenance tool/method. I was doing ADF for about 2 months at the end, and am now trying a 5 day cycle with fasting on days 1 and 4. I fast 36 to 40 hrs at a time and quite enjoy the feeling and the results. Astonishingly, I have also now been taken off Thyroid medication after 30 years (unheard of eh? supposed to be a… Read more »

Jon
Guest
Jon

Just wanted to add: What if we could take our digestive systems to the gym? As we get older our digestive system seems to slow down as with everything else. And older people can weight train, right? What if you could target train your digestive system and bring it back to life? I think feasting and fasting combined can do that…this has so much potential and is very exciting…I think we are on the verge of something incredible…like a giant reset button!

Kurt
Guest
Kurt

Is Dr. Lam’s clinic still open?

Jan
Guest
Jan

Seems to be, when I searched Google.
http://www.metabolichealthcare.com/

Kurt
Guest
Kurt

Thanks. His contact page said he was not taking patients at this time, and when I tried the phone number it was not working, unless I dialed incorrectly.