Marginal Exercise Advice From a Newbie

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Albert finishing 10KI have lots of patients who are incredibly fit. I have patients who have run marathons. I have a patient who rides in rodeos. I have patients who have completed Ironman Triathlons. And I have lots of patients for whom exercise has always been a part of their routine, a lifelong habit. Though...
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Are You Obese?

Americans are getting heavier and have been doing so for decades. One in three adults in the US is obese. Overweight and obese people are more likely to develop diabetes, high blood pressure, heart disease, and other serious health problems. What can be done? Last month the ...
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Why Losing Weight Is So Hard

I’ve written many times that losing weight is the second hardest thing I ask my patients to do. (Breaking an addiction like smoking or alcoholism is the hardest.) The frustrating thing is how little we know about how to lose weight successfully. But we are learning more all the time about why losing weight is so difficult. Much about dieting and weight loss is poorly understood, but let’s first lay out some facts that are well established. Weight loss and weight gain are caused by an i...
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Yoga Or Stretching Helps Chronic Back Pain

Everyone hates stress, and for good reason. Stress makes us miserable. Perhaps for that reason, stress is blamed for virtually every disease for which the cause is still unknown. Later, when we discover the true cause, we find that it is unrelated to stress. We thought stress causes stomach ulcers before discovering the bacterium that is the true culprit. We thought stress caused heart attacks before a study comparing high-stress to low-stress individuals showed that this wasn’t true. Stress cau...
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Linaclotide is Safe and Effective for Chronic Constipation

Chronic constipation affects about one in six people in the U.S. and is a problem that primary care doctors hear about very frequently. Symptoms include infrequent bowel movements, hard stools, straining, abdominal bloating and discomfort, and a sense of incomplete evacuation. It’s not a dangerous problem, but it causes plenty of misery for lots of people. Though doctors have a few remedies for chronic constipation (which I’ll list at the end of this post) they are only temporarily and modestly ...
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Sitting Won’t Kill You, Except on Train Tracks

In the last couple of weeks the media has published stories making it sound like your Ikea chair is a death trap waiting to assist your suicide through the dangerous activity of sitting down. Stories with sensational titles like “Is Sitting a Lethal Activity?” (see link below) make you think that you’re better off walking outside for a smoke. Let’s spend a few minutes sifting the solid science from the wacky conjecture. You might as well sit down for this. The media interest in the idea that si...
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Evidence Mounts in favor of Weight Loss Surgery

Readers who have been following my posts for a few years know that weight-loss surgery is amassing an impressive body of scientific evidence supporting its effectiveness and safety. (Links to my previous posts about weight loss surgery are below.) This week, two studies in the Archives of Surgery attempted to compare the different kinds of weight loss surgery. An LA Times article (link below) has a clear explanation of the different kinds of surgery and summarizes the findings of the studies. T...
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This Isn’t Your Father’s Heart Disease

What’s the most common cause of death among American women? Breast cancer? Accidents? Suicide after watching too many Lifetime Channel specials? Nope. Heart attacks kill more women than any other cause—same as men. A generation ago heart disease was mistakenly thought of as an exclusively male disease, but patients and physicians have learned that preventing and treating heart disease is critical in women too. This week the American Heart Association published their updated recommendations for ...
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