Why can’t mainstream medicine admit low-carb works?
, medical review by Dr. Bret Scher, MD
in Weight loss 
A leading American low-carb physician (who personally lost 150 pounds on the ketogenic diet) expressed his anger and frustration over the closed minds of mainstream physicians who won’t acknowledge the mounting medical evidence in favor of low-carb eating.
Dr. Tro Kalayjian, a board-certified internal medicine and obesity medicine physician, just published a heartfelt, almost despairing blog post about spending a week listening to speakers at the recent Obesity Week Conference in Las Vegas, Nov 3-7. The conference brought together more than 4,000 obesity professionals from around the world. This year, the annual conference focused on diabetes.
Kalayjian, who goes by the name “Dr. Tro” on his blog and social media, lamented: “I don’t quite know how to express my feelings and thoughts about this event, but the words ‘anger’ and ‘hopelessness’ immediately come to mind.”
That’s because speaker after speaker at the event, while touting “there is no one best diet”, still then defaulted to promoting a low-fat diet, with multiple small meals featuring plenty of “healthy” grains, fruits and vegetables. This, writes Dr. Tro, is “legacy” messaging that ignores the mounting evidence in favor of low-carbohydrate diets for diabetes management and reversal.
“My anger and hopelessness are best exemplified by the first keynote speech, delivered by Dr. William Cefalu, who is chief scientific and medical officer of the American Diabetes Association,” writes Dr. Tro, adding that Dr. Cefalu stressed, “The best diet is one that a patient can adhere to.”
But, says Dr. Tro:
If adherence is the main issue in the diet wars, then low-carbohydrate and time-restriction (both ketogenic) approaches should be considered the BEST diets…… The statements that harp on dietary adherence are a half-hearted attempt to recognize the growing data of approaches like low carb and time restriction that pay little attention to the failed messaging of multiple small meals, lean meats, and whole grains.
Dr. Tro is the medical director and founder of Dr. Tro’s Medical Weight Loss and Direct Primary Care, in Tappan, New York. He is a member of Diet Doctor’s new Low Carb Expert Panel. This panel is made up of a select group of nine talented and experienced low-carb clinicians who are helping set the standard of care for therapeutic use of low-carb and keto diets. Dr.Tro supports patients in low-carb and ketogenic eating for weight loss and diabetes management.
At the conference, Dr. Tro was struck by the fact that physicians refuse to see the big picture.
These puzzle pieces seem to be hiding in plain sight. Several lectures mentioned the harms of sugar and sugar-sweetened beverages. And yet low-carbohydrate approaches are glossed over in favor of low-calorie and low-fat diets, medications, and surgery. Why can’t these physicians put the puzzle pieces together?
As we said in our Facebook post about his blog: It is time for more obesity and diabetes doctors to admit failure. Let’s stop the fake open-mindedness, claiming “there is no best diet” while then continuing to promote only a high-carb, low-fat, eat-often message. We know it is less effective than a low-carb, ketogenic diet for diabetes management and better blood sugar control.
For more, read Dr. Tro’s post: Obesity Week 2019: Why is it So Hard for Doctors to Admit Their Failure?
Guides
How to lose weight with a low-carb diet
Why low carb can help you lose weight
Posts
All weight loss is not created equal
Why the scale is not a good marker of successful weight loss
Weight-loss videos
![Are all calories the same?]()
- MEMBERS ONLY
![Why a low-carb diet and other questions]()
![What's it like being a low-carb doctor on TV?]()
![Is obesity caused by too much insulin?]()
- MEMBERS ONLY
![The cause of obesity]()
![The cause of obesity and diabetes]()
![What to do instead of counting calories]()
![The perfect treatment for diabetes and weight loss]()
- MEMBERS ONLY
![Low carb explained]()
![Becoming a low-carb doctor]()
![Motivating people to change their lives]()
- MEMBERS ONLY
![Do you have to count calories to lose weight?]()
- MEMBERS ONLY
![Weight-loss struggles of women 50+]()
![Advanced low-carb tips!]()
- MEMBERS ONLY
![Can an overweight person be healthy?]()
- MEMBERS ONLY
![Why we get fat]()
- MEMBERS ONLY
![Isn't weight loss all about counting calories?]()
- MEMBERS ONLY
!["I was becoming that stereotypical fat doctor"]()
When I was diagnosed with my hba1c at 7, which came as a complete surprise to me because I had been eating the American Diabetes Association diet guidelines for more than 30 years in an attempt to prevent diabetes because I had seen my cousins lose their lower legs and feet - so when my dad at age 70 was diagnosed with diabetes I chose"prevention," my doctor said it was time for medication. I was already taking drugs for hypertension, arthritis inflammation, fibromyalgia, and depression and I did not want more drugs. So I told him I was going to get online and find out if there is a better way to get this under control with my diet. His reply was, "okay, but come back in 3 months to have another test run and we can discuss the situation again then."
I came home and googled "diet to reverse diabetes" and the dietdoctor.com website came up and I spent 3 days reading everything on it, I bought Dr. Fung's books on Amazon for next day delivery, cleaned out my pantry, went shopping for food and a glucose meter and started eating Keto by the end of the week and I did before and after testing of every individual food I ate in an attempt to learn how my body was responding to what I ate. As I noticed changes in blood pressure which I had been tracking daily for years I slowly cut back on how often I was taking the hypertension medicine (I called my doctor to discuss it first), then one day I noticed I wasn't having pain that needed medication any more so I never took any more of it, and I tapered off the anti-depressant (I had been on it and off of it for 12 years so I was well versed in this) and then a day came about 8 weeks in that I noticed for the first time in more than a decade that I felt really amazing, I felt like I had before all the illnesses had set in - I cried tears of pure joy my heart was bursting with gratitude for Dietdoctor.com. When I went back to the doctor for my 3 month check up my HbA1C was 5.3, and I had lost 80 lbs in that 3 months without exercise because I am disabled. My doctor was shocked, which is putting it mildly. His eyes welled with tears for me. For that appointment I prepared a print out of what I was eating, links to the websites I was using, and information about Dr. Fung's books and I gave it to him, and I said, "Doc, please read this because it is saving my life and I know it will save many other lives." When I went back for follow-up at 6 months I was down a total of 110 lbs, my HbA1c was still 5.3 but this time all my other blood markers were remarkably healthy as well - great Cholesterol and Triglycerides, no more inflammatory markers, my Vitamin D level which had been critically low and for which I took prescription Vitamin D of 50,000 units 3 times a week for 3 years and it had not gone up to a normal range was now in a normal range without the pills, my B12 went into the high normal range and it had been deficient, and many other things improved as well. This way of living began in April 2016 for me and it has changed and saved my life. It hasn't always been easy because there have been long plateaus, and I would like to drop 100 pounds more so I keep testing and changing things up but the fear that doctors have about people not being able to sustain this way of eating are unfounded. After all, our ancestors did it for thousands of years - and if a doctor simply tells patients the truth about the fact that the whole of their physical well being can be greatly improved upon, medications abandoned, and great joy returned to living + an increased possibility of staving off many modern diseases such as Alzheimers, depression, other forms of dementia, hypertension, PCOS, etc - patients will be much more willing to learn about it and make it happen.
One note about my doctor - He used the information I gave him. He made information sheets to give to patients, and because he is a teaching doctor at the clinic and hospital in my town - he talked with the other doctors about it and set up a "keto support group."
The best doctor is one that can admit they don't have all the answers, and will listen to what their patients tell them and ask questions to fully understand their life and their circumstances.
Those who admit that they were wrong have a chance to regain my trust.
His direct language and simple message may have a chance at getting through.
Challenge all the delegates to use LCHF on 10 of their most difficult patients and come back a year later with the results.
Maybe structure the challenge as a big group study.
My weight went from 107 kgs to its current 91 kgs. Although my weight loss rate has slowed, my body measurements continue to reduce as fat gives way to muscle. Blood pressure went from 140/85 to 117/70 resting. All within the short space of 3 months.
Following a LCHF regime was simple as; cut out bread, potatoes, fruits, pasta and fermented wheat products. My new habit tells me to look at the carb content and total sugars as described on food labels - and refuse the high content items. Easy enough to bypass take away food shops and sandwich bars. Dining out, I've found most restaurants will happily substitute high carb ingredients if asked.
Thanks Andrea (my enlightened GP), and thanks to the authors of "What The Fat?" (recommended reading, available on line and Kindle).
Cheers
Had my doc told me this I would've went home and started the CHOCOLATE DIET asap, lol. God bless Dr. Tro, Diet Doctor and other docs out there who really care about their patients.
One Dr at a time, it is a start and what you have done you have literally saved several others. Awesome ......
I want Dr. Tro and all LC docs to remember that it’s not about their medical colleagues; it’s about US, their grateful patients and followers! Please keep focusing on us and not the naysayers! We appreciate you.
I switched from ER to clinic a year ago as part of my plan to de-stress and reduce cortisol levels and at the clinic I have begun teaching patients about the benefits of eating this way. I wish I could say I am well supported in this, but I am not. And I find it increasingly difficult to work on a team that is pushing statins and pushing insulin (for Type 2 DM might as well wave the white flag of surrender.) Despite this lack of support, patients who have met with me instead of the diabetic educator are seeing bigger drops in their A1cs and their weight, despite not eating those "healthy grains"! I've helped a 570 lb patient lose 140 pounds and we haven't even been at it a year. His biomarkers are great. His stasis ulcers healed. I worked with many patients, with less dramatic results, but the community is several thousand pounds lighter. Seems like you'd think they'd want me teaching 40 hours per week. Ha! I wish. No in fact I'm starting to get push back. Our clinic puts on "lunch and learns", serving up pizza and soda. Donuts and bagels and sugar everywhere. Candy magically appears on my desk. I feel like I'm on a keto globe amongst sugary flat earthers. Considering dropping out of mainstream medicine all together. Sigh. I come here for inspiration and knowledge building. If the folks at Diet Doctor notice a lot of traffic from a little rural county in Northern California, it's probably from all the people I inform about Diet Doctor. Keep up the good work.