Open Letter To Doctors

“Education is our passport to the future, for tomorrow belongs to the people who prepare for it today.” – Malcolm X

Dear Primary Care Doctors,

I am writing to you all with the hope of working together to assess how we can together augment  the current health treatment system to include a health healing system. 

I am IFBB Pro Hafid James and am writing you in my capacity as a lifestyle coach, with all the examples and references I raise based on my studies and experiences in dealing with clients. As a lifestyle coach I work with clients to improve their health that I feel will give them the greatest chance to achieve their respective goal(s). Whether it be weight loss, building muscle, improved fitness or aid with lifestyle-related conditions such as high blood sugar, elevated cholesterol, hypertension etc. I believe the healthier you are the better you can achieve and sustain the desired goal with the added effect of improving ones quality of life. For my clients and myself optimising one’s health is the process of making one whole and balanced, giving the body what it needs and making sure hormones, nutrients, etc. are balanced. 

One of the main obstacles with new clients is having to overcome the conflicting, false or misleading narratives they’ve been exposed to for years. Media sources (social, movies, TV) claim you can be overweight and healthy while simultaneously implying you have to look fit to be healthy. To be clear, I do not define health by a “look”. You can be overweight, ripped or underweight, but if you are not whole and balanced, in my opinion, you are not healthy. We are also subjected to ‘click bait’, books or documentaries full of false or misleading narratives, often based on a non-creditable or incomplete studies with a hidden bias. These are published with more of a profit motive then actually trying to help. The other conflicting/doubtful narrative I observe in a lot of new clients often appears to originate from physicians. This isn’t a generalisation about all doctors. As stated, I am only considering the content of a surprising number of discussions I have had with my clients. I am aware that we need doctors for a multitude of reasons. There are many injuries, ailments and conditions that eating blueberries and kale will not correct. You are a pivotal part of our healthcare system but these are still issues that I feel need to be addressed. For years I’ve avoided discussing this. I deal with clients so I know sometimes they may not give an accurate account of advice dispensed or you tell them do abc and they’ll do xyz. But I keep getting very similar stories from each client and it’s patently frustrating and sometimes heartbreaking to observe what clients have done at the behest of their doctor. So instead of remaining mute, if I speak up I might help change one’s mindset and subsequent approach to their health. 

I personally feel that in today’s society with the understanding we have as it relates to a healthy lifestyle and the benefits it has to improving physical and mental health I shouldn’t have clients tell me “my doctor said I have to lose weight (to get healthy) - so just do an hour of cardio a day”. Physical activity is a factor but shouldn’t be a focus as people with high activity levels get strokes too. It has also been shown that doing cardio and/or extreme low calorie diets alone are not the most efficient or healthiest way to burn fat - observe the aftermath of most ‘Biggest Loser’ contestants. Similarly, I often have to educate clients about high blood pressure and the importance of sodium because their doctor said stop using salt. Without adequate salt/sodium whilst still working out they frequently experience dizziness, lethargy and cramping yet never actually address a major reason for their hypertension - the ‘imbalance’ ratio of sodium to potassium. Or hearing that eating eggs is the reason for their high cholesterol (when it’s the yolk that can help increase HDL and decrease LDL) and yet ignoring the inflammatory foods: pastries, cereals, pizza or the inflammation due to a ‘imbalanced’ ratio of omega 6’s to omega 3’s that the average diet provides. Then there are those clients on multiple medications for multiple symptoms all originating from the same root problem. When I ask did anyone ever do an in depth analysis of your lifestyle habits (mainly dietary) the majority say no. With one food log of their current eating habits I can see what the problem is; they are not eating to provide the body what it needs to optimise weight loss or build muscle. 

We fear the things we don’t understand and we are brought up to be fearful of cholesterol, salt, carbs, fats etc. While scientifically our knowledge on these topics has grown over the last few decades, we as a society have not changed established bad habits. I’ve had conversations with 15 to 50 year olds and their understanding on health was about the same. For example: thinking cholesterol in itself is bad or believing you can get your RDA of potassium from one banana. If we weren’t fearful, but understood the relationship between weight loss/lifestyle illness and a healthy lifestyle we would be in a much better place. The Oxford Dictionary defines doctor as “a qualified practitioner of medicine”. So I don’t expect a physician to have a full understanding of nutrition as it relates to lifestyle illnesses, weight loss, etc., unless that physician went out to specifically seek that knowledge. Physicians have to realise that title ‘Dr.’ carries a weight of creditability to it so when you as a practitioner make certain claims people generally take it as gospel. I know that applies to myself - to a much lesser degree. I have a title of IFBB Pro (International Federation of Bodybuilding), so when I say something it has more weight and creditability then when the average gym bro says it. That’s one major reason why I don’t dispense advice (unless you’re a lifestyle client) because I want to be careful not to give someone only a fraction of the puzzle without access to the whole gestalt. Without providing clear context and enough information, advice can be confusing, rather like reading a study that maintains fats are bad, but the next study says fats are good. What we say (or don’t say) is as important as are the impressions we give to the people we are trying to help.

The other concern I have is the focus on symptoms and prescriptions of different medications for different symptoms without a strong emphasis to improving overall health; we have normalised the automatic acceptance of medication. Some think because they’re getting older administering medication is a normal progression or that their doctor said they had to medicate because with advancing age diet and exercise wouldn't be enough. How can you say diet isn’t enough if we never focused on the diet and their lifestyle in the first instance? These same clients, in their 40’s to 60’s, had high blood sugar, elevated blood pressure, cholesterol, etc. We have worked together to improve their health and they were able in time to discontinue or will soon be off their medication. This suggest to me it’s not so much the age of the body as much as it is how we treat it. Further evidence of this is the increased rate of obesity and lifestyle illness in children. Owing to technology and environmental factors each generation eats worse than their predecessors thus causing these problems to occur at an earlier age. A medication-first mindset also makes it harder to encourage someone to improve their lifestyle. People generally look for the easiest way out of any situation so if they had a choice between eating less highly processed food, eating more veggies and working out as opposed to taking a pill as an alternative people are generally going to take the pill. Not to mention the possible adverse reactions when dealing with drug-food interactions. The drug-food interactions can have a beneficial synergistic relationships but they can also had adverse reactions. These adverse reactions are increased with people taking multiple medications for multiple symptoms. So with the over reliance on medicines physicians can potentially be treating symptoms while blocking or eliminating the nutrients needed to heal the problem. I am not against medication. I know there are situations when medication is needed, but wouldn’t it work better in conjunction with rather than replacement of a holistically based healthy lifestyle? I’ve had clients who were told to take synthetic iron supplements, for example, but if your healthy status isn't complete (healthy gut with a balanced microbiome, healthy cells, adequate vitamin c) you may not be able to adequately absorb it making it less effective from the start. 

I am not blaming the medical profession for our health crisis; everyone has a part to play. From an individual’s own personal choices, to parents trying to change their and their children’s eating habits, to better instructions on nutrition within the school system and access to affordable quality foods are urgently needed. I don’t believe I have all the answers but I strongly believe a comprehensive solution would be proper nutritional education and understanding while forming stronger networks to work together. I work with a therapist, physical therapist, sport coaches, etc. and I also want to work with doctors because we do need you. It would be almost impossible to come out of this crisis without engagement of the medical profession as well. I simply want all interested parties to come together and see how we can work to make a real positive change in Bermuda’s health care system, with both healing and prevention. What I want for Bermuda is what I want for all my clients. To be happy and healthy.