Detail from Pieter Bruegel's The Triumph of Death

The Dark Ages were an inglorious period of human history bounded on the one side by the Classical Age and by the Renaissance on the other.   These grim times began when a classical empire was savaged by barbarians plunging the world into a long era of darkness ruled by ignorance, superstition and fear, and ended finally by the intellectual stirrings of the Italian Renaissance.

I believe that the latest dietary study published in the New England Journal of Medicine is an early indicator that our own era of dietary darkness may be coming to an end.

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I’ve had a number of people email me about a new study appearing in the Archives of Internal Medicine purportedly showing that statins really do provide benefit to those who take them regularly.  As you can see from the heading of an email piece I pasted above, even Medscape is all over this article and blasting it out to physicians all over the world.

I’m sad to say that this is the same kind of paper I would have been taken in by 20 years ago before I really understood how to read the scientific literature critically.  In fact, I would have used it myself to justify giving statins to all kinds of people, and I’m sure other physicians are doing so right now.  But I would have been in error to base my prescribing on this paper, and all the other docs out there giving statins like they were candy are in error as well.

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Despite the title of this post, it isn’t really about why low-carb is harder the second time around per se. It’s more about attitude toward dieting and why diets in general are difficult, sometimes even the first time.  What with it being a new year and all, I figured I would go ahead and get things stirred up early with my thoughts on the psychology of dieting.

I can’t begin to count the number of people whom I have seen in my office who have fallen off the wagon and who told me that they just couldn’t stick with their low-carb diet for any number of reasons.

A typical conversations goes something like this:

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All of you commenters have done your job.  You’ve brought up several issues that I neglected to address in my last post.  Let me address them now.

First and foremost is the question about peri- and post-menopausal hormonal balance.  From long experience I can tell you that it is difficult for many women to lose weight in the peri- and post-menopausal years, especially the peri-menopausal years, without some hormonal balancing. It can be done, but it is more difficult.  MD keeps promising to post on the subject in detail, but right now she’s up to her eyes in another couple of projects that are consuming most of her time.  That time not consumed by her projects is consumed by little ole me, who needs his fair share.

There is a book on balancing hormones that I feel is the best one of the bunch out there right now.  It is by an acquaintance of mine, whom I run into at medical meetings all over the place.  His name is Uzzi Reiss, M.D, and he is the gyn doc to the stars.  I’m not kidding.  He probably takes care of half the peri- and post-menopausal Hollywood crowd.  He has an enormously busy practice.  I pushed him to write a book early on, but he deferred saying that he couldn’t afford the time away from his practice.  But he finally did come out with one.  It was published about 7 or 8 years ago, and so isn’t completely up to date, but, as I said, I think it’s the best of the bunch out there, written by someone who certainly knows what he’s doing.

At the time he wrote this book, he was using Tri-Est, which is a blend of all three forms of estrogen found in the normal female.  MD prefers more estradiol than found in Tri-Est for weight loss purposes; in fact, she, herself, uses only estradiol.  At the time Dr. Reiss’s book was written compounding pharmacies weren’t as common as they are today, so it wasn’t as easy to get estrogen compounded so specifically.  I think for those of you interested, Dr. Reiss’s book will give you a lot of information to get you started on your own quest.  Many women – MD included – started out on Tri-Est and starting fiddling from there.  The most important thing is to work with a physician who knows what he/she is doing to get your hormones working for you instead of against you.

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