Super Size It With Guest, Dr. Allen Kinsler

Map-of-Obesity-ratesUltrarunner, Dr. Allen Kinsler joins us today to discuss his work with low income and homeless populations and the issues of obesity in the US. Seems like rich folks are gaining weight just as fast, maybe faster, but is it for different reasons? And, the new ET Fartlek feature is a fail. I don’t have the energy to play with the audio tracks, so we’ll work the fartleks into the next show… You’ll have to listen to know what that means.

Direct .mp3 file: Super Size It With Guest Dr. Allen Kinsler

Obese show appendix. Allen sent this to me after the show – Lots of complex issues (I think he’s looking to secure a spot on a future show again… hmmm):

Thank you very much for having me on. I think the saliva finally started coming back in my mouth about 30 minutes ago. Totally nervous. Hopefully I didn’t come across as a pompous asshole doctor. The problem is so complex and getting worse. It is a huge source of frustration. Not to mention that the numbers of people out there that are obese are going to overwhelm the medical system. Some would argue that has already happened.

Medicine/medical care, is very personal and can be a sensitive subject. Everyone has their own experiences and there is nothing more personal than one’s health. It was really hard because the way I practice medicine works for me and my patients. Certainly not everyone agrees with me which is why I am always reluctant to discuss this in public forums.

I am big into figuring out the cause and fixing that issue. I do a fair number of joint injections for pain. However I refuse to inject someone’s joint with steroids unless they agree to go to physical therapy. My explanation is that the pain is there for a reason and steroids are getting rid of the pain but not fixing anything. We need to fix the mechanical problem. I get some resistance but it is amazing when they go and sort out the issue and I never have to inject them again. The more economical plan for me is to just keep injecting them every 3-6 months that only really helps me ($). I refuse to work that way.

I got curve balled with the weight loss drug question: I still don’t know the answer as I haven’t looked up the drug. The quick snap shot of all the weight loss drugs thus far are is this: they yield about 10% weight loss (but only in about 50-60% of people, it’s not even a given that if you take the pill you will lose weight. the pills only work as long as you are on them. Drug approval time for treatment is usually less than 6 months, some of the amphetamine based ones are no more than 3 months. In 12 months time after stopping the drug people gain all the weight back. Cost is usually $300+ a month. In my view having someone lose 30 lbs over 6 months for$1800 (not to mention the costs to see me, get labs, etc etc) when they are going to gain it back seems to be pretty futile and a waste.

I do use medications, many are very helpful. However for my chronic disease stuff (diabetes, blood pressure, cholesterol) medications are always accompanied lifestyle counseling and tons of encouragement with the goal that one day we can hopefully stop the pills.

I did attach 2 articles that I tried to incorporate into the show that provide good discussion. They likely make way more sense than I did.

Really appreciate the work you guys put into the show.

4 thoughts on “Super Size It With Guest, Dr. Allen Kinsler

  1. On the CX Nationals issue, Gary said this event was a “big deal” but I doubt 99.9% of Austin residents would see it that way. Why should the residents of Austin have their park torn up by visitors that are participating in a sport that they’ve never heard of? Regardless of the USAC planning, the number of walkthroughs that they did, and the offered funding for sod replacement at Zilker Park, wet CX courses are unsightly gobs of rutted mud on the Monday after the event and that hardly buys the sport of CX any goodwill, especially when it affects a treasured shared resource like a park. USAC should know this and in general, the USA needs to get away from running boutique CX events in manicured parks and golf courses. I’m sure they could have found a course 30 miles west in the hill country where nobody would have complained about running Nationals after a few days of steady rain. Didn’t Lance used to host a MTB race out there on his ranch? In Belgium CX events are held on the outskirts of towns, where they run the courses through farms that are plowed up anyway in the spring. Finally, of course Gary knows that Austin is an oasis in Texas, much like Ann Arbor, Cambridge, Boulder, Athens, or any other prominent university town where the thinking may be a little different than the greater area that surrounds them. It’s a learning experience for USAC, let’s see if anything is done differently in Ashville, Hartford, and Reno.

  2. Thanks for the show (and good top 10 list too). Coincidentally, on the commute after listening to this on a run, I caught the last bit of Brian Wansink being interviewed on NPR about the same issues.

    I hadn’t thought of our national obesity rate as a very complex issue until this show. In addition to savvier and savvier marketing of food products, it seems like convenience of fast food, and availability of healthy options, has never been as big of an issue as it is now. When we’re on the road and stop for lunch, the only healthy options I’ve been able to find for our family are either a) pack lunch ahead of time from home (as if we’re going on a journey in the wilderness), or b) going into a grocery store and buying individual items. I’ve seen articles on “food deserts”, and it doesn’t even seem like that research takes into account the scarcity of healthy foods available for people given their behavior patterns (on the road, getting quick bite to eat during commute, school kids with limited transportation). It also seems like family food traditions have never been as unhealthy, and are growing unhealthier.

    Re the moto super cyclo cross, maybe it’s time to spin off a new podcast?

    • I agree with you Nicole. You have to expend so much more effort to eat healthy or even just reasonable. The default is bad food unless you really plan ahead.

      We didn’t even get a chance to hit on much of the lifestyle barriers: feeling safe enough to exercise (violence, cars, snowplows, etc), commuting, city planning (suburbs don’t encourage walking to the store, etc), elevators, desk work, etc, etc. People just don’t have to move as much these days.

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