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Obesity and Fitness Are Revolutionized by Reddit, Not Doctors
Greatist Journeys explore amazing stories from extraordinary people. Richard "Dick" Talens is the Co-Founder and Chief Growth Officer of Fitocracy, one of the web's most popular fitness tracking sites. The views expressed herein are his. For more from Richard, check out his profile on Fitocracy and follow him on Twitter.
My parents are medical doctors — my dad is a family practitioner and my mom is a rehabilitation specialist. For as long as I can remember, their friends and patients turned to them for nutrition and exercise advice (which I’ll often refer to as just “fitness” for brevity’s sake). “Eat less, move more,” they would prescribe for weight loss, which made up the bulk (no pun intended) of their fitness requests. I grew up in a small community, so I would often see their patients greeting them on the street, each time just as rotund as the last time I saw them. I was also a bit of a chubby kid myself, which I attributed to physical laziness, rather than my diet. After all, I’d always assumed my family ate healthily; we consumed plenty of whole grains, fruit, and vegetables — just like the ones prominently displayed on the food pyramid that I vividly remembered hanging on the walls of the doctor’s office.
A few years later, in my own attempt to lose weight, I discovered the world of “Internet fitness” which was then still in its infancy. In 2003, it was impossible to find online fitness communities that did not involve an unnecessary array of shirtless men and supplement popups. Needless to say, a geek like myself found this world to be a strangely fascinating but intimidating place. It was the first time I saw people successful in their fitness endeavors. The strangest part was that, within these walls, people blatantly ignored most doctors’ fitness recommendations. Those with the most success actually ridiculed FDA requirements and turned a deaf ear to medical professionals.
Huh? How could one ignore the fitness advice of doctors only to achieve better results? It wasn’t until years later that I understood the answer.
The State of Affairs
The U.S. is currently spending $190 billion on obesity, an entirely preventable disease. Many people assume that doctors, key players in health care reform, are competent enough to battle this epidemic through prevention. But what if I told you that many doctors know just as much as, say, the person sitting closest to you while you read this article? Dr. Yoni Freedhoff, who runs one of the largest behavioral weight management programs in Canada, and authors the blog “Weighty Matters,” says just that.
"Despite the fact that diet and weight related disease are the leading cause of death in the developed world, most medical schools and residencies dumb it down to "Eat less, exercise more." If it were that simple, of course, the world would be skinny. That oversight fails not only our physicians, but society as a whole," says Dr. Freedhoff. By the way, Dr. Freedhoff tells me that the entirety of his knowledge on the subject came from other sources.
You might be wondering why “Eat less, move more” doesn’t work from a fitness standpoint. It’s because the adage provides absolutely no context, no detail that one can use to reach their goals. When it comes to weight loss, creating a caloric deficit is the most important thing that matters; eating less, not moving more, is the most realistic way to do so. Here's a discouraging fact: A 220 lb. man walking up 27 flights of stairs burns the caloric equivalent of half an Oreo (check out this completely unscientific, but accurate chart showing the determinants of weight loss). Many people focus on the “move more aspect”, only to find themselves lacking results and eventually burning out. Now, I didn’t learn this from any sort of formal education. I learned this from my own experiences, the experiences of those similar to me, and just plain reading a lot of science on the subject.
Am I saying that doctors should be thrown under the bus for our obesity woes? Not entirely. Doctors cannot help what’s in their medical curriculum any more than a computer science major can help what programming languages he or she is taught in school. In fact, some doctors are actually quick to acknowledge the gaps in their education. I’m simply arguing that the answers to obesity cannot all be found in the medical profession.
Here’s a good case-in-point: Over the last few decades, it was not uncommon for doctors to turn to the food pyramid when providing dietary recommendations. Yet those versed in the latest nutritional literature (and almost everyone who frequented a fitness community) knew that this was a farce. “I think you could turn the food guide pyramid upside down and it probably would work better to be frank,” says Dr. Layne Norton, a PhD in nutritional sciences. “Studies have actually shown replacing some carbohydrates with protein actually provide better body composition and health outcomes”.
Knowledge similar to what Dr. Norton presents was unfortunately tucked away in the fitness niche corners of the Internet for much of the last decade. You wouldn’t stumble upon it unless you were a hardcore fitness enthusiast or a researcher trolling through the thick jargon of PubMed. Until a few years ago, few people outside of my fitness network were familiar with basic, science-backed fitness concepts, such as increasing protein, ignoring dietary fat paranoia, and compound resistance training. Then, something amazing happened that pushed this content toward the mainstream: Social discovery sites like Reddit were born.
Reddit and the Birth of Online Fitness
Reddit’s fitness subforum, /r/fitness, is different from the average fitness site in two ways. First, Reddit’s voting system provides a reliably transparent soundboard for fitness knowledge. Fitness is an industry rife with myth and misinformation, and on other sites, it’s extremely difficult to separate fact from fiction. On /r/fitness, users post a piece of fitness content and the community quickly bands together to dissect it. Good information that holds up to scrutiny is voted up and codified into the community’s beliefs while myths are quickly demolished. Secondly, Reddit attracts relatively mainstream users that would never dare set foot in a fitness forum. For the first time, many truths on exercise and nutrition were being spread outside of the niche fitness world. Findings that flew in the face of traditional beliefs like this one — stating that cardio is not an effective means for weight loss — were suddenly brought to light and spread at a rapid pace.
Reddit obviously isn’t the only burgeoning hotspot of fitness knowledge on the Internet, but its dynamics make it the best example of a recent trend. Lately, you’ll find fitness forums on many geeky, non-fitness focused websites, such as Something Awful, XKCD’s forums, and even 4chan (protip: don’t go there). Much of their content contains information gleaned from findings first brought to attention by Reddit. This new movement has acted as a catalyst for many new communities, which have popped up in the last few years, such as Paleo, CrossFit, and Intermittent Fasting.
Basically, geeks did what they do best. They accumulated fitness knowledge and spread it as if it were a funny cat picture.
The result is an era of health empowerment made possible by the Internet. A person like Jesse Stillwell suddenly found himself losing over 300 pounds by essentially following a high fat, low-carbohydrate regimen many doctors would scoff at. He learned about it on Something Awful, another geek hangout spot. “If I were just told to eat less, move more, I would have quit at the 'move more' part,” Jesse told me. A World of Warcraft veteran, Jesse would have never stepped foot in a traditional fitness website.
Where We Go From Here
But let’s stop for a second and be realistic here. Obesity is a far-reaching epidemic, and most people who suffer from it aren't going to go scouring Reddit for fitness advice. What this latest trend does do, however, is offer some hope that knowledge will eventually make it into the hands of the mainstream. Just as fitness myths are propagated because they are repeated over and over again, one can only hope that facts can do the same.
We cannot look to the current healthcare industry for many of the answers.In fact, that industry might be incorrectly named. Just ask Joseph Lightfoot, a medical student in his final year who, as a coach for the UK’s under-19 lacrosse team, is familiar with the worlds of both fitness and medicine.
“In medical school, I have learned about disease,” said Lightfoot. “However, I have not learned about health.”
And for now, the Internet is the best option that we have in the fight for better health.
Do you agree with Richard? Is the Internet an effective tool to spread health knowledge and combat obesity? Let us know your thoughts in the comments below!
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I agree 100%—I changed my whole family's health by dumping the mainstream advice that had never worked and trying some "crazy" Paleo diet I found on the Internet. (And I can't wait until this hits the mainstream and people stop using that word about me.)
Great article, love it! ... I stopped using mainstream advice for health and fitness and turned to the internet about 10 years ago, and I'm so glad I did.
It makes me sad though that so many people still seek the advice of mainstream so called professionals, who like this article only know how to treat disease and not create health.
Great post Dick. As a future doctor, and a enthusiast of all the beliefs you've discussed, I agree that the medical establishment has failed when it comes to stymieing the obesity epidemic in this country. I won't go so far as to say it's responsible for it, nor do I think with perfect information, clinicians can turn the ship. It is such a multi-factorial, complex phenomenon. That said, during med school and thereafter, I am going to do all I can to make sure that I can redirect efforts towards maintaining good health and spreading effective, sustainable policies. The sources that flow to the masses should receive information through the careful, and objective sieve of physicians, scientists, and the larger healthcare industry which are armed with the resources, training, and social responsibility to hold intellectual high ground. It would be wise for the establishment to learn from the lessons of the internet community so that effective policies can become the new mainstream.
Oh joy, yet another millennial who claims to have discovered truths that prove the "so-called experts" wrong!
Personal anecdotes might be personally compelling, but a subset of Redditors sharing stories does not constitute a scientific study. There are piles of scientific articles out there - go read them before doing the Dunner-Kruger thing and self-declaring yourself to be more knowledgable than the folks who have devoted their lives to studying these things.
@Sfzc Let's be clear here, the author never mentioned that all experts were wrong. When it comes to health and fitness, the experts that do devote their lives to studying these things would be nutritionists, dietitians, physical fitness researchers... What he stated was that not all doctors have the proper knowledge to provide fitness and nutritional help, which is true. Different types of doctors have different levels of expertise when it comes to exercise and nutritional assistance. I would not go to my family doctor to ask for advice because I know I would probably not get as much knowledge as if I were to ask a nutritionist at my gym. Now even though experts study tirelessly around these subjects, with all the knowledge we know about our bodies today, one cannot expect a doctor to know every single detail. Tying into this, the mainstream types of fitness advice many doctors provide today (because they do not have the proper knowledge, nor do they necessarily require it in their everyday practices) cannot be the answer for all people requesting nutritional and exercise help... That is why Reddit is such a great platform to search for advice; online fitness provides the opportunity to discover contemporary methods of losing weight or improving fitness levels.
@Sfzc Did you even read my article? ;)
@Sfzc I think the point of the article is that most doctors *don't* spend their lives studying nutrition and weight-loss. For that you have nutritionists and dieticians - most of these have their own opinions on a healthy lifestyle. I have read a number of scientific studies that support and refute the low-carb diet (studies shouldn't aim to support or refute anything, but there you go). I've been as critical as I can, and I can happily come to the conclusion that sugar is worse for you than fat. I'm not going to tout it as the truth, but it's what I have discovered and I'm not going to ignore science just to go along with the social norm of dietary fat-bashing.
@Sfzc I think you misunderstand the article. It says the opposite. The social forum platform allows aggregating of the scientific evidence, dissecting it, debating it, disseminating it, and answering questions. It isn't proving "so-called experts" wrong, it is presenting the work of the experts and making it accessible, including uncertainty and/or options. (There is more than one way to be fit.)
The problem this solves isn't the fallibility of experts; it is weeding through the information for your specific case. Most medical doctors are generally not experts in this field and don't keep up with the science. (Your GP isn't an expert on many things health related which is the "General" part of GP. They send you to specialists for specialized knowledge, whether it be a neurologist, proctologist, ob/gyn, dentist, or nutritionist).
Then there is the problem with seeking advice from individuals with agendas. If you go to an Atkins service you'll be told the Atkins diet is best. If you go to a Paleo diet pusher, you'll get pushed towards a Paleo diet. And those are possibly effective programs. Then there are the snake-oil salespeople with ineffective programs and devices.
This is why a public forum with at least a few science-minded people competing their findings can lead to better understanding and answer specific questions. It is basically a public version of scientific peer review of specific questions, complete with competing evidence and links to references.
@Sfzc For the last decade, I've talked to thousands of people, spent thousands of hours reading pubmed magazines, experimented on my body using different methods... everything from low carb to fat to intermittent fasting... and worked 1-on-1 with dozens of clients.
So nope, no Dunning-Kruger here (that is what you meant when you said Dunner-Kruger, is it not?).
For the last decade, I've talked to thousands of people on the Internet -- many experts like Martin Berkhan and Alan Aragon, spent thousands of hours (not a typo) reading pubmed studies, experimented on my body using different methods... everything from low carb to fat to intermittent fasting (lost 70 lbs of fat and put on about 40 lbs of muscle), and worked 1-on-1 with dozens of happy clients on a multitude of fitness goals.
So nope, no Dunning-Kruger here (that is what you meant when you said Dunner-Kruger, is it not?).
I have personally spent a large chunk (10+ years) of my life using myself as a guinea pig with regards to health and fitness and have experienced the things that do and don't work, so does that make me more or less of a so called 'expert' than those who have devoted their lives to 'studying' these things?
What about yourself Sfzc, have you 'personal experience' or do you rely on studies like the 'experts'??
“Eat less, exercise more.” If it were that simple, of course, the world would be skinny.... BUT it's not that simple because people refuse to eat less and move more. and who is advocating aerobic exercise WITHOUT eating less? the two in conjunction will improve health and increase fat loss. it even states in the studies you reference, some of the links don't even work properly, that the study participants did not change their diets. so if their exercise is not burning more calories than they're consuming, it won't do much. this woefully oversimplifies the situation, not to mention omits pertinent facts. bogus articles.
They're kind of revolutionized by both. I mean.. last time I went into the doctors office he asked me how much exercise I was getting.
I disagree, "Eat Less and move more" (or, preferably, "Eat better and move more") is VERY effective, but it should be used as step 1.
If you're overweight and live a sedentary lifestyle then "Eat less/better and move more" is a great way to start down a healthier path, it's worked for me and some of my friends, but you have to keep the understanding in mind that it's a step on the path, not the real solution.
"Eat less and move more" is a great rule of thumb when it comes to losing weight. Unfortunately, many people do not understand that this "rule" implies something crucial to the process--discipline.
Internet fitness? Reddit? You mean those "gurus" who guarantee me weigh loss in days without me doing anything except give them my credit card number in exchange for a box of baking powder pills and a pretty bottle of colored water? Or those pathetic "experts" peddling their "revolutionary weight loss e-book"?
Should I rely on the Internet for information regarding my health? Yes, but I will still gravitate towards reputable sites. The Internet is where you can find such advice as, sc**w the medical community; I lost 30 pounds on a high-fat diet and I'm telling you that you should do the same thing, (check out my blog and my pics on Facebook if you need proof)!" Between losing 30 pounds but clogging my arteries triggering a heart attack, and sticking to "eat less and move more," which ALSO WORKS FOR ME EVEN THOUGH I DON"T BLOG, REDDIT, etc. ABOUT IT, what do you think would be the better option?
Finally, are you and your final-year-of-medical-school friend surprised that doctors are taught MOSTLY to cure disease (or sew that gaping wound of yours that you got in an accident) and not to "create health"? Would you also be surprised to learn that architects learn mostly how to design buildings and not actually to construct them (and so it's not always their fault if the building collapses--could be the sub-standard cement used by the greedy contractor).
At least you had the sense to acknowledge that health care and obesity are big complex issues and not all the answers can be found on the Internet. Frankly, that is a monstrously SILLY assumption.