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!