Keto, a Primary Medical Treatment: Dr. Westman

Keto, a Primary Medical Treatment: Dr. Westman

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[Music] hello everyone I have another special guest dr. Eric Westman is here I did an interview before so welcome back thank you it’s great to be back and listen I wanted to bring you on because for a couple reasons I’m what’s unique about you is you’re in a clinical setting you actually are medical doctor you practice on a regular full-time and you your mode of therapy is like food therapy like you do keto I mean this is like so rare so I wanted to get a chance to pick your brain and just dive in here because a lot of times if you look at the videos out there they’re from people who have never actually worked one-on-one with a patient and that is a huge advantage when you’re dealing with just experience because you don’t always get the same type of person so I think probably being a practice expanding your view point of you know you can’t just put everyone into one little hole right absolutely and well as you know as a clinician everyone’s different so people have different stories different actually different metabolism different bodies so having a clinical base for me now and and in the past I’ve been doing this now about 12 years in a private practice at a university at Duke University and that was after eight years of clinical research doing clinical studies and publishing them in peer-reviewed journals so I know the difference also between doing a study and doing something in clinical practice you have much more flexibility when you’re dealing with someone one-on-one in the clinical practice exactly so that’s why I wanted it I want to try have some very interesting questions the first question is when you have people that come in to see you are they looking for Kito or are they looking for losing weight do they know anything about keto the whole gamut excuse me I’m in a unique setting where well some people walk into my office and they I watched every video of mine they they know exactly what to do in fact money because they have to wait have already started that that’s a whole gamut from also I have individuals who are referred by other doctors in the area here in Durham in North Carolina and they are not so up on the they may not even have Google to do a little research on what the clinic does and then and the third set of folks have no idea what I do they there they just come in the my doctor sent me I guess in that middle group it’s people who have asked their doctors for help with obesity with you know treating with weight loss or diabetes control but it I think a unique nature of the clinical setting I’m in because it’s a insurance and Medicare Medicaid based so the other types of health care providers I get a wide range of folks actually very rarely did someone come in and pay out of pocket to my Wow Duke so yeah some people have no idea why they’re there most people come for obesity and diabetes treatment although I’m comfortable now treating most diseases with monitoring because I’m an internal medicine specialist by training but answer your question most people come for obesity and diabetes but not everyone interesting now I get I get this a lot so people always ask me well do I have a referral from new medical doctor just just because you know in my area min Virginia you know there’s there’s not a lot of medical doctors that even know about keto they’re not taught that so people are trying to go to the medical doctor and try to like they want to be on this eating plan but they also need the medical doctor so there there’s they’re doing this this conflict so do you what’s your you know your quick answer on dealing with their doctors and that are kind of anti they’re kind of like oh no you shouldn’t do that that’s number one it’s it’s dangerous it’s gonna put you at risk so you know that’s one of the things I mean if they live close to you of course you would come to see you but what if they’re Nebraska and they’re like on that what am I going to do yeah of course we’re trying to fix that within our new company which I will talk about later I hope but in actually making available doctors and training them ourselves but yeah the current situation is kind of sad you know if a doctor says it’s unsafe or it’s gonna kill you they’re clearly out of touch so you know more than your doctor does there was a recent article in the news that said you know here are diets that are deadly and keto was one of them is right now I do kind of roll my eyes because that’s so out of date and you know you can’t police every media report but so for doctors well I guess I have two responses one is if you’re otherwise healthy if you’re not on any medications you don’t have any really serious medical problems ongoing I mean you had your appendix out and and maybe your tonsils and and something you don’t need your doctor to do this I mean there’s enough information now that you can do this with proper teaching and coaching without your doctors support and so or one thing you can say is well can we agree to disagree on the diet I’m just going to do this can you monitor everything else right that you would normally measure that so that’s one strategy but but I do caution that if someone is taking medications and I think if the diet is unsafe it’s just that medications can become too strong right so if you’re handling the district cause the blood pressure coming down you’re on medication now it’s gonna come really low or another point you bring up about if you’re on insulin which I want us to spend a little minute on this because if you’re a diabetic type two and you’re on insulin and you don’t monitor that and you go on keto your your blood sugars are coming down and you’re still taking the same insulin you’re gonna end up with a serious hypoglycemia reaction we see the blood sugar can go down fifty to a hundred units in one day or that’s milligrams per deciliter but I mean 50 to 100 points so if you don’t produce the insulin you will get a hypo now a lot of people get hypose they think nothing of it I I don’t want a hypo man I it can be life-threatening so another strategy that we use is we would rather have the blood sugar be a little higher than to be too low and a lot of doctors don’t understand that they they want really tight control as someone’s changing the diet losing weight so that so actually there’s kind of a training that’s important for doctors to go through that might not be totally apparent to the doctor who’s new to this so even let’s say you went to your doctor if said I’m gonna start this keto diet what should I do with my insulin the doctor might say well you know diets aren’t very powerful you know they’re not very strong just go ahead and try this oh no no no no so that’s a caution I have I mean insulin is being pushed so much now by medical doctors and I Batala gist and and in fact most of my patients think they can never come off the insulin because they yeah yeah and just for those of the that are new watching dr. Westman you just study I think I think this is based on your own clinics that you were able to drop the use of insulin like 98% is that give me the actual figures on that because this is like mind-blowing data right here well so this in several papers that are published in the literature in fact our first one was published in 2008 so that most people have forgotten about it sadly so yes you know in there and you know we made the kind of policy decision to never say that one died it’s better than another another diet can’t work and so in that paper we showed that the low glycemic diet worked for diabetes but the low-carb keto or keto diet worked better and we got to take people off of insulin more frequently a big study that came out this year Sarah Hallberg dr. Hallberg at Purdue was the first author they were able to take most people off or at least reduce insulin in a year and over 200 people now in our own clinic analysis with about 50 people that’s where this data comes from we were able to take people off ninety percent of people off insulin in seven weeks and it says I just want to stop there because that’s like not trivial yeah you come it’s amazing it’s unbelievable it is unbelievable because they we’re talking like 90 over 90 plus percent of the people within seven weeks yeah this should be on every newspaper I mean this is like huge because the because the here’s the problem yes they’re trying to regulate their sugars but the damage of having high levels of insulin people don’t realize that you have a lot of problems with that even like someone’s a diabetic type 2 and they’re on insulin and there are normal blood sugars with Jake and a lot of insulin they don’t necessarily decrease the risk from heart disease do they right no no and it really just creates a chronic meaning a a long term problem that you’ll never fix but you know the insulin field and insulin makers just makes stronger insulin whether now 500 which is five star five times stronger than the 100 units and so people are coming to me and stronger and stronger insulin of course what your body does is just like turning the volume down when the noise gets louder you just turn it down and so that you actually don’t fix the problem you just get more and more insulin in your body says no no no I’m not going to listen so I guess the but the way I say that and one reason it’s not on the headlines I guess is that the dominant medical field of pushes insolence so I it’s you know we’re outliers we still small number of people and depend so I’m kind of given up on trying to change the mindset of the mainstream folks even the general doctors in my area because they’re taught oh you have diabetes you’re gonna have it forever you have to take medicines and you’ll never fix it and that that’s not the case I mean so it’s like as you said right at the start we understand that food is more important than any medication yeah fortunately just not a lot of money and food is a practitioner you he start recommending food and in consulting and education was there’s you know it’s not a money-making activity question I have you were a past I think the rector or I don’t know if it was the president of the American Diabetes Association right yeah no it’ll be medicine obesity medicine Association now president and past chairman the board you get to go through all of those okay so so that was an organization that had nothing to do with keto right well interestingly the reason I got into the obesity medicine Association it was to teach the keto diet and so actually there are a number and I would say I don’t know 5 percent 10 percent of folks who use the keto diet in that Association house the Association has about 2100 individuals so it’s growing I mean it’s small but it’s growing you can actually sit for a board for obesity medicine now called the hey B om American Board of obesity medicine so but in the guideline of the OMA will be Smith’s physician Association there is a a approval of using a keto diet as an a safe and effective way to treat obesity so there is a national organization that approves of sanctions or however you want to say it endorses the use of a keto diet well that is increasing great data because I did idea yeah I probably could use that and just quotes for people that are like oh it’s dangerous well it’s they’re recognizing it well typically your email by the end of the day yeah good now when you when you were running this organization or being a part of it obviously there’s a lot of different fixed ideas or other theories that people have a hard time unfixing like you guys probably would do symposiums and think conventions right yes into meetings every year and you would pose that you would probably speak on Quito imagine now what was the response did they all go yeah this makes sense I’m on board or what did you get people rolling their eyes or what what happened well so I’ve been teaching there for about ten years so in fact the the people who taught me there you know this obesity medicine Association has been around seventy years and so there are people who now retired the people who created the organization and help to teach me as well and they all knew going back to when dr. Atkins was practicing and other doctors who were using different techniques that the low-carb worked and it was just a matter of what people do it is it mainstream enough you know the doctors push back and say you can’t eat all that fat and so it’s changing now fortunately the pop culture is aware that eating fat is not a big a deal as people thought it was but so the obesity medicine Association most of those doctors will use some sort of medication first and then use a low carb or or lower calorie diet in addition to it we now use Lokar yeah yeah they just well so you know the diet is less important is the drugs and that organization as a whole but there is a subset of folks who use a keto diet and only like me so I rarely use medications sometimes I will especially if individual has gone to my you know compadre down the street who uses medication and they don’t want to pay for out of pocket there they might come to my practice which is insurance pay and then ask for the medication that was prescribed somewhere else it’s not like I’m philosophically or morally opposed and that is I mean I’m an internist I used to prescribe medicine all the time now it is I can take it away and I would say 95% of my patients are strictly or just uniquely keto without medication I mean this is the trend this is what people want people want Doc’s that actually involve food they want Doc’s that actually emphasize the food and that’s what’s missing yeah what about there’s another organization it’s called the obesity society what is that what is that all about yeah the obesity society is the research group in the u.s. so I think of the the obesity medicine Association as the medical clinical doctors obesity society is the researchers and then the third group is the surgical group American Society of metabolic and bariatric surgeons and the surgeons and the the research group get together once a year in what’s called obesity week that’s usually in the fall and the obesity medicine Association the clinical group meets on that on its own twice a year usually on one side of the country in the u.s. going back and forth but those are the three major organizations in the US that address obesity what kind of trend tied into research one yeah what kind of trend are we seeing with the medical new medical doctors coming on board using using some of these techniques food therapy whatever what’s happening who is there any training training program is there any type of ongoing seminars with doctors can start to learn these the basics well these are there are a few few and far between the programs that are are starting to me the nutrition part is the old paradigm so you might get into a a program that’s supported in your area by the local hospital even learn from that group but they’ll pull in the old you know food guide pyramid and all that which you know should be kind of erased from history so sadly the groups that are well-intentioned in it and addressing obesity are still teaching doctors the old nutrition or they’re teaching the new medications that are for new fda-approved medications and you know really it’s easy for a doctor just to prescribe a pill or a shot than to go into all the details about the food and make sure they’re oh you know you’re having you know one soda a we could you know with sugar no you can’t do it’s simpler in this big system to just prescribe medicines there’s a third element that we obesity medicine doctors have or a third approach and that’s the very low calorie diets where people just buy the products it’s they’re designed so that you don’t eat any food you don’t take any medicine you just buy the products now the problem with that is when you’re you’ve lost your weight with the product what do you do and so if the you haven’t been taught what to do after you use the products people just go back to that weight and you know two years later they’re on the products I mean so that’s not a great long-term answer and so you you have an interview in your clinic you part of it it’s education right oh yeah so yeah so do if you’re gonna just teach lifestyle or and really I just it’s 100 percent diet at first and my clinic there are lots of ways to do it I mean people can read a book again if you’re you’re not on any medications and don’t have any serious medical problems go out and get one of the great resources now available or you come to a clinic I take an hour in a teaching class format so it’s a group group session so you know all the new people come in get a full 30 to 45 minutes with me or my colleague dr. will Yancey and so it’s like a the model of the clinic that we have is like it’s a referral specialty clinic so other doctors will send patients and I’ll say their doctors don’t get any training in weight loss and I went out to eat special training that’s all I do so I take a history about the diet about the weight and things that people have tried use a one-hour class and you know one of the aspects of the class that you can’t get from canned teaching out there or reading a book is that it’s individualized so someone sits down for an hour with me or with another teacher they can ask questions that in their mind you know everyone has a little different way of looking at nutrition for example you know you said I couldn’t have you know diet soda but can I have carbonated water with flavor you know or you know everyone has a unique way of looking at the world and the nutrition and so a class like that it’s helpful in that regard but it’s not necessary I mean now after the class I usually now allow people to go about four weeks without touching base with me I give them you know email consult if they need it in that time but so there’s the initial evaluation the teaching and then at one month a four-week follow-up visit which works pretty well I like that I am in practice I did seminars some three times a week it was a mandatory orientation and I basically didn’t even take them on unless they went through it so I screened out a lot of people that you know aren’t gonna follow up anyway so I wanted to really get the only the people that were wanting to know about it and they just became great clients and better follow through so I think the you know and they have to get this basic data because you’re basically stripping off all the bad information and you’re getting rid of these myths and one by one but the people don’t even know what they what they have in their mind that’s false until you bring it up and they’re like right what you mean that’s not good I’m like no drinking orange juice every morning is has a lot of sugar you know even when you you know give the whole spiel it’s a lot of information and they go out and there you know life nutritionist dr. grocery store clerk who ever you know church friends at synagogue knit you know they they get the information there you know what are you doing this doesn’t look right and so the follow-up visits are really important to focus people on this and I’m pretty careful to say other ways can work but that’s just not the way we’re doing it and I like teaching someone to drive on the left-hand side of the road in a car it’s a process you learn to get in the car on the other side and you you actually keep to the left of the line they’re not the right of the line anyway so you don’t need the low fat foods out there you can have full fat things anyway so that there’s an initial teaching and then there’s that practical ok you’ve tried it out to it you come back and let’s keep adjusting it’s another metaphor I use is like it’s like teaching someone to ride a bike you know it after a while you just did you get it and then you don’t need your parent or someone behind you making sure you don’t fall but you know you might fall and you know you might skinned your knee when you’re learning to or bruise your ego in the keto world when you don’t do it quite right and a good practitioner will help just kind of in a supportive way through all of those different things because we know that you know you’re gonna fall down if you’re gonna learn to ride a bike you know that’s right well you know I think that one of things I was loved is checking on your website and I really find it interesting what you’re evolving into and you’re going to be spreading because you because here’s the thing like there’s a certain percentage very high percentage of people that are on medications and they’re like ok I want to do keto but then they have to work with the medical doctor altum Utley the ideal situation would be having places at least one in every city a place where you can go that someone’s keto friendly someone that actually educates you someone you can bounce questions someone that can help handle your medications and there’s not hardly anyone that I know other doing this except you you think right now there’s four clinics but you sprint you have these plans of expanding to other clinics around the country and plugging in doctors that are educated I think that is going to be the way of the future and I want to definitely support you on that I think that also I want you to before you explain it what what it is I want people to I’m gonna put a link down below you can check out what dr. Westman is up to and what’s gonna be happening but you can actually even invest in its clinics you can actually support its clinics and you can donate to expanding clinics around the country and guys I had a comment before like oh you know that’s a money-making thing actually no it’s not it’s more like a it’s like a on purpose thing you’re actually because you believe it it’s a it’s a new service yeah and it’s something that is uh it’s ultimately gonna happen but it’s gonna take someone like you to just go out there and start pushing it because it’s a boulder you’re going up against all these fixed ideas however I know a lot of people watching donate to various causes this would be a very very good thing to donate on something that actually is going to help people for real and get results so maybe you can summarize kind of what your plan is to gonna put clinics or get doctors educated and spread it yeah well it just to be clear it’s not a donation it’s actually owning part of the company okay and this is kind of new to me I’d never been involved in a crowdsourcing equity campaign so you’re not just buying a product early and then when the company makes the product you get it that’s a Kickstarter kind of thing this is you’re actually the owning part of the company but if the company gets profitable you gain from that investment so but if you think of it another way you’re purchasing the ability to get a clinic in your area for example so it’s kind of like you are buying something but it’s not a it’s actually equity and stock in the company and you know part of the I’ve been doing this now 20 years in research and twelve years in a clinical setting in a university and universities are not listening in fact there was a paper published this year in Pediatrics where individuals who were doing a keto diet with type 1 diabetes were surveyed and showed that they could get off all this insulin they still needed some but but it was a Facebook survey that’s going to be changing academia and this is a anyway long story short it it’s the people changing the academics so all of the work I’ve done the published papers didn’t change anything Wow and I want change what do I do it well so I’ve been going around talking with people that the grassroots and the grassroots can have to change us which leads to it crowd sourcing equity kind of campaign where individuals with as little as four hundred and eighty dollars can actually change the world and well I finally stepped back and realized with entrepreneurial minded people coming to me that and and you understand this with YouTube’s internet platform but to get to the millions of people who need this we have to do something beyond just an individual doctors clinic all right so now the strategy here is if you can’t lead from the top what you do is you get footholds in all the different clinics so the business model at which you can get to at the heel clinics slash offering site it’s all all in there at your leisure you can look through your your satisfaction but the business model is we go in and get little footholds and clinics we rent space and we do the practice within a clinic that wants it for their patients so there it doesn’t have to be clinic policy change and you don’t have to go against the guidelines and all this is so it’s kind of like the metaphor is like putting a Starbucks or a coffee shop within a target shopping center so established practice already as you plug into a stylish practice and then they want it for their patients and then you’re gonna be raining the doctor no well so no we we trained our own people and we’re at right at the moment we’re using nurse practitioners and pas the different states allow it less expensive yeah and they can be trained very well in a very focused practice I believe and do a very safe job I’ve worked with lots of pas and nurse practitioners over the years so actually we don’t train the doctor in the clinic the doctor just wants it for their patients they realize that they can’t do it themselves so it’s like Target or a big store of benefits they have a coffee shop there because more people will come in they want coffee they get the benefit and yet they don’t have to make the coffee so they’re friendly at least they’re introduced to it and I think as a first step this is gonna be the desk because they’re going to see the results they’re gonna go wow I need to know more about I need to get involved well then that’s what’s happened in my area most doctors turn or become interested when we share patients right it’s almost like there’s a intellectual lazy like people are numb doctors are numb to the science that’s presented right and what they but they do value what happens right in front of them yes so the more and more that we share patients and show what kedo can do that’s how the grassroots can change the system and so I’ve given up on going in change the system from above and then what’s the policy gonna be you’re gonna help you believe that which is against the guideline no you don’t have to do any of that so it’s like establishing a little little beach Aikido friendly beat heads if you will I think that’s brilliant I think that is I see that as being and the wave of the future is gonna happen and I’m glad someone’s doing that I just seem it’s a lot of work and I so I’d appreciate you investing more energy in that can’t stop it now with the mission so yeah right and you you have a lot of credibility and research so that’s gonna be exciting you also I think in your fourth clinic or I was reading the website there was a large group of Doc’s that are gonna be involved in this in one of your clinics or was it a university or what was it you know so our optimal place to go is a multi-specialty clinic where there might be 50 doctors 50 a hundred doctors you know 50 of them are internal medicine diabetes the bread and butter medical issues today well not bread and cheese and butter the conditions are diabetes and obesity so an internist can’t fix that they just give drugs and so a multi-specialty clinic will send all of their patients to the healed clinic that would call it the heal clinics a chi al for healthier eating and living coming out and healing but so they they’ll send all other patients so that for the heal clinic if you put it in the right spot there’s actually no need for marketing because all of the doctors want the clinic there and they’re gonna send their patients there because they want it for their patients so we don’t actually teach all the doctors in the multi-specialty clinic but that becomes the referral source to populate the business for the business model I think it would be great because I would like to even post on the website like just a list of all the different class you can go to if you’re in that area but we need someone in Virginia yeah I think you also have a lot of connections to other medical doctors like even cardiologists and people that are doing keto and different specialties I mean yeah you’re I think I don’t know where I saw it that I was I was kind of Wow there’s this cardiologist oh that was on your um your facebook on there’s different videos there was cardiologists using keynote as fasiqun Aachen that was you know and I have to just also credit you for putting together the doctor birth keto Health Summit in October just like the last October because you brought Dave Feldman and Ivor Cummins who speak a lot about the cholesterol and so the cardiologists are all up in arms the old cardiologists because the total cholesterol and the LDL can look worse but the new way to look at a lipid profile looking at the triglyceride and the good HDL cholesterol actually just about all the time someone on a keto diet it looks better so yeah but there are some established cardiologists who are speaking out about this now you know how Iver Cummins and dave pelman are not medically established folks they’re kind of critics from the outside critiquing what the medical world has done and so dr. Eric thorne in Northern Virginia is a cardiologist who uses this in his practice and talks about it and dr. nadir Ali is in Houston at the University of Houston then Brent sure SH er is a cardiologist in Southern California but you know these are individuals who are just speaking out you know it’s showing data but having the ability to get beyond the you know it’s almost been like a taboo for cardiologists to say anything other than do a low-fat diet and and so they’ve broken out of the mold and I just don’t see any academics in the u.s. there was a conference that I went to in Toronto put on by a Canadian cardiology Association and we had a workshop there dr. Blair O’Neill is the past president of that Association had all those tremendous success on his own which is usually what happens the story behind this and then he asked me to come give a workshop at the cardiology meeting in Toronto and this just happened you know six weeks ago and you know standing room only the doctors are the young doctors are on to this I mean they don’t have that old I’m afraid of the fat what am I going to do they want to do what works but cardiology as that’s not like the last vestige of you know when what about that LDL you know now two-thirds of the time it gets better but one 2/3 of the time we’re doing that well you need to do the small LDL large LDL and even now I just look at the triglyceride and HDL as the main factors and the lipid profile but so cardio they’ll come around but um they’re there again they’re drug focused and like most medical doctors today it’s it’s medication focused right well this has been very enlightening guys if you would like to spread a good message if you’d like to learn more about this these heal clinics I put a link down below check it out look at it read it and get involved it’s it’s a worthy cause and thank you so much doc for being out here and uh my pleasure yep okay but keep up with dude doing Thanks alright have a great great day

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Keto, a Primary Medical Treatment: Dr. Westman

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Dr. Eric Westman’s Site:

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Dr. Berg interviews a special guest, Dr. Westman. He’s the associate Professor of Medicine at Duke University Health System and Director of the Duke Lifestyle Medical Clinic, Co-Founder of Adapt Your Life and Chief Medical Officer and Co-Founder of Heal Clinics.

Dr. Eric Berg DC Bio:
Dr. Berg, 52 years of age is a chiropractor who specializes in Healthy Ketosis & Intermittent Fasting. He is the author of The New Body Type Guide and other books published by KB Publishing. He has taught students nutrition as an adjunct professor at Howard University. He no longer practices, but focuses on health education through social media.

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Dr. Eric Berg received his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1988. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Berg is a licensed chiropractor in Virginia, California, and Louisiana, but he no longer practices chiropractic in any state and does not see patients. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Berg and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. The Health & Wellness, Dr. Berg Nutritionals and Dr. Eric Berg, D.C. are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this video or site.
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