Western medicine is solid as a concept but a disaster in mainstream practice. It’s made me a lot of money but I don’t trust it to keep me healthy. Exercise and diet are by far the most effective ways to maintain health and minimize the need for medical care. Good habits should keep me away from expensive medical treatments.

It’s so easy to fall off the exercise bandwagon and so hard to get back on it. Medicine keeps us busy during shifts and emotionally exhausted after. But there are solid ways to keep a good exercise routine going.

A healthy lifestyle

Fat pets don’t get a thyroid test, they get fewer portions. The human body isn’t that much more complicated.

Antipsychotics, beta blockers, prednisone, insulin, and progesterone are among the biggest weight culprits. But a 0.5 gram tablet isn’t going to magically turn into 10 lbs. Metabolism and increased appetite are, however, all potential culprits.

Calorie budgeting is sister to checkbook balancing. Too little and you’ll lose weight, too much and you’ll get fat. A healthy lifestyle is a constant pull and push and unless you’re a weirdo, hitting that perfect balance every day is damn near impossible.

Medicine’s lifestyle

Medicine is a terribly sedentary job. It might not seem that way but your time is spent mostly entering EHR data, standing at the OR table, or replying to work emails.

Sedentary jobs are metabolic killers. Whatever you eat that day goes straight to your ass. And calorie restricting on those days can backfire with rebound face stuffing.

The stress from sustained focus and lack of mobility is the other factor – it increases fat deposition and causes central obesity. It doubly leads to binging which is a condition I know intimately.

A 7-day stretch of work is often followed by 2-3 days of lazing around the house, trying to recover from the onslaught. Not to mention, the diet often goes out the door during that work stretch.

Diet

For many medical professionals diet will do a lot more to control weight than will exercise. The toughest thing about food is that it’s such a great tool for decreasing anxiety.

Eating when stressed, when sleep deprived, when anxious, or when burnt out, is a great way to feel some relief. And it’s never veggies which relieve anxiety, the most potent anxiolytics are meats, breads, and sugar.

Processed foods fuck with your metabolism but the heavy animal leaning US diet isn’t that much better for the stressed out sedentary medical professional. A more plant based diet is probably better though I’m reluctant to suggest a fully vegan diet. It makes for a potent statement but a hard diet to stick to.

I do a mostly whole plant-based diet. Vegetables, fruits, nuts, rice, some bread. With such a diet it’s tough to gain weight. In fact, it can be a little tough to keep your weight on.

Exercise

Keeping up your activity level is critical. Avoiding sitting down for long periods of time will help you burn more calories. This means you can eat more which might help those who constantly feel hungry.

I love the feeling of exercising but I dislike the routine of exercising. The thought of getting ready to go to the gym or starting a workout routine is like sitting down for tax-time.

But once I’m in the gym or doing a routine, fuck, I feel amazing. The muscles flexing, the stretching of the tendons, the controlled movements, the sweat, and feeling my breathing – unmatched.

And then when you’re done and you shower and you sit down to do whatever you were going to do, your body feels light and rested. You have that perfect balance of soreness and relaxation.

Diet Tools

As someone who wants to minimize the need for medications or a doctor, I need certain diet tools. My diet tools are very simple.

• knife
• cutting board
• pan
• black pepper
• turmeric (or cumin, oregano, basil)
• salt
• olive oil

You don’t need a spiralizer. You don’t need a blender. You don’t need a pressure cooker, slow cooker, air fryer, or a microwave.

In fact, you don’t need an oven or stove top. A hot plate will do. Watch YouTube videos and you’ll see amazing dishes created with a hotplate alone.

I don’t use a lot of oil but sometimes I need it, ideally virgin and unheated. I’m comfortable with salt usage if I have the opportunity to sweat it out. You can substitute your own spices but the fewer the better – it keeps things less complicated.

Cooking your own meals at first is a pain in the ass. You’ll likely still go out and get some outside food; some of the bland shit I’ve made in my time has been inedible. But then you figure out which spices to add to stimulate your appetite.

Exercise Tools

For exercise, good walking shoes shoes and a resistance band will get you 95% of the way there.

I first got expensive running shoes. Then hiking shoes. Then I got high quality walking shoes. And then… I realized that I didn’t need any of that shit.

I now use whatever shoe I have. My shitty, used loafers, for example. I have been putting about 15,000 steps on these every day for the past 3 months. I got them used at a thrift store 6 months ago.

With that blue exercise band above I have done all the following exercises:

• squats
• deadlifts
• shoulder presses
• biceps curls
• triceps extensions
• bench presses
• forearm curls
• lat pulls

There are so many more exercises I could do with them but that’s pretty good right there. They accompany me on my travels.

Achieving Good Shape

You’ll know you’re in good shape when everyone tells you “Dude, you looks too skinny!” Since the majority of everyone around you will be a slightly overweight, they’ll consider you underweight. When in doubt, calculate your BMI. If you’re above 20 then it’s not you who has body dysmorphia.

Your weight will fluctuate, that’s normal. It’ll take a while to get the hang of the diet and exercise thing. You’ll calorie restrict too much and rebound into a hangry, binging beast.

Eventually figure out how to assess your hunger signals better. You’ll overeat before you get super hungry. You’ll know when to have more dense foods and when you can get by with roughage.

Being in good shape feels amazing. That’s one thing I’ve unequivocally discovered. There is no mistaking when you’re in good shape – even for the overachieving doctor types.

You might not be all that overweight or you might even have a normal weight but your goods might be in all the wrong places. Stress tends to affect fat distribution, often settling in the center section or more proximally.

The Cost Savings

My main goal of maintaining my health is so that I can stay away from healthcare in the future. Western medicine has its place but it can’t make up for decades of unhealthy living.

Every part of the body has its own instruction manual and it’s different for each person. There are basic concepts worth following such as adequate sleep, stress control, a good diet, and maintaining activity.

A lot of diseases can be prevented. The ones easiest to prevent are:

• type 2 diabetes
• heart disease
• high cholesterol
• hypertension
• osteoarthritis
• digestive issues
• insomnia
• cancer
• major depression
• COPD
• liver disease
• kidney disease

Some of us will lose the genetic lottery and come down with something chronic or terminal. Some things aren’t avoidable but I’m focusing on the things which I have control over.

I hope that I have the maturity to deal with whatever comes up which is out of my hands.

Peer pressure for appearance

Women have the pressure to look anorexic while men have the opposite pressure to look large and manly. For the dudes it means looking thick. You want thick masculine legs, large beefy arms which often means lots of carbs.

I’ve found that when I’m more active than sedentary, when I have a sport which I’m regularly playing, and have a healthy baseline diet, it’s harder for me to gain excess weight.

At the same time, at 6′ tall, I feel best when I weigh 168 lbs but then I look anorexic. So then I try to bring my weight up to around 175. We all feel the pressure one way or another but it’s good to recognize that pressure.

Carving out time

Why are medical professionals so busy? We earn a ton of money per hour and live in a country in which even the minimum lifestyle is a luxurious one by world standards.

Yet we barely have enough time for our families, much less ourselves.

Carving out time to exercise is hard. Maybe you can fit in 30 minutes before your shift or after. But the added stress from this schedule squeeze might have just as many bad effects as being sedentary.

If you’re so busy that you don’t have time to experience some activity during the day then that should be a red flag. We shouldn’t let society, lawyers, medical boards, and politicians profit from us having workaholic tendencies.

It’s as hard to get a couch potato away from Netflix as it is to keep a doctor out of clinic or hospital; different presentation but the same problem.

Good practice for the future

For those of you who are hoping to retire early, getting into a good exercise and diet routine is good exercise. Learn the habits now so that they come easy once you have more time away from clinical medicine.

I’ve always been a rather active person but since I retired 2 years ago, I’ve made activity and a healthy diet an even bigger part of my daily routine. It now feels weird if I haven’t exercised for 2-3 days.

The worst thing to do is to assume the life of a workaholic. What if one day your medical profession lets you down and you have nothing to show for it but your years wasted sitting in front of a computer screen?

My routine

My routine changes a lot. But the last few years it’s been a combination of yoga, hiking, rock climbing, walking, and biking. It all might sound really planned out but nay, it’s a mishmash of if all.

I try to go for a walk every day and have done that probably 98% of the time. Next, the goal is to do some sort of exercise every day. If I know I have a very busy day ahead of me then it’ll just be yoga. If I am not feeling yoga then I’ll be doing some band exercises.

For days when I have time for the gym, I’ll do rock climbing or maybe do some racquetball.

When I need to go meet up with friends or go to an appointment then I’ll try to take my bike or rent one from the bike sharing stations. It’s a great exercise.

Today I did bands for shoulders and some chest. I did my morning ab routine and I’m still planning on going bouldering. I’ve done my walk for the day, too. I consider these days my golden days – feels so fucking good.

I have some good arthritis in the left middle DIP and in the right 1st MTP but exercise has been the best medicine for both. I haven’t taken a tylenol or advil in 6 years; which isn’t a sign of health, just a lifestyle choice which may or may not work for another person.