Physical Therapists Should Be Promoting Weight Loss

Image: Obesity by Jesper Sehested using Creative Commons - (CC BY 2.0) 

Physical Therapists Should Be Promoting Weight Loss

By Dr. Sean M. Wells, DPT, PT, OCS, ATC, CSCS, CNPT, Cert-DN

Physical therapists (PTs) specialize in movement, exercise, and rehabilitation. Our role as healthcare providers extends into many facets  of life and wellness. From stress reduction to nutrition, PTs ought to consider interventions beyond the basic modalities.  Diet can have a substantial impact on weight loss and its commiserate reductions in pain and inflammation, and improvements in function. Regardless of what setting (e.g. outpatient, nursing home, acute care), PTs can educate patients on the benefits of weight loss and even provide simple steps to reducing weight. 

What are the best nutrition methods PTs can provide patients to reduce or even prevent obesity in the first place? A simple answer can be found in the literature centered on the Whole Food Plant-based Diet (WFPBD).

Obesity can be significantly prevented and reversed in WFPBD better than in vegetarian and omnivorous diets (Lap Tai & Sabaté, 2014; Turner-McGrievy et al, 2004). In these two studies subjects saw a significant weight loss that impacted their quality of life. The weight loss benefits extend beyond just shedding pounds. A WFPBD can reverse type 2 diabetes and control blood sugar. One study reported a WFPBD controlled blood glucose levels for 84% of patients and partially controlled levels for 16% of patients in just 3 days (Chowdhury, 2017). WFBPD can reduce blood sugar and cholesterol which also may translate into a lower rate of upper body musculoskeletal disorders (Smith, 2003). When applied at the corporate level, WFPBD reduced chronic diseases, cholesterol, and diabetes -- with a significant reduction in upper extremity injuries also noted (Taylor et al, 2017). Such weight loss and reductions in upper extremity injuries should be highlighted in PT practice and education!

While low-carb diets are all the rage right now, they are not the best diet for weight loss. Despite some positive data, the overwhelming evidence shows that the initial weight loss is short term, especially when compared to a long-term plant-based diet (Dutton et al, 2014). More concerning is a meta-analysis and systematic review which highlights an increased risk of all-cause mortality in those following a low carb diet (Noto et al, 2013). Data from the China Study published by T Colin Cambell and son edify such long-term data -- a WFPBD is the ideal diet for weight loss. 

A WFPBD has been shown to not only treat but also prevent type 2 diabetes in WFPBD (Satija et al, 2016). BMI reduction aside, a WFPBD may reduce obesity and diabetes through the reduced consumption of advanced glycation end products (AGEs). AGEs occur when food, especially meat, is cooked over high dry heat. When cooking with high and dry heat also includes sugars, such as seen during the browning effect during caramelization or barbecuing, the concentration of AGEs goes up exponentially.  Best methods for reducing AGEs is to educate patients to avoid meat, cook foods using low heat, and use moisture such as water during cooking (e.g. stewing or poaching) (Uribarri et al, 2010). AGEs have been associated with diabetes and other conditions relating to PT practice. AGEs have been found in the joints of patients with arthritis, and reducing dietary consumption of them will reduce pain and improve function. Provided the robust weight loss and type 2 diabetes reversal, it's no wonder the American Association of Clinical Endocrinologists endorses WFPBD to lose weight and normalize blood sugars. Reducing AGEs via a WFPBD and educating a patient on low-heat and moist cooking methods are a win-win strategy.

Physical therapists working with clients who are trying to lose weight, reduce or treat upper extremity issues, or reverse type 2 diabetes should recommend a WFPBD. The WFPBD is an ideal diet of choice for weight loss and maintenance. So, PTs, set aside your bias and break-out of your routine interventions: exercise and diet can be the best intervention for weight loss -- there's no reason to exclude nutrition!

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Keywords: nutrition, continuing education, Florida, PT, physical therapy, weight loss, diet, fat

Disclaimer: The above article is written as opinion piece and does not convey specific legal and/or practice act advice. Students and participants need to check their State laws, practice act, and other legal restrictions before implementing nutrition interventions or assessments. The consumer of this article and our courses acknowledge that the State laws, practice acts, and restrictions can and do change. The Nutritional Physical Therapy team cannot be held liable for changes to such laws: the student, PT, or person engaged in such nutrition actions are responsible for examining laws and regulations as they see fit.