Chiropractic, the obese patient and evidence-based metabolic health care

Why the obese patient needs wellness chiropractic care more than ever during an obesity pandemic

FOOD IS MEDICINE, AND WEIGHT LOSS IS HEALTH CARE. If you believe that food really is “medicine,” then you’d have to agree that weight loss could be considered health care. Today there is a plethora of information and reproduceable research written in peer-reviewed journals regarding the obese patient and “unhealthy weight” that is costing us and killing us. And yet 70% of Americans are overweight or obese, and the numbers are growing. It’s speculated that by 2030, if trends continue, one in two adults will be obese.

With the COVID-19 pandemic shining an even greater light on this “hidden pandemic,” obesity’s role can no longer be ignored for its impact on overall health. The systemic effect of obesity puts the obese patient with COVID-19 at an even greater risk for compromised lung function, inflammation and other comorbidities like cardiovascular disease, diabetes and kidney disease. What we’re seeing is that obesity is the foundation for most all other diseases and puts us in harm’s way for the next coronavirus.

Obesity is the ‘dis-ease’

The issue is that the disease of obesity, with its ICD-10 code, is often overlooked as a disease — yet its “side effects,” or comorbidities, are what are being addressed in allopathic health care.

As is often the case, modern medicine tends to chase the symptom and not address the cause. Diabetes, high blood pressure and dyslipidemia are symptoms that all have their foundation in obesity. A solution, based on chiropractic philosophy, is to address the cause of this unhealthy weight. If we address the cause and can prevent or ameliorate the symptoms of that “dis-ease” we have helped our patients immensely.

Who better than the champion of getting to the cause, the chiropractor, to help the metabolically unhealthy obese patient? The National Institutes of Health recently stated that only 12.2% of the U.S. population has optimal metabolism, meaning almost 88% of our patients need an intervention. That is an overwhelming majority of chiropractic patients.

The obese patient: awareness of unhealthy weight and obesity

What may seem self-evident, but isn’t, is the fact that many patients lack the awareness of how severe their body mass index (BMI) actually is.

A substantial proportion of individuals who are overweight or obese do not self-identify as overweight, and many parents of children who are overweight or obese likewise fail to identify their children as such. Couple this with the fact that most physicians still have a difficult time discussing weight with their patients and it indeed becomes an issue, as a patient undiagnosed with obesity is a ticking time bomb — one that we, as chiropractors, must address.

The chiropractor, diet and insulin resistance

Chiropractic education has a greater concentration on nutrition than medicine, so who better to treat unhealthy-weight patients than the chiropractor?

Advising patients on their diet is a great primary intervention to prevent future disease. But what if that patient is already in trouble? What if your patient suffers from comorbidities of obesity? That same diet could be an effective secondary intervention to remediate those symptoms.

One of the main reasons your patients develop diabetes, high blood pressure, cardiovascular issues and other symptoms associated with unhealthy weight is insulin resistance. Besides adjusting your patient, advising on nutrition, exercise and positive mental health, utilizing an evidence-based, chiropractor-supervised dietary intervention is exactly what your patients need. The chiropractor can now, in collaboration with the patient’s prescribing physician, be paramount in helping patients reduce or remove their side-effect-producing medications they are taking for those comorbidities associated with unhealthy weight.

Insulin resistance, as Mark Hyman, founder and medical director of The UltraWellness Center, says, is perhaps the single most harmful hormonal disturbance in the body. Gerald Reaven, MD, professor emeritus at Stanford University, said that insulin resistance coupled with hyperinsulinemia was the cornerstone of metabolic syndrome and that the dead-on bull’s-eye for insulin resistance and hyperinsulinemia is the overabundant carbohydrate. In our hyper-palatable, overprocessed food environment, simple and many times liquid carbohydrates are all too accessible for adults and kids. Many of those foods are easily recognizable, but there are other foods labeled as healthy such as granola, orange juice, veggie chips and some yogurts that contain high amounts of carbohydrates.

Even condiments contain sugar and high-fructose corn syrup so that by the end of the day the amount of “sugar” we’ve eaten creates a hormonal tsunami starting with this macronutrient’s effect on insulin. This hormonal storm sends us down the road to metabolic syndrome. Remember that our bodies, for millions of years, were designed to gain weight as an innate mechanism for survival. However, today, our physiology remains the same, yet our physiology and environment are not in sync. This high intake of sugar creates insulin resistance, weight gain and eventual ill health.

Why an evidence-based protocol?

What’s the best diet? The one that works best for the patient.

But, I believe it should be one overseen by a health care provider, coached by a chiropractic assistant in the chiropractic office and backed by science. It needs to be easy and convenient, and it needs to taste good if a partial meal replacement is one aspect of the diet. It must also be successful for the patient. It should yield robust weight loss in a repeatable, measurable and predictable way while being safe and effective:

  • Safe in that, even in the weight-loss phase, all the recommended daily allowances for the macro and micronutrients in this diet are met.
  • Effective, where on average men lose 3.5 lbs. per week and women 2.5 lbs.

Its predictability strength relies on scientific methodology. A good diet should have a weight-loss phase, but also a stabilizing and maintenance phase so that the health benefits of a 10% weight loss last long-term. Lastly, any significant diet utilized in a health care provider’s practice should have some hard evidence behind its efficacy.

Answering the call during the obesity pandemic

We have an obligation, a calling, to help humanity. Chiropractors have always answered that calling.

Today obesity is the pandemic that is hidden amongst us, causing havoc with our health, our pocketbooks, our health care system, and most importantly, our kids. Chiropractors must be frontline in stemming this rising tide with the obese patient. We can help our patients and their families by offering a structured, easy-to-do, scientific protocol that works every time — just like gravity.

Why? Because it’s our physiology that dictates whether we gain weight or keep it off. It’s not our patient’s fault. It is not about eating too much and working out less. There is hope. We indeed can use food as medicine, and weight loss as health care to improve community health.

DENNIS BARLEY, DC, CCSP, a 1985 Life University alum, has been in chiropractic practice for 37 years and an Ideal Protein provider for the past 13 years. He is currently the vice president of health care strategy at Ideal Protein, where he helps providers implement the protocol within their practices. The Ideal Protein Protocol weight management system targets the root cause of weight gain through a low-carb, healthy-fat, adequate protein diet. Thousands of chiropractors across North America have added ancillary revenue to their practice by offering Ideal Protein, a safe and effective solution, to their patients who struggle with weight-related comorbidities. His motto in health care is from Mahatma Gandhi: “Be the Change You Wish to See in the World.” For more information on Ideal Protein, go to


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