My LCHF clinic is set up somewhat like the Intensive Dietary Management clinic of Dr. Fung and Megan Ramos (Ontario, Canada). Every two to four weeks, we evaluate a certain number of people, in our case 12 to 14, and we gather them all in one room for an entire afternoon of teaching. Then, we do 1-hour follow-ups every two weeks at first, then once a month, in small groups of four.
The teaching sessions are intense, with lots of material to cover. It gets serious. But it also tends to be fun, with lots of laughter. We can usually feel a sense of camaraderie emerging amongst our patients. They start to feel like they're all in the same boat. They won't be alone eating "weird" food (a.k.a. natural food), checking out grams of carbs on labels, and refusing a donut at work during a meeting.
Indeed, creating a sense of community has been one of our good moves (we've also had bad moves, but that's for another blog entry). For instance, we created a Facebook page reserved for our participants. Nurse Sylvie, Marc the kinesiologist, and myself moderate it on a daily basis. In this page, we discuss relevant topics, share recipes, answer non-medical questions, provide support and encouragements, etc. If butter goes on sale somewhere, or if a certain brand of bacon has 4 g of carbs per 2 slices, you'll hear it there first!
Nurse Sylvie and I hesitated before creating a FB support group for our patients, in February 2017. We feared that it would be too much work. There are, already, quite a few social media groups dedicated to keto or low-carb lifestyle, in different languages. Not many, however, are supervised by healthcare professionals, who validate the quality of the content. So we took the plunge.
As it turns out, it's hugely useful and helpful, and it only takes a few minutes per day, as the more advanced patients often help the beginners. We don't even need to answer ourselves half the times. But it makes a difference. This group really makes a difference.
Why social support is vital
I think people don't just enjoy being part of a group. They need it. Especially when they are doing something that goes against the social norm, such as reversing their type 2 diabetes by making different food choices, or losing weight by eating more fat.
I personally belong to a social media group of doctors who have adopted a low-carb way of eating. Those doctors have been instrumental in helping me do medicine in a way that goes against the current norm and the current guidelines. I need that social group to keep on doing what I do, even if I have access to all kinds of good scientific evidence in favor of low carb.
So, for my patients who get told "eating keto is extreme and crazy", "all this fat will make you fat", "you'll get a heart attack", "stop thinking it's about food and take your pills", and for those who don't even have the support of their spouse and family members, and for those who get judgmental looks at the grocery stores because they are overweight and their shopping carts contain 35% cream, butter, olive oil in a giant format, and perhaps even bacon, I think it's also essential to feel like they belong to a community of like-minded individuals to whom this is the norm.
If it takes a village to raise a child, then it certainly takes a village to help people reverse their chronic diseases caused by lifestyle habits and decades of wrongful dietary advice, and go against the social norm. In this case, I'd say it takes a village of bacon eaters.
So, if you don't already belong to a group of low carbers, I encourage you to go search for one. Be careful with the sources of the information provided, of course, but mainly, get support and share your victories and struggles. Reach out. You are not alone: you belong to a global village of hundreds of thousands of people worldwide.
If you're a low-carb healthcare provider, I would like to encourage you to consider offering non-medical online and/or group support to your low-carb patients, especially if frequent one-on-one follow-ups are difficult. Education, coaching and other interventions can help patients gain confidence, knowledge and motivation to persevere, and to continue to manage the social, physical and emotional aspects of their low-carb journey towards health. So help them beyond the four walls of your office if you can. It's a village you will enjoy inhabiting.
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Dr. Èvelyne Bourdua-Roy
