Introduction:
Leslie came into my office worn out and exasperated. She was thirty- six years old, but she felt like she was pushing eighty. She was overweight, a trend that started in her late twenties while taking the antibiotic minocycline for her acne. She struggled daily with fatigue, sluggishness, insomnia, and lack of motivation. Her skin was broken out, her hair was thinning, and she had persistent loose stools. On top of all this was her extensive list of medical ailments: irritable bowel, type 2 diabetes, hyperlipidemia, autoimmune thyroiditis, depression, and anxiety.
After seeing several other GI doctors, a chiropractor, a hormone specialist, and an expensive cash- only functional doctor, she was confused and frustrated by the conflicting recommendations. Here she was at thirty- six, on four different medications with ten supplements to boot. “This isn’t the life I envisioned for myself,” she told me on that first visit. “I’m way too young to be feeling this old.”
Much of her frustration stemmed from not knowing what to eat. What should have been simple had become so complicated. She had gone Paleo in her late twenties to combat weight gain and she soon progressed to the Whole 30. She felt better for a short time on those diets, but when the weight gain and fatigue slowly started to creep back in, she desperately searched for a new diet solution and tried eliminating phytates and lectins. She’d been gluten- free for almost ten years and by the time I saw her in my office, she had completely eliminated grains, legumes, dairy, and nightshades. Her diet now consisted mostly of arugula, avocado, grass- fed meat, and bone broth, with very little variation. At times she’d test herself with some beans or whole- wheat bread, but she’d experience gas and bloating, which the diet gurus she was following warned was proof of inflammation.
“It is maddening to follow all the experts’ recommendations religiously and do exactly as I’m told, only to feel worse than ever and see my weight fluctuate like a yo yo!” she exclaimed. With each progressive elimination, she’d see at most short- term improvement, only to slide back into the same exhaustive pattern. The last straw came when she tried the ketogenic diet to lose weight, but it just made her diarrhea worse and it was now a bigger problem than ever.
At this point in our conversation, she was physically slumped forward, elbows on her knees, staring at the ground, eyes welled up with tears. I pulled my chair closer to hers and leaned in so we were on the same eye level.
“Leslie, it’s going to be all right. We’re going to get you better.” She looked up, a glimmer of hope in her eye. “I totally get your frustration. This is the most confusing time in human history for people who just want to get better. Too many experts saying too many different things. I need you to trust me. If you’re with me, then this is rock bottom right here, right now. Today is a fresh start for you with a new approach that makes you feel better and restores the real version of yourself that has been missing these last few years.”
Over the following months, Leslie and I worked closely together to make some major changes. We took her off most of her supplements and slowly reintroduced diversity back into her diet. Foods that she had been told were off- limits were brought back at the right time, in the right amount. She began to really enjoy her food for the first time in years. The restrictive diet had been challenging, boring, and futile for her. She got rid of her bone broth and tapered down on her...