BARIATRIC SURGERY
IS NOT THE ENTIRE SOLUTION
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Episode 246:
Show Notes
Episode 246:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:18) Welcome to the second part of our special two-part podcast with the wonderful bariatric surgeon and holistic health professional, Dr. Arun. Last week we finished talking about frameworks and about gut health and now we're ready to dive further in. So I begin by asking Dr Arun about his framework for gut health. Please enjoy.
Dr Arun Dhir (00:42) I think it is important to understand that I often give the analogy of you know I love my garden okay so I love gardening a little bit that de-stresses me so I often give the garden analogy. So I often say that you know say if you go into a house and you see the backyard, it's full of weed,s you know so you don't immediately if you want to transform that garden you don't just start throwing seeds randomly of beautiful plants that you want to see one day. No, you have to pull out the weeds till the soil, and then you have to design where you want to plant what kind of plants and then you start to feed those plants or nourish those plants. The same thing happens with, say, improving your gut health, you know. If somebody has got features of gut inflammation, now just for the information of the listeners, the inflammation in the gut does not necessarily present only with gut symptoms. I just want to be very clear about it. A lot of people think Oh I've got a bit of constipation, I've got a bit of reflux, which means I've got gut inflammation. No, instances of say inflammatory bowel disease or even irritable bowel syndrome, colitis, those things are signs of inflammation in the gut, but you can also get things like brain fog, you can get poor skin, you know issues like eruptions, and even psoriasis. I've seen psoriasis improve just by improving the diet of the individual you know. So these are other non-elementary or non-gut related symptoms of poor gut health that we need to know about. So coming back to what you asked me originally, what is the framework of how do you optimise your gut health? So the first thing is the four R's that we often talk about, which is a very well-known thing. It's not something that I have devised but first is remove. So remove the things that are causing or the foods that are causing inflammation in your gut. The most common of them are ultra-processed foods and which is high in sugar, they spike your insulin levels, create bad bugs to flourish, the fungi to flourish. I do assessments of course, there is a role for assessments and if there is a need for an endoscopy that's what they get. But the important thing is I have not so much believed in doing extensive expensive investigations, especially fecal microbiome and all that. The reason is we are still in our infancy in understanding what exactly they mean. Like what if I told you you've got so many billion colonies of Bacteroides in your gut bacteria? Well, that can change based on what you are consuming. So that's the first thing you remove. Number two is you replenish the soil. So essentially you dig up the soil. That's what you would do in your backyard if you had taken off the weed. Well, that's what you're doing. You're going through a phase of, let's say fasting. Let's say you know going through a framework of what you're eating, how you're eating. Because sometimes you know if you go through this process very quickly, you can release a lot of toxins into the stream that can cause a toxic response. Then you start to replant or replenish. After you replenish, you actually replant, which you can take probiotics, you can take live foods, you can drink yogurt, those sorts of things. And then you sort of you know continue to restore and maintain the final R is you continue to sort of support the growth of the new gut bacteria. Now is this immediate? No. For some people it may take a longer duration of time. But it's the small steps that give you the confidence that yes I'm heading in the right direction.
Dr Lucy Burns (04:38) Yeah yeah I love that. And I love the garden analogy. And I think that like gardening, it's well, you can't just plant a garden once and then leave it and that's done and dusted. You know it's that ongoing maintenance. Which you know the garden analogy is a metaphor for life really isn't it?
Dr Arun Dhir (05:00) Oh it is. Everything needs ongoing maintenance. Relationships need ongoing maintenance, right?
Dr Lucy Burns (05:05) Yeah yeah you're right. Yeah, finances, health, everything. Yes so yeah absolutely. So we all need to be tending to our metaphorical gardens.
Dr Arun Dhir (05:15) Yeah and I think that's where talking to the first point that I said, you know, that we live in a world of ignorance. And I often say to my patients, you know, just become curious. Just become open-minded. When you become open-minded, you start to seek knowledge. You're not rigid in your tracts. And I think experts like yourself who've got a holistic view around, okay, how do you tackle this? They can give you insights that you couldn't get from reading 10 books, for example.
Dr Lucy Burns (05:48) Yeah absolutely. And again you know you're a yoga teacher. I mean you know, I think that there is a very small group of surgeons who are yoga teachers. But within that, and again you know, speaking sort of I guess more spiritually things like the ego. How that holds on to our belief system. And so unless people are aware of that. Recognising that the ego whose job is to protect your inner soul and all of those things. If that's strong, then that doesn't allow you to be curious. Because you know there's that cognitive dissonance that comes when people have to then question what they've been doing or practicing or teaching for the last decade. And that's hard.
Dr Arun Dhir (06:42) Yeah and I'm glad you brought up the topic of you know the spiritual aspect of it. Because one of the things that I did, Lucy, during COVID-19, when you know in Melbourne we were in lockdown and everything was shut. And the first thing that was shut was elective surgery. Like I mean who needed surgeons during COVID when people were dying? Because they couldn't breathe, and they had to be in the ICU and on ventilators. The thing was that you know I launched this YouTube channel and I started making videos. Because I thought people needed that engagement, you know. So I thought that's the best way I could serve. And one of the things that I spoke about in the video, I remember it took me a lot of courage to actually put that video out there. Which was the physical, mental and spiritual reasons why obesity is such an issue in our society? Now who would have thought there is a spiritual reason for people being overweight? Well, the fact of the matter is yes. You know, and I think when we are, I don't use the word spirituality as much. But I definitely use the word purpose. When you do not have a purpose in life, you are bored. And I see this a lot with men. Men often come and they say Oh, you know, I just go and do the same thing. I'm talking about middle-aged men, right? They are in their 50s and all that. They've lost that spark, right? They've lost that drive. Everything is like you know all right it's same old same old. Go to work in the morning. Come back. Have your beer. Watch some foodies on the television. Go to sleep and repeat. Like life is like cut and paste literally right? There's no adventure. And I see women when they come and see me. Most of them are again in their middle age and all that. They say I've been giving of myself all through my life. It's my time now. So it's taken them so long to actually realise that you know I matter right? That's how I see purpose comes in. When you don't have a purpose in life, you feel lost. You don't have self-care. You don't have any place for self-love. Self-love is a very deep subject, I would say you know. If you don't even self-care, you can't understand self-love, right? And you know as they say in the holy book, and I'm not a Christian. I was raised as a Hindu but I now call myself a spiritualist because I believe in all religions. All wisdom comes from all sources. I truly believe that you can't pour from an empty cup. If your cup is empty, what are you going to give to somebody else? And I think that was a big profound aha moment for me because I realised that, you know if I don't take care of myself, how can I be setting an example for my patients. How can I serve them right? I'll never bring good energy or high energy to them if I am in low energy myself.
Dr Lucy Burns (09:47) Yeah I love that. I love that, and I think it's in the medical community, you know, we serve on the altar of self-sacrifice, and doctors are burning out, you know, at a rate of knots largely because they don't look after themselves. They don't prioritise self-care. They're working many of them in an environment that doesn't allow them to do that. And you know there's all sorts of reasons for that. But actually it's crucial because our whole healthcare system depends on not just doctors but healthcare workers, nurses and allied health being able to look after people long term. And if they can't do that, then they leave the system and the system will crumble.
Dr Arun Dhir (10:43) I agree, you know and I think it's both ways, Lucy. In many ways, you know it depends on the environment and it depends on the individual. You would agree that you know the environment is rough, I mean, when I was working in the public system, it was like a treadmill, right? You just go, you do your operating, you see your patients, you are answerable, you attend meetings and all that sort of thing. So the point I'm trying to make is you're right, there is a high degree of burnout, but there is a reason why burnout is there. And the way I look at it is when you don't have a purpose, a higher purpose of why you're doing what you're doing, then things start to lose meaning. And when things start to lose meaning, and this analogy could be applied to anything, whether it's relationships, whether it's your financial well-being, whether it is your workplace sort of fulfillment. Whatever it is, you know things don't work out when you are not seeing a purpose in them, you know you'd never give your 100%. So I just say, you know, you got to spend this time, this finite time that we have all been given on this beautiful journey of life. And I'm not trying to be philosophical here or anything. Reality is that time is limited for all of us, right? If you are not giving to the world, you are a taker, right? Either you're giving or you're taking. You have to see what is more fulfilling for you. If you're a taker, you will only be able to take what is given to you right. But if you're a giver that means you have more for you. That's why you're giving right. Why would you give something that you don't have? You can't give what you don't have. I know it sounds ridiculous but you can't give. If I don't have 12 oranges to give to you, Lucy, how can I give you 12 oranges? I can't. Yeah. So it's a choice, right? It's a conscious choice. Which side do you want to be?
Dr Lucy Burns (12:46) Yes, but I think it's interesting because I think what happens is people get mixed up. They think that if they're giving their 12 oranges when they haven't even eaten an orange themselves. So they're now depleted. They're orange-depleted. They haven't looked after themselves. They're giving away everything and then they just run out. And for some people, they're so fearful of being a taker that they don't see the difference between looking after themselves and taking. And so they fall into the trap of persistently or constantly giving every single day of the week.
Dr Arun Dhir (13:30) Yeah. And that's when they feel depleted and that's when they say, oh, you know this is life. You accept it, right? You go into that mode of acceptance. But I think if there's one thing that can lift us out of that state of you know let's call it acceptance. And I'm not saying you always have to fight your reality. But I believe education is the antidote to fear, doubt and worry and distress. This has been my belief. I've worked on it. I'm a reader and I love associating. Like, I mean imagine if anybody was listening to this conversation, they could just get their own pearls of wisdom. And I'm not saying this in an arrogant way. I love listening to podcasts myself. That's how I educate myself. I set aside one to two hours of learning reading time every day. That's like food for my soul. It's become my habit. Now you would say you know Arun, not everybody has the privilege of taking out one to two hours because there are little kids to tend to. People are hungry. People are crying and all of that. Well, I've gone through that stage as well, Lucy. I have kids. I'm a dad and I'm proud to be a dad, you know. But I think a moment comes in your life, and you say, I know what I'll just keep feeding that seed that I've planted. I'll just continue to nurture it in faith. Because let's be honest, without faith nothing can happen. If you don't even believe that you know one day I'm going to be healthy, fit and going on that trip that I've been planning for for years now. Right. It is never going to happen. It's never going to happen randomly. Right. Let's be honest about it. So you've got to believe in that vision. And I'm not talking about you know law of attraction and those kinds of things. I'm just talking logic. If I never wanted to become a surgeon in Australia, it would have never been on my radar. I would have never planned for it or anything. And I get it. Sometimes things happen randomly as well. And that's when you've got to be open to kind of you know taking those nudges.
Dr Lucy Burns (15:43) Yeah. Yeah. Absolutely. It's interesting, isn't it? Because you're right. I mean there is this concept we talk a bit about called learned helplessness, which is where you know, and again, it's hard, particularly with weight management, where people have had failed attempts. And so their brain looks at past events to predict their future events and says they've always failed. So you'll always fail. And so then they always fail. And then they're in this cycle of persistent failure, thinking that they will never get to where you want to go if you believe you can't get there. So I love that. And you're right. I mean if you actually thought there's no way I could ever be a surgeon, you would never be a surgeon. Like you just wouldn't.
Dr Arun Dhir (16:29) And by the way, when I was kind of you know I did my schooling in India. There were only three options for me. I often joke about it. You know when I was giving my VCE my year 12, and there were no doctors by the way in my family. None from my mother's side or from my dad's side. And they said you've only got three options. Either an engineer, a doctor or a failure. I said Oh my God, you know that's a lot of pressure on a 12-year-old. But I tell this to my kids often. Right. And you know what that did, Lucy, is that I look back now and you know I've come to this firm belief that there are no accidents in this universe. Everything is what you're going through, this pain right now, if somebody is listening to this and they're going through some painful moment. You know what? You are meant to go through this. And I don't say this in a irresponsible way. But I say this, that you know that moment for me when I did not get through the first time, when I sat my exams in a career that I wanted to and I was feeling ashamed of myself. That was building resilience. That was building courage and clarity in my own mind that no, this is actually the path that I choose to take. So failure is good for you. In fact now in entrepreneurship, people who are CEOs at the big companies, who are hiring CEOs and paying them the big dollars, are actually seeing not just their successes, but they are seeing how many times they have failed as well and risen. So failure is when you accept that you have fallen down. Success, truly or courage, is when you fall and you get up. So that's resilience. Right. And I think that's really critical for us to understand that yes, you may have failed in your previous attempts of weight loss, being on a diet, being on whatever modality you may be. And say if you're now thinking surgery, this is the first fear that I know I deal with my patients. I tell them, do they have a fear of weight regain after surgery? They say yes I do. It's a real thing. Yeah absolutely. And I say, how do you overcome fear? And just as I said a moment ago, there is no magic prescription or anything. The only antidote to fear, doubt and worry is education. Start educating yourself. Become hungry for good authentic sources of knowledge. You will find it. The sources are there. And you know what is most important. I say that anybody who you can look at, we live in a world which is so connected now. Right. You can find anything about anybody on this planet. Now there's no such thing as privacy. I actually joke about it. And I say you know you can easily find somebody who has gone through the same challenges as you have gone through in the world and who has come out successful. You're going through some relationship issues. Well, find somebody who has gone through this exact same problem that you have gone through. And look, as humans we go through only a few handful categories of problems. Right. Let's be honest. I've studied this intensely as well. Whether it's a financial issue, relationship issue, whatever it is. Find somebody who has gone through that issue. Study them. Study their personality and what their life journey was, and they came out successful. How did they do it? That is your sort of recipe of success. Not coming from a person who is sitting on a pedestal like a doctor or whatever, but it's coming from lived experience that we call it. They have gone through the shit. Excuse me for using that word. But they have gone through what you are experiencing right now. And we all go through that. Nobody is immune to it. Nobody is immune to it. And that is what makes you humble. And that's what makes you open-minded.
Dr Lucy Burns (20:41) I love that. I love that. And I think you know again you're right. Like failure, we look at it as a bad thing. Dr Mary and I often say you know there are two options. You either win or you learn. And they're the two. So you learn from your experiences. And I think that's where probably lots of people miss the opportunity with failure, instead of being able to look back on it and think, well, you know what, could I do differently or what were the reasons that I wasn't successful this time. We kind of just bury it under a rug and move on. And we see this all the time, even in you know Facebook groups where people, you know, sort of it's a bit like a confessional, they're confessing what they've done the day before. And everyone's trying to encourage them, which is wonderful. But the encouragement is usually don't worry about it. Tomorrow's another day. And that's like yeah well that's step one. But step two is, and then reflect back on what you could have done differently, or what you would have liked to have done differently or what you need to learn so that you can do it differently. And that's a bit, I think, that people often miss.
Dr Arun Dhir (21:54) Yeah. And I think just to add to that, Lucy, I also feel talking about an individual who may be experiencing weight issues in specific is that you know when we are in that moment when we are caught up in the mess for want of a better word we our brain seeks security. Our brain seeks comfort. And you know in a world of comfort and convenience, where everything is on your fingertips, guess what is the easiest way to get comfort. Right. It's the food that's hiding in your pantry. Right. You take out that packet of potato chips or you know that Tim Tam packet and immediately your brain gets that sugar kick and you feel safe now. I feel comfortable now. I feel safe. You know it's like imagine if somebody just came out of the computer screen, who you admire, who you love or whatever it may be and gave you a hug. Right. It feels like that. You know you feel safe. You feel comfortable. So that's where we need to sort of bring in that you know don't seek for that reward. Like we have a reward center in our brain. Don't seek food-related rewards because that sets up a pattern. Every time you feel uneasy and uncomfortable again, you will go back to the same pattern. Oh, eating food made me comfortable eating that donut made me feel really good, you know. So you've got to train your brain. I know I'm talking more from a logical sense, but it is really a blend of logic and emotions right. We all go through emotions. And I'm talking about you know myself, probably yourself as well. We all go through different emotions during a day. And I like to communicate this. I was telling my wife yesterday, you know, I feel a bit flat. I feel a bit low. Probably just leave me alone for a little while. You know I mean, I think it's important to communicate and that's the other challenge. We have lost the art of constructive, respectful communication. You know that's why you start to place importance on these key crucial pillars to build good, meaningful, deep relationships. If you're not learning the art of communication, you can never build a good relationship. It's just not going to happen.
Dr Lucy Burns (24:23) Yeah absolutely. Absolutely. And again, you know society these days is the way we communicate is different. So again, accepting that there are now different forms of communication, but that nothing really replaces in-person, good quality, deep relationships.
Dr Arun Dhir (24:45) Yeah I know I often say to my kids you know the best gift that I can give you is your dad is and these are mind you these are like kids who are thank God for this they're healthy they're doing their own things whatever they want to do is. I said I can bring my mindful presence to you, 100 per cent presence. That's the gift that I want to give to you. So when I'm dropping my daughter off at school, I'm not on my phone. I'm not trying to do 10 other things, or when I'm having to catch up with them, or whatever it is. I'm not doing 10 other things. I just consciously put my phone away because it hurts me, honestly, when I see individuals in a cafe who are sitting in front of each other and on their phone screens, and I'm not making a judgment, just reporting here of what I see. You may call me like an old-fashioned person, but at the end of the day, you know I think communication is so essential and I call it mindful communication, constructive communication, connected communication.
Dr Lucy Burns (25:50) Yeah absolutely absolutely. Oh goodness, oh well, I think I could talk to you all day but we probably need to go and you know do our day jobs but it has been wonderful. I think this conversation has been fantastic. I hope, lovelies, that you have learned or heard some glimmers, some pearls and all of Dr Arun's connections will be in the show notes. I can't wait to get into his book. I'm really interested in the Happy Gut book so we will certainly be putting a link to that as well. Arun has the most fabulous day. Thank you so much for your time today. Really appreciate it.
Dr Arun Dhir (26:35) Thank you Lucy. It's been a delight having this conversation with you and wish all your listeners best wishes as well.
Dr Lucy Burns (26:41) Thank you so much. All right lovelies, I'll talk to you all next week. Bye for now.
Dr Lucy Burns (26:49) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
