Lifting does a lot more than build bigger, stronger muscles. More and more research is showing it’s an effective way to lower the risk of heart disease, bone fractures, depression, Alzheimer’s disease, strokes, and scores of other ailments — and it’s a hell of a lot cheaper than medication or surgery.
If you’re like us, you’ve probably wondered why you don’t hear doctors, high school health teachers, and everyone in between recommending barbell training like they do vitamins and prescription meds.
Spencer Nadolsky, DO, decided to do something about it. A board-certified family and obesity medicine physician, he’s dedicated his career to upending the broken healthcare system that pushes pills and prescriptions over pull-ups and protein shakes. He calls himself the Doc Who Lifts, and he’s our kind of guy.
We sat him down to learn a clinical perspective on lifting, longevity, and how he’s changing the way we do doctor appointments.
BarBend: Thanks for taking the time to chat, Dr. Nadolsky. Your site says, “Our medical system is broken” because we “push prescription medicines onto our patients before using lifestyle.” Why do you think exercise is so rarely “prescribed” by general practitioners?
I think the system’s broken in a few different ways. I do want to advocate for doctors because they’ve got it rough — seriously, everyone’s against them — but the system is broken because there isn’t reimbursement for giving good lifestyle management. You get reimbursed for the amount of people you see and the more quickly you see them. For a family doctor, an internist, or a primary care provider, the system isn’t set up to give good lifestyle counseling.
On top of that, culturally speaking, many of our patients don’t want lifestyle advice. They just want a prescription, they want something easy.
It’s a three-tiered problem. The third thing is that physicians aren’t pushed enough in medical school to really hammer that lifestyle is medicine. The advice they’re taught is to tell patients to eat less and move more, but there’s not enough time to really teach patients how lifestyle management works and to figure out the best ways to get them to implement best practices.
BarBend: I feel like sometimes, you might hear a doctor tell people to eat less fat and do more jogging, but lifting weights is still seen as a weird thing for a doctor to tell a patient to do.
BarBend: So what do you say when a patient asks why they should be picking up barbells?
Well, there’s been some really cool studies showing it could be just as beneficial as aerobic training with regards to blood sugar and blood pressure regulation.
Then there are some things you don’t get with cardio, like bone strength, which is very important as you age and it’s why osteoporosis is such a big deal. Healthy aging includes keeping your bones nice and strong for both women and men.
There are also some benefits that aren’t necessarily quantifiable, like quality of life and functionality as you age. There’s a lot of people who live longer but they just don’t function well. Their quality of life isn’t as good because they’re not strong and mobile.
BarBend: What are your thoughts on strength training as a means for preventing mental health issues, like Alzheimer’s and depression?
For me, I do a combination of strength training and aerobic training, which is probably best for everything, including mental health, blood sugar, blood pressure, lipids, all those things. But any type of exercise is probably going to improve mental health and likely neurological health as well. So I try and prescribe a combination.
But from a practical standpoint, I’ve got to prescribe what people like to do, because people generally don’t do what they don’t like. However, I’ve found people do like lifting weights if you bring them to the gym and introduce them to it. It’s more tolerable than cardio for a lot of people.
BarBend: That’s an interesting part of the equation. Some mental health professionals know that if their patient does regular exercise, gets plenty of sleep, meditates regularly, and eats a lot of greens, it will treat a lot of their symptoms.
But they know the patient just won’t do that, so they feel they have to prescribe meds.
What I do first is ask the patient if they exercise. Most people will say, “Not really.” Then I ask if they’d be interested in learning more about it, and they say, “Eh, sure.”
A lot of people are interested in it, but they’re intimidated by it. I’ve found that actually bringing patients to a gym and teaching them, showing them the weights aren’t scary, is really the way to get people into it. It takes some hand holding but it really does a lot for them when it’s coming from me, their doctor.
It’s hard to say, “Go lift some weights, get a trainer.” But exposure therapy, going with them and saying “This isn’t so bad, is it?” That can make such a difference. Nobody in the gym really cares what other people are doing, after all.
BarBend: There aren’t many doctors who will go that far for their patients! That’s awesome. When did you make this transition from doctor to online fitness evangelist?
I am an obesity specialist, but I was in a family medicine clinic and because of all the bureaucracy and system issues I talked about earlier, and the lack of autonomy, I really wanted to do my own thing. The problem is my wife is a navy doctor, so every three years we’re moving. So I can’t build up my own clinic.
Then this company SteadyMD comes along, and they told me they want to be the next online medicine clinic and for me to be the pilot doctor. So now, patients who want a doctor who lifts and understands lifestyle are not confined to doctors who are in their location. And I’m not confined to patients around me either, I can have the patients who are really interested in this. And my social media presence really helps me to influence a broader audience, too.
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Eating more vegetables can improve health and help you lose fat. Eating vegetables fills you up. They are very low calorie. Replace some high calorie foods with them and you will lose weight. Eating more vegetables is associated with better health as well. It is a win win. Here are some ways I help patients eat more of them. This is important in programs like the 27 Day Fat Loss Prescription Coaching program I run with @chroniclesofstrength #DocsWhoLift #veggies #healthydiettemplate #healthydiet #fatlosstips #vegetables
BarBend: Tell us a little more about online doctor’s clinics.
With these types of programs, you don’t have to drive to see your doctor at your clinic, you don’t have to wait thirty minutes in the waiting room, and you have a doctor who understands your lifestyle.
Whereas in the past, telemedicine was all about acute care —calling a doctor for your sore throat and so on — this is more for chronic, long-term and preventive care. And you get to know people and they have you as their doctor forever. So it’s pretty cool. I’m licensed in enough states that I can treat about 70 percent of the U.S. population now, and the goal is to eventually be able to cover the map.
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Hey y'all I've been collaborating with @rpstrength on how to make your own healthy diet template. Eating lean protein, a lot of vegetables, healthy carbs and fat is super important to not only body composition but also health. Click the link in my profile to learn how to individualize your own healthy diet template. #rpstrength #rplifestyle #docswholift #healthydiet #healthyeating
BarBend: It’s fair to say that most people, for whatever reason, will simply never track calories and macros. What body recomp strategies do you have the most success with?
For the average person who’s just trying to lose some weight and get a bit leaner — that’s pretty much all my patients — I do what’s called meal templates.
It’s kind of a mixture between meal plans and tracking calories. Basically, you figure out how many meals they’re going to eat in a day and you come up with a template of different kinds of foods you can swap out various foods for. You don’t have to eat chicken breast, it can be salmon, lean beef, any protein. It doesn’t have to be broccoli, it can be spinach, asparagus, and so on. You don’t have to eat rice, it can be quinoa, beans, you can swap out grains for fruit, etc. It’s much more imprecise than tracking calories and weighing food, but I find it’s much more practical.
I also use strategic meal replacements if they need it. A lot of people have issues with lunch: if they’re working and the best thing they can do is get a takeout, I say, “OK, just drink a protein shake and eat an apple instead.” That’s a strategy. And then if need be, we’ll try fasting and things like that.
If someone loves tracking their calories, it’s the best way. It can’t not be the best way because it’s so much more precise, but from a practicality standpoint — even though it just takes a few minutes a day — it becomes so tedious and annoying for people. I don’t like doing it either, so I understand.
But with the meal templates you’re focusing on healthy habits while also having a bit of portion control built in as well so it works pretty well.
This interview was edited for length and clarity.
Featured image via @drnadolsky on Instagram.