Intro
Dr. Spencer Nadolskyis an osteopathic family physician who specializes in weight loss (bariatric medicine) and cholesterol (lipidology). While earning a BA in exercise science, he wrestled heavyweight for the UNC Tar Heels. He was ranked 3rd in the nation at one point, while also garnering Academic All-American status. He is currently a family medicine resident physician working in Newport News, VA.

Matt: I have a tough time following your Facebook page because of all the pictures of food. Why are you torturing me?

Dr. Spencer: I love taking pictures of my food (laughing). I started doing this because I thought if people saw what I ate they’d get a better idea of how to do it all themselves. People were always asking me about my lifestyle so I just started recording parts of it. I had a lot of positive feedback for the pics showing what I’m eating and people told me it gave them a better idea of what they could/should be eating as well. I thought alright, I’ll keep doing it. I know it’s kind of ridiculous to take picture of what I’m eating, but the whole idea of Facebook is pretty ridiculous in the first place. So you know, if someone doesn’t like it they can just defriend me or not follow me (laughing). That was my attitude about the whole thing. I’ve received a lot of personal messages from people thanking me for doing it so I’ll keep it up.

Matt: Absolutely. I enjoy the posts myself, but was very jealous because we lived in a hotel room without a kitchen for 6+ months so I couldn’t recreate any of the meals myself (laughing).

I’ll forgive you for the pained caused because I think your approach to medicine is one that should be highlighted. It might be self-evident, but is there a backstory to why you care so much about pushing lifestyle change (lifting, eating, laughter) before drugs whenever possible?

Dr. Spencer: Yeah, this actually started when I was younger. My Dad was a high school biology teacher as well as the football/wrestling coach and my Mom was an elementary school teacher. They really promoted a healthy lifestyle to us. Sports, working out, eating well, and just being healthy. As I grew older and got into sports I thought I could rely on my last name to be good since my brother was really successful, but I wasn’t at first. I had to work hard and learn a lot about exercise and nutrition science. Over time I built up my physique and was able to do well enough to earn a scholarship for wrestling at UNC Chapel Hill. I thought in my mind that it was great to use nutrition to build physique to achieve athletic prowess and whatever, but I wanted to be a doctor….I wondered if I could use this knowledge to improve people’s lives and health in general? So that’s the way I went and in medical school I learned pharmacology and all this stuff. You learn that lifestyle is pretty much the #1 treatment for the majority of problems you run into, but it’s almost a joke because most doctors know that patients won’t do it so it’s not even recommended by their actual doctor. This happens even though that it should be recommended, but they just don’t do it. I’m very passionate about this and I’ve actually helped patients make changes with lifestyle changes which gets better results than any drug out there. I try to push it as much as possible and teach other doctors to do the same even though most patients won’t do it. You continue to do it for the small percentage of patients who will. These life changes can be very gratifying for the physician to see.

Matt: Do you see the medical industry starting to change at all or do you think it’s going to be long, hard process to adjust to more of a lifestyle approach to medicine?

Dr. Spencer: There’s always a push in certain groups and always a conversation of how to do this. There’s usually a concern about Big Food infiltrating some of our guidelines and other conspiracy theories like that at the same time.

Physicians all want to push this, but there’s a system failure in that we get 10 minutes with a patient. This sets us up from failure from the start when pushing lifestyle medicine. It’s much easier for someone to come in and for us to write a prescription than to do counseling and refer them to the right person.  If the system were better and if we were reimbursed for doing recommending lifestyle changes (another issue people are working on) I think the movement would be much stronger. A lot of doctors are burned out who are pushing for this. It’s very tough with the system in place…with insurance and everything. That’s kind of a long answer, but I really hope that the system chances and goes towards a lifestyle approach.

Matt: So you’ve got a lot on your plate right now. You’re the medical editor at Examine.com, you’re a licensed practicing physician, an online coach, training for a bodybuilding competition, and you’re building an online presence. Can you walk me through a normal day for you?

Dr. Spencer: Yeah, so it depends on the day, but right now I’m working in the hospital today. I’m actually post-call at the moment. I usually wake up at 5 and start pounding my aeropress coffee. I might do some cardio while reading a journal article. I respond to emails and maybe get a lift in if I have enough time. After that I’ll go to the clinic around 8:30am til 5. In between patients I’m thinking about blog posts and things like that. When I get home I cook dinner for me and my wife and then start working on the ideas for the blog. On the weekends my wife may be working because she’s a doctor as well and sometimes our schedules line up correctly. When this happens I’ll work on ideas for the blog and I’ve really gotten into the video side of it lately. I don’t know if you know who Omar Isuf is, but he kinda inspired me to do this through his own Youtube channel. I’m always trying to think of ideas for fun videos and to teach/encourage health to fitness professionals and the general population. It really depends on the day, but I try to get up early and be as efficient as possible.

Matt: I’ve been following the blog and read about the recent switch you made from low-carb to high-carb for the bodybuilding competition. Could you share some of the highlights of how its gone so far?

Dr. Spencer: Yeah, it’s actually been very liberating. So after wrestling where I was really high-carb and even just high calorie in general so I switched to a low-carb, higher fat, moderately high-protein diet. It went really well and I was able to get very lean. I did notice that my performance in the gym went down, but I didn’t really care because I wasn’t wrestling or doing too much athletic activity besides bodybuilding anymore. When I decided to do a competition my coach recommended that I switch to a high-carb diet. I’m friends with some of the people who wrote the Atkins diet and also a part of the low-carb advocacy group, but I’m also part of the evidenced based advocacy group like Alan Aragon and others. I knew in my mind that carbohydrates don’t kill or harm if tracked in an appropriate manner. It’s just easier to have a lower calorie diet when you’re avoiding carbs for the most part. So I decided that I might as well make an experiment out of it and literally switched in a eucaloric manner. I switched my fat calories over into carb calories and tracked it all while taking pictures and everything. The interesting thing is that I lost weight in the beginning while doing this, but what it really comes down to is that I was tracking everything and increasing my awareness of my diet. I could have probably lost weight on the high fat diet…there wasn’t anything special about the carbs for fat loss. One thing that did stand out is that my performance in the gym went way up. I was able to do the same amount of reps in the 2nd and 3rd sets as I was the first set which was pretty cool. Now since my calories are on the lower end because I’m getting closer and closer to that prep, but in the beginning it was really cool to not see a body fat gain with those higher carbs compared to what I was eating before.

Matt: When is the bodybuilding competition and what are you working on down the stretch?

Dr. Spencer: No lagging body parts or anything. My calves are pretty small and they’re not going to get any bigger anytime soon (laughing). Basically I’m trying to keep the muscle I have right now and get as shredded as possible in that timeframe. It was fun at first because it didn’t seem like I was on a diet, but now I’m getting lower in calories there’s a threshold that I met where all of a sudden it feels like I am of an diet and it’s not as fun. But it’s going to be ending here in the next six weeks so I want to end it out perfectly. After that I want to go back to a diet that’s not so restrictive. I’ll stick with the high-carbs this time.

Matt: So this was a one time experiment type thing or do you see yourself doing this again?

Dr. Spencer: Yeah, I guess it’s possible that I do some more contests. However, it is interesting because I was a heavyweight wrestler and never had to cut weight like a lot of my friends did. I’d never experienced this before and now I understand that it just isn’t fun. It’s fun getting lean, obviously, but the diet restriction is brutal.

Matt: I saw that you did an interesting online coaching group recently where you had participants pay you $500 up front with the opportunity for a full refund if they followed your coaching perfectly. Had you seen something like this before? What was the intent behind structuring an online coaching group like this?

Dr. Spencer: I was planning on working for Precision Nutrition because I really liked their coaching program. I loved the idea of having an online coaching group so I just had to do it myself. The individuals that were in my weight loss clinic could only meet with me once a month and they were pretty successful, but I wanted to see if I could improve it. I added a private Facebook group to see how people did when they had contact with me online the participants did about 100% better. I figured I could expand this into an online coaching thing for a future source of income so the idea for the pilot program you asked about was started. I got a lot of interest just by throwing a Facebook post out there. It was interesting because I really can’t do medical stuff online, but I can do health and weight loss coaching. I figured that if I did this I would have to get before/after photos and just test it out to see if it was something I could really run with. I took just a few clients for the pilot and told them they could all earn their money back by finishing it, but I got to keep the before/after pics.

A lot of people come to me looking for weight loss, but I’d rather work with people who have slight medical issues because that’s what I can do really well. I can get people lean, but there’s a lot of online coaches that can do that too.

Matt: That’s very cool. So I’d be remiss if I didn’t ask you about Examine and the team. Obviously the team has been working incredibly hard to get this point. Where do you see Examine going from here?

Dr. Spencer: Yeah, so I recently stepped down as director and am back to being a medical editor for Examine. We decided that Kamal Patel having his MBH and his MBA would probably be a better fit for the position. The job requires a lot of reaching out to different out journalists and interpreting studies, which I’m good at, but he’s probably even better. So right now we’re looking for ways to potentially get into textbooks and to make Examine more of a household name amongst people outside of the fitness world. The fitness industry loves it, but I think spreading the word even more will be help us get to where we need to be. Sol is still working to develop the business aspect, but I think from an academic standpoint trying to get into PubMed and other academic institutes will be huge for us.

Links to follow/connect with Dr. Spencer and the Examine team:

• Personal website/blog, FB page, and Twitter
• Examine.com