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ReforMedicine: Navigating the Intersection of Mental and Physical Health in Primary Care


The interconnectedness between physical and mental health has been a subject of interest in the wellness landscape, prompting discussions about the importance of holistic approaches to healthcare. For instance, recent studies have explored the relationship between depression and obesity. Research published by the National Institutes of Health (NIH) highlights compelling evidence suggesting that individuals with obesity face a 55% increased risk of developing depression over time. Conversely, those experiencing depression exhibit a 58% increased risk of obesity.

This bidirectional association between depression and obesity illustrates the impact of mental health on physical well-being and emphasizes the role of physical health in mental wellness. Moreover, it carries significant prognostic implications for healthcare professionals. David J. Usher M.D., a family practice provider and medical weight loss specialist, shares his observations regarding the interplay between mental and physical health among his patients.

Drawing from extensive experience, Dr. Usher states that many individuals struggling with depression or anxiety also struggle with weight management issues. Stressors related to work, relationships, and personal life significantly affect eating behaviors and weight management efforts. To address these stressors, one must recognize their profound impact on both mental and physical health.

The seasoned healthcare professional emphasizes the importance of addressing the roots of mental health issues to facilitate holistic wellness, acknowledging that focusing solely on physical health may overlook crucial aspects of overall well-being. He also highlights the role of social connections in promoting mental well-being and advocates for individuals to consider social engagement as part of their holistic wellness strategies.

Reflecting on patient awareness, Dr. Usher has observed distinct differences between male and female patients regarding the acceptance of mental health issues as contributors to overall health problems. Women, he notes, tend to be more collaborative and open to seeking help sooner, influenced by their experiences with obstetrical and gynecological care. In contrast, men often resist seeking help until they have exhausted all other options. He stresses that it’s critical to address mental health concerns in both male and female patients to achieve comprehensive wellness.

ReforMedicine, an independent direct-pay family medicine clinic and medical weight loss practice in Wisconsin, navigates this landscape by integrating mental health considerations into its physical health assessments. It employs routine screening for depression and anxiety during patient checkups, utilizing intuitive observations and standardized questionnaires to identify potential mental health concerns.

Dr. Usher founded the clinic in 2011, driven by his vision of reshaping the culture of health through his innovative approach to healthcare. ReforMedicine’s Medical Weight Loss Program, for instance, attests to his commitment to addressing chronic relapsing obesity. This program provides patients with personalized treatment plans to achieve long-term success in weight management and overall well-being under the care of a team of experienced healthcare professionals.

The founder notes that many patients participating in medical weight loss programs may be taking psychoactive medications for depression or anxiety, which can impact weight gain. In ReforMedicine’s Medical Weight Loss Program, identifying and addressing medications that contribute to weight gain is a key component of treatment. The practice, therefore, requires asking about patients’ histories of significant trauma, recognizing its critical impact on mental health and its potential manifestation in obesity.

Dr. Usher also cautions patients against high-carb diets. Carbohydrates, particularly those derived from processed sources, have been shown to contribute to various health issues, including diabetes and high blood pressure. They can also impact higher cortical function, serotonin levels, and dopamine levels, leading to feelings of anxiety and depression.

With this, transitioning to a lower-carb diet is crucial, as it can yield both physical and mental benefits within a relatively short time frame. Eliminating unnecessary sugars and starches (carbohydrates) and focusing on protein-rich foods can help individuals break free from dependency cycles and experience improved mental clarity, better sleep quality, and reduced sugar cravings.

“Weight itself isn’t the root issue,” Dr. Usher supplies. “It’s merely a symptom of a larger problem, which is the western carbohydrate-toxic diet. Once you address that underlying problem, improvements start happening almost immediately.” He urges individuals to prioritize protein intake and essential fats over unnecessary carbohydrates, which have been ingrained in dietary habits for generations. Consumers must learn to shop wisely and be discerning about the information they receive, given the rampant profit-driven dissemination of misinformation surrounding nutrition.

Ultimately, navigating the intersection of mental and physical health in primary care requires a multifaceted approach that acknowledges the interconnectedness of various domains. ReforMedicine champions a whole-person approach to wellness across multiple domains including physical activity, healthy eating, adequate sleep, and financial well-being.

Dr. Usher remarks, “I believe that understanding the connection between mental and physical health is fundamental. Exercise is a proven approach to treating depression and anxiety. In our practice, what we do is encourage our patients to find activities they enjoy that involve physical movement instead of prescribing specific exercises. This approach empowers patients to have more control of their health journey and make choices that align with their preferences and lifestyle. This promotes a better sense of self-efficacy, which contributes to overall psychological & mental wellness.”

M&F and editorial staff were not involved in the creation of this content.

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