Larry Chu, MD, and I have a few things in common. We’ve both been carrying around excess weight, and the judgments that come with it, for more than a decade. We’re disciplined about exercise and have been known to undertake an endurance feat: for him, climbing Mt. Kilimanjaro; for me, completing a century bike ride. And we are neither lazy nor ill-informed; we thoroughly understand the conventional wisdom (or is it wisdoms?) about how we’re supposed to eat.
Then there are some ways in which we differ. Chu, an associate professor of anesthesiology and the executive director of Medicine X, has shown signs of metabolic syndrome. I haven’t — at least, not yet. He is willing to go on a very-low-calorie diet in which, one day, he skipped breakfast and ate 22 almonds for lunch. I’m not — at least, not yet. Last but not least, he’s putting the data from his “health hack” online, down to the frequency of his bowel movements. I’m not — not now, and not ever.
And that’s Chu’s point. We’re all different — not just our motivations and behaviors, but the other factors that play into our body composition, including our microbiomes, hormones, stress levels and sleep habits. “Obesity and weight loss are a very strong case for precision health,” he says in my story in the most recent issue of Stanford Medicine about his personal blog project, precision: me. “We know that one single approach will not work for everyone.”
Precision: me chronicles the first 90 days of Chu’s physician-supervised, personalized quest to lose weight and reverse prediabetes. (Spoiler alert: It worked.) He logged his weight, glucose levels, lab tests, medications, food, exercise and symptoms: hunger, headaches, fatigue — and, yes, even constipation. Part of finding out what works for a particular individual, he said, is conducting an “n=1 experiment” like this and tracking the results.
And part of it is seeing how that individual compares to others — so the more people who make their results available for research, the greater the public benefit. “We’ve got thousands of people doing n=1 experiments on themselves, whether it’s gluten-free, dairy-free, very-low-calorie or low-carb,” he told me. “Imagine what we could learn if people shared their data the way I’m sharing the data.”
The precision: me site includes podcasts in which Chu chats with his weight-loss physician, Rami Bailony, MD, of Enara Health. Particularly poignant are Chu’s descriptions of the “fat shaming and blaming” he’s endured over the years, by everyone from doctors to colleagues to family members. In the “Frustration” podcast, recorded at a point when his weight loss had stalled, he said, “I felt anger at the people who have, throughout my lifetime, trivialized weight loss as something where you simply cut down what you eat and you’re going to lose the weight. And the anger was, they don’t understand my struggle. This is my story, my body, my journey.”
Previously: Precision health: a special report from Stanford Medicine magazine, Aim higher: Dean Lloyd Minor calls for widespread embrace of precision health, How Stanford Medicine will “develop, define and lead the field of precision health” and “No ordinary conference”: The magic that is Medicine X returns to the stage
Photo of Larry Chu by Leslie Williamson