Introduction to Dr. Shawn Baker
Dr. Eric Westman: When you look and talk carnivore there’s one name that comes up. One doctor. It’s Dr. Shawn Baker.
Welcome to the YouTube channel.
Dr. Shawn Baker: Thanks for having me. You’ve been doing this for a heck of a lot longer than I have. All respect to you for pioneering this way of thought for many, many decades now.
How Dr. Shawn Baker got involved carnivore
Dr. Eric Westman: You’re welcome. For the first part of my career, I was working with a brilliant PhD in the smoking cessation world, and my job was to keep him safe because he had all these great ideas. And now, I feel like I’m trying to keep you all safe with all these crazy nutrition ideas.
We started studying this 25 years ago and I got into this by patient care. Two of my patients did it in front of me.
Assume that someone doesn’t know who you are, where you’re from, what you do. How did you get involved in this? It started with your training, and then how did you get involved in being the carnivore lightning rod at the moment?
Dr. Shawn Baker: I was a conventionally trained physician. My specialty was orthopedics. I had a fairly standard career for much of it. I spent some time in the military and did a lot of trauma surgery before I went into my own sort of private-type practice.
Getting involved in nutrition
It wasn’t until I was probably in my early 40s that I took a greater interest in nutrition, solely for personal reasons, because I wasn’t happy where I was health-wise. I’d been an athlete my whole life. I’d always trained and exercised since I was a teenage kid and I still do it.
My health was going in a direction I didn’t like. I was probably developing some level of metabolic disease. I was feeling my 40-some years of age at that time. As an aging athlete, you’ve got a lot of mileage on you, and I didn’t like that.
I started with, let me just go on a diet. The first time I’d ever thought about dieting in my life, because I’d always been able to compensate through exercise. I ate a lot of protein, and I didn’t eat a lot of junk. I made a concerted effort to focus on diet.
I went on this basically low-fat, high-fiber, vegetable-heavy, lean protein diet. I lost weight. At the time, I was walking around at about, I’m a big guy, you’ve met me, 290 lbs at about 6’5″, and I’d been there for about 20 years as an athlete.
Working out and exercises
I needed to be that size because I was competing in strength sports. I dropped from that down to about 230 lbs over about three months. It was exercise three times a day, severe caloric restriction, and the food was “healthy.” It was chicken breast and salads. I was jumping rope, a couple thousand jump ropes in the morning before I’d go to work at the surgical practice. Then at lunch, if I had a clinic day, I’d run in and get a quick workout over my lunch hour. And then at night, after I put my kids to bed, I’d do another couple thousand jump ropes.
As you can imagine, that’s not sustainable. So, I was miserable. I was weak. And I looked good.
Dr. Eric Westman: You said so much in there. So, trained as a physician, did you go back to your medical training to figure out what to do then? Or did you, like me, get very little nutrition training?
Nutrition
Dr. Shawn Baker: Well, the prevailing thought, and it still is today, is that it’s all about calories in, calories out. It’s also all about if you look at the USDA recommendations, basically, fill your plate with a lot of vegetables and grains and lean protein, and minimize the fat.
I did that. I don’t disagree that it can work. It’s just very hard to sustain. It’s very hard to deal with constant hunger. I remember the nurses saying, “Dr. Baker, we liked you so much better when you were fat.” They said it playfully because I was grouchy. I was hungry all the time.
I said, “I can’t do this. I just can’t maintain this. I’m a disciplined guy, but—”
Discipline
Dr. Eric Westman: I have to editorialize a little bit, and that is, as physicians, we’ve gone through high school, through college, through medical school, and sitting on our behinds in lectures. We had to be in the OR, learning how to not even scratch an itchy nose if you had a mask on.
Imagine asking everyone to do what you did, to be hungry all the time and to have to exercise all the time. You were already selected to be able to do something really difficult, and you did it.
Dr. Shawn Baker: I don’t lack discipline. And I’m fine. It’s preferable to be more comfortable in the long term. I did that, and then I discovered that I couldn’t maintain it. So there’s no way I can do this for the rest of my life.
Dr. Eric Westman: Even you?
Dr. Shawn Baker: Yes, even a guy who’s almost psychotically obsessed with performance. Some of this, I couldn’t see that as being something sustainable for me.
Dr. Eric Westman: I tried to make the comparison and contrast to the average person who comes to us. Many of them haven’t even finished high school. They couldn’t sit in class. To ask them to do what you did, what many doctors do, it’s just not practical.
Dr. Shawn Baker: I agree 100%.
Low-carb and Keto
From there, I discovered some of the low-carb thoughts. I think the first book I read was Gary Taubes’ book, Good Calories, Bad Calories. It put in my mind that maybe some of this nutrition stuff isn’t crystal clear like we thought it had been.
It cast enough doubt in my mind about the whole value of nutrition science. It’s not that there’s no value there, but there’s a lot of flaws within. There’s a lot of assumptions. I, at some point, discovered the low-carb stuff, the keto stuff. I did that. I remember when I went keto for the first time. I was super excited because, for the first time in my life ever, and I was probably in my mid-40s at that time, I wasn’t hungry. I was a guy who was used to putting down 6, 7, 8,000 calories a day as a big athlete. I would go to a restaurant, and I’m not exaggerating, I’d eat two, maybe three appetizers. I’d get a couple of entrées, and then for dessert, because I couldn’t decide between the red velvet cake and the cheesecake, I’d just get them both. I ate a lot of food because I was a big guy and always hungry.
I remember the first time going “Whoa, I’m not hungry.” This is weird. That was a revelation to me. In my mind, it was like, for the first time, I had this sense of satiety that I’d never had before. From there, and this is the interesting thing for me, I was still practicing orthopedics at the time full-time. We had a situation where we had a lot of obese patients that needed knee replacements. That’s what you see. That’s what the population typically looks like. Unfortunately, these patients are at higher risk for complications. They have a higher risk for blood clots, infections, and poor overall rehab. So, as a local community of orthopedic surgeons, we all got together and said, “We’ve got too many people that are struggling with this stuff. Let’s all agree to not operate on people with a BMI over 35 unless we’ve done X, Y, and Z to get them to lose weight.” We all agreed to that, so one person didn’t just take all the people that were obese. But they didn’t give you any guidance. It was like, “Get your patients to lose weight, good luck.” You know how that goes.
Proposing keto to patients
Because I was doing a ketogenic diet at that time and had success with hunger, I started proposing it to my patients. Maybe 20–25% of them would take me up on it and actually do it. But the thing that really blew me away was that, in that cohort, I would typically say, “Here’s a diet. Read these books. Watch these videos. Try this diet out.” And the people that would do it often would come back to me at the two-week point because I would follow up in two weeks to see how things were going. “How’s your diet going?” Very often, they would say, “Doc, I know we’re scheduled for a knee replacement in two months, but my knee doesn’t hurt anymore.” That was when I was like, “Wait a minute.” I would say, “What? If your knee doesn’t hurt, there’s really not a good indication to do surgery at the moment. So as long as you keep on your diet and it’s working for you, you don’t need surgery.”
That, to me, was a light-switch moment. Then I got really excited because, by that time, I had done thousands of surgeries. I’d done hundreds and hundreds of knee replacements, gazillions of knee scopes. I was like, “Wait a minute, we can impact these people’s lives in a way where they don’t need surgery.” Even as a surgeon who liked to operate on people, if it were me, I’d rather not have the surgery. I think most people feel that way.
From keto to carnivore
That’s what got me into this place. Then, from keto, I ran into this wacky group of people just eating only meat. They called themselves a zero-carb group, “Zeroing in on Health,” and it just sounded so bizarre. What do you mean? Where’s your vitamin C? Where’s your fiber? Where are your phytonutrients, all that stuff? I was already bought off on the low-carb being beneficial and not terrified by fat. I wasn’t there anymore, and so, I was at the point where I said, “I’m just going to try it.”
This was 2016. I tried it for 30 days, and I felt great. Even more so than I felt on keto, believe it or not. I mean, my digestion was better. I felt like I was a little less inflamed. I got a little stronger, which is cool as an athlete. I’ve been there ever since and I’ve been promoting this carnivore diet. For the last, I guess, eight years, I’ve been doing this. I’m starting my ninth year of this stuff. It’s been interesting. I tend to say, “This is a therapeutic tool.” I don’t care if you want to get a tattoo and call yourself Carnivore Carl, that’s up to you. From the physician side, you probably see this as well, it has such dramatic therapeutic potential that we should at least be willing to discuss it with our patients. If they want to do it for three months or six months, and it helps them significantly, good for them. Then they can figure out long-term what they want to do. Some people decide they want to do it long term. Other people are like, “Yeah,” and they incorporate a few other things back in. Many of them are still fine with that. That’s where I’m at right now.
Dr. Eric Westman: How did you get the idea that this might help other people, too? I guess you learned it from a group that already was?
Helping other people
Dr. Shawn Baker: I’d already seen people that it was seeming to help. The only reason I tried it is because no one wants to be the first guy to try something. “Let me see how these guys are doing.” I’d known there were some people doing it, and they were making pretty, what appeared to be at the time, extraordinary claims. “My depression got better,” or things we as physicians would scoff at. “What, you had a diet and your depression went away? Get out of here, dude.” Or, “Your arthritis got better?” We would kind of ignore that.
I can remember specifically, years ago, I had a lady come in telling me how bread hurt her knees. I started looking at her allergy list, and she had 15 allergies, one of those kind of wacky patients. You kind of compartmentalize these patients as being a little bit strange. “I’m going to take what they say with a grain of salt – when do you want to schedule your knee scope?” type of thing. But, I’d heard enough people doing that. I was on social media at the time, on Twitter, and I had, not the account size that I have now, a few thousand people following me. We were talking about it, goofing around. Saying, “I’m going to get scurvy, or my heart’s going to explode.”
I managed to convince, believe it or not, in 2017, 100 people to do it for 90 days, and we recorded the data. We called it an N = 1. We got 100 people to do it for 90 days, and we tracked their data. The average person lost about 30 pounds. Their heart rate went down by 10 points. They lost 8 centimeters off their waist. Everything was subjective, we didn’t have any money, and everything we could measure subjectively got better: digestion, sleep, mood, libido, and skin. All these things got better. That’s kind of where that started
Dr. Eric Westman: 100 in a row? Or selected? What percent had success?
Dr. Shawn Baker: Almost all. I know it wasn’t all of them. It wasn’t a formal, formalized study. It was more of a survey.
Dr. Eric Westman: Basically, you do it, it works.
Now, we compare it to studies where the professor gets 300 people assembled, and people barely do it, or they try it, and they teach a difficult way of doing it. That’s what happened at Stanford. They never actually asked anyone who used it. Then people fall off, and they say, “No one can do it.” Well, no. If someone can do it, it pretty much works. I guess you weren’t thinking of carnivore as an elimination diet at that time. It was just healthy eating, you felt great, and it helped, you’d be fit, rather than a medical treatment?
Dr. Shawn Baker: I think it was still a merging thought on this. I think it still is.
To be honest, I think we’re still trying to figure out some of this stuff. There’s very little money for nutrition-based research when it comes to mitigation of disease. It’s all drug, drug, drug, drug. It’s a slow process to get funded, to get the studies done.
You’re absolutely right. There is zero doubt in my mind that this can help people with X, Y, and with lots of conditions. The question is, does it help 80% of the people? 20% of the people? We don’t know that yet. That’s where the next phase will be, to start doing interventional trials. Keto had a fair bit of that already. So this makes sense.
Carnivore as another version of low-carb
Dr. Eric Westman: We’re following another grassroots area, where people with type 1 diabetes, or the parents of people with type 1, are doing a similar low-carb diet. I see carnivore as another version of low-carb. They had such great results. We surveyed their Facebook group, and it was published in the journal Pediatrics. Similarly, there was a carnivore group that was surveyed and published in a paper.
But the rebuttal that came back from someone I knew, someone in academia, said, “Those were exceptional people. Those were exceptional families and exceptional children, and no one really can do that.” I don’t agree with that. In fact, I’m thinking that it’s almost malpractice to not offer some kind of dietary change because the arrogance to assume that someone can’t do it. Of course, if you teach it in a difficult way. Carnivore has an easy idea of what to eat, so that takes away the worry about making complicated meals. You’ve gone from 1 to 100, and now, even on my YouTube videos that I do, I have to assume that these aren’t people lying. And yet, there are benefits of not eating vegetables.
There’s a difference between these internet anecdotes and carefully assembled clinical trials where you’re vetting out and making sure someone actually had that experience. Even with the type 1 Facebook survey we did, we validated and verified the blood tests that people self-reported to be sure. We talked to the doctors and also got the clinical verification.
As this grassroots movement grows, people are not eating vegetables, and there are a lot of pre-clinical reasons why that would work. I’ve certainly seen diabetes reversal and all these medical problems go away. What’s the next step to formulate? What percent will have benefits? How do you teach it so that most people will be able to do it? I followed, and in fact, was an initial investor in your company that teaches this. What have you learned from now, in the trenches, implementing this with people?
Implementing carnivore with people
Dr. Shawn Baker: Let me just make one comment. We’re talking about the ability to sustain or actually do this. I remember an interaction I had with another physician who said, “I don’t want to fight my biological urge to eat a cookie.” I’m “That’s not real, cookies never existed!” So, that’s obviously not a biological necessity by any means.
As you probably are aware now, and I’ve been talking about this for a long time, and I know you have to some degree, we always saw low-carb and ketogenic diets as weight-loss diets and maybe, diabetes management, but there is so much more. It impacts mental health, inflammatory conditions, and autoimmune conditions. I see this every day. We’re getting more and more people saying, “Look, it is not just a weight-loss diet”. There are a lot of ways you can lose weight. You and I both concede, there are lots of ways you can lose weight.
Some of these things uniquely seem to have additional benefits with regard to other conditions.
Dr. Eric Westman: Some are easier than others. You white-knuckle through low-calorie exercise.
Dr. Shawn Baker: It’s a lot easier when you don’t have to rely on discipline and you can rely on your physiology a little bit. Makes it a lot easier, for sure.
Appetite going away
Dr. Eric Westman: The appetite going away is something we don’t talk about a lot. We assume that people know. There are a lot of people who don’t know that. They’re watching this for the first time. They’re thinking, “This is kind of crazy.” The fundamental difference, once you start fat-burning, your hunger goes away. In that group of a hundred people with results, I’ll bet that was universal.
Dr. Shawn Baker: I don’t remember specifically asking that particular question. I’ve seen that one of the more common things people talk about is cravings and addictions. They’ll say, “For the first time, I found the off switch.” I remember talking to a girl who was 800 lbs. She couldn’t stop eating cookies, candies, and sweets. When she went carnivore, she lost 500 lbs in two years. She said, “I’ve found the off switch for the first time in my life.” She had failed gastric banding procedures and things like that.
With the new GLP-1 drugs, people are more in tune with satiety. This is how these drugs act in many ways. But this is something that you only need a drug. I’m sure you’re familiar with Dr. Ted Naiman, Dr. Andreas Eenfeldt, and their Hava Podcast, where they talk about satiety per calorie. Carnivore fits perfectly right in there. It’s the perfect way to get satiated. Your initial question was about how you implement it. What have been the early results?
Talking to people about carnivore
You’ve had so much experience in this. I just talk to people about it. Whether you’re obese or not, many people come to us malnourished in a way. The definition of malnourishment is not necessarily underweight. It’s just not the right amount of nutrition, the correct nutrition.
They may be missing fat-soluble vitamins, not getting enough protein, or possibly there may be certain minerals they’re low on. If you give them whole, unprocessed, very nutrient-rich foods, a lot of times that helps them meet those nutritional needs, so they’re not hungry all the time. People ask “How much should I eat, Dr. Big?” I tell people to eat enough so they don’t want cupcakes or whatever the junk food is. That’s their initial guidance. You tell them that you have to eat enough to overcome those addictive behaviors. That may take a few months. Then, once you get there, you can play with macronutrient ratios, meal timing, meal sizes, and portions. It’s a lot easier when you’re not dealing with this psychological nightmare of addiction. I think that’s the first step. I think when you’re treating chronic disease, you are probably, in many ways, dealing with some sort of ultra-processed food addiction. If you don’t realize that, you’re going to be spinning your wheels. You have to be prepared to do that.
You mentioned our company, Revero. What we do is literally be in contact with patients on a daily basis as necessary. Some of them need it. Some people, you can say, “Go read this book and have at it,” and they do great. But there are a lot of people who just need that hand-holding. There are some people that you have to just keep answering questions, reassuring them, re-motivating them, and giving them the knowledge to continue to do that. We found that that’s been very helpful. When I was practicing as an orthopedic surgeon and waking up to, “Nutrition is important” I had no resources. There was no one I could send them to. The best I could do was send them a YouTube video or recommend a book. I had no time to talk to these people. I was lucky to get five minutes to see my patients. In the busy orthopedic clinic, a 15-minute appointment would be a luxury. I usually had 15-minute appointments, but I’d be double-booked all the time. It was like, “I got two of you guys in 15 minutes.” I felt like I was on roller skates in my clinic all day, just running back and forth. That’s not a good way to do medicine. When you slow it down and ask, “What are we actually doing here?” the goal should be to heal the patient. Healthcare has devolved into disease management, symptom whack-a-mole. That’s not what we signed up for as doctors. I’m sure you feel the same way. I would imagine.
Dr. Eric Westman: I, at a VA, Veterans Affairs Clinic, learned evidence-based medicine and clinical trials. But I was frustrated and not happy with the tools I had. We managed diseases. I like to fix things. I’m a DIY kind of guy. I love YouTube. I can just look up what tool I need and how to do something. It wasn’t rewarding for me as a doctor, as an internist. As an orthopedic surgeon, you could just fix the knee.
Dr. Shawn Baker: That’s one of the reasons I went into orthopedics. I remember as a medical student rotating through my primary care specialties and watching how miserable the doctors were. They were complaining because the patients were never compliant. They never got better. They were beating their heads against the wall. I thought, “Ortho’s great! Somebody breaks their leg, I stick a metal rod in them, and I’m done. Good!”
Dr. Eric Westman: Think about that, it’s kind of a selection bias. It’s like depressed people going into psychiatry because they can tolerate other depressed people. The classic difference between internists and surgeons is that surgeons want to fix things. “A chance to cut is a chance to cure.” Then we, as internists, are kind of, “Oh well.” I think the saying was, “We’re the last to get off a dying dog, the fleas”. We were called fleas. That’s the stereotype. But nutrition is the key, something neither of us got in training. Even today, there’s not much training about nutrition. That could make us vulnerable to doing things that aren’t healthy or aren’t safe.
Safety limits of carnivore
Being in this world, watching people do the carnivore diet or versions of it, what have you learned about the safety limits of it? Are you worried that you’re on the edge of the cliff, that someone’s going to die? Or how far from the cliff are we?
Dr. Shawn Baker: I’ve said this many, many times: there are many ways to get healthy. Carnivore is a tool in the toolbox that you should use when necessary.
For some people, it is more appropriate than others simply because many people don’t need to do it. There are a lot of people who could just remove some ultra-processed garbage from their diet, and their health would dramatically improve. But there are certain people who, as crazy as it sounds, are already eating a clean diet, no ultra-processed food, no excess sugar. They’re eating some meat, some vegetables, some fruits, and then they remove those things, the fruits and vegetables, and their health gets better. I’m like, if it works, it works. Who am I to say that they’re lying to me? I’ve seen that ad infinitum at this point, thousands upon thousands of people.
You can watch the video here.
