I think another angle we aren’t considering is what the rest of the patients are like. We’re all putting in massive amounts of effort to improve our health and are ready to commit to strict diets, costly supplements, changes in lifestyle etc. We’d probably be prepared to do whatever a doctor told us if it’d help with 100% compliance. What percentage of patients would you say are like us?
There was a study of ketogenic diets in cancer patients (which turned out to be amazingly effective) in which half the participants dropped out, and literally died, because they couldn’t give up bread. How many diabetics drink alcohol and eat junk food with their eyes and feet on the line? How many people want to treat minor problems with drugs or surgery instead of just changing simple habits and showing a bit of restraint?
Reversing lifestyle diseases is a big commitment for both the doctor and the patient, and in most cases neither are up to the task. Doctors and the system itself play the percentages. Low risk, low effort, low cost, and it satisfies the majority. I guess we’re just in another one of those “the 1%” categories, although I imagine there are more and more people getting desperate for health all the time.