There’s been a lot of buzz around living a plant based lifestyle lately. Is eating plants really that good for you? What is the secret to good health? I was recently at the Singularity University Global Summit in San Francisco and had the opportunity to interview Dean Ornish, who is famous for challenging the belief that there’s no way to reverse heart disease and diabetes. He’s proven that by combining diet, exercise, yoga and meditation, you can get better, at any age. Below is a transcription of my interview with the man himself, in which he spills on his latest book: UnDo It! and exactly how he gained the courage to challenge the entire medical community.
As your career and journey began, how did you decide to explore natural medicine?
I got into it on a personal level when I became suicidal and depressed when I was a freshman in college. I found these techniques were really helpful to me in getting past that and rediscovering more inner sources of peace, joy, and well-being. When I got to medical school I realized a lot of the patients were dealing with those same issues even though their doctors didn’t even know about it, because most doctors are depressed themselves. When the patient starts to talk about themselves feeling depressed it makes the doctor feel uncomfortable because it reminds them of their own issues, so they change the subject.
In medical school, I was also learning how to do bypass surgery with Michael DeBakey, one of the inventors of bypass surgery. We cut people open, we bypassed their clogged arteries, he would tell them they were cured. And more often than not they would go home and do all the things that had caused the problem in the first place: smoke cigarettes, eat junk food, stress, not exercise, be lonely and depressed. And their new arteries would often clog up, so we cut it open again, sometimes multiple times. So, for me, a bypass surgery became a metaphor of an incomplete approach and we were literally bypassing the problem and we weren’t treating the cause. I got sort of obsessed with the idea as I began to get into it more deeply, that in dogs, cats, pigs, rabbits, and monkeys, you could cause them to get heart disease if you fed them unhealthy diets or put them under emotional stress. And you could reverse it if you changed those things, so why should people be any different. Everybody people are just different and that made no sense to me. So, one of the nice things about growing up in Texas and going to medical school there is that there is this pioneering ethos that if you’ve got this crazy idea, go for it. It won’t work but you’ll learn something, so we will support it. So, we put it to the test, and the Plaza Hotel in Houston donated 10 of its rooms to us for a month.
I got a small grant, so we were able to do a pilot study back in 1977 over 40 years ago and found that it worked. Their chest pain went away, but they not only felt better, they were better in ways we could measure. Their blood flow to their heart improved. So, I finished medical school and did another, more rigorous study. This time we had a randomized control group, went to Boston for my medical residency and fellowship, came to San Francisco, began the most definitive study. And then now the idea that heart disease is reversible has become mainstream and then was able to spend 16 years to work with the people for the Center for Medicare and Medicaid Services, CMS, to get a new benefit category called intensive cardiac rehabilitation created, so that Medicare will pay for our program in hospitals and clinics and physician groups around the country. And they’re paying over $9 -to $10000 dollars per patient.
So that makes it financially sustainable for doctors to provide the program and it’s a team approach for the doctor’s cutback, but also if you’re a nurse, a meditation yoga teacher, exercise physiologists, registered dietitian and psychologists and all of them work together. People come twice a week for 4 hours at a time for 9 weeks, for a total of 18 visits for 4 hours each for 72 hours. An hour of meditation, yoga, an hour of exercise, an hour a support group which is really why we’re getting such unprecedentedly high levels of adherence and an hour of a group with a lecture. And we’re getting bigger changes in lifestyle, better clinical outcomes, bigger cost savings and better adherence anyone’s ever shown before and it’s working.
Did you always intend to pursue medicine in college?
Yeah, I really wanted to get into medical school and that’s part of why I got so depressed as I felt like I was stupid. Now that I was in a school with a bunch of really smart people, it was just a matter of time before they realized what a mistake they’d made in letting me in and it was kind of a whole series of things. My college roommate was one of the few people that scored a perfect score in his SAT’s that year. I just began to feel like an impostor, that I was stupid and that I was never going to mount to anything. And I thought, why don’t I just kill myself, because people who are dead look like they’re peaceful. I almost did that, but my older sister had been a child of the 60s and she studied with a man named Swami Satchidananda. He was an ecumenical spiritual teacher. He opened Woodstock. He came over here in 1966 with Peter Max, the artist brought him, and started a Yoga Institute. There’s an old saying that when the student is ready, the teacher appears and that was really true for me.
So, my parents decided to have a cocktail party for the Swami, this was in Dallas in 1972 which was pretty weird back then. He came into our living room looking like what a Swami would look like: long white beard and saffron robes. He began a lecture and started off by saying nothing can bring you lasting happiness which I had already figured out. But he was glowing, and I was ready to give myself in and he went on to say that nothing can bring that to you. But the good news is that you have that already. And not being mindful of that, we often run after, as I mentioned in my talk, if only I had more money, more power more accomplishment, more beauty, more sex, then I’ll be happy. If people would love me then I wouldn’t feel so lonely. We doctors have among the highest rates of suicide, drug addiction, divorce of any identifiable group because how we’re trained and how we often work these things. And once you set up that view of the world, then until you get it, you feel stressed. And the stakes go way up because it’s not winning or losing, it’s being a winner or loser that’s on the line, and people don’t want to be around losers. I’m sure at some point in your life you said if I just made ten thousand dollars a year I’d be really happy, and then that’s not enough and the goalposts keep moving. If it’s not now what, it’s so what. It doesn’t provide that lasting sense of meaning. So, people say things like the letdown that comes from accomplishing a goal is so great, I always make sure I have a dozen projects going on at the same time so that I could just immediately turn my attention to something else. But what the Swami taught me and what my life’s work has been about has been that when you can quiet down your mind and body and experience more of an inner sense of peace and joy and well-being and realize that’s really our natural state, it’s not something you have to get, it’s something we already have. And then perhaps the ultimate irony of life is that not realizing that we often run after things that we think we need to do to get what we could already have if we just stopped doing that. So, people say, are you a Hindu and he’d say, I’m an ‘undo’. And that’s where the title of the book came from.
These same lifestyle changes can undo or reverse the progression of so many chronic diseases and the more diseases we study, the more underlying biological mechanisms we look at, the more reasons we have to explain why these changes are so powerful and how quickly people can get better, in ways they can feel and experience, but also in ways we can measure. Ironically using these very high-tech expensive state of the art scientific measures to prove the power of these very simple and low-tech low-cost interventions.
And we see now as we live in this time of abundance, we seem to have everything to keep us healthy, and depression and suicide is probably at an all-time high.
Yeah in part because in some ways the people who are often the most depressed are the ones who have gotten everything, and it didn’t bring them what they thought. The people who are household names or worth five billion dollars can’t say I wish I just had more money then I’d be happy. At least before you had the myth to think if I could just get those things then I’ll be happy. Then once you have them it doesn’t bring any joy. That’s when people get very despairing. That’s what happened to me and that’s one of the reasons why I mentioned in my talk that a study came out recently, the more time you spend on Facebook the more depressed you are because it looks like everybody has this perfect life but you. People don’t post authentic bad things that happen to them mostly on Facebook. In our support groups, they do. Growing up 50 years ago when people had an extended family or a neighborhood with three generations of people who lived together or even a job that felt secure that you’ve been at for ten years or more, or that extended family you saw regularly, or a church or synagogue…Any sense of community where people can be where they watch you grow up and they know where you messed up, they know your dark side, and yet they’re still there for you, is very primal in a very healing way and many people have nowhere that feels safe enough to open up and be authentic, and no one that they trust enough to do that with. So, the goal here is to say in our support groups, for example, is not to help them stay on the diet, it’s to create a safe environment where people can let down their emotional defenses and trust each other to be authentic and open.
Somebody could say I may look like the perfect father, but my kids are on cocaine or someone else could say, instead of saying, why don’t you send them to a drug rehab center which I’m sure they thought
of, but which only makes them feel more distant, to say, what I am feeling and to express that as a feeling, like saying, I’m feeling sad to hear that, I’m sorry to know that, my son has a problem, or I used to have a drug problem. It doesn’t change the fact their kid is still addicted to cocaine, but it changes everything about how the father feels about it.
They don’t feel the shame and guilt and stress and loneliness and depression. Now they are part of this community that can really support them. And then paradoxically that makes it easier for him to address the issues that he’s dealing with. So, the reason I’m still so passionate about doing this work after 40 years is that it enables me to work with people in a very sacred moment when they are hurting and when people are in pain. There is an openness to change and transformation that you don’t always find because change is hard. Change takes effort. It can be stressful at times but if you’re in enough pain and suddenly the idea of change, especially if the science has shown that if you’re willing to make these changes you can make your pain go away, or much lower, your chest pain will go away in most cases due to heart disease. Then people and the science proves that if you make these changes you’re likely to get better.
People often say things like having a heart attack was the best thing that ever happened to then and the first time I heard that I thought they are nuts. They said that’s what it took to get their attention to begin making these changes that have made their life so much more joyful and meaningful. And that’s an opportunity as a doctor. I wasn’t trained to teach people to do, I’m trained to kill pain, to numb pain, to bypass pain, literally or figurative, but the pain is there for a reason. It’s saying you’re not doing something that’s in your best interest. And again, the Swami used to say when you get tired of banging your head against the wall you’ll stop doing it and you’ll stop blaming the wall. The pain is here to say there’s a better way to do things. And the research enables us to empower people and say if I’m willing to make these changes I’m likely to get better and not only feel better but actually reverse the underlying disease that’s causing the pain in the first place.
You mentioned how social media increases our levels of depression. What role do you think social media is playing to make the world a healthier place?
My wife Anne, who I’ve worked with for 20 years, who co-authored this book, we were meeting with people twice a week for 9 weeks and Medicare and other insurance companies were paying for. After they finished their 18 sessions over 9 weeks, they would meet on their own. But we kept enrolling so many people that we ran out of places for them to meet at. So, she came up with this idea of doing virtual support groups using Zoom, which is a video conferencing you could do. And it actually works as well or better because they’ve already made the bond with each other in person over those first couple of weeks. But now if they’re on vacation they’ll pick a time where all 15 of us are going to call in together. And the way Zoom works, whoever’s talking kind fills up the screen. You don’t push buttons and it works really well. We’ve been doing this now for many years. It’s an example of how technology can really bring us together. Facebook could do that. They’ve got 2 billion users. I think if they want to go to the next level of intimacy, the next level of success is to create groups that feel safe for people. Anything that can bring us together is really healing.
Until recently, we were following what the FDA’s food pyramid was telling us to eat. How has social media changed that?
Our interview is a good example of that. Awareness is always the first step in healing. That’s why I love doing this work because that’s why I wrote the book. That’s why we have our ornish.com website. That’s why we train hospitals and clinics around the country. I gave a talk two weeks ago to the sixth-international conference on nutrition and medicine at George Washington University co-sponsored by the Physicians Committee for Responsible Medicine. Over 1000 doctors were there, and if each of them has a thousand patients, that’s a million people we’re going to raise awareness for just from that one hour that I spent. So, my TED talks have been seen by over five million people. So, I’m always looking for leverage points having seen what a powerful difference these changes can make, to get the information out to people who could use it especially when they’re suffering to transform the lives for the better.
And then more people have the opportunity to share their experiences and their stories.
And then it becomes a virtual cycle.
What is the one thing you can point out that will greatly impact the obesity epidemic?
I worked very closely with some of the major food companies, with PepsiCo with McDonald’s. I got McDonald’s to put salads on the menu for the first time and with PepsiCo to make less unhealthy versions of foods or to buy healthy juice. But I think one of the reasons people are obese is because of loneliness and depression. And some people smoke to deal with their loneliness, as I mentioned in my talk. Or a well-known food writer said when I get depressed I eat a lot of fat. Fat coats my nerves and numbs the pain. Or food fills that void, or alcohol, drugs, opioids, video games, work numbs the pain. And so, for me, it’s not enough to give people information. We’re drowning in information. Smoking is bad for you. Everybody knows it. It’s on every pack of cigarettes. So, information is important but it’s not usually sufficient. We have to work at the deeper level. And for most people, the deeper level is that they’re unhappy. And so, when we work on that level and the support groups are one way of doing it or spending more time with your friends and family. When we work on that level then we find the people are much more likely to make and to maintain lifestyle choices that are life-enhancing than ones that are self-destructive.
You mentioned adding salads to McDonald’s. How do you feel about plant-based food, but genetically modified plant-based?
I think the jury is still out on that. I think if you can get plant-based foods that are not genetically modified that’s probably even better, but a genetically modified salad is better for you than grass-fed organic beef, especially in this country. It’s not like we don’t have the resources to do it that way. And I think that there’s more and more evidence coming out that when you eat a whole food plant-based diet you’re not only not eating the foods that cause disease but you’re getting literally hundreds of thousands of other substances that protect you and is healing.
What about people that have aging parents who didn’t necessarily live with the best habits in their life: what’s a way that you think would be able to help shift their parent’s perspective?
Again, that’s where awareness comes because when I began doing this work I thought that the younger patients who had less severe disease would do better, but I was wrong. It wasn’t how old they were, our studies taught us, it wasn’t how sick they were. It was simply a function of one thing. The more you change your diet lifestyle, the better you get at any age which is a very empowering message to get to people. Basically, people say they have bad genes and can’t do anything about it. We did a study with Craig Venter where we found that we could change the expression of over 500 genes in three months and turning on the good genes, turning off the bad genes. And by the way in our studies, we found that the primary determinant improvement was how much you change your lifestyle at any age. In our study where we could reverse heart disease, the greatest amount of reversal was in the oldest patient who was 86 at the time but he made the biggest changes. Again, not to blame, but to empower.
If you’re a victim of bad genes what can you do? I’ve been working with Bill Clinton since 1993 when he first became President and when his bypasses clogged up ten years ago, his cardiologist held a press conference and said it was all in his genes, he couldn’t do anything about it. His diet and lifestyle had nothing to do with it. So, I sent President Clinton an email. I said it has everything to do with it. Again, not to blame but to say look if it’s all in your genes you’re just a victim. You’re not a victim, you’re one of the most powerful guys on the planet. Here’s what you can do about it. And I thought the friends I value the most are the ones who tell me what I need to hear, not what I want to hear, and you need to know this and maybe I’ll never hear from him again. But a couple of days later we met, and he’s been doing this now for 10 years. I think if you’re a former president, especially one who was not known for eating very healthily, makes these changes I think it really empowers them and inspires other people and gives them new hope and new choices that they didn’t have before.
When making these changes a lot of people, including myself, are driven by results, so when you see instant gratification in some way it motivates you to keep going. What would be a step, or a good first step where you’d see the most or quickest results to motivate you to continue on the path?
There’s two basic strategies. One is small and gradual changes and the other is big rapid changes. And most people think small gradual changes are easier, and for some people they are. I wrote a book called, ‘The Spectrum’ that was based on this finding that the more you change, the more you improve at the age. So basically, you decide how much you want to change, we’ll support it, we’ll track it. If that’s enough to accomplish your goals, great, if not, do more. If you indulge yourself one day, it doesn’t mean you’ve failed. So much of the language of behavioral change has this kind of fascist shaming quality through it like I cheated on my diet. Once you call foods good or bad it’s a small step to saying I’m a bad person because I eat bad food. And once you go on a diet, chances are you’re going to go off it, and you’d beat yourself up even more. So, this is just a way of eating to the degree you eat healthier, if you indulge yourself one day, eat healthier the next. If you don’t have time to exercise one day do a little more the next. Whatever you do there’s a corresponding benefit. And then as you begin to make these changes and you feel so much better then you’re going to want to do more
The other approach which you have to do if you’re trying to reverse disease because you’re dealing with life threatening conditions is make big changes all at once. Go on a vegan diet, whole foods, low fat, low sugar vegan diet, do an hour a day of meditation and yoga, half an hour of walking and support groups. And we actually are finding we’re getting much better adherence to that than interventions that ask people to do a lot less, even though that’s counterintuitive. We’re getting better adherence to our program. It’s 9 minutes long. 94% of the 72 hours are completed and a year later after 9 weeks, it’s over. A year later, 85 to 90 percent of the people are still following it, on every site we train around the country. Whereas most doctors say they get their patients to take their Lipitor, their Statin drugs but there’s no way they’re going to change your lifestyle and yet less than half of people prescribed Statin’s are taking them after just 6 months. And the reason is that the pills don’t make you feel better, but the lifestyle changes do.
Because these mechanisms are so dynamic, if you really make big changes all at once the way that we prescribe, if you’ve got heart disease and you can’t walk across the street without getting pain, without getting chest pain or you can’t make love with your spouse or play with your kids or go back to work without getting chest pain and usually within a few days to a week or two, most people are essentially pain free.
What I gain is so much more than what I give up. And it’s not about living longer, it’s about living better. Those are choices worth making and it reframes the reason for making them for fear of dying which is not sustainable to joy and pleasure and love and feeling. And so, the paradox is that when you really make big changes all at once you feel so much better so quickly. It really reframes the reason for making them for preventing something bad from happening years down the road which is hard to relate to, I can think more clearly, I have better sexual function, as I talked about in James Cameron’s new film. I look younger, I can grow some brain neurons, my brain can get better, bigger. You don’t have to start being forgetful. All those things are reversible. And as I mentioned in my talk we just began the first randomized trial to see if Alzheimer’s disease can be reversed. And I think that I’m hoping that it can be.
We talked about what you consume and what you eat. What about how you eat and how you consume it, the state that you’re in a rush, or stressed?
My wife did a DVD. It’s in the back of the spectrum book with guided meditations and one is called, ‘Eating with ecstasy’. It’s really based on what Jon Kabat mindfulness work was, where he would have people meditate on a raisin. If you really focus your awareness on something you get more pleasure. And on the other hand, if you eat mindlessly, everybody’s had an experience of eating a bag of popcorn while in a really intense movie and suddenly you look down and the other bag is empty. So, you got all the calories, but you didn’t really enjoy it, because you weren’t paying attention to it. But if you really eat mindfully and chew slowly and really smell the food and taste it and enjoy it, you can get more pleasure. Or if you’re making love with your partner and you really give it your full attention, it’s so much more erotic than if you’re just going through the motions literally and figuratively.
How do you define happiness?
Happiness is when I stop disturbing what’s already there. And for me, being with my wife and our two kids, just being together is really happy. And then there’s always sex, drugs, and rock and roll, but that’s another story.
Name a book that’s impacted your life.
There’s so many, but probably “The Structure of Scientific Revolutions” by Thomas Kuhn, which I read when I was in college. It talks about how paradigms really create a sense of order in the world. And as long as you realize that they’re limited, that’s great. But most people mistake the paradigm for the world itself. So, in the 16th century when the paradigm was the earth, was the center of the universe and everything revolved around it, and then an Italian philosopher named Bruno came along said actually the earth revolves around the sun, and they burned him at the stake. That’s what happens when the paradigm is challenged because it doesn’t just challenge the facts, it changes the whole sense of order that that provides. A hundred years later Galileo came along and said the same thing, they forced him to recant under the threat of the Inquisition. But by then he’d shown people and they could see for themselves using
a telescope that things weren’t the way that they were taught. Then science became the dominant paradigm and science has great value. I’m a scientist because it’s a great way to kind of sort out what’s true and what isn’t and what works and what doesn’t, and for whom and under what circumstances. But it’s limited. Not everything that counts can be counted as Dennis Burkett once said, not everything that’s meaningful is
measurable. But a lot of things are. So, I think things that are measurable are important, but it also helped me understand why there was so much opposition in our early studies when we showed that heart disease was reversible. I thought everybody would be happy to know that, but it actually was very threatening because it threatened the order that that conception had provided up to that point. So that book really gave me a lot of courage and helped me understand why people were reacting in ways. Ultimately, they came around and now that’s become the mainstream. But it took a long time.
To learn more about reversing chronic illness, check out Dean’s latest book UnDo It. Available on Amazon