I have always taken a diet history when I do a complete physical examination and have been told by many medical students and residents that I am the only doctor they have ever heard do that. It has paid off royally in my ability often to make a correct diagnosis. A good example was a little boy who a pediatrician sent me from quite a distance. He thought the child might have Duchenne muscular dystrophy because he seemed weak. When I examined the boy I could find no signs of a muscle disorder. His diet history was quite startling. The mother was a single parent and a busy executive. She had little household help and said she would pick up food from a fast-food place and did little cooking. I asked her to send me a three-day list of what the family ate. It was quite unbelievable. I told her my answer to feeding my two children was to make out menus on the weekend and do the necessary grocery shopping and cooking. Two weeks later she called me and said "You have changed our family's life. We all get along better and everyone seems to have more energy." I saw the little boy again and he was a different child. I had to laugh that I "cured muscular dystrophy with a better diet." The referring pediatrician was amazed.
The teenage girls that I cared for who had anorexia and bulimia also gave me unbelievable lists of what they ate or didn't eat. I don't remember having to hospitalize any of the girls. By working with them and having a good psychiatrist follow them was what they needed.
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