By Mark Huberman
Dr. Anthony Lim is a board-certified family physician with a special interest in whole-food, plant-based nutrition. Dr. Lim grew up in San Diego, and upon completing his undergraduate studies at Stanford University in human biology (Phi Beta Kappa, 1998), he went on an extended journey that included studying Mandarin and traveling in China for one year, as well as working as a management consultant, and teaching 5th through 8th grade math as an Americorps volunteer. Dr. Lim obtained a law degree from Harvard Law School in 2004 and subsequently passed the California Bar Exam. After much soul searching, he realized that his true calling was in medicine, graduating from Boston University School of Medicine in 2010.
Dr. Lim, how are you this evening?
I am doing great. I’m sitting right here in my office at TrueNorth with my new dog, Balto. He is fast asleep right by my feet. He’s a poodle mix that our family recently adopted from a local shelter. Dr. Goldhamer has graciously allowed me to bring him to work, and today was his first day. He has been a hit with the patients and staff alike, and many joked that he is now the new therapy dog.
My late father used to say that most people don’t worry about their health until they’ve lost it, and they don’t really change their way of thinking until they have some sort of a health crisis. But as I understand, that wasn’t the case with you. Tell me about how you learned about whole-food, plant-based nutrition.
It’s a pretty funny story. I first learned of the whole-food, plant-based movement in July of 2014. Believe it or not, at that time I was eating a low-carb diet, and there were a couple of years during my residency training that I was actually advocating a low-carb diet for many of my patients.
However, in July of 2014, I happened to be watching PBS and saw Dr. Joel Fuhrman come on the television. I had never heard his name before, but he was giving a presentation on whole-food, plant-based eating. This was the first time I had ever heard those four words mentioned together. He was making these amazing claims about the power of a whole-food, plant-based diet to not just prevent, but actually reverse and cure, chronic illnesses such as heart disease, diabetes, autoimmune disease, hypertension, and high cholesterol, and it really piqued my interest.
The very next day I checked out Dr. Fuhrman’s book Eat to Live from the public library. That same day, I read his book cover to cover, proceeded to watch Forks Over Knives and Fat, Sick, and Nearly Dead on Netflix, and by the next morning I was officially a convert to the plant-based movement. I have not looked back since! You know when you see and hear the truth face to face, you can’t deny it. I would say that since that point I have had an ever-increasing, confidence that this is the right way to live and I have, in my own mind, committed the rest of my life to this movement.
Above: Dr. Lim with his family
One of the things I often hear is that in medical school they don’t teach anything about nutrition. Was that your experience earning your medical degree at Boston University? Did you really have no exposure to nutrition?
I know, it’s crazy, isn’t it? For the life of me I cannot remember a single lecture about nutrition. The only exposure I recall was more of an afterthought; for example, telling patients to try to eat more fruits and vegetables at the end of a visit. Considering that the vast majority of chronic illness is so strongly connected to what we eat, we must take steps to incorporate more nutrition education into medical school curriculums.
So when you had this epiphany about the wisdom and power of a whole-foods, plant-based diet, did that change both your personal and professional life?
It dramatically changed both. Personally, my diet has changed significantly to include far more fruits, vegetables, legumes, and whole grains, and far less animal products and processed foods. Before my “conversion moment” and during my low-carb phase, I was avoiding foods such as rice, potatoes, and oatmeal, which are now staples of my diet. I also ate far more meat; I even recall once going to In-N-Out Burger and eating not just one but two low-carb burgers consisting of two beef patties, tomato, and onion wrapped in leaves of lettuce. I had the misguided belief that it was fine for me to eat as much meat as I wanted as long as I minimized my carbohydrate intake.
My professional life has also dramatically changed. Previously, I worked in the Family Medicine department at Kaiser Permanente in Santa Rosa, California, providing general clinical care to children and adults. Since going plant-based, I continue to work at Kaiser, but only a half-day per week. I also co-lead their monthly plant-based class along with a nutritionist, Melanie Larson. This class is Kaiser Santa Rosa’s most attended group class, with anywhere from 40 to 60 people in attendance each month, which shows the growing interest of the public in this area. We frequently have guest speakers, including Dr. Ben Brown, the Medical Director of Dr. Dean Ornish’s Lifestyle Medicine Program, and this August, Dr. John McDougall will be our guest speaker. In addition to my work at Kaiser, I also serve as the Medical Director of the McDougall Program and as a staff physician at TrueNorth Health Center. Essentially, I have migrated from 100% general clinical care to a mixed practice that is focused on healthy living, primarily through a whole-food, plant-based diet.
As a result of your own conversion, did you lose weight and experience other improvements in your overall health?
I was already relatively healthy before becoming plant-based. I was very active and was not overweight. However, I would say that since going plant-based my overall health has improved even further. For example, I lost about fifteen pounds and went down two waist sizes despite eating as much food as I wanted. Friends of mine are sometimes shocked at the amount of food that I consume. In addition to losing weight, my cholesterol numbers, though not bad to begin with, improved as well.
I imagine you also began to feel better along the way?
Absolutely! I now have good energy, my GI plumbing is working better, I feel less heavy and tired, especially in the afternoons, and overall I feel very “clean” inside.
How did you break your plant-based news to your family?
Soon after going plant-based, I went back to my hometown of San Diego with my wife and kids to spend a week with my parents, my brother, his wife, and their three kids. On the day we arrived, I gathered everyone around and said, “I have one favor to ask during our week together: that we watch Forks Over Knives together as a family. It’s a short documentary and it will be well worth your time.” So we watched it together and the very next day my parents essentially cut out animal meat from their diet because they were so compelled by what they saw in the film. And my brother’s family has dramatically decreased their meat and dairy intake while increasing their fruit, vegetable, legume, and starch intake.
How did you find your way to Dr. Alan Goldhamer and TrueNorth?
It was August 7th, 2015—I will never forget that day. My mom, knowing of my passion for plant-based nutrition, forwarded me an email from the McDougall Newsletter that contained an announcement of a new physician opening for a joint position between the McDougall Program and TrueNorth Health Center. By this time, I knew well who both of these men were. I had heard them both lecture at different conferences, and was inspired by each of them. So you can imagine my excitement and disbelief at the prospect of being able to work closely with them. I applied immediately, and a few days later Dr. Goldhamer called me in for an interview. I showed up at 3:30PM at TrueNorth (less than a five-minute drive from where I live in Santa Rosa), and three hours later, I was offered the job. I was so shocked and even remember saying, “You know Dr. Goldhamer, I understand if you need some time and you need to interview other applicants.” But Dr. Goldhamer, being the confident and decisive person that he is, simply said, “Nope, I know what I want and you have what I want, so I’m done.” Needless to say, I accepted the job on the spot and the rest is history! I began my new positions that very month.
Above: Dr. Lim with Dr. Alan Goldhamer
I am told that your wife is an M.D. as well, a Dermatologist. What did she think of this whirlwind conversion?
She has been thrilled to witness first-hand how happy, passionate, and fulfilled I am on a daily basis in my new roles. I have known her since I was 18 years old, and she saw me through an eight-year long journey after college, exploring the worlds of foreign language, computer science, business, law, and teaching, essentially trying to figure out what I wanted to do with the rest of my life. So she could not be happier or more excited to see me find my true calling these last couple of years.
Has she shared your enlightenment about being plant-based?
Yes, she also eats far more plant-based now. She recently got her labs checked, and I’m happy to report that her cholesterol levels have improved dramatically since changing her diet.
I know from my many years in this health movement that it is always a great plus when your spouse is on the same page.
Absolutely! As the saying goes, “Happy wife, happy life!”
Tell me what it is like working with Dr. Goldhamer.
I am inspired by his commitment and passion toward healthy plant-based eating and the relatively unstudied field of water fasting. What Dr. Goldhamer has built here at TrueNorth is unique and like nowhere else in the United States, much less the world. He is brilliant, eloquent, charismatic, decisive, and an overall great leader. I appreciate his hands-off style of management as well. He hires the right people and then gives them the autonomy to run their own practice in the way that they see fit.
What is so special for you in working at TrueNorth?
In medicine nowadays, it is rare to witness true healing occur in your patients. More often than not what we’re doing is putting band-aids on patients in the form of medications, surgeries, and procedures, and rarely getting to the root cause of illness. And so what is so special about TrueNorth is that day after day I stand witness to patients making radical dietary and other lifestyle changes that address the root cause of their chronic conditions and, ultimately, brings them to a much healthier state.
Just today I had a one-month follow-up phone conversation with a 63-year-old male patient of mine after his four-week stay at TrueNorth. He has a history of coronary artery disease and has had a stent placed. Prior to coming to TrueNorth, he had hypertension, requiring a powerful blood pressure medication called amlodipine. He had recently learned that he had a condition called “diastasis recti,” often associated with obesity, which is basically a separation of the two sides of the rectus abdominus muscle (the abs). His surgeon told him that it would likely require surgical repair.
During his stay, he water-fasted for 15 days and transitioned to a plant-based diet, eating TrueNorth food for the remainder of his time there. In four weeks, he lost over 20 pounds, and he came off his blood pressure medication with better blood pressure than when he arrived on medication (his blood pressure on the day he left was in the 100s/70s). His follow-up labs one month after leaving the program showed that compared with his labs prior to his stay at TrueNorth, his total cholesterol had dropped by 50 points, his LDL (the bad cholesterol) had dropped by 30 points, and his triglycerides had dropped by 50 points. He was excited to report 100% adherence to the plant-based diet since leaving the program.
He had an office visit with his cardiologist a few days before our phone call. His cardiologist was shocked to see how well his blood pressure was controlled despite stopping the amlodipine. His cardiologist also backed off of his previous recommendation to start a cholesterol-lowering medication, given how much his lab values had improved in such a short amount of time.
My patient also had a follow-up visit with his surgeon for his diastasis recti. The surgeon was surprised to discover that the separation between my patient’s rectus abdominus muscle had shrunk from two finger widths to one finger width, and from 8 cm to 6 cm long. The surgeon no longer recommended surgery for him, and instead suggested that he continue to try to close the gap through continued weight loss and lifestyle change.
Finally, my patient reported feeling overall much better. He reported far more energy (he no longer woke up feeling tired in the morning), and he had reduced his coffee drinking from three cups per day to a single cup once a week! In the past, he had suffered from weekly headaches requiring high doses of aspirin. In the four weeks since leaving TrueNorth he has yet to have a single headache. In the past he had also suffered from right shoulder pain from an old injury, and had required six to eight Advil multiple times a day to control the pain. Since leaving TrueNorth, he has taken a total of two Advil. He also was very pleased with how well his GI plumbing was working. I could go on and on, but this is just one example of the kinds of miracles that we are privileged enough to witness here on a daily basis.
Above: Dr. Lim lecturing at TrueNorth
Fasting had to be an entirely new experience for you. Tell me what that education has been like?
In all honesty, I knew very little about water fasting prior to working at TrueNorth, but was excited to learn more. In a short amount of time I have developed a deep appreciation for water fasting’s ability to reset one’s palate and allow one’s body to literally heal itself from the inside-out from a multitude of conditions, as evidenced by patients such as the one I mentioned above. Dr. Goldhamer was confident from the day I first interviewed with him that within a few weeks of working here I would witness first-hand the beneficial effects of water fasting in our patients and become convinced of its healing powers. He was absolutely right!
What is the importance of fasting under professional supervision?
Common clinical issues that can arise during extended fasting beyond two to three days and that require medical intervention include: dehydration, electrolyte imbalances, and symptoms such as nausea, vomiting, weakness, and light-headedness; thus, professional supervision is critical to fasting safely.
What role does fasting play in the full recovery and maintenance of health?
I see fasting as a powerful healing modality that is complementary to whole-food, plant-based nutrition, in terms of optimizing one’s health. It is useful for anyone hoping to recover from most chronic medical conditions, as well as for those simply trying to maintain overall good health.
In an earlier conversation, you told me about another patient who had a very positive result recovering from ulcerative colitis, a condition that, in my experience, has been a very challenging one even for hygienic physicians. Can you share that case history with us?
Absolutely. I recently took care of a 32-year-old female with a long history of severe ulcerative colitis characterized by 8 to 12 episodes a day of diarrhea with blood and mucus. When I first met her she was on multiple powerful medications, including the maximum dose of an oral corticosteroid called budesonide, the maximum dose of an oral anti-inflammatory medication called mesalamine, and daily mesalamine suppositories. Despite these medications she continued to suffer from daily abdominal pain and diarrhea. She was finally prompted to seek help when her gastroenterologist suggested she start on yet another medication called azathioprine, a powerful immunosuppressant drug with adverse effects that include lymphoma and bone marrow suppression.
During our time together, both at the McDougall Program, where I first met her, and then subsequently during her three-week stay at TrueNorth, we essentially switched her from a Paleo diet, which she had been on during the months leading up to the program, to a plant-based diet that was very simple and based primarily on steamed vegetables and white rice porridge, since that was all her body could tolerate. I’m happy to report that she was not only able to come off all her medications, including the budesonide, the oral mesalamine, and the mesalamine suppository, but for the first time in years she reported having normal bowel movements. That first day she had a normally formed stool without blood and mucus she told me it had been so many years since seeing a normal stool that she had all but forgotten what one looked like. I recently followed up with her since she went back home, and she reports continuing to do well. She remains off all medications, and is slowly expanding her diet to include other foods such as sweet potato.
What are some other conditions that you have seen respond quickly and effectively to fasting and the whole-food, plant-based diet at TrueNorth?
I would say hypertension, diabetes, high cholesterol, and overweight/obesity are the conditions that respond the most quickly and effectively to water fasting. I have also seen remarkable outcomes in many patients with autoimmune conditions such as rheumatoid arthritis, lupus, and psoriasis.
Do most people that come to TrueNorth go on a water fast?
Yes, I would estimate that roughly two-thirds or more of the patients who come to TrueNorth go on water fasts of varying lengths. Some patients who come on medications that cannot safely be discontinued may juice fast instead of water fast. Other patients come simply to stay here and eat the food—after all, the food here is truly unique. Chef Ramses Bravo and his team do an incredible job. I know of no other place in the world where a person can eat three meals a day of deliciously prepared SOS-free (salt, oil, sugar) whole, plant-based foods.
Is the great food one of the perks for you working at TrueNorth?
Oh my gosh, it’s one of the biggest perks! I am thankful each and every day to be able to enjoy the wonderfully wholesome food here at TrueNorth. Since I do not live on the premises as some of the other staff do, I frequently bring home Tupperware containers filled with TrueNorth food for the rest of my family to enjoy.
Above: Dr. Lim showing off his vegetable grilling skills!
What are your impressions of some of your other colleagues at TrueNorth, particularly your fellow M.D.s, Michael Klaper and Peter Sultana?
My colleagues across the board here at TrueNorth are exceptional. I look forward each and every day to coming to work in such a mission-driven, collegial, and supportive environment, and feel truly honored to work here. Specifically, with regard to Drs. Klaper and Sultana, they are both extremely gifted, intelligent, and caring physicians who I hold in the highest regard and who I consider to be invaluable mentors.
Are you involved in some of the medical research being conducted at TrueNorth?
Yes, and under the umbrella of the TrueNorth Health Foundation, we will be devoting ever-increasing time and energy toward expanding the research that goes on here. Recently, the British Medical Journal published a case study of one of our patients, a 42 year-old woman with non-Hodgkin’s lymphoma, who experienced a significant reduction in the size of her lymph nodes after a 21-day water fast followed by eating an exclusively plant-based, SOS-free diet. It is our hope to put out more case studies like this with other chronic conditions, such as ulcerative colitis and rheumatoid arthritis, in addition to conducting larger studies involving a greater number of patients.
Do you think that research demonstrating the benefits of fasting and a whole-foods, plant-based diet is one of the keys to their great acceptance?
Absolutely. The meticulous research by physicians such as Drs. Ornish, Barnard, Greger, Esselstyn, McDougall, and Campbell is the reason that the whole-food, plant-based movement is as strong as it is today.
Have you ever crossed paths with Drs. Caldwell Esselstyn Jr., T. Colin Campbell, or any of the other folks featured in Forks Over Knives?
I have heard both of them speak and have been inspired by their talks. I have also met them briefly. When I think of Drs. Campbell and Esselstyn, I think of the saying that Dr. John McDougall passed on to me: “We stand on the shoulders of the giants who come before us.” He said this in reference to the plant-based leaders who came before him, who he deeply respected and admired, individuals such as Dr. Dennis Burkitt, Dr. Walter Kempner, and Nathan Pritikin.
Have you become familiar with any of the writings of the pioneers of the modern-day Natural Hygiene Movement, like Drs. Shelton, Benesh, Esser, Gross, and more, who were some of the giants upon whose shoulders the current giants of the field stand?
Yes. I actually have Dr. Shelton’s book Fasting Can Save Your Life on my bookshelf, and it is at the top of my reading list. In time I look forward to diving more deeply into the works of Drs. Shelton, Benesh, Esser, Gross and other pioneers within the Natural Hygiene Movement.
You mentioned that one of the unique things about the TrueNorth kitchen is that it subscribes to what Alan Goldhamer has coined “Vegan SOS,” meaning plant-based with no added oil, salt, or sugar. What is the importance of avoiding these three additions to our diet?
I think the main issue is the extreme degree to which the food industry has bombarded our food supply with these substances, as illustrated by the book The Pleasure Trap, written by Drs. Doug Lisle and Alan Goldhamer. As a result, our taste buds have been hijacked by the food industry, and we are in a constant state of craving more and more. By eating only minimally processed, SOS-free, plant-based foods here at TrueNorth, patients are able to reset their taste buds and get off of their addictions to these substances.
Above: Dr. Lim with Dr. John McDougall and Mary McDougall
I have often heard Dr. Goldhamer say that putting someone on a water fast for a period of time will certainly alter their taste buds and make them look at whole-food, plant-based food in a much more positive light.
Absolutely. Many patients who come here cannot “stomach” or tolerate the food when they first arrive. After they finish their water fast and begin eating again, they report that their first bite of steamed squash or their first sip of vegetable juice tastes absolutely divine!
What is the key to keeping people compliant with this program?
That’s the million-dollar question. One of the things we hope to do is more follow-up studies to really see not only how adherent patients are to this lifestyle, but also what interventions we could do to improve compliance. Behavioral change is one of the most difficult things and, in fact, it is one of the areas that I focus on a lot in the lectures that I give here at TrueNorth, at the McDougall Program, and Kaiser Permanente.
There are several things that I have found to influence compliance, but one of the biggest is social support. If patients are able to find people who share their passion for plant-based eating, as opposed to people who are going to denigrate them for eating that way, that is huge.
Another factor is accountability. I’ve found that some patients do well, at least during that initial phase when their new habits are still taking hold, if they check in on a regular basis with someone: a close friend, a health coach, or their physician.
A third huge factor is what I call “environmental shaping,” and by that I mean they need to get rid of everything in the house or their immediate environment that could possibly tempt them to stray, and instead replace it with healthy, whole-food, plant-based foods that they can eat to their heart’s content.
The last factor is that people have to “know their why,” meaning that they really have to understand why they are trying to achieve health. It could be because they want to be around to see their grandchildren graduate from high school, because they want to run a marathon, hike a mountain, or simply feel better day to day. The more they can tap into that underlying reason that gets them fired up and motivated, and remind themselves of this on a day-to-day basis, the more they’ll be able to stick to their new dietary patterns.
Do the better foods and recipes available today make adherence to this lifestyle easier than ever before?
Yes. Recipes from people such as Jeff Novick, Katie Mae, Cathy Fisher, Chef AJ, and Ramses Bravo make eating plant-based both easy to prepare and more delicious than ever. That said, I would say that the foods that we should be eating today are actually things that we were eating a lot more of in the past, like fresh fruits and vegetables and less processed foods. As Michael Pollan says, “When you’re trying to figure out what foods to eat, eat something that your grandmother would recognize.” So I actually think we’ve had access to these foods all along. In some ways we’ve made it harder to eat these simple nutritious foods due to the rise of the fast food and processed food industries.
So do you believe that salt, oil, and sugar are the foundation of “the pleasure trap,” and that if people would simply cut them out completely they would avoid it?
Yes, I agree that salt, oil, and sugar are the foundation of “the pleasure trap.” Thus, when I see a patient and he or she admits to eating a large bag of M&Ms or an entire package of cookies in a single sitting, clearly the patient has a food addiction, and in such cases I agree with Dr. McDougall’s mantra that “moderation is not an option.” That said, I think certain healthy individuals without underlying medical conditions are able to eat a piece of candy or put a small amount of salt on their baked potato every so often without it triggering a dangerous cascade, and for these people moderations is an option. I acknowledge that this is not a view that’s shared universally by other plant-based physicians, but I tend to be more moderate in this regard. I am open to the possibility that my views will continue to evolve with time. In the end, my advice for each patient is an individual assessment that I make based on the history and medical conditions that the patient comes to me with.
Since you have been able to make this remarkable conversion and evolution in your medical thinking, are you optimistic that the light will go on for more of your colleagues?
Yes. I tend to be an optimistic person by nature, but also I have some evidence to back it up. One of the things I point to is the number of Kaiser healthcare providers who have attended The International Plant-Based Conference put on by the Plantrician Project that is now in its fourth year. The first year it was held, there were less than 5 Kaiser employees that came. The second year, which was in 2014, the same year that my father and I first attended the conference together, there were around 40 Kaiser people. Last year, in 2015, there were almost 100 Kaiser providers! So, in the space of three years we’ve gone from 5 to 40 to 100 Kaiser employees, and who knows how many there will be this year. So it definitely strikes me as a movement that is rapidly picking up momentum.
One interesting thing to note is that among the 100 people that came this past year, virtually all the medical specialties were represented. For example, at a special dinner held during the conference for the Kaiser folks, I just happened to sit at a table with a pulmonologist, a psychiatrist, a nephrologist, and an internist, and then there was myself from family medicine. On top of that, multiple disciplines were represented. In addition to Kaiser Permanente physicians, there were Kaiser nurses, nurse practitioners, registered dietitians, occupational therapists, social workers, and more. It is trends such as this that I have witnessed in just a couple of years that give me great cause for optimism.
Above: Dr. Lim with his parents
I believe you mentioned that your father was at the last Plantrician Conference. Tell me more about him and the rest of your family.
My father is a wonderful role model for me. He is a retired OB-GYN. When he talks to me about his career he always says nostalgically, “There was never a day I woke up and didn’t look forward to going to work.” And that’s a tough bar to meet. I think it was one of the reasons I kept jumping from career to career, continually seeking that same degree of career satisfaction and fulfillment. It felt really good to finally tell my dad that I too wake up excited to go to work each day. On a side note, it has been a lot of fun collaborating with my dad. In his retirement, and since becoming plant-based himself, he has started lecturing and giving presentations at venues all across San Diego, such as the Rotary Club, Town Council meetings, and vegetarian or vegan-related conferences. I even had him give a guest lecture at True North and Kaiser during his most recent visit to Santa Rosa, and he was a hit! Both groups demanded that he come back to give a repeat performance.
As for my mom, she is a gifted acupuncturist with a healing touch, and she has played a pivotal role in raising me to be the man I am today. I will be forever grateful to her because, had she not forwarded me the email announcing the job opportunity to work with Drs. McDougall and Goldhamer, I would likely not be having this conversation with you!
I have one older brother who is also a physician. He no longer practices clinical medicine and is now a very successful biotech entrepreneur with a focus on developing medications to treat cancer. He is a role model for me and is my closest friend; we were each other’s best man at our weddings.
Finally, my wife and two kids, ages eight and four, are the joys of my life. They have been very supportive of me and excited for me as I embark on this journey.
They have to love having you in one place as opposed to living all over the world?
They definitely love having me in one place and in one career!
So, is it fair to say you’ve found your “true north” at TrueNorth?
Yes! Often now when I give lectures at Kaiser, TrueNorth, or the McDougall program, I tell the audience that it’s the first time in my life that I can say that 50 years from now I truly believe that I will be devoting my life to this same cause. I could never say that before. I am just so grateful that I have found this calling in life.
I think it was the late great P.T. Barnum who said, “If you love what you’re doing, you’ll never work a day in your life.”
Absolutely. I can attest to that. Amen!
What do you do when you’re not working?
My favorite hobby is tennis. I’ve been playing since I was a kid. This last year I had my best season ever playing competitive USTA singles, and went undefeated during the regular season. I attribute my successful season in part due to my improved overall health since going plant-based.
My Christian faith is central to my life and everything I do. I thank God every day for his many blessings upon me and my family, and rely on His strength during challenging times. We attend weekly services at a vibrant local church and take part in a community group that meets regularly.
So, you’ve been a teacher, you’ve been in AmeriCorps, you’re a lawyer, you’re a doctor. Do you plan to write a book about all this?
No immediate plans, but perhaps someday. For now, I am content to simply devote myself to being a whole-food, plant-based doctor.