30 July 2012

Weight Loss

On request of some of my friends, here are more details about weight loss. This is a kind of more easy to understand version of this earlier post: Calories - Eating less doesn't work.

When I am talking about obesity and diabetes (usually they go hand-in-hand), I also talk about other chronic diseases such as cancer, heart disease, arthritis, allergies, Multiple Sclerosis, Alzheimer etc... The pattern of incidence is the same around the world for these diseases. Where there are more obese people, we are more likely to find chronically sick people as well. This means, that the cause must be the same for all these conditions. So if we find the cause of obesity and diabetes and are able to cure it, then we will reduce considerably the incidence of developing chronic diseases as well.

Now, let's see what in our body is responsible for the storage of fat in our tissues.

When we consume food (energy = calories), the food is broken down to fatty acids. These fatty acids are then utilised by the body for different purposes, they travel in our bloodstream and go wherever they are needed. For instance, if we exercise, they will be burnt by our muscle; a child will need them to grow organs and bones; or when stress hormones are released, they mobilise the fatty acids (energy), so they go wherever our body needs them, and help us cope with stressful situations. These hormones use the energy instead of storing it as fat. Hormones are responsible for the regulation of energy in our body.

Here are the hormones responsible for mobilisation and storage of energy. It's quite simple.

1. Hormones that mobilise energy:
  • Epinephrine
  • Norepinephrine
  • Adrenocorticotropic hormone
  • Glucagon
  • Thyroid-stimulating hormone
  • Melanocyte-stimulating hormone
  • Vasopressine
  • Growth hormone
  • etc..
2. Hormones that promote fat accumulation:
  • Insulin
ONLY INSULIN! (and this was established beyond reasonable doubt by the mid-1960s).
Let me repeat: insulin is the only hormone responsible for fat accumulation. 

If you ask any doctor, they should know about the role of insulin, as this is taught in medical schools around the world since the 1960s. So the obvious recommendation for weight loss would be to lower insulin levels in our body. We also know what makes the insulin level spike in our blood: it's sugar and starches and even animal protein (muscle meat) to a certain level. The only food without effect on insulin levels is fat (fatty meat, fish, eggs, butter...). So the ideal diet to loose weight would be to considerably lower carbohydrate (sugar, starches) intake and increase fat intake. In fact, such diets were recommended to diabetic and overweight patients before World War II, with good results. (Later, about what happened to the science of nutrition and why fat became evil and carbohydrate the good guy. Before it was the opposite.)

What doctors recommend is to eat less and exercise more.

First, let's see what happens when we consume food with a lot of carbohydrate. When we are hungry, our brain tells us that we need energy to be sent to our organs, so we eat. When we eat carbs and sugar, our blood sugar level goes up, this make our insulin level rise, and insulin will take the calories we just consumed, for storage in our fat tissues. On the other hand, our organs haven't received the calories (energy) they need to function well. So our brain tells us: "Hey, eat some more, I haven't got what I need to repair tissue or to grow." So the signal we receive from our brain is to eat more, even though our stomach is physically full. That is why people who constantly eat sweets and/or are overweight, are hungry all the time. High insulin levels make us hungry. 

When we see our fat tissues grow, we have to discipline ourselves and try to eat less. This makes us suffer. We have to say "no" to food despite our brain sending us the message to eat more. So we eat less and we are even more hungry. The first occasion we are alone.. we eat, overeat, usually junk, and we loose the fight against weight loss. 

Eating less will not help if the food we eat is sugar laden. The little food we eat will be stored as fat and will not be available for the body (organs) to use it wherever it is needed.

The same thing is happening with exercise. An overweight individual goes out "to run some fat off". We know that overweight people usually have high insulin levels in their blood which will prevent the use of calories from fat tissues. What happens after a 5 km jog? As the body could not release energy from the fat stores, it consumed energy wherever it was more available, from the organs. If we exercise regularly with high insulin levels, the result will be a shrinkage of our muscle and other organ tissues over the long run. After exercise, as our organs are depleted, we are hungry and tired. So we eat and sit to play video games. Eating carbs will make things worse, as insulin again is high, as a result fat stores will grow.

So we eat less and exercise more... and on and on... 
Recommending these 2 things (which make people even more hungry) is not a long term solution. We are not gluttons and sloths in the first place. We become gluttons and sloths as a result of high insulin levels in our blood. So telling an overweight child that he is "lazy and eating too much", is an insult. He is doing exactly what his brain is telling him to do (because of lack of energy in his organs): eat more cookies in front of the TV. It is not his fault! Have you noticed that obese children on average are not as tall as the kids of their age? It is because, with high insulin levels, the energy they are eating is stored as fat and cannot be transported to the bones and organs to grow, even though sufficient grow hormones are secreted by their glands. The energy will be taken by insulin and not the growth hormones.

"Loose weight camps" will not work over the long term either, where people eat low calorie meals and exercise day-in day-out. Usually, people give up after a few years on such diets, and gain their weight back. Of course, a low-calorie diet works for a while (carbohydrates and insulin levels are lower on calorie restricted diet, than on an eat-as-much-as-you-want regimen). People will loose some of the fat tissue, but they also loose organ tissue. They end up starving their organs. An obese persons organs are very similar to those of an emaciated person's. Both are starved and are smaller in size.

I do not think it is natural not to satisfy hunger. Animals eat when they are hungry, they do not need to discipline themselves and say "no" to food, yet they are not obese and diabetics. In abundance of food, animals multiply, they do not become overweight.

Fortunately, there are doctors now, who recommend to lower carbohydrate intake, this will result in low insulin levels, and will lead to weight loss, even without exercise. (I highly recommend daily exercise for health, and not for weight loss reasons.)

If we do not eat carbohydrates, we have to eat some other form of energy which is fat (more meat, fish, organ meat, eggs, butter). On such diet, insulin levels are very low, so the energy will not be stored as fat, but instead will be mobilised by other hormones to go to the right organs and used to repair or grow tissue.

The amazing thing on such diet, is that we are not hungry and we eat less in quantity. It is very difficult to overeat and in fact we tend to skip meals instead of frequently thinking about food. On the "dietary fat causing heart disease" myth, I wrote previously more in detail:
You can also find some information on the harmful effects of high carbohydrate, low-fat diets.

Bottom line: Weight loss happens in the absence of insulin and not on a "eat less, exercise more" regimen. 
You can find more details on exercise and weight loss in this article: The Scientist and the Stairmaster.
This presentation is a very good summary of what I'm talking about:

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