I love in medicine that I am always learning.
Weight is a struggle for many of us. My father weighed 300 pounds, so I have grown up with body weight issues always on the forefront of my mind. But if you are heavy, how do you fix it? Do you eat high protein, low carbs? Do you work out more? I love this video from funny or die, which shows how much our “good eating” recommendations have changed just in the past few decades. Don’t eat that bacon! No, eat the bacon, but don’t eat the eggs! No, eat the eggs, but not the bread!
I am part of a female physician online group, and many MDs champion the book the Obesity Code. So I decided to check it out.
In his book the Obesity Code, by Jason Fung MD, he explores why there has been an obesity epidemic. Steadily since the 1970s, we have been calorie counting and blaming the toxic environment of
- low fat, high carbs
- eating out
- fast good
- sedentary lifestyle (tvs, cars, video games, computers)
- high sugar
- increased portion sizes.
He looks at genetics. There was a Danish study which looked at adopted children- are their weights like their biologic parents or the adoptive parents? They found NO relationship was seen with the adoptive parents, indicating environment is not a factor. There was a big correlation with their biological parents. A further study by the Danish team showed 70% of obesity was familial. But this didn’t explain why obesity has skyrocketed in the recent generations.
He looks at calorie counting. We have been taught calories in – calories out = body fat. But he talks about how the number of calories in causes changes in your burning of calories. He makes a great analogy about money in vs money out. If your income goes down, you wouldn’t keep up your same spending habits- you would conserve and spend less. Your body does this as well- at its extreme (starvation), you conserve body energy by temperature dropping, heart rate slowing, and hair and nails grow brittle.
- He argues that obesity is a hormonal, not a calorie disorder. What are these hormones? He names leptin, adiponectin, and lipase. Though later he advocates insulin and cortisol are the biggest influences.
- All calories are not equal. What metabolic response does that specific type of calorie trigger? Think sugar vs. oil and how they cause differing insulin release.
- When you reduce calories, your body metabolism slows. When you go back to normal eating, your metabolism STAYS slower. In a favorite line, he states, “Caloric reduction and portion control strategies only make you tired and hungry. Worst of all you regain all the weight you have lost.”
- Less calories cause hormone changes to stimulate hunger. (ghrelin makes you hungry, and other hormones make you feel sated and full.)
He looks at exercise. Clearly exercise is good, but does it cause weight loss? He would argue no. In the body activities which consume calories, the basal metabolic rate is your biggest one. There are indirect ways exercise helps your BMR burn more calories (like increasing muscle mass), and it is good for health, but it does not cause weight loss. He knows this is controversial. He cites many interesting studies in his book. His view is 95% of weight loss is diet.
Body set weight. Every body has a set weight, which your body will try to return you to. So the real question is how do we change this set weight?
He focuses on hormones: particularly insulin and cortisol. Why does one calorie get used to heat the body and another get deposited as fat? Hormones deliver messages to cells. The receptors on the cells get the message.
Stay tuned for some blogs on what I find. He also has a you tube video here.