I first became aware of Jason through his Etiology of Obesity YouTube playlist which is just a phenomenal series of presentations.
I will link to those and Jason’s new book The Obesity Code: Unlocking the Secrets of Weight Loss, the web page at keto summit.
I must say I think you’re a brilliant critical thinker and you’ve certainly — you’ve made me think hard about some of the problems that you talk about.
But why don’t we start about you telling us about Gino.
So, Gino is a case report that you published on your website today.
I know that you have permission to talk about some of his details and his test results.
I mean, this is a reader who wrote into me and very briefly what happened is that — I’ll tell you that this happens all the time that people get on the wrong track about type II diabetes.
And I can talk a little bit more about what happened but his story was that he — it’s quite typical.
He basically went to his doctor and gotten on, put on a lot of medications.
So, it’s interesting but over 50% of the American population is classified as pre-diabetic or diabetic.
So, in fact, it’s most the population, which is scary.
Diabetes is the new black.
So, the thing is that when you go to see your doctor, what happens is that they give you medications.
That’s what we’re trained to do.
You go to somebody and you get medication and then you go back and get more medication and more medication and more medication, eventually get more on insulin and then more insulin and then more insulin and more insulin.
And that’s pretty much what happened to him.
He also got some advice from a diet and exercise standpoint to basically eat low calories, reduce your calories, increase your exercise, which is basically the kind of eat less move more advice that we’ve been giving for about 30, 40 years.
Unfortunately, it doesn’t work.
We know that it doesn’t work because practically everybody has done it and it doesn’t work for everybody.
We also have large studies that show it doesn’t work.
So, the women’s health study, for example, shows that these sorts of ideas where you can just cut off 2 your calories a day and walk for an extra ten minutes and take the stairs, they simply don’t cause weight loss.
So, anyway, he did this for years and wasn’t getting anywhere.
And then finally, he read about some of what I was talking about which is that what we think about obesity is not quite correct, that we must treat the underlying hormonal cause.
And by applying these principles, he can drop pretty much all his weight and his diabetes essentially went away.
And you should see the pictures.
They’re quite stunning.
Yeah, it’s striking, the picture.
Was that his primary complaint? When he first went to a doctor, what was he complaining about? Well, most of these people get diagnosed asper-diabetic so it’s mostly they don’t complain.
They usually go there for their routine checkup and their blood sugars have been kind of creeping up year after year.
And the thing is that what Ideal with is a lot of type II diabetes and it affects a lot of people.
And I think that most doctors have the wrong idea about it, and this is an idea that this is a chronic and progressive disease.
I have a lecture that I call The Two Big Lies of Type II Diabetes.
And the first big lie of type II diabetes is that it’s kind of progressive, that once you get it that you have it for life, there’s nothing you can do about it, you got to take your medications and then you’re going to go on insulin and take your insulin and it’s progressive.
There’s nothing you can do about it.
It’s like aging.
It’s a one-way street.
You get older you can’t go the other way.
And that’s the idea that’s promoted, in fact, by a lot of people, a lot of doctors.
So, the American Diabetes Association talks about it, Diabetes Australia, all the major diabetes associations have on their website something to the effect that this chronic and progressive, don’t even try to get better, is the sort of the message that’s out there.
And I think it’s completely wrong because it’s a reversible disease.
And the thing about type II diabetes is that it’s quite easy to prove that it’s a reversible disease.
If, for instance, somebody comes to me and says, well, they’re diabetic or pre- diabetic and suddenly they lose 50 pounds and they take themselves off their medication.
You go, “Okay, great.
” You don’t go, “Oh, you’re such a liar.
It’s chronic and progressive.
There’s no way you can get better.
” And it’s simply a case that if you lose that weight that diabetes will go away.
Soothe question is, how do we get there? And this is the problem with the Diabetes Association is that they kind of promote this idea that it only gets worse.
So, 3 they’re telling people to kind of give up hope now, just this kind of learned helplessness that they’re trying to instilling the population that you shouldn’t even try to get better, you shouldn’t even try some of these alternative dietary methods like ketogenic diets or other diets like that.
So, that’s important to understand because if you believe them then you’ll just simply go along with doing what they say which is taking medications, taking insulin, and it’s the wrong thing to do.
The second big lie is that lowering the blood sugar is the goal of therapy.
Because again, the problem is that blood sugars are only the symptom of the disease.
It’s not the diabetes itself.
So, you can take insulin, for example, to lower your blood sugars and it will.
It will lower your blood sugar.
But you’re going to gain a lot of weight.
Everybody who takes insulin knows that.
So, this is the thing that always happens so that people start these medications or insulin that makes you gain weight and then they come back and they say, “Well, Doc, you always told me that I needed to lose weight and here you are, you gave me insulin, I gained a bunch of weight.
How is that good?” And the doctor never has a good answer.
He says, “Well, that’s just the way it is.
You should eat less and move more.
” And the problem is not that you needed to eat less and move more.
The problem is you started them on insulin and it’s obvious to see the problem is insulin so you need to get the insulin down, not up.
And those are the things I talked about specifically to type II diabetes.
But in the end, the idea is that this is a reversible disease.
It affects a lot of people and there’s this kind of movement to kind of normalize it and say that it’s okay to have it.
It’s not okay to have it.
This is a disease that’s completely reversible, that’s completely curable.
But our treatments are making things worse.
So, therefore, we must use the right treatments, not just say it’s okay if it gets worse.
It’s not okay.
Because diabetes, type II diabetes is the leading cause of blindness.
It’s the leading cause of kidney failure.
It’s the leading cause of amputations.
There’s diabetic foot ulcers.
There’s heart attacks.
It basically kills every part of you.
So, it’s not okay.
It’s not okay that it’s progressive.
You need to say, “Well, I have type II diabetes.
Let me find an appropriate treatment for it and it’s not medications and it’s not insulin and it’s not the low-fat diet.
” We’ve done all three of them and they’re a complete failure.
So, I know that Gino wasn’t directly under your care then.
He was a reader.
But, obviously, you do have a lot of people underneath your care.
I think that’s one of the things that makes you such an interesting person to listen to, is that you are in the trenches helping people.
You’re not just a researcher sat in 4 some ivory tower.
So, tell me, what are people doing? So, if it’s not the medication and just moving more and eating less as the solution, what did Gino do? What he did was he implemented a very low carbohydrate diet and used some intermittent fasting as well.
So, what you must understand is that the whole — it’s a little complicated, but the whole idea of type II diabetes, what you must think about is that the body is just full of sugar.
It’s not the blood sugar but it’s the sugar in the body.
So, what happens when you take insulin? So, if your body, you’re eating a kind of sad American diet for 50 years, you’ve gained a lot of weight, not all at once but a pound or two every year and then suddenly you’ve got this big beer belly.
You get the fatty liver and you get the type II diabetes.
That’s very typical by the time you hit 50 or 55 or 60.
And that’s what happens.
Then you get diagnosed with diabetes or pre-diabetes.
Essentially what you must think about is that your body is basically filled up with a lot of sugar.
And the reason is that with eating a lot of processed foods.
There’s a lot of foods that aren’t that great for us.
So, as you fill up with sugar, what happens is that the sugar that you eat, the carbohydrate, eventually spills out into the blood because our body is kind of full of sugar already.
Imagine that our body is a sugar bowl.
You eat, the sugar comes in and then its pills out into the blood.
So, what the insulin does and what a lot of the medications do, things like Sulfonylurea and then most of the standard medications for type II diabetes, they don’t get rid of that sugar.
So, what they do is they take that sugar that’s spilled out in the blood and they basically just ram it back into your body.
So, the body says, “Whoa, what am I going to do with it?” So, it sends it all elsewhere.
It sends it into the liver, sends it into the heart, sends it into the feet, sends it into the eye and turns a lot of that into fat.
And the problem is that you haven’t done anything about this sugar bowl that’s too full.
Your body is still full of sugar.
So, the next time you eat the same thing happens.
Sugar comes in, spills out into the blood, you take your insulin, you ram it back in.
So, the body essentially just fills up with sugar.
Now, once it gets to a certain point, it can’t take anymore sugar.
So, you try and use your insulin to kind of ram it in but it doesn’t go in.
It’s like that suitcase.
When you’re putting in your clothes and stuff, it fills up.
But at a certain point it’s hard to put those extra two pairs of pants in.
5 It’s the same idea.
Your body is now so full of sugar that even taking the insulin you can’t ram it in.
So, what do you imagine your doctor does? He gives you higher dose of insulin.
He doubles up your dose of insulin.
So now you’re ramming in the sugar into your body.
So, eventually it just fills up again.
And at some point, it fills up and even the higher dose doesn’t work so your doctor increases your insulin again.
And that’s exactly what happens to everybody.
So, people start with one medication and then they go to two medications and three medications and insulin and more insulin and more insulin.
So, you see that when you started your type II diabetes, you started with one medication, low dose and you wound up on like 100 units of insulin a day, for example.
So, your diabetes never got better.
You’re taking more and more medications to get the same blood sugar result.
So clearly, your diabetes has done nothing but get worse.
And so, what they try to tell you is that it’s worse because that’s the way it works.
That’s the way that the disease is.
But it’s not the way it is.
What you’ve done is you’ve treated the disease entirely incorrectly because what you’ve done is you focused on the sugar in the blood and you’re just ramming it into the body and not getting rid of it.
So, you’ll never get better.
So, what happens over ten, 15, 20years, of course, is that all that sugar is in your body and every part of you just starts to rot away.
So, you get the kidney disease, you get the heart disease, you get the strokes, you get the cancer, you get the blindness, you get the amputation, you get the diabetic foot infections, you get every kind of damage imaginable.
And that’s because all that sugar is everywhere.
It’s the same as if you have a dirty kitchen but instead of throwing out all your garbage, you just throw it under the sink.
Then you can pretend like your kitchen is clean but it still smells.
That’s the whole problem.
You forced all this sugar from the blood out of the blood.
But you didn’t get rid of it.
You shoved it into the body.
So now your doctor can say, “Wow, look at your blood sugars are so good.
I’m doing such good job.
I’m a good doctor.
” And meanwhile, you’ve got your heart attack, you’re on dialysis and you’ve got a nerve pain like crazy because your nerves are completely shot to hell.
And you’re going blind.
And your doctor thinks that he’s done a great job because your blood sugar is so great.
But he’s done a terrible job because you’re getting sicker and sicker.
And the funny part is that in 2008 the first of like five, six trials came out that proved that this concept of just focusing on the blood sugar was entirely incorrect.
So, what they did was they took two groups of people and one group got a lot of medications to force down that blood sugar, the other people got kind of a medium amount.
Per the conventional theory that it’s all 6 about the blood sugar, you should do better if you take a lot of medications to force it into your body, right? Of course, it didn’t make any difference.
So, whether your blood sugar, your overall average was 8.
5 or 7.
5, it made no difference.
And people were puzzled by this because that was kind of — the thought was that it’s all due to the blood sugar.
So, they should have known for quite few years now that this paradigm of simply treating the blood sugar is incorrect because that’s not the disease.
The disease is that your body has too much sugar.
You haven’t taken care of the problem.
So, if you look at it that way, then you can understand that the solution is very simple.
If your body has too much sugar, you can do two things.
You can stop putting it in or you can burnet off.
And that’s what you need to do.
What you don’t want to do is just keep forcing it in, which is what we’re doing with our current therapy, like 99.
9% of type I diabetics are treated by forcing the sugar in, right? So, think about your car.
So, if you have a car and you’re filling up the gas tank but there’s no more room in the gas tank so you start pumping the gas into the backseat.
Well, okay, that’s not very good.
You have too much gas.
So, what are you going to do? Obvious.
You’re going to stop putting the gas in then you’re going to run your car a little while to burn it off.
What you’re not going to do is go back to the pump six times a day and keep pumping it in.
But that’s what we tell people to do.
Eat plenty of carbohydrates, cut your fats with glucose to sugar.
And its chain of sugar that gets broken down.
And we keep eating all the time.
So, people say, “OH, you should eat six times a day.
And don’t fast.
” It’s funny because people who do it for religious reasons, they get told not to fast.
But what happens when you fast? Your body lowers down the blood sugar.
That’s what it does.
Now, that car with too much gas, you got to run it.
And you force your body to burn it off.
You force your car to burn down the gas.
You can do the same thing.
So, if you look at it that way, the solution is quite simple.
One, eat a very low carbohydrate diet, so ketogenic diets are great.
And there’s tons of people who have done ketogenic diets and reverse their diabetes.
If that is not enough, then you can do more.
You can run that car.
If you take zero calories, if you fast fora day, you will force your body to burn 2000calories of glucose.
That’s what it’s going to do.
And it’s not that you have too little energy.
Everybody says, “Oh, I’m going to be tired.
I do a lot of physical exertion.
Because you 7 got too much energy, not too little energy.
So, you got to burn it off.
And that’s the whole thing.
Yeah, you might be hungry.
I’m not saying that it’s the easiest thing in the world but you’re not going to be sick.
You’re not going to be tired because your body will provide you the energy it needs.
And that’s what you need to get better.
I have other people say, “Oh, yeah–” It is funny because I’ve put hundreds, probably over a thousand people on fast.
And when we started, people might say, “Yeah, it might work but nobody will do it, right?” And I said, “I’m a doctor.
My job is not to tell people what’s easy to do.
My job is to tell people what they need to do to get better.
” Whether they do it or not is not my problem.
Of course, I provide support so that they can do it obviously.
But the key is not to give a solution that’s just ineffective but easy.
Who wants that? It’s like if you need to get surgery, you don’t say, “Yeah, you know, you need surgery but it hurts a lot so, you know what, you should just die.
” That’s just ridiculous.
If the solution is to change your diet and to fast, then we’ll provide enough support that people will be able to do it.
Not, “Here, take your insulin but I know that you will get worse in the future.
For sure, you’ll get worse.
” And the funny part is that the diabetes associations, they don’t even pretend that you will get better.
They actually tell it to your face that, “Hey, you’ll take this insulin stuff and you’ll get worse.
Count on it.
” But that’s just the way the disease is.
But it’s not.
It’s getting worse because they’re treating it completely incorrectly.
It’s crazy because in any other field, if you have a success rate of 0% most people would just say, “Okay, that’s the wrong treatment.
That’s the wrong solution.
” They don’t just say, “Wow, that’s just the way it is, so get with it.
” It’s crazy to think that this is the way we treat type II diabetes which is honestly the 21stcentury kind of plague because it affects so many people and it affects so much of what we do.
But haven’t they got at least half the equation, right? So, the analogy that you said with the car, what can you do to dispose of more gas? Well, you can drive the car harder and faster.
So, maybe the recommendation to move more is correct and you can dispose of some glucose maybe doing some weight lifting or maybe even endurance exercise.
That is at least helpful.
It’s helpful for sure.
But in terms of whether it’s going to make a difference — like there are people who can but if you look at how many calories you burn, for example, doing exercise, it’s very little.
We’ve all gone on that treadmill and watch that calorie counter and it goes up slowly, right.
We’re not talking about 30-year old’s.
I’m talking about 80-year old’s, 75-yearolds.
So, you must be aware that I’m talking about a 75-year old lady who 8 weighs 250 pounds who has bad knees and bad hips and a bad back who can’t even walk let alone run.
So, I’m not saying that that 30-year old shouldn’t just go ahead and do a lot of exercise.
I think that is very useful.
But if you’re 75 and your knees hurt and you just can’t do it, then you live in — I live in Canada and it’s like freezing cold outside.
It’s difficult to exercise that much.
So, if you think about it, the scales are totally off.
Again, yes, if you can do several hours ate time, that’s fine.
But mostly people I’m talking about are going to do maybe a little bit of walking, half an hour three, four times week.
That’s good for them.
You think that that’s not much but that’s good for them.
And if you think about how many calories they’ll burn, that might be 100, 150 something like that.
They’re walking slowly, right.
Let’s face it.
They’re like your grandmother.
They’re just not going to be out there running10ks and half marathons.
So, the thing is, if you’re going to burn150 calories four times a week and you should burn in a day of fasting, say 2000 calories, because of that sugar, the scale is totally off.
So, they will do much better with the fasting than the other.
The other problem with exercise is that it never causes as much weight loss as we think it does because there’s a lot of compensation effect.
So, again, it’s different depending on your population.
But for the general population, when they have done studies of exercise and they calculate how much weight people should lose, and this is a well-known phenomenon in research, the amount of weight people does lose is often at least one-third.
It’s two-third less than they think it should be.
And it’s because if you do a lot of exercise then you’re going to compensate in your spare time that you’re not exercising by being less active.
And they see this in studies of children in Phys Ed, for example.
Every study of Phys Ed in schools has failed.
The reason is that when you put these odometers on kids, for example, and you measure how many steps they take and you would do Phys Ed in school, what happens is that that child when they go home they’re less active.
If they didn’t do Phys Ed in school when they get home they’re more active.
So, the overall amount of activity in the day is the same whether you do Phys Ed in school or whether you don’t.
That’s why this sort of things is not as effective as you think they should be.
So, there is an effect.
So, yes, if you can do a lot of exercise, you will probably do well.
But again, there are lots of stories of people who are endurance athletes who developed type I diabetes.
Tim Nocakes, for example.
He ate a very high carbohydrate diet.
He 9 developed type II diabetes.
Peter Attica, right? He wrote all about this.
He was this endurance swimmer and he was like 25 pounds’ overweight, swimming three, four hours a day.
So, there are lots of stories out there of people who have done lots of exercise but have not still been able to get rid of the type II diabetes.
There’s Sir Redgrave who is the UK– The British rower, yeah.
— rower who wound up a type II diabetic I think shortly after he retired.
So, again, yes, they are related but not the same thing.
I know I’ve certainly seen it in myself both the insulin resistance despite exercise and then what you’re talking about being hungry as the result of doing a moderate amount of exercise and then being more sedentary too, certainly.
If I do a huge bike ride, then I’m going to move my body a lot less because of that.
And surely those things start to cancel each other out.
So, what’s going on here? When I walked down the street here in California, some people the rest of the world might consider it as quite healthy place, I would say that most of the people that I see are at least slightly overweight.
So, what’s going on? Is this just about food choices or are people eating too much food? I think a lot of it must do with the food choices that we make now.
So, if you look at overall trends, for example, you can see that much more people eat out than eat it.
If you go back 50 years, right, there’s a lot more people who eat in fast-food restaurants.
There’s a lot more processing of our foods and so on.
Bandit’s not necessarily that eating out is bad for you but they tend not to use the best things.
So, they’ll put in a lot of sugar because sugar, for example, makes food tastes good and it’s really, cheap.
So, you can make a food taste amazing with very little cost by simply putting more sugar in.
So, you see this with sauces, for example, barbecue sauce, all kinds of sauces.
They’re just loaded with sugar, ketchup and all these other sauces.
And stuff you wouldn’t probably never do yourself people would do in processed foods.
They inject chicken breast with all this sugar solution and stuff and it makes it taste good.
So, the processing of the food is one of the major changes.
So, we’ve made several changes in our dietary habits since the 1970s so it’s interesting because there’s two main changes since the 1970s in the way that Americans eat.
So, the 1970s seven dietary guidelines for Americans, of course, switched everybody to a kind of high carbohydrate diet, which would have been 10 fine if everybody was eating kind of yams and beans but nobody ate that and it was all white bread and pasta.
So, the bottom of the food pyramid, which grew up with, was rice, potatoes and bread.
So, we’re all told to eat lots of bread, lots of bread because it’s low in fat.
Turns out, of course, it wasn’t that greaten idea to go to a very high carbohydrate diet.
Not that I have — I think that insulin is the main driver of gain weight so you can eat a high carbohydrate diet if it’s relatively unrefined, unprocessed kind of whole foods.
You can still do very well.
There are studies of people who eat lots of yams and sweet potatoes and so on and do fine.
But there’s lot more fiber, there’s lot less processing.
But in Canada and the United States, carbohydrates generally mean bread and pasta handouts and waffles and that kind of thing.
That’s what we ate because we thought low fat was so healthy for us and we ate lots of fat.
Now, that wasn’t a great idea so that a caused a lot of problems.
But the second major change which nobody talks about very much is the increase in food, in meal frequencies.
If you look at the NHANES study, the Handsaws a giant American survey of health trends.
And if you look at 1977, the average American ate three times a day — breakfast, lunch, dinner, that’s it.
If you go to 2005, that’s gone up to almost six times a day.
So, people are eating all the time.
So, you’re not going breakfast-lunch-dinner, you’re going breakfast-snack-lunch, -snack-dinner-snack.
So, you’re constantly stimulating insulin.
So, there’s two important things when you’re talking about development of insulin resistance which is how high your insulin goes and how often you stimulate it.
Because it’s always the case.
It’s a combination of the level and the persistence of that level.
Just like if you are to make money.
If you say, “I make $100.
If you made $100 in a year it wouldn’t be very good but if you made $100 in an hour it would be very good.
So, that frequency is very important.
It’s equally as important as how high the level is.
But we kind of ignore it and think it doesn’t matter.
Of course, it matters.
So, those two changes are the two changes you need, high levels of insulin, persistent levels of insulin to develop insulin resistance because that’s what happened over time.
So, you must address both issues.
So, you must change your diet back to a kind of a whole foods diet, one that doesn’t stimulate insulin a lot and then you must go to kind of three meals a day at least with a period of fasting in between.
Because the thing is that the reason that we’re all getting sick is that we’ve lost that balance.
Remember that fasting is just the flipside of eating.
When 11 you don’t eat, you’re fasting.
That’s the technical definition of it.
Or we would kind of fast from say 7 o’clock p.
We’d have dinner at 7:00 p.
and say eat breakfast at 7:00 a.
there’s 12 hours of fasting.
So, you’ve got 12 hours of eating, 12 hours of fasting.
Now, we eat the minute we get up to the minute we go to bed.
So now you have like maybe six hours of fasting or seven hours of fasting and the only time we’re not eating is when we are sleeping.
And we put food in our mouths all the other times.
So now you’ve got like 16, 18 hours of feeding and six hours of fasting.
So, it doesn’t work.
Our balance is completely off.
So, to get us back into balance, you must, one, change the food back to kind of whole unprocessed foods and then, two, make sure that you have a period of fasting every day.
I mean, the very word itself, breakfast, is interesting because it’s the meal that breaks your fast.
What does that mean? It means you should be fasting every day because if you are not fasting you cannot break your fast.
So, therefore, what people recognized long, long time ago was that fasting is part of everyday life.
It’s part of that balance between totally thrown off and nobody ever talks about it.
They just talk about should we eat fat orchards, low fat, low cab, this and that.
Well, what about the meal frequency? What about reintroducing periods where you let your body digest what you eat? Because when you eat you’re putting food energy in your mouth and your body is going to store it.
So, if you put energy in for 12 hours in a day and you let that energy come out for 12 hours in a way you’re more likely to be in balance than if you’re putting energy in for 18hours a day and then you can come out for six.
You do that for several decades and you wonder why you’re gaining weight.
Well, I’ll tell you why.
Your balance is completely off.
I mean, it’s crazy to think that people will say something like eat six times a day to lose weight.
It’s like, okay, well, eating doesn’t make you lose weight.
Eating more is not likely going to make you lose weight.
It’s like you should rub your hands in the dirt six times a day to clean your hands.
Well, rubbing your hands in the dirt makes them dirty.
That’s the very definition.
You don’t do it more to get clean.
Eating more times a day is just not going to make you lose weight.
There’s no reason.
You hear it enough people go, “Yeah, that’s good idea.
” That’s not good idea.
Why don’t we go back to a time when we didn’t have the obesity epidemic and look at how many times they ate? It was two to three.
And nobody cared if you skipped breakfast.
They’d say, whatever, right? You skip breakfast, fine.
You skip breakfast.
I don’t care.
There’s nothing in the word breakfast that12 says you must eat it as soon as you get up.
You can break your fast at dinnertime.
It doesn’t matter.
But you must have that period of fasting every day.
I’m quite drawn towards this idea because it seems to me that you’re not just replacing one nutritional bogeyman for another.
So, I’ve seen that in this sphere or community where before it was sugar that was the villain and now we just swapped one macronutrient for another.
So, do you think that’s the most important thing or is there something specifically evil about carbohydrate? I don’t think there’s anything specifically evil about carbohydrates.
So, in fact, if you look at populations, there are lots of populations that have eaten high carbohydrate diets and done very well.
So, what you must do is try to explain that fact.
If you look at the Kitara, because everybody, it’s been well-studied.
Soothe Kitara were this kind of tribe in New Guinea, I think.
They ate about 70%carbohydrates.
And they didn’t have any obesity at all.
And people would say, “Wow, look.
You can eat lots of carbs and have no obesity and no diabetes.
” That’s true.
If you measure their insulin levels, which they did, their insulin levels were at the five percentiles of the Swedish population, which is because Dr.
Lundeberg who did the study was Swedish.
So, he compared them to Swedes.
So, these people were eating a lot of carbohydrates, had an insulin level which was lower than95% of the Swedish average kind of European population.
So, yes, you can eat carbohydrates and have very low insulin levels.
And that’s the whole point.
If we make the argument that insulin is the main driver of obesity, which is what I do in The Obesity Code, then it doesn’t logically follow that the only thing that raises insulin is carbohydrates.
There’s a lot more that goes intuit because insulin resistance, for example, affects insulin levels, fiber affects insult in levels, vinegar affects insulin levels, fructose affects insulin levels, fatty liver affects insulin levels, cortisol does, animal proteins do.
There’s so many different things.
So, we must kind of move past this idea that it’s all just carbohydrates because it’s not.
Lots of people — So, the Okinawans were a notoriously healthy in the old days.
Now, they’re kind of becoming westernized.
But in the old days they eat tons of sweet potato, very high carbohydrate diet, and yet they are one of the longest-lived people on Earth.
Bandit’s not that carbohydrates are intrinsically bad.
I think what’s intrinsically bad is the processing that we do to carbohydrates.
So, the bread and the refined grains and stuff, you take out the fiber, you take out the fat.
So, all these things make insulin go higher.
So, when you eat — if you’re to look at say a glycemic index, because the glycemic index for carbohydrate food is very closely approximates the insulin index.
You can look at 13 two carbohydrates foods, beans, for example, and white bread.
The glycemic index is very different.
You can take 100 grams of beans and you can look at that glycemic index and you can see that it doesn’t raise the blood glucose very much and, therefore, insulin also doesn’t go up very much.
But if you eat a couple of slices of white bread, insulin and glucose goes way up and you know that insulin goes way up to follow.
So, you can’t say that it’s simply the carbohydrates.
And this is to your point of switching bogeyman, right? At first, the big bogeyman was fat and that wasn’t a great idea.
And then we switched it to carbs and then we switched it to sugar.
I mean, they all have a grain of truth.
But the question is what’s the language the body talks? Because the body doesn’t give two shits about calories.
There’s no bomb calorimeter in our body.
It doesn’t measure calories so it doesn’t care about it.
And it doesn’t care about carbohydrates.
But it cares about insulin.
Because if the insulin is high it responds one way, if insulin is low it responds a different way.
An`d we can measure these differences.
So, that’s what we need to know.
Because we need to speak the language the body is speaking.
You can’t go and demonize calories because you can take two foods, say a plate of cookies and a salad, with the same number of calories.
The minute you put it in you mouth the cookies will spike your insulin and the salad with olive oil will not.
So, they’re vastly different for the same number of calories.
Therefore, calorie is not the language that the body speaks.
It doesn’t matter.
So, why are we obsessed about calories is truly beyond me because my body doesn’t care if you ate 100 calories or not.
But when that insulin goes way up that’s instruction from my body to react a certain way, which is to store fat.
Whereas you eat — say, I drink a cup of olive oil and it’s got like 500 calories.
But insulin doesn’t go up at all.
So, that’s instructions to act a different way.
And youkan debate about what way it is but in the end, you got to find out what it is that the body cares about so that you can make those adjustments.
This kind of brings me around to one of the things you’ve talked about which I think is most interesting and that’s proximate versus ultimate causes.
And I instantly recognized this from the conversations have with my two-year old daughter.
Like any kid, she continually asks why.
And the reason she asks why is because I haven’t satisfactorily answered her question.
So, she will see aft guy and say why is that guy fat? I could say, “Well, he consumed more calories that he expended.
” And technically that’s the correct answer but you 14 know what she’s going to say.
Why? Why did he consume more calories than he expended? Yeah.
Why do you think that’s happening? And maybe can you just explain the difference between a proximate and ultimate cause? Yes.
So, the proximate cause is what happens immediately upstream.
So, if you say the proximate cause of fat gain is too many calories in versus how many calories out, it’s not a very good way to approach how you treat people.
Because there’s something that caused it.
And if you don’t treat that, then you’re not getting to the kind of root cause.
So, if you take the example, for example, of a plane crash.
A plane crashes because gravity was stronger than lift.
That’s true in all cases.
Just like the first law of thermodynamics.
It is always true.
So, therefore, you might say, well, if that’s true, then all you must do to prevent all plane crashes in the future is to have more lift than gravity.
Bigger wings, less weight, you’re done.
It’s obvious, right? It’s the law of gravity.
It’s just not the general suggestion.
It’s the law.
Well, obviously think that’s stupid, right? Because what caused the lift to fail was, say, inclement weather, poor training or mechanical failure.
And that’s the ultimate cause.
That’s what caused the problem.
So, therefore, if you have poor pilot training, lift fails and then, therefore, lift goes down, gravity is the same, boom, you crash.
So, if you treat the proximate cause and just build the plane with ginormous wings, you will still crash because the pilot has no training will still crash that plane.
And then you’re going to wonder why.
You go, “Wow, it’s the law of gravity.
How can it be wrong?” It’s because you didn’t understand.
It wasn’t the law that was wrong.
It was that you had the wrong idea.
You’re treating the proximate cause.
So, if you treat the ultimate cause, you’ll say, “Wow, the ultimate cause is poor pilot or human error and we need more training.
Or inclement weather and we need better forecasting or we need better scheduled maintenance.
” And, therefore, when you treat the ultimate cause, therefore, you are able to actually reduce problems.
And the same thing happens with alcoholism.
And Isai alcoholism is the same.
There’s too much alcohol in versus alcohol out.
So, again, if you look at the first law of thermodynamics for alcoholism, you say that’s always true because you can’t manufacture alcoholism from thin air.
So, therefore, it’s always true.
Therefore, if you simply stop drinking alcohol, boom, you’re done.
You’ve cured alcoholism.
15 Well, you haven’t.
You have done nothing.
Because you’re just looking at the proximate cause.
What was the ultimate cause of alcoholism? Well, it’s an addictive drug.
There are people who have a lot of social problems or they have problems and that’s why they have turned to alcohol.
That’s the ultimate problem.
So, if you treat alcoholism with Alcoholics Anonymous, which is support groups and peer support and stress relief and all this stuff, now you’re getting and acknowledging that it’s addictive and going for substance abuse counseling and that kind of thing.
Now, you’re going to make a difference because you treated the actual ultimate cause.
If you just treat the proximate cause and say no more alcoholism, you haven’t done anything.
Then that’s the thing.
If you look at proximate cause you think you’re being very logical but you’re just being very stupid.
You don’t understand what’s going on.
And the same thing happens with calories.
The proximate cause is calories in, calories out.
It’s always true.
But what causes the calories in to go up and what causes calories out to go down? Well, that’s the ultimate cause and that’s what you need to know.
This will be unspoken accusation.
There’s a problem with all these calorie theorists, is that the unspoken accusation is that it’s your choice.
Eat more calories or reduce your calories out.
So, they say, okay, calories are the main ultimate cause because that’s the proximate cause but the ultimate causes you.
You let yourself go.
You didn’t want it bad enough.
You didn’t follow the diet.
I don’t think that’s true at all.
I think that you’re looking at the proximate cause.
And for instance — and that was just recently shown, that big Kevin Hall study on The Biggest Loser.
What you find, of course, and you’re familiar with that, right? It’s all over the news for a while.
Yeah, I’m familiar.
When they followed The Biggest Loser contestants, their calories out went super, super low.
Because you never treated the ultimate cause of the obesity.
You didn’t break the insulin resistance.
You didn’t give them a treatment that worked which is — so their diet was eat less, move more, right? They ate a lotless.
They moved a lot more.
Their metabolism just went to nothing.
They’re burning like 800 calories a day less.
And that’s the thing.
If you say calories in minus calories out, you assume that calories out stay stable.
It does not.
It absolutely does not.
So, therefore, nobody is breaking any laws of thermodynamics here.
What’s happening is that you reduce your calories in and you cause your calories out to reduce.
So, you start out, say, at 2000 calories in, 2000 calories out — and this is what happens to everybody.
You reduce your calories in to like 1200 and you think that these 16 calories out will stay at 2000 and then you’re just going to lose weight like crazy.
That never happens.
What happens very quickly and forever, like for six years of The Biggest Loser, is that your body just does this.
Now, you’re eating 1200 you’re burning 1200.
You’re not losing weight.
The problem is you’re burning 1200 and you still feel like crap.
So, then you say, “Okay, well, I’m not going to eat 1200 anymore.
I’m going to eat 1500 because I feel like rap.
” Your body is still burning 1200 because it wants to regain its weight, boom, all your weight comes right back.
And now, you feel like crap, you feel worse than you did originally because before you’re burning 2000 calories you were still overweight but you’re at least not feeling so lousy.
Now you’re feeling lousy and you’ve regained all your weight.
It’s such a bad strategy.
I mean, for so many years, all based on this faulty understanding what thermodynamics mean.
And these people would just say, “Oh, just cut a few calories.
” And there’s so many people who just say that, cut a few calories, cut a few calories.
That is guaranteed to fail.
Guaranteed to fail.
We know why it happens.
We know why it fails.
We have 30 years of experience.
Who hasn’t reduced their calories in? 99% of people have done it.
I’ve done it.
And it doesn’t work.
We all know it doesn’t work.
So, to continue to advise people just to reduce their calories and focus on calories, remember your body just doesn’t care about calories.
So, to focus on something your body doesn’t even care about is ridiculous.
But the strategy itself is so bad that I find it almost laughable if it wasn’t so serious that people would focus on something that is so irrelevant.
There’s an overlap between insulin and calories, of course.
I say that calories are not relevant because it’s not what the body cares about.
But almost all calories raise insulin to some extent.
, unless you drink pure fat which very few people do.
I mean, Bulletproof coffee is one example maybe of a pure fat drink.
But if you drink pure fat you may not raise your insulin but almost no food that we eat in normal society is pure fat.
So, almost all foods will raise insulin.
But they don’t dose in the same degree.
So, if you eat salad with salmon you can eat the same calories but it will stimulate insulin a lot less.
The bread slices will raise it a lot more so, therefore, it’s much more fattening.
That’s what I’m saying.
There’s an overlap here between calories and insulin.
But we focused on the wrong thing.
We should 17 have been focusing on the insulin response of the body.
We focus instead on the calories because it’s easy.
It’s easy to measure.
You can read that package of food and say it’s this many calories.
When you just try, and reduce those calories and the problem is when all those calories are highly processed, they’re all designed to stimulate insulin maximally.
So, you take food which is like those hundred calorie packs.
Your insulin probably goes way up.
It’s 100 calories but it’s all like processed like wheat and sugar.
It’s just enough to make you really, hungry.
You think you’re okay but you’re not.
You’re much better eating 500 calories of say protein and fat, like nuts.
That’s the funny part, right? So, we have all these studies and the Predated study and all these studies about olive oil and nuts, for example.
It’s been well established.
And all these people talk about Mediterranean diet.
Well, that’s a much higher fat diet and, therefore, it has more calories.
So, nuts are very high in calories.
They have a lot of protein and a lot of fat.
Avocados, very high in protein.
It’s very high in oil so, therefore, a lot of calories.
But what we’re starting to recognize is that those are very healthy foods because the insulin response is not that high.
So, you can take a lot of calories but it doesn’t stimulate the insulin so much so it doesn’t give your body the instruction to hold on to that fat.
So, eating a lot of these healthy fats, for example, will give a lot of calories but not a lot of insulins, therefore, your body doesn’t want to store it because it has no instruction to store, which is the insulin.
It has a lot of calories.
But what does it do? It burns it off.
And, therefore, you can keep your metabolism running at a high level using a much higher fat diet.
And that’s the mistake we’ve made.
We’ve gone through a very low fat diet and, therefore, that’s the problem that’s why we get into this biggest loser sort of problems where they just — their metabolism just shuts down.
But I think it’s kind of ironic, is that people talk about this kind of metabolic shut down and it’s kind of like discussed all over the place and what nobody real lee had an article about is how do you fix that? Because that’s what we want to know.
How do you fix that? And that’s what we can do.
We know the science behind it.
We can fix it.
Well, don’t stimulate insulin but give a lot of calories and your metabolism will get better.
The other one is fasting.
Fasting is quite interesting too because it forces the insulin way down.
And then so how do you — have you ever measured somebody’s body composition as they go through an extended fast? Because one of the concerns that I had from looking at the work of George Cahill and the Minnesota Starvation Experiment was that you saw a lot of lean tissue loss as well as the 18 fat.
And so, you might lose some — so when you look at an obese person they want to be inefficient with their calories.
They want to up-regulate their metabolism.
And muscle is one of the most metabolic actively active tissues.
Soothe last thing you want to do is get rid of some muscle during an extended fast.
Have you measured somebody’s body composition and seen it change over a fast? No.
I don’t have access to that but I’ll say this.
First, the Minnesota Starvation Study was interesting because it was not a starvation study.
They took 1500calories a day.
So, it was a calorie reduced diet.
And what happened, of course, their metabolism is just same as The Biggest Loser.
They just totally got shut.
The metabolism like dropped 30%.
So, it’s the same thing as the biggest loser.
The exact same data.
The fasting is completely different.
So, the problem with the print scans is that there’s two issues.
One is that everybody assumes that loss of protein means loss of muscle.
But it doesn’t.
There’s a lot of other tissues, a lot of connective tissue that I think can be gotten rid of.
So, there’s a whole process called autophagy which is where you stimulate the breakdown of these kind of old subcellular parts.
And you can show that they feed into gluconeogenesis.
So, yes, you are burning protein.
But I’m not sure that that’s a bad thing because think that there’s a lot of excess protein.
So, if you lose a lot of weight, for example, you have this connective tissue because that’s what was holding theft cells, that’s your skin and so on.
And so, I’m not sure.
Yes, you do burn some protein.
But I don’t think it’s muscle.
Second is that if you look at the — there is some data from Kevin Hall.
He did an extended fast and measured oxidation.
So, carbohydrate oxidation, protein oxidation and fat oxidation.
Now, what I’m going to show and has been shown kind of repeatedly, even with Cahill’s data, is that the protein, you have a baseline kind of protein oxidation.
It doesn’t go up.
It goes down very slowly though.
You continue to have some protein turnover.
But what you’re not doing is you’re not revving up your body to burn protein.
You have the kind of normal turnover and that ‘sit.
Because if you think about it, if you have repeated — so, a couple of questions.
Why would the body store energy as fat if it planned to burn muscle? It doesn’t make any sense.
That’s like saying, “Oh, I’m going to store lot of firewood in case I need it for the winter.
” But when I need it, I actually chopped of my sofa and throw it into the fire.
And then I have all this firewood.
Why would the body do that? Now, 19 it doesn’t make any sense.
So, yeah, some protein gets burned but I think that’s good thing, not a bad thing.
And, two, if you look at the actual amount of oxidation, so initially carbohydrate goes way up but then after two, three days it’s kind of completely gone.
All the glycogen is gone.
And then fat oxidation goes way up.
But protein does not, never go up.
It has a small blip and then it goes down and continues to go down as you go.
And what you can show is also that the amount of protein is reclaimed through the urine.
So, you have a lot of, in terms of the ammonia stuff, Cahill’s data, look at all that.
So, the thing is that if you think about it, if you think that you store fats and burn muscles as soon as you fast, think about what would happen in the caveman days, with the lions and tigers, who will routinely go three, four, five days without fasting.
So, if you keep doing that where you eat and then don’t eat for five days, as may have happened in the caveman days, you’re going to store fat and burn muscles, store fat and burn muscle.
Eventually, you’re going to just turn into100% fat.
That doesn’t happen.
Those cavemen, those Kalahari Bush people, those indigenous American Indians, they had no fat.
Why? Because when they didn’t eat for three, four, five days, because it was winter and there’s no food, they burned fat.
That’s exactly what Kevin Hall’s data shows.
When the chips are down, you burn fat because you stored it.
Not for the first couple of days.
And the first couple of days are just burning glycogen, carbohydrates.
But this whole worry that you’re going to lose all your muscle mass is kind of ridiculous truthfully.
People have fasted for 2000 years’ minimum.
So, they talked about it, Jesus Christ talked about it.
So, you know that at least there’s 2016 years of fasting.
Every time around Easter they talk about the40 days of lent and this and that.
So, people have fasted for that many years,2000 years.
So, do you think that when people are fasting regularly people are just falling on the streets? No, not really.
They did their fast and then they went on with their day because they burn fat, they burn sugar and that’s it.
They didn’t suddenly become weak as kittens.
It doesn’t make any sense.
If there was going to be a problem with the fasting the way that we do it then nobody does40 days and 40 nights anymore.
We would have known about it a long, long, long time ago.
I mean, there are problems with fasting.
There are re-feeding syndromes.
There are different things that you do have to watch out for.
But severe muscle breakdown is not something that I worry about.
I mean, I put like over thousand people on fast in varying durations.
Zero people have come to me and 20 said, “Well, my muscles are so weak I can’t get around.
” In fact, a lot of them say, “Wow, I have so much energy that I just don’t know what to do with it anymore.
” And the reason is that we’ve kind of unlocked those fat storages.
We forced your body to burn some of the fat stores and they have like 100 pounds of fat there.
They’re suddenly releasing it all and they’re like, “Wow, I have energy to spare.
” And the thing is that if you look at lean mass of The Biggest Loser people who remember of doing like six hours a day of exercise, their lean mass was still going down.
So, it’s not like it’s zero lean mass when you lose weight anyway.
So, everybody gets all worried about that but it’s like I don’t worry about that at all.
And people talk about, “Oh, what about nutritional deficiencies and this and that?” Like, okay.
Let’s think about this for a second.
If I have somebody in front of me who is 300 pounds’ type II diabetes and is going to have diabetic foot infections, amputations and blindness and kidney failure, what you need to do is treat that diabetes.
The fastest way I know how is to put them on a fast.
That will get the sugars down.
That will get the weight down, yes.
Is there a problem? There could be problems.
But those are potential problems that I can deal with.
What I want to deal with is the problem righting front of me.
I don’t worry that he has nutritional deficiency.
Like scurvy? Vitamin deficiency? Are you kidding me? Like I’m not going to treat the problem righting front of my face because I’m worried about scurvy.
I’m not worried about scurvy.
I’m not worried– Right.
You’re worrying about reshuffling the deckchairs on the Titanic.
So, I mean, yeah.
I mean, sure.
Maybe there are some muscle loss.
You saw that even when you’re exercising six hours a day.
So, I don’t doubt that there is some.
Is there going to be loss of connective tissue? Yes, absolutely.
I hope there is.
Because what are you going to do with all that excess connective tissue once all the fat goes? So, I hope that there is? Is there autophagy which is again a protein clearing out process? I hope that there is.
So, there is all these things that I do want to happen that I need to face right now because that’s the problem, not some potential problem in the future, therefore, I’m not going to treat this guy with the best treatment I know how.
It’s ridiculous, some of the people, they’re like, “Oh, yeah, we have muscle loss.
So, then who’s going to have diabetes, blindness, dialysis and nerve pain and then we’ll cut off his feet? That’s better? Are you kidding me? You’ve got tube kidding me.
21 There’s a problem here.
It’s like chemotherapy.
Are there going to be problems with chemotherapy? Hell, yes.
Your hair falls off, you’re nauseated, all this stuff.
It doesn’t mean you don’t treat that cancer.
You got to treat it.
So, if somebody staring me in the face and saying, “I need to take care of this problem,” then take care of the problem.
And then you can deal with the rest later.
If somebody just has the five-count salutary, that’s not the appropriate person to put on this severe fasting regimen.
That’s not what I’m talking about.
We never do that.
We never have a protocol for everybody.
So, if you came to me and you said you wanted to fast for 30 days, I’d say you’re crazy.
You don’t have enough fat that you need toad it could be you could start losing muscle.
But the guy — I had a 75-year old guy I saw this morning.
He had diabetes for 35 years.
He was like 380 pounds.
He went on 30 days of fasting.
Is inappropriate for him? Yeah.
In fact, he felt so good he’s done it a couple more times since then because his diabetes just won’t go away and his weight won’t go down.
It goes down when you fast but you must keep at it.
So, you must choose the appropriate tool.
The context is important.
So, there’s some people that, oh, sometimes you see these comments that are like, “Oh, you know–” They have like three pounds to lose and they’re body builders and then they want to fast.
I’m like, okay.
You’re totally taking what I say out of context.
This is not for you.
Don’t take it like it’s for you.
You have three pounds to lose and no diabetes and your main goal is to build muscle.
That’s not the right thing.
You want to do something else.
Buti you’re 300 pounds, do no exercise and have type II diabetes, yes, then it maybe the appropriate thing for you.
And that’s why we individualized all of it for people.
So, do people need to be supervised? If they’re watching this video and they see the context and they see this might be relevant, do they need to be medically supervised or is there something that people can do by themselves? If you’re on medications, then you should be medically supervised.
If you’re notion medication and you’re simply pre-diabetic, short fasts are okay.
Anything up to like 24 hours is not bad.
But there are people that shouldn’t fast — pregnant women, children, breastfeeding women, if you’re severely underweight or amenorrhoeic, yeah, there are people that shouldn’t do it, just like everything else.
You got to have 22 the experience to know how to do it.
So, if you’re on medications then, Yahya probably should be supervised.
You should ask your doctor, “I want to dot.
” You know what’s going to happen when people ask their doctor about this? They’re not going to know anything about this and they don’t want to know who you are.
So, how can people make it happen? So, do they need to come and see you or how does it work? Well, we provide dietary counseling but we can’t provide medical counseling.
So, we can’t tell people you should take this medication and this medication.
It’s not legal.
You can’t give advice like that online.
We can give kind of general advice in terms of diet and so on.
But in the end, their own doctor or themselves must take responsibility for that medication change.
So, if you’re taking insulin, for example, and you don’t eat, that dose of insulin must go down.
Otherwise, you might go very low and die.
Those are the things that we provide in our clinic because I can supervise people and take care of all those problems before they happen.
And we have a lot of experience with that.
We can do that for people.
But if you’re on medication, so you must be aware that there could be problems.
If you change your diet and it’s not just for fasting, if you change to a very low carbohydrate diet, you may need to change that medication too.
That low carb diets are much more well -known and accepted and this is a much more intensive sort of regimen.
And there’s nothing wrong with being more intensive.
It means that you’ll get better effects but there’s greater risk as well.
Yes, you do have to have, make sure your kind of well covered in terms of that.
I don’t say that everybody could do it.
But a lot of people can.
You go back to some of these religious like lot of Muslims, for example, where you have month of fasting, Ramadan.
They’re not supervised.
But the whole community does this.
So, everybody knows what’s going on.
So, if you’re having problems somebody will fix you right away.
And people say they can’t do it.
What about those millions of people who do all the time, all those Greek Orthodox people who do it constantly, all the Muslims who do it constantly, all the Buddhists who do it constantly, all the Hindus who do it constantly? There are literally hundreds of millions of people right now that are fasting.
Is it just us Westerners that have this problem? Yeah, exactly.
It’s crazy that we kind of humanize that so much when it’s just a tool for us to use.
It’s the most powerful tool because you can’t go lower than zero.
You can’t do any better than eating zero.
So, it’s a very powerful 23 tool and has lots of problems too, which we acknowledge and we take care of.
But to throw it out is like ridiculous.
It’s like taking the best tool of your toolbox and just saying I’m not going to use this.
you’re done because you have a tool and you’re not using it.
Ketogenic diets, fasting, they’re in the same kind of thing.
Both try to lower insulin.
But fasting is just more effective.
But there’s more problems when you try to use it kind of willy- silly.
Well, Jason, this has been wonderful and very informative.
I’m grateful for your time.
And the book, if anybody is interested in reading it, it’s The Obesity Code: Unlocking the Secrets of Weight Loss and that is out now.
And then also, I will again link to the Etiology of Obesity YouTube playlist which is a weekend well spent, isn’t it? How many hours of video is that? It’s a lot.
Yeah, I know.
Thank you so much for your time.
And is there anything else that you want people to know about? No.
I think that’s it.
I mean, the book covers essentially what causes weight loss, what doesn’t cause weight loss.
I think it’s good for everybody to understand that because then you can adjust your diet to the way that you want.
And it may provide that kind of missing piece especially talking about insulin resistance and meal frequency that a very, very few people discuss.
I think it’s just huge part of weight gain, is this kind of frequent eating all the time, not giving your body a chance to kind of digest the food and use the foods.
Nobody talks about it anymore because we’ve all kind of been brainwashed into, “Oh, you must eat breakfast.
You must eat constantly throughout the day.
” If we’re meant to graze, we’re like cows, right? But we’re not.
We’re humans so we shouldn’t be grazing.
You should eat your meals and that’s it.
When you eat, you eat.
When you don’t eat, you don’t eat.
Don’t just eat all the time.
It’s the worst thing you can do.
That’s great advice.
And, of course, intensive dietary management.
Comes the website as well.
I will link to that.
Cheers then, Jason.