A Short Primer on How to Lose Weight – What to Eat and When to Eat by Dr. Fung

Here’s a startling truth. I can make you fat. In fact, it is pretty simple to do. Actually, I can make anybody fat quite easily. How? I simply prescribe insulin injections. Sounds simple, doesn’t it? Well, it is! Giving people extra insulin leads inevitably to weight gain. All that is required is to raise a persons insulin and they will become fat pretty quickly. In type 1 diabetes, when insulin levels are extremely low, patients lose weight no matter how many calories they eat. They can eat and eat all they want and never see the side effects of added weight (even to the extremes where they are eating excessively but rail thin).

So, to summarize, give insulin – gain weight. No insulin – lose weight (even to the point of death which, of course is something all try to avoid). The implication is clear and that is that insulin causes weight gain and thanks to this fact, I know I can make you fat. Knowing this is crucial because if insulin causes weight gain, then losing weight depends upon lowering insulin. Logical right? But instead of taking this fact and running with it, we’ve been told to focus obsessively on calories. If you have ever considered trying to loose weight, you have surely heard this before and almost every diet out there will tell you the same. Why is the focus never on insulin levels?

The standard (and almost always failed) weight loss advice is to restrict a few calories every day by reducing dietary fat and eating multiple times per day. Small meals, less fat, lower calories is suppose to lead to weight loss. Sound familiar? This does not lower insulin much since dietary fat has little insulin effect and eating frequently constantly stimulates insulin secretion which is actually the opposite of what you want if you are looking to lose weight. This ‘caloric reduction as primary’ advice has an estimated failure rate of 99.5%. So, if you have tried calorie restriction to lose weight and failed, understand this. You were expected to fail. You almost had no chance of trying to lose weight in this manner and succeed, unless you are one of those .5% that it did work for but who are we kidding, they probably didn’t lose much weight either unless they made some other life change at the same time.

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So here’s the situation. ‘The Man’ tells you that obesity is a caloric balance and that you should eat less and move more. Sounds simple but then ‘The Man’ tells you to eat a low fat diet, and to eat 10 times a day. Sounds a little harder and more of something that would be difficult to follow for an extended period of time. Because of this, this advice fails virtually everybody. And then, to make matters worse, when you fail, ‘The Man’ tells you it’s your own  fault for being such a lazy, weak willed person who can’t stick to a diet or follow simple habit forming instructions. His advice was good, ‘The Man’ tells you. You were just a failure. That’s what ‘The Man’ wants you to believe. But he is wrong and you need to start believing that the advice is wrong, not you.

A good way to look at this caloric misinformation is to imagine we have a classroom of 100 pupils. One of these people fails. When one person out of 100 fails, it’s likely his fault. Maybe he played too many video games or didn’t come to class. Maybe he didn’t study or just wasn’t smart enough to pass the class. Whatever the reason, only on out of 100 failed. But what if 99 students fail? Then it’s not a problem with the students. The problem is with the teacher. In this scenario, this is obvious to us. Everyone fails, the teacher or the class itself is at fault and it is clear. In obesity, the problem of rampant obesity means that it is very obviously not the fault of the people. Too many people are obese and the problem is not the people. The fault lies with the official dietary advice.

Understanding that obesity is a hormonal disorder, not a caloric imbalance (as discussed in our last post) means that we must instead focus on the insulin effect rather than the number of calories to successfully lose weight. Reducing insulin depends mostly upon 2 things:

  1. What you eat
  2. When you eat

We often think and talk about the first problem, but both are equally important in lowering insulin levels. Even if you eat an extremely healthy diet and count every calorie, avoid every fat, and eat clean, the matter of when still applies and needs to be careful taken into consideration.

What to eat

The three different macronutrients stimulate insulin to different degrees and are what you should focus on when trying to lose weight. Knowing how each effects the body is essential so this is something you will want to remember. Carbohydrates, particularly refined carbohydrates raise insulin the most. From the moment you eat a carb, your insulin is going to shoot up practically immediately. Protein also raises insulin significantly, although blood glucose remains stable. Eating protein won’t have as drastic of an effect on your insulin levels but it will effect it some. In addition, animal proteins stimulate more insulin release compared to plant proteins. Dietary fat raises neither glucose nor insulin. That’s right, fats do practically nothing to your insulin levels.

Most natural foods contain varying combinations of the three macronutrients and therefore raise insulin to varying degrees. For example, refined carbohydrate-rich foods like cookies have the greatest effect on raising insulin and glucose. Fat rich foods like salmon have little effect on insulin which is why it is featured in almost every diet out there. However, this differing ability to stimulate insulin means that foods also differ in their fattening effect. This is only common sense and when you think about it, you will see how easy it is. Here is a perfect example, 100 calories of cookies, is far more fattening than 100 calories of salmon, despite what all the obesity ‘experts’ claim. The calories just aren’t the same once they enter your body.

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The overlap between calories and insulin effect is what causes the confusion between the hormonal (insulin) hypothesis of obesity and the caloric hypothesis of obesity. Many people say that ‘A calorie is a calorie’, which is, of course, true. But that’s not the question I asked. The question is ‘Are all calories equally fattening’? To which the answer is an emphatic no. Insulin stimulating foods like glucose are more fattening than non-insulin stimulating foods like kale, even if you have the same number of calories.

Certain factors increase insulin which encourages weight gain. The most important factors and foods that raise insulin are refined carbohydrates, animal proteins, and insulin resistance.  Fructose, from added sugar and fruits, can directly cause fatty liver and insulin resistance. This leads the body to increase insulin secretion to compensate which, of course, leads to weight gain.

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Other factors decrease insulin, protecting against weight gain and these are the ones you want to remember in order to lose weight. Acids found in fermented foods (sauerkraut, kimchee) and vinegar lowers the insulin effect of foods. That means that having some vinegar on your salad is really helping your body fight fat so add some more of that dressing! Animal protein causes secretion of incretin hormones that slow the absorption of foods thus lowering insulin. Thus meat has both pro- and anti-insulin effects making it almost a neutral food. Fiber also has this same effect of slowing absorption and insulin effect. A bowl of oatmeal is a healthy way to start your body off on the right track for the day as it is full of fiber and will help lower your insulin levels. 

Thus, the main principles for lowering insulin and losing weight would include the following, as detailed in The Obesity Code.

The Obesity Code: Unlocking the Secrets of Weight LossRules for ‘What to Eat’

  1. Avoid added sugar – causes insulin resistance and high insulin
  2. Eat less refined grains – High insulin effect
  3. Moderate protein – excessive consumption can be fattening
  4. Don’t be afraid of eating natural fats – Low insulin effect
  5. Eat real unprocessed foods – refining increases insulin effects

Funny. That’s precisely the sort of no-nonsense advice your grandmother would have given. I guess it’s about time you listened to her advice!

When to eat

The second and equally important part of lowering insulin is understanding the question of ‘when to eat’. All foods can raise insulin, which leads to obesity. But there is another important contributor to high insulin levels outside of food – insulin resistance. This refers to the situation where normal insulin levels are unable to force the blood glucose into the cells. In response, the body raises insulin in a knee-jerk reaction to ‘overcome’ this resistance, and these high levels will drive obesity. But how did insulin resistance develop in the first place?

Our body follows the biologic principle of homeostasis. If exposed to any prolonged stimulus, the body quickly develops resistance. An example of this resistance is a sleeping baby. A baby can sleep soundly in a crowded restaurant because the noise is constant, and the baby has become noise ‘resistant’. But that same baby, in a quiet house, will wake instantly at the slightest creak of the floorboards. Since it has been quiet, the baby has no ‘resistance’ against noises and thus awakens quickly. This is the same with your body’s consumption of foods and they cycle of when you eat.

If you listen to loud music constantly, you will become slightly deaf. This ‘resistance’ to loud noises protects the ear from damage. Raising the volume to ‘overcome’ this resistance works but only temporarily. Volume increases and you become progressively more deaf (resistant to loud noise), which leads you to raise the volume again. The solution is not to keep raising the volume, but to shut it off.

Think about the story of the boy who cries wolf. Raising the alarm constantly may work at first but eventually leads to the villagers becoming resistant to the signal. The more the boy cries, the less effect it has. The solution is to stop crying wolf.

Insulin resistance is simply a reaction to too much insulin. The body compensates by raising insulin, but that only makes things worse because higher insulin levels lead to more resistance. This is a vicious cycle.

  • High insulin leads to insulin resistance
  • Insulin resistance leads to higher insulin.

The end result is higher and higher insulin levels, which then drives weight gain and obesity. Therefore, a high insulin level depends on 2 things.

  1. High insulin levels
  2. Persistence of those high levels

Providing extended periods of low insulin levels can prevent the development of insulin resistance. How to provide those low levels? A daily period of fasting.

This may sound strange, but this is the way we used to eat. Suppose you eat breakfast at 8 am and dinner at 6 pm. You eat for 10 hours of the day and fast for 14 hours. This happens every single day, and the reason we use the word ‘break-fast’. This is the meal that breaks our fast implying that fasting is simply a part of everyday life. The body spends roughly equal portions of every day in the fed (insulin high, storing fat) and the fasted state (insulin low, burning fat – Ketosis). Because of this nice balance, weight tends to stay stable over time. Up until the 1980s, this was pretty standard practice and obesity was not a big issue.

Somehow, we moved away from this traditional way of eating and now eat constantly. We are hounded to eat something the minute we get out of bed in the morning whether we are hungry or not, believing that eating white bread and jam is better than eating nothing at all. We are pestered to eat throughout the day and not stop until it is time for bed. Large surveys show that most Americans eat 6-10 times per day. Now our body spends the majority of time in the fed state, and we wonder why we can’t lose weight.

Eating constantly does not provide the critical period of very low insulin to balance the high insulin periods. Persistently high insulin leads to insulin resistance, which leads only to higher insulin. This is the vicious cycle of weight gain that we must break with fasting.

For the boy who cried wolf, which is the better strategy?  Stop crying wolf for a month, and then cry loudly once, or cry wolf constantly, but a little more softly? Similarly, to start burning body fat, you must allow prolonged periods of time of low insulin.

Rules for ‘When to Eat’

  1. Don’t eat all the time (time-restricted eating or intermittent fasting). Stop snacking.
  2. If you want to lose more weight – increase the fasting periods

We often obsess about the foods we should or should not eat, the question of ‘what to eat’. But we often ignore the equally important question of ‘when to eat’. By attacking the insulin problem on both fronts, we have a far higher chance of successfully losing weight. Now you are well informed to begin losing weight in this manner and, when followed correctly (and logically), that weight will fall off!

 

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Reprinted with permission from Dr. Fung.

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