Diet Doctor: Rising star or fraud?

I just got a long blog post devoted to me by the blogger CarbSanity. I suppose I should feel honored, especially since she calls me a “rising star” promoting low carb diets. Unfortunately her blog seems mostly concerned with proving that everything Taubes says is wrong. Thus, of course, I must be wrong:

CarbSanity: Guyenet v. Taubes: Is There a Working Hypothesis for Obesity?

I found the arguments amusing. Inconvenient facts are by definition “irrelevant”. On the other hand, facts that support your position “falsifies” the alternative. Here are a few striking examples: 

Irrelevant facts?

Here is a version of the “carbohydrate hypothesis of obesity” that I agree with:

Excessive amounts of carbohydrates (especially refined carbs / sugar) increases insulin and results in fat gain.

CarbSane does not agree. She apparently does not believe that the hormone insulin is an important factor in common obesity. Conveniently enough, these facts are judged irrelevant in her post:

  • Giving insulin by injection leads to fat gain.
  • Taking insulin away (type 1 diabetes, octreotide injection) leads to rapid fat loss. Probably it is also “irrelevant” that at least 14 studies of the highest quality have shown more weight loss with low carb diets, and that these diets lower the insulin levels.
  • Obese people normally have very high insulin levels.
  • Thin people normally have low insulin levels.

Flimsy falsification

Basically CarbSane’s “falsification” boils down to the fact that weight reduction instead results from a calorie deficit (stated in big green letters towards the bottom of her post). Well, duh, of course. That’s just stating the obvious, that the first law of thermodynamics exists.

It’s like saying that to get to the North Pole, you must move north. That is indeed true, but platitudes like that do not help anybody.

The problem with reality

The calories in calories out view of weight loss is not only obvious, it is meaningless. It works fine in a lab, but in reality people can’t know how many calories they are eating. And they certainly do not know how many they are burning. And even if they could know these numbers, they may not like having to stay hungry indefinitely to artificially reduce calories in below calories out.

The interesting thing when it comes to weight loss is not that a calorie deficit works. It’s how we can best accomplish this calorie deficit in the real world. Ideally with no unnecessary hunger involved. The best answer so far, demonstrated in quite a few studies: remove the sugar and the starchy foods.

Incidentally this also reduces the insulin levels. And whether this has an effect on the fat cells (à la Taubes), or by reducing leptin resistance (à la Lustig), or both, it seems to work pretty well for most people wanting to lose weight. Especially people with metabolic syndrome (obesity, diabetes, hypertension etc.). A condition that incidentally comes with abnormally high insulin levels to start with.

Of course, all this will be considered “irrelevant” by people who know that it just ain’t so.


AHS showdown: Gary Taubes vs Stephan Guyenet

Guyenet, Taubes and why low carb works


LCHF for beginners

All about weight loss

Why Americans are obese: Nonfat yogurt


Regarding the title of this post: I have not been called a fraud by CarbSane yet. But judging from earlier events that may just be a question of time.

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  1. Barb
    There was a great exchange on Mark's Daily Apple a couple of days ago between Robb Wolfe and Mark Sisson. One of the comments that they made was "at some point, calories do count". I've seen people doing LCHF who were consuming just way too much food on a day to day basis. I've learned to eat enough for satisfaction, some days it's a little more, some a little less.

    CarbSane may be upset that she's not supermodel thin. For many formerly obese individuals, supermodel thin is not a possibility. She may also be trying to work against her body type. She is clearly delusional, claiming she fits into a size 8. Someone should explain to her that spandex is a privilege, not a right.

  2. Mike
    I suspect you hit it on the nose there. She's probably upset that she hasn't gotten thin enough on low carb. If she had the answers to become supermodel thin (or even to having a average slim figure) she'd probably be there.

    That's an objection to low carb I've heard alot. Why if low carb is so good at weight loss aren't it's proponents slim? Well, in the end genetics and individual metabolisms and lifestyles. will factor in. I'm not where I'd like to be weight wise but I was almost 300 pounds and I'm 220 now. I suspect with exercise (which I don't do as frequently as I should) I could alter my body composition but there is only so much any diet can do. If the choice is low carb and 220 or low fat/low calorie and bouncing between a high weight and a low weight feeling hungry all the time and binging when the hunger gets to be too much, the choice is obvious.

    Yes, at some point calories do count, but for the very obese, it's not until those last 20 pounds or so. At that point, the lifestyle changes such as exercise become important. Not in terms of burning calories, but in terms of directing the calories taken in to building muscle and altering body composition.

  3. Nina
    Why target you when other, more high profile media quacks are peddling such dangerous advice?

    I hope for his sake that these 2 famous men don't die soon.


  4. Barb
    @Mike - Agree with post 102! I'm at a healthy weight for my age and body type. The difference between my high and low weight right now is a 3 pound swing. I've lost 41 pounds eating LCHF. If I lost another 4 or 9 pounds, i could fit into a smaller size, and I'd have a nice round number when people ask me how much weight I've lost, but it would really not appreciably affect my health.
    At my annual visit this summer my doctor was blown away. My labs were ideal (although my total cholesterol was 210, he laughed and said, "With triglycerides of 31, I'm not concerned about that." He did not stop grinning at me. At the end of the visit he said, "Keep it up, you're doing what works, but you know, no one does this on their own." Well, apparently he was wrong.
  5. Maggan A

    Now I have also read her "stuff".

    I had enoug after her saying that LC food is dangerous because Atkins slipt on ice and died from his injuries.

    I mean... seriously? This woman is not serious! This is a pricewinner in bad arguments.

  6. palo
    Carb((In)Sane has some nerve promoting eat less and move more since, by her own admission, using this system at 5'2" she has not gone below 200 lb. in the PAST THREE YEARS!
  7. Maggan A
    palo or someone else...

    how much is 200lb in kilos?

  8. 90.91

    And she laughs at TOM NAUGHTON for being "chubby" in his movie. Clearly she hasn't seen him lately. I saw him in May and he was rail-thin.

  9. Maggan A

    In some way i can understand her. It must be terribly frustrating to fail whit a diet that has proofed to be so successfull for so many others,,,,

  10. Well, it helps if you actually follow it. :-) But yes, there are those who hit a wall and can't go any further. That did in actuality happen to me.

    But anyway, the point (my point at least) has more to do with the fact that the woman is incredibly rude. If she failed the diet, or if the diet failed her, she could get SO MUCH more help and good feelings from everyone if she would just be pleasant. If she would just quit talking so ugly about everyone else, I'd be willing to give her a huge break.

    I have allowed her attitude bother me, though, to the point that in this regard I risk being as rude and unpleasant as she has been, so I am going to force myself to stop commenting on this issue.

  11. Maggan A

    yes i know the wall - been there done that. But then you just have to keep on going.

    I dont care if i never loose another pound. For med the healtissue is the most important.
    I´m 52 years old, but feel like 20. I will never go back to carbs again. LCHF is not a diet - it is a lifestyle.

    And you are right! Why pay attention to rude women?!

  12. Alexandra
    @Robinowitz I could not agree more. I never discuss my very noticeable transformation unless asked. I too am living proof that low carb "works." Eat this way and feel the bliss of no more hunger.
  13. Maggan A
    Qustion to the english speaking people all over the world;

    Ar there any supportive webbsites avalieble on the web for you, wich you can turn to when you have questions on LCHF in practise?

  14. Robinowitz
    Maggan A-There are so many helpful blogs that it's almost overwhelming! For a good starting place, look at the right of the Dr's page and he's got a blog roll of some other blogs he follows. I'd start reading and go from there. Tom Naughton's Fathead blog is hilarious and informative, Dr. Mike Eades' Protein Power blog is a wealth of info, etc. I think you'll find all sorts of great and helpful stuff this way. Some of them have differences of opinion about kinds of carbs, quantity, etc...but they tend to mostly believe the same basic LCHF fundamentals.
  15. Steve L
    I am getting tired of all this.

    It would be nice if bloggers on these issues would stick to dicussing the facts, and refrain from impugning motives and personal attacks.

    This criticism applies to a greater or lesser degree to most people who blog on this subject, so I am not just criticising this blog.

    Readers can make their own judgments about whether (insert name) is arrogant, egotistical, greedy, stupid, aggressive, balanced , knowledgeable, nice, horrible, fat, lean, a shill, or whatever.

    To all bloggers: more signal, less noise please. Resist resorting to the ad hominem stuff; in the end it does no good. I know how hard it is to resist attacking someone who has attacked or misrepresented you. I live in a glass house too.

    Please (all) impress me and others with high quality discussion while treating others with dignity and respect (whether or not you think they deserve it. Show you are better by not taking the bait.

    Steve L (maybe I will post this comment on other blogs to show I am trying to be even-handed here)

  16. Steve L
    Let me add, Andreas, further to my comment above, that you so far are one of the more irenic/polite bloggers ....


  17. Dave
    @Mike, actually what they feed livestock to fatten them up is grains, what they force-feed geese for foie gras is again grains. You'd think they'd feed cows bacon and butter to fatten them up..

    I don't remember the exact study, but there was one where rats were fed large amounts of fat, and they got fat. Conclusion, fat makes you fat. Only somewhere in some small obscure passage of the study it was casually mentioned that in order to get the rats to actually consume those large amounts of fat, they had to lace it with lots of sugar... which was of course not at all considered to play a part in making them fat, since we all know, fat makes you fat.


  18. BioPhysicist
    I have also tried to read CarbSane's blog. I agree with some of what she says,
    but I find her writing very poor and it's difficult to actually make sense of anything. The site is also very messy, it certainly doesn't help having such 'twee' styling and the constant obsession with nastiness destroys her credibility. The fact that she refers to her readership as 'Gang' sounds very childish and suggests that her blog is an egotrip for her. Having a few people read what she is saying has maybe gone to her head somewhat.
    This is a very nice site Andreas, thanks.
  19. CarbSane does not understand anything about science. She has DELETED this linmk immediately when I posted it.

    This shows how mice became obese WIOTHOUT consuming more claories than the controls. They ate at unnatural times:

    Sorry, CarbSane ,you NON- expert disgruntled crank,: the caloric hypothesis of obesity is a dead horse in the world of science. Maybe you'd understasd your own obesity if you actually bothered to follwo genuine science on the topic

  20. CU
    Carb(In)Sane, Colpo and Krieger, the axis of evil, are shills under the payroll of the USDA and Big Agra, who want to push their dangerous grains on the world.
  21. Jess
    I don't get it.

    I was overweight.

    I counted my calories in(or the rough estimate that I can make of them, anyway,) kept track of my calories out (again, the rough estimate,) created a deficit, and lost the weight. I now maintain a 19 BMI, and I still (roughly) monitor my calories so that I can still enjoy foods I like without putting the weight back on. I exercise several times a week. Do I eat low carb? Yes, but only because doing so makes feeling satiated easier. I don't *not* eat carbs, I just choose them wisely so that they "count" ie fiber, as pre/post workout fuel, etc.

    Am I an anomaly? Or is it simply that most people don't want to have to track what they eat?

  22. MargaretRC
    You've arrived. You've incurred the wrath of the truly lunatic carbsane. Nothing to worry about. Most of us know to ignore her rants.
  23. MargaretRC
    @Steve L. I read nothing ad hominem in the paragraphs above. He stuck to refuting the arguments posted by carbsane. He most certainly did "stick to discussing the facts."
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