Fat forecast: Disaster

BMI 40

Things are getting worse. According to a new report, severe obesity (BMI > 40) will soon be normal in the United States.

Looking at past trends and calculating the likely future, 42 percent of the American population will be obese by 2030, compared to 34 percent today. The trend for severe obesity looks even worse:

Prediction for severe obesity

Here is the actual increase of severe obesity from 1990 to today, and different projections into the future:

BMI 40 Prediction

During the next two decades the number of people suffering from severe obesity (BMI > 40) is predicted to more than double, from 5 to 11 percent. That’s just insane.

Morbid obesity is becoming normal. The old conventional thinking (”eat less and exercise more”) is clearly not working well enough. It has failed. It’s the approach that’s been used for decades, as the situation has gone from bad to worse.

Besides, having to count calories is very unnatural. It’s basically an eating disorder. No animal in nature needs to count calories – they just eat real food when they are hungry.

We desperately need to rethink the foundation of the advice we give. The simplistic calorie thinking needs to be replaced with an understanding of the hormonal regulation of fat tissue. We need to go from an basic engineering perspective (”calories in, calories out”) to actually understanding how the human body works.

We can’t ignore biology. We can’t ignore hunger. We need a way to make people with weight problems want to eat less calories than they burn.

Luckily there is such a way: avoid eating the high-sugar, high-starch food that increase your appetite. Basically avoid the normal American diet.


ABC News: Fat Forecast: 42% of Americans Obese by 2030

Gary Taubes has also written an interesting new article on the problems we face:

More about the obesity epidemic


  1. Alexandra M
    I was just at the grocery store, and my eye was caught by a box of "weight control" instant oatmeal. One serving contained 24g of carbohydrate, about 9 grams of it fiber. On the plus side, it contained less sugar than the "reduced sugar" type, which had the same carb count and 9 g of sugar!


    I shared the Taubes article on Facebook. Let the flamewar begin!

  2. gretchen
    The really scary thing is the rise of headless people, as in this photo.
  3. Alexandra M
    Tom Naughton mentions that in his movie Fathead - imagine if you recognized your own torso on TV!
  4. moreporkplease
    No problemo! Just read about a new pain-free gastric technique that requires no surgery! You see they put an endoscope down your throat along with a micro-surgery tool and they can staple your stomach from the inside! It's so easy to do, the inventors think every plastic surgeon/spa will be able to offer it!

    Costs only US$11,500. It's called POSE and it's in trial stages now. The inventors hope it will replace Roux-Y, LapBand etc. and be approved for those who want to drop those last pesky 20 as well.

    After your stomach's stapled, you can only eat 1 cup (1/4 liter) of food at a time. The inventor suggests you eat 3-5 cups of food a day. In the trial, there was a 80% patient satisfaction rate. The unhappy 20% complained because they were hungry all the time. Gosh, I wonder why????

    But see, the obesity epidemic is not an issue! We can all just have this 30-minute procedure, pay the spa, and our weight-loss concerns are solved forever! Who needs to diet or exercise when you can just staple? (NOT).


  5. Michelle
    It is an eating disorder. I've said this before and have been shot down for it. We are training our kids to develop this disorder and it's shocking. I want to shake those in authority; however, money rules this world of ours and the only response I would achieve from them is the sewing up of their pockets to stop the money falling out.
  6. Jane
    In the 60's we/I just ate bread 210 grams a day, with butter and fatty meats or cheese, 100 grams boiled potato's, 150-200 grams vegetables and about 100 grams of meat or sausage, with fatty sauce. That was it.
    I did not eat anything els, no fruit, no milk, no cookies, no sweets. I just did not like it and was not used to eat it. So it was less then 1500 calories consumed. Ride mu bike on the way to work. That's why I stayed normal weight 60/65 kg /169 cm. until I was about 50 years old. Later ate more cookies and so on because my partner need it next to the coffee and did not like to eat alone. Also at work birthsday's came with cake's. Result was clear. Gaining weight. So calories do count, only we never count them before.
  7. Val
    @Jane re-read the article ,a calorie is not a calorie when it comes to food and the way the body metabolizes it.Like the good Dr. said you have to understand how the the body works and maybe then you will begin to realize it's what you eat not how much(that comes later as a
    result of eating rubbish and not changing your food choices)
  8. Jane
    I am eating 6 month LCHF but still have gain weight. Now I try to eat less fat.
  9. dr-no
    @Jane: I hope to see the NuSI (Nutrition Science Initiative) come forward. There are so many things to find out, including reasons why some people on an LCHF diet do not lose weight. It starts with primitive definitions: what is a low-carb diet, exactly? What exactly did you eat? How did it affect your metabolism? How does YOUR metabolism work, right now? We need to understand the metabolism of nutrients in toto to really understand what's going on and how you can be helped. Maybe your lack of weight loss isn't even a marker of metabolic disease and you are healthy indeed. Or you started eating healthy (in terms of metabolism) without weight loss as a consequence. Just pondering...

    Furthermore, I repeat it again and again: " 'A calorie is a calorie' violates the second law of thermodynamics" (Feinman and Fine (2004), Nutrition Journal 3:9).

  10. Jane
    I know that calories are not all the same. But I think total calories is important in loosing weight.
    I am 62 years young. Last 6 months I ate and eat all meats, fish, butter, cream, creme fraiche and coconut oil, with few or no vegetables. When I gained first, I thought it might be because I am building up my vains and all. There is everywhere discussions going on about eldery people, that it is difficult to loose weight and that you have to cut calories therefore, less proteïne or less fat. I whish I knew. Eating less may be the key. One says to eat very low carb (less than 20 grams), an other says you must eat at least 50 grams, and again an other says you must eat 100 grams. Well, I try to stay around 20 grams, max. 30. Most of my life I ate about 100 grams of carbs. So today I ate 40 grams of proteïne, 127 grams of fat, and 27 carbs. Must be good.
    I wonder how much everyone eats on a common day, in grams of proteïne, fat and carbs.
    All you can eat or want to eat: how much is this for you?
    I have office work, and don't exercise except doing homework.
  11. Not sure how valid their calculations are. they use measurements such as how many fast food places are being built and the cost of "healthy" food to come up with this 42%. I wrote a little did bit about it: http://wp.me/p2mRdq-6c
  12. deserttomte
    I was a data point on this curve with a BMI of 42 nine and a half months ago. Now I am leaving this behind - with LCHF/Paleo/Primal living I've lost 90lbs, reduced my BMI by 11 points and now I'm just 10lbs away from no longer being clinically obese. The science is there now, we have a much better understanding of nutrition and health. Thanks Dr. E for helping get the message out!
  13. moreporkplease
    Hi Dr No:

    "There are so many things to find out, including reasons why some people on an LCHF diet do not lose weight."

    But all of us in this space understand the main reasons why: we know all the major cases, they're classic! :) And they all tend to be about what Westman calls the "Chet Atkins" diet - so please, don't anyone here take it personally:

    1 - (often a man) "Why doesn't this work for me? I follow it exactly! For breakfast I ate a hard-boiled egg, a [insert brand name here] low-carb shake, and a cup of coffee with 3 tablespoons of cream and 4 spoons of splenda. For lunch I had 16 oz. of hamburger drenched in butter, 1 cup lettuce with blue cheese ranch dressing, 2 diet cokes, and a [insert brand name here] low-carb dessert bar. Dinner was just another 16 oz. of sausage with [insert brand name here] low-carb sauce, 1 cup salad and parmesan dressing, with 1 slice [insert brand name] low-carb bread and 2 [insert brand name here] low-carb cookies! Yeah it was 6,000 calories, but calories don't count and besides I took a 10-minute walk around the block with my elderly dog."

    2 - (often a woman over 40) "Why doesn't this work for me? I followed it exactly for 3 years! I'm living on 12 total carbs a day and have never lost more than 35 pounds. Sure I'm Peri-/post-menopausal and probably still insulin-resistant, but I refuse to get a hormone test or take any drugs. Gary Taubes told me this would work and I blame him for cherry-picking his evidence! I still eat my 14 oz. of protein a day, and my 2 cups salad - for snacks I only have 4 oz cheese with nuts and 3 tablespoons coconut oil and cream. Before bed I never eat more than 1/2 a [insert brand name here] low-carb candy bar. Do you think I need to raise my calories to 2400 a day and add more coconut oil? I never exercise, I know I should start stretching."

    3 - (often a man under 30) "Why doesn't this work for me? It's all junk science anyway! I tried low-carb for 3 days and couldn't even lift my 700-pound-tire to flip it! On the 4th day I found I couldn't finish my marathon! Clearly low-carb gave me a glucose deficiency. I'm going back to 400 carbs a day - you need carbs to exercise, so I'm going to eat 6 sweet potatoes right now. I'm not fat anyway like those lazy old broken people; they're disgusting."

    (giggle). Sneaking away now. . .these cases aren't meant to poke fun at anyone here. . . :) They're generic.

  14. PhilT
    @Jane - about 70g of protein, <30g of carbs, 60-80g of fat per day.
  15. Maggan A

    this translation from a Swedish paper might give you som hints


  16. Galina L.
    @Jane,@ Val,
    Many people loose weight by counting only carbohydrates because macro-composition of food matters. However, a lot of LCarbers later in their diet come to a realization that the amount of food matters too and it is possible to over-eat on LC diet and gain or regain weight even without eating LC versions of junk-foods, as moreporkplease suggested, by just eating too much food, too often, and at the end of the day, yes, eating too many calories. It looks like the weight loss is more challenging for ladies at middle age and older, and reading articles about some young girl loosing 50 - 60 lb in 6 weeks on a LC diet may have nothing to do with your personal situation.
  17. Jane
    That is not much, about 1100 kcal. 60-80 grams of fat is not high fat.
    @Galina L.
    I was told to eat 2,5-3,5 times as much fat as proteïn and that proteïne must be your weight in kg. That is what I was doing, building up my health (and weight). I was told that to much diary fat is wasted and could not add to body fat, and that to much protein can convert to carbs.
    It is sure interesting to see how much others eat, like PhilT did.
  18. Clint Primoff
  19. Zepp
    Calories is important.. but the moste important is to get your metabolism to use more of your body fats.. without this one can count Calories as on want.. its not given you any energy deficit!

    And a ketogenic diet do lower the blood sugar, insulin levels, uppregulate fat oxidation in cells, promote lipolysis in fattcells, promotes ketosis and gluconeogenesis!

    And if one have a normal apetite, one should get less hunger, if the body can use does stored fats.

    And another important thing is to listen to your bodys real demands of energy, not the cravings.. its almoste a psychological thing.

    And last but mayby the moste important thing, one should always get attention on to get all the nutrishment a human needs!

  20. Calories count the other way, too. If you are not getting a sufficient number of calories, you may be slowing your metabolism--the thyroid will respond by down-regulating and then weight loss is slowed.

    I find that I have to eat a minimum number of calories to keep losing, otherwise my weight loss stalls. For me that number is nearly 1700 calories a day (based on my basal metabolic rate).

    1100 calories may be too few for you. I know it seems counter-intuitive to eat more to lose, but your body is programmed to maintain its weight to avoid starvation.

  21. Jane,

    This is what worked for me:

    First, I reduced my intake of carbs (to about 20-30 grams per day) to reduce the release of insulin. With normalized insulin levels, my body was able to release and start using my stored body fat. I kept an adequate protein intake and kept my intake of fat low. Why did I keep my fat intake low? Because, I had enough stored fat and I wanted to use that fat first.

    Once I reached my desired body weight, I increased my fat intake and I continued to keep my carb intake low and my protein intake adequate. I still eat very little carbohydrates, between 20 and 50 grams per day, and a moderate amount of protein, about 80 grams a day. I get the rest of my daily calories from fat.

    I don't count calories because I don't feel hungry all the time like I used to on a high-carb diet. As a matter of fact, on my low-carb diet, I get full very quickly. When I started my low carb diet, I had to eat 2 eggs and 2 slices of bacon for breakfast to feel satiated. Today, I can only manage one egg and one slice of bacon and I feel full.

    Hope this helps. Good luck with your weight loss.

  22. Galina L.
    I think by now you found out by personal experience how milk fat gets wasted or not. I am pretty much in doubt that anyone knows for sure how much of what any given person should eat in order to loose weight because individual differences are very substantial. A while ago on that blog people commented on the 70 lb weight regain of a very prominent LC promoter Jemmy Moore, who eats very little carbs but puts an insane amount of butter everywhere and has some fondness for LC junk-food. Many people who eat LC diet experience a weight-loss plateau or even a weight-gain mostly because they over eat cheese, butter, have too much cream with their coffee, also eat too many nuts.

    I really want you to check some blog-posts

    Sure limiting carbs works, but if you reached the point it is not working effectively any longer, pay attention on the amount of food and calories, eliminate all snacks, check your food intake with a free web-site fitday.com, just don't pay any attention on their recommended amount of calories. The main advantage of LC - it makes eating less easier.
    protein 62
    fat 120
    carbs 70

  23. Jane
    @Violeta @Galina L.
    Thanks for all your good advises and urls. I will let you know if it works.
    Up to now I have lost 1 kg in a few day doing less fat but eating enough.
  24. Barbara
    I'm an example of someone who had to use lowering calories and intermittent fasting to lose weight. The closer I came to goal weight - that last 10 pounds - the harder it became. I'm post menopause, and have thyroid problems. I had to get calories down to 1200, and not eat until 2:30 pm daily in order for ANY weight to come off. Once the weight started to come off it was a little easier and now I can ease up a bit. For me personally, this was what worked.

    Those who have many pounds to lose must realize that they MUST get the body to burn BODY fat, not the fat they EAT in order to lose weight. The Perfect Health Diet suggests that adding some "safe starches" like sweet potato or white rice, and lowering protein slightly, and lowering fat may help when weight does not come off. For others a ketogenic diet is the only way.

  25. dr-no
    @Jane: "But I think total calories is important in loosing weight." Yes, calories burned are important. Calories consumed is a different category. The only thing concerning both we know for sure is that you have to consume a minimum amount of calories per day to survive (this is the first law of Thermodynamics). Everything else is subject to debate and experiments.

    @moreporkplease: Please enlighten me on case 2, I don't see the hint. On case 1: I don't know of any LCHF overfeeding studies in humans that could illuminate the issue at hand. Please support your implied claim ("absolute calories count") with either a number of cases plus a valid biological model OR a clinical controlled trial OR an in vivo human experiment.

    @Violeta: "I had enough stored fat and I wanted to use that fat first". Probably you could have also eaten fat, because fat is not "stored" in a kind of biological warehouse, it is continously piped in and out of fat cells, directed by hormones. But if you lost weight on your diet regime (and more importantly, improved your health and your risk factors), any method is fine. :-)

  26. It's Simple
    Eat meat and vegetables, nuts and seeds, some fruit, little starch and no sugar. Keep intake to levels that will support exercise but not body fat. Practice and train major lifts: Deadlift, clean, squat, presses, C&J, and snatch. Similarly, master the basics of gymnastics: pull-ups, dips, rope climb, push-ups, sit-ups, presses to handstand, pirouettes, flips, splits, and holds. Bike, run, swim, row, etc, hard and fast. Five or six days per week mix these elements in as many combinations and patterns as creativity will allow. Routine is the enemy. Keep workouts short and intense. Regularly learn and play new sports. This works.
  27. Galina L.
    You are one of thous people who thinks that what works for you will work at the same manner for everybody else. You advise worked for me till I turned 45 years old. My very athletic naturally thin husband who actually over-exercise, started to grow thicker in the middle-body after 50 years old, but he is still at the perfect BMI. Thinking that dialing with weight issues is very simple is very stupid, not everybody is guilty being a couch potatoe, and among couch potatoes you can meet plenty of thin people who believe they just don't eat more than they should..
  28. sophie
    I am glad to know I am not the only one with difficulties.

    I do not have a lot of weight to lose. I am 35, and just have weight to lose on my stomach. I always knew there was something wrong with my processing of sugar and insulin levels, so I was excited to start with LCHF and had high expectations.
    When I started I realized how much carbs I was taking in through fruit but it was rather easy to switch.
    Now it has been 3 weeks and I am not seeing great results, aside from the reduction of hunger pangs and no more cravings.
    I may be eating too much dairy, so I will follow your advice and reduce my intake, and see what happens.
    Is it possible that LCHF doesn't work as well if you have less weight to lose? I spent the last week with a friend and we have eaten the same foods: he has lost 3 kilos and me nothing! Of course he is much bigger than me.

  29. Helena
    Hi everybody. Avoid everything that is not natural. No margarin no light products as the fat has been replaced by un natural things. And eat natural fat just to not be hungry.

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