How to Lose Weight – the “Magic” vs. the Insulin Way

How is it possible for people to lose weight both on a low-carb diet and on an extreme low-fat, plant-based diet?

Is it because of different kinds of “magic”, as the provocative long blog post from Denise Minger argues? This is the left illustration above. Or is it all possible to explain via the effect on hormones, primarily insulin, pictured above to the right?

Dr. Jason Fung writes more about it in a new blog post:

Thoughts on the Pritikin Diet [extreme low fat]

This inspired me to update Dr. Fung’s graph. Here’s the updated way I think about the fundamental role of insulin in obesity these days:

Can my graph be improved? Feel free to tell me how in the comment section.

Earlier

In Defense of Low Fat – Denise Minger vs. Dr. Fung

Why are Asian Rice Eaters Thin?

Weight Control – A Question of Calories or Insulin? – Dr. Andreas Eenfeldt

26 Comments

  1. Chris the Barbarian
    I would add that chronic elevated Insulin is the real culprit. Without insulin we would just die, we just need the right amount of it at the right time. Certain Amino Acids rise Insulin even higher than Glucose - but not long, so it isn't really bad. Eating Sugar nonstop will keep it high, most of the time.

    Insulin isn't the bad guy, don't blame him ;).

  2. Tor H
    Malcom Kendrick says that without glukagon, you can live without insulin:

    "Once you have changed your thinking around this way, it should come as absolutely no surprise to find the following. If you have a mouse, and you destroy its beta-cells (insulin producing dells in the pancreas) it will become diabetic, and die. However if you get rid of the glucagon producing cells as well, the animal will not have a high sugar level and will not be diabetic – despite having no insulin at all. It will also appear to be completely healthy."
    http://drmalcolmkendrick.org/2015/08/04/turning-diabetes-upside-down/

    At least mice can :)

  3. Chris the Barbarian
    And how do the nutrients go into the cells then ? Does this work differently in Rodents? Curios, will have to look for that.

    And don't forget DKA. Without Insulin, you pretty much die of DKA after ~48 Hours. So, I'm still happy my Pancreas pumps out enough Insulin :).

    Replies: #6, #8
  4. Vicente
    Hi Andreas,

    you are confusing real causes with aggravating circumstances.

    Constant food availability is not a cause.

    Food-reward and addiction are just aggravating characteristics of the real problem: processed food.

    You can't integrate the LCHF real food paradigm with the ideas of those who think obesity is a problem of food quantity and lack of willpower.

    High food-reward is not the problem.
    Low food prices is not the problem.
    Constant food availability is not the problem.
    Eating every three hours is not the problem.

    Reply: #10
  5. stenB
    Of course it is hormonal and Andreas is right, yet some people can over eat also on LCHF, but there are no hormones driving it so the risk is minimal. There is another factor outside of this subject, that makes the low fat attempt a dangerous non-starter! Without sufficient fats in the food we cannot absorb vitamins or antioxidants from the food we eat! The low fat arm can even be harmed by adding more fruit and veg, while the high fat arm will thrive on it! The main reason for all anecdotal health benefits from LCHF, the way I see it.
  6. Tor H
    No idea, but according to Malcom Kendrick, they appeared comlpetely healthy.
  7. Pierre
    There is no magic because any kind of diet that is calorie deficit will lead to loss of weight. First law of thermodynamic.

    The only difference with a LCHF diet is that you won't have hunger pangs every few hours with a crazy need to eat carbs. You will lose mainly fat and water and you should be able to preserve your lean mass if you exercise by lifting weight and eat enough proteins.

    Look at this nutritionist with her carbs diet who needs to constantly snack through the day.

    http://www.businessinsider.com/what-a-nutritionist-eats-in-a-day-2015...

    Reply: #9
  8. erdoke
    Insulin is mainly an anti-catabolic hormone, not really an anabolic one. It's a myth that insulin is needed for cellular glucose uptake in insulin sensitive people. In fact after it reduces hepatic glucose output, the gradient decreases and cellular uptake is slightly reduced in line with it.

    Regarding the article. I'm curious how the white rice + sugar + orange juice diet which Denise Minger also mentioned can be explained with the above flow diagram... That's not (directly) insulin reducing for sure.

  9. erdoke
    Initial calorie deficit does not necessarily mean long term weight loss, not to mention fat loss. Compensatory mechanisms kick in and calorie expenditure will be decreased sometimes even matching the reduced input.
    Reply: #16
  10. George
    Once again Vicente wins the thread.
  11. VK
    Food reward does NOT equal addiction. It's the idea that within the brain, things have changed such that we lose our will power and are not able to stop overeating.

    Everyone who is LCHF knows that they have to ease up on low carb treats and fat at some point.

    Every low carb forum on Facebook stresses to their members not to get too carried away with butter, peanut, almond based treats.

    Reply: #13
  12. Apicius
    I really like the graphic. Thank you for posting this. I realize it creates a lot of debate, but it is a good tool to help guide discussions and create clarity.

    What about fake sweets, like a soft drink or hot chocolate beverage made with artificial sweeteners? My guess is that they trick the tongue, creating an insulinogenic response, creating spike in insulin, and then feeding the vicious cycle.

  13. Martha

    Every low carb forum on Facebook stresses to their members not to get too carried away with butter, peanut, almond based treats.

    Please assure me you're not getting your scientific health info from Facebook groups. If so, you have more problems than you think. ;)

    Look you can't have it both ways: you can't claim to be able to eat steak without calorie counting using the excuse that its fat is satiating & so self-limiting, then turn around and claim that butter somehow is addictive. I'm just not that stupid.

    Look, do the experiment. . . take out 3 sticks of salted butter and eat them all at the same sitting. Of course you can't do it. I've challenged quite a few people to this and no one has even been able to finish 1 stick. But if you believe this nonsense on food reward, you should be eating salted Kerrygold uncontrollably because it contains both high fat & salt.

    Yet in real life who can choke down a whole stick of butter? Because after about 4 tablespoons you just literally get disgusted and put your spoon down. In real life we all know natural foods with their natural fats are highly satiating. We have all experienced it.

    As for those horrible "paleo cookies," you shouldn't eat them because they're processed food. There's nothing actually paleo about them - all processed coconut & almond flours, processed maple syrup, etc. No one mistakes processed coconut flour for Real Food. Your grandma certainly had no idea what it was. ;)

  14. Anna Katrina
    Hi Diet Doctor. I think it is a shame that this new diagram leaves out the "Protective Factors" at the top: Vinegar and Fibre. Having read all of Dr Fung's pages on the aetiology of obesity, I seem to remember that he included them because there is good experimental evidence that both these things do help patients to 'process' all the foods they consumed better, no matter what the level of carb restriction. And let's be honest, while the definition of good carbs can be generalised, the most effective level of carbs for anyone is something they have to find out for themselves. As Dr Fung has argued again and again, healthy eating isn't really about macronutrients, it is about how the body responds to the food we eat.

    The most inspiring thing I read lately that expands on the point of why vinegar and fibre are important protective factors in the human diet is a book called GUT by Giulia Enders. It is a really engaging explanation of digestion and how our bodies break down food. There is absolutely nothing about hormones in this book, but many clues as to why food has such a quick and powerful effect on our wellbeing, and why there is so much individuality in what foods work best for us.

    In fact, I think an interview with Giulia Enders, who is a young medical student, would be an excellent addition to your site.

    Reply: #15
  15. Anna Katrina,
    Fibre is still there. I did not include vinegar as I find it an unattractive solution to pour vinegar over everything we eat, even if it would probably help us lose some weight.
  16. Pierre

    Initial calorie deficit does not necessarily mean long term weight loss, not to mention fat loss. Compensatory mechanisms kick in and calorie expenditure will be decreased sometimes even matching the reduced input.

    Of course not, as soon as the diet is stopped, the old habits come back in force and the person get back all the weight lost and more, this is called a yoyo diet.

    Compensatory mechanisms follows the first law of thermodynamic.

    Energy needs are related to your mass, if you weight 100 kg and go down to 80 kg , you can not eat like person who weights 100 kg and expect to stay at 80 kg, unless you burn all excess calories in physical activities.

  17. Tor H
    So, how much more does a person that weight 100 kg need to eat to stay at the same weight compared to a one who weight 80 kg?

    What happens if the 100 kg person eat the same amount of calories from natural fat and moderate protein, will he gain weight or loose weight . . . . or perhaps stay the same?

    Reply: #18
  18. Pierre
    Weight of 100kg does not mean anything without knowing the body composition and the diet of that person.

    If you take a couch potato person with a crappy (grains ,sugary drink, etc) diet then you can expect these things to happen (same calorie intake).

    http://www.usefulthings.com/blog/wp-content/uploads/2014/05/couch-pot...

    1) Inflammation will disappear, the body will release all excess water, so here you have a weight loss.
    2) fecal matter stuck in the in the intestine will finally go out, here again you have a weight loss.
    3) lean mass should increase because of the better alimentation. here you have a weight gain.
    4) BMR will increase, so you can expect a fat loss.

    In the end the person should weight less, because the body composition will change according to the new diet.

  19. Tor H
    I was thinking more of this part of your comment:
    "Energy needs are related to your mass, if you weight 100 kg and go down to 80 kg , you can not eat like person who weights 100 kg and expect to stay at 80 kg, unless you burn all excess calories in physical activities."

    Let's say both the 100 kg person and the 80 kg person are weight stable. Does the 100 kg person need to eat more to stay at a stable 100 kg?

    Reply: #20
  20. Pierre
    The answer can be yes or no.

    It depends of their BMR and level of activities.

    http://www.hussmanfitness.org/bmrcalc.htm

  21. Tor H
    No, the only difference is their weight.
    Does the heavier person need to eat more to stay the same weight?
  22. Mathieu
    You've put "Exercise" in the "Lowers insulin" section. But I think it would be more accurate to add "Lack of exercise" as contributing to insulin resistance in the same area as Fructose is.

    Here's why: Exercise is not like "Fibre" or "Vinegar" or other macronutrient mixing strategies that blunt the insulin response. Rather, exercise has been shown to:

    - Improve insulin sensitivity in its own right by enhancing insulin stimulated GLUT4 translocation in cells. http://www.ncbi.nlm.nih.gov/pubmed/21352505

    - Lowers glycogen stores in both the liver and skeletal muscle, and therefore acts as a sort of "buffer" area for both incoming fructose (liver glycogen) and glucose (all glycogen) blunting those effects.

    - Increases fatty acid oxidation rates which lowers the risk that fatty acids will hang around in the bloodstream or accumulate in organs (fatty liver). Theoretically this should break a cycle of "gluconeogenesis->fatty accumulation->fatty liver->insulin resistant liver" (if done regularly) that can be brought on by by things like fructose.

    I'd note that LCHF people get the last two benefits without exercising :) But that doesn't mean exercise won't improve them further.

    However, you are also correct in having placed it where you did. Here's why: Exercise also lowers stress (unless overtraining) and improves sleep quality so it could just as well have been placed on the Cortisol part of the image too.

    Bottom line is: exercise, people!

  23. Vivien Schapendonk
    I think the effect of sleep deprivation is underestimated in your above schematic for 40 plus woman.. As an early 40s lady i have had zero weight decrease for 2 months. 2 nghts of melatonin and 2 kgs gone. Without good sleep weight lose is not possible for me
    Reply: #26
  24. E Dickey
    I am 70. I have very poor control. I take 75 units of Nova Rapid. I have a large tummy. Basketball size. I have been eating your food now and now eating 10 cups of salads, My sugar spikes and so edema on my ankles wit a remarkable red skin.. I have been told that Insulin Stop fat burning and enhance fat storage.

    So I challege any one to use me that knows what they are doing my condition. I am sure you just do not have my problem and once the insulin not work, Nothing will save me.

    I cut my protein to 2 eggs a day and2 bacon. Nothing for lunch with 10 cups of salad with 3 ounce of fry meats in butter. after which sugar goes up.

    if you cannot eamil send me phone and I will ring you

    ASAP!

    Thank you

    Reply: #25
  25. Bjarte Bakke Team Diet Doctor
    E Dickey, make sure you get your question answered by Andreas or one of our other experts by asking them directly on the membership site. You can try it for free for 30 days. I think they can give you some great advice.
  26. Bjarte Bakke Team Diet Doctor
    Vivien, have you tried adding a fasting regiment to LCHF? It works wonders and I'd recommend starting by skipping breakfast and only eating lunch and dinner 3 days a week. Learn more about intermittent fasting.

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