Is elevated insulin why we get fat?

Is obesity caused by consuming excess calories? Or is it, in fact, the actions of our metabolism and hormones — especially elevated insulin — that make us fat?

An engaging editorial in the Los Angeles Times is explaining that it could well be the latter.

Written by US science writer Sam Apple, the op-ed describes for the lay reader the nuanced, scientific debate about the carbohydrate-insulin model (CIM) of obesity.

Apple’s opinion piece was prompted by a recent journal publication by Harvard Professor Dr. David Ludwig and 16 other prominent scientists and clinicians from across the spectrum of research into obesity’s causes. That paper explored the arguments around excess calories versus CIM as the cause of the obesity epidemic with notable balance and reflection.

Translating that landmark publication into plain language, Apple says, via the authors, that maybe we have made no progress reversing the relentless rise of obesity over the past 40 years because we have misunderstood the fundamental cause of why we get fat.

Los Angeles Times: Do we really know what makes us fat?

American Journal of Clinical Nutrition: The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

In the LA Times piece, Apple describes the carbohydrate-insulin model this way:

“We become obese because our bodies secrete too much of the hormone insulin, which instructs our fat cells to take up and store fat. Insulin functions like a supervisor at a food warehouse. It directs the trucks dropping off their loads in the warehouse and then locks the doors. Our bodies may have more than enough stored fuel, but if insulin levels remain elevated, the fuel can’t escape our fat tissue to nourish the rest of the body. We begin to feel weak and hungry. And we eat more.”

Diet Doctor Medical Director, Dr. Bret Scher, MD, also recently discussed the influential paper by Ludwig and co-authors in a special video on Diet Doctor’s Youtube Channel.

“The paper does a fantastic job of exploring the details and the specifics. It isn’t about ‘who wins.’ It’s about understanding the complex field of nutrition and obesity and how that affects people in the real world,” Dr. Scher says.

Both Apple and Dr. Scher note that if the authors of the Clinical Nutrition article are right, and obesity is fundamentally a hormonal and metabolic issue, then one important way to treat it is by reducing carbohydrates. Doing so lowers insulin, allowing our fat cells to release the calories they are storing.

Writes Apple: [If CIM is correct] “….we should replace the refined carbohydrates in our diets with healthy fats and protein without much concern for counting calories.”

Although Dr. Scher warns, “Saying CIM is ‘right’ doesn’t mean it explains everything about gaining weight. To me, it means it is an important contributor that we need to recognize, but many other factors intersect to contribute to weight gain as well, including calories and the quality of the food we eat.”

Do you want to try a low-carb diet to improve your metabolic health, reverse your type 2 diabetes, or help you lose weight? Diet Doctor can help. We are the largest and most trusted source for evidence-based, low-carb, and keto diet health information. And we also provide users with recipes and support.