Low carb explained

Do you want to know more about low carb as a treatment for obesity and disease? Perhaps nobody can explain it better or more enthusiastically than dr. Mary Vernon.

Mary Vernon, MD, is one of the world’s foremost experts on treating obesity and diabetes with low carbohydrate nutrition. She’s a practicing family physician, educates doctors on low carb and is active in and former president of the American Society of Bariatric Physicians (doctors specializing in treating obese patients).

This is an interview I did with her at the recent ASBP conference in Las Vegas.

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  1. Hi Andreas
    I love your interview series. Keep them up please.
    I noticed how you tried to confront Mary Vernon with the fatfobia of the US government, but that was dodged elegantly. I guess she is better of standing on a good foot with the officals and work for change in a more pragmamtic way :)
  2. Mo
    Another great infomative video. Thank you!
  3. Outstanding interview, Andreas! Mary is so easy to talk to and she makes so much sense. I love her response to calories. LOL!
  4. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Thanks all!

    Yes, Mary is very talented at giving interviews and a total pro. I messed up the recording (new equipment) and we had to restart everything twice before it worked. She didn't mind at all and just started again as happy as ever. She's great.

    PS: I have two more interviews coming up.

  5. Cindy Spalding
    Thanks for these videos, Andreas. Can't get enough of them. Great work!
  6. Garry
    Dr. Vernon mentions the Boden study at 31:07 when discussing spontaneous reduction in calorie intake. Here's the link to that study if anyone is interested: http://www.annals.org/content/142/6/403.full.pdf+html
  7. Petra

    I eat lowcarb for 1,5 years now and I feel great and energetic

  8. Susannah
    great stuff.. I can't believe how simple this really is. Been low carb for almost 3 months now. sure I have lost weight but I feel amazing. I feel relaxed but energetic.. it is a great way to feel. I am gliding on a consistent plane. Thank you for this great interivew doctors Eenfeldt and Vernon
  9. Esther
    Love this video. Who are the authors she mentions, though? "Mike and Mary Dan____"? Would love to know. Thanks for your website!
  10. Meghan
    @Esther, It's Mike and Mary Dan Eades.


  11. Mary B
    I eat very low carb (20 grams), but still don't lose weight. Perhaps too much protein? too many vegetables? (not starchy). Low carb for 2 years, lost 40 pounds in the first 5 months. I do feel great, but I would like to have less fat on my body. It just won't budge.
  12. eddie watts
    Great interview, i watched this morning as soon as it appeared on my facebook feed which i happened to be on.

    Mary B: probably best to write down everything you are eating and review the contents. are you doing any resistance exercise? i personally find this makes all the difference.

  13. Margaretrc
    @Mary, some say a short fast can kick start fat loss again? Worth a try. If you are keto adapted, which after 2 years you most certainly are, a short (half a day, one day) fast should be a piece of cake (sorry for the bad phrase, but it seemed appropriate!) And keep in mind that just because you aren't losing weight does not necessarily mean you aren't losing fat. Go by how your clothes fit rather than what the scale says. Muscle weighs more than fat--perhaps you are gaining muscle. Just some things to think about. In any case, sticking to it is the right thing to do! I haven't lost much weight, but my clothes fit a lot better than they did, my belly is flatter, and I have tons of energy, and that is more important to me than anything. I haven't been at it as long as you have, but I plan to.
  14. Doc,
    Do you know of any MD doing LCHF in Oslo or Bergen?
  15. As a follow-up, I would be more willing to take diet advice from Mat Lalonde, who is in great shape. Is this faulty logic? What do you guys think?
  16. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Sure. Dr Sofie Hexeberg is a very well known low carb positive MD in Oslo, with a big private practice. She is probably your best option by far:


  17. Thank you. I might be practicing in Bergen but I'm sure she will have a like minded MD there. I'm great with aches and pains but for anything metabolic I'd rather refer.
  18. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    I can certainly understand your thinking, but I think that it can easily be very misleading. Young men with lucky genes (and a gym membership) can often be in great shape while eating any amount of junk food.

    Postmenopausal women with another kind of genetic makeup may have a hard time staying really thin even when exercising and eating perfectly. It's far from a fair comparison.

  19. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    You'll be an expert in the metabolic stuff before you know it. ;)
  20. Esther
    @Meghan -- thanks!
    @MaryB -- Mary, do you suppose your body knows best? Perhaps you've levelled off because you're at a healthy weight (she talks about in the video at 17:00) or maybe you should do a food journal for awhile (18:00). I did that not long ago and was amazed the amount of food I was eating. Food journals aren't fun, but they can be enlightening! Congratulations on losing 40 lbs. I am inspired! 8-)
  21. @Doc, good point. What about someone like Mark Sission though--he's in great shape for his age. I know it is a very simple-minded way of looking at the big picture of nutrition and health, but I would expect that someone that knows a lot about these topics would look the part. Again, I don't mean to be offensive, just honest and perhaps a little deluded.
  22. Doc, in all honesty, I am already. As someone who has had all the biochem, human physiology and all the rest PLUS putting in hours and hours of my own time understanding the specifics of fat, protein and carbohydrate metabolism, I have a pretty good handle on things.


    I'm an ache and pains Chiropractor. I love treating people for pain, not for obesity (which I've fought with over the decades), hypertension or diabetes. I'd rather have them in the hands of a competent medical doctor. Plenty of pain for me to concentrate on in the world. I'm happy to refer and to share. Wrote to the good MD you referred me to; looking forward to her response.

    Thanks again.

  23. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Mark Sisson has a quite impressive physique for his age, I certainly agree. I'm sure a lot of people believe what he says because of it. Luckily Mark knows what he's talking about.

    Dr Vernon is older, a woman and don't necessarily spend her life exercising by the ocean though, so I don't think that is a fair comparison either.

    I also don't think that we must all look like fitness models at 50+ to be worth listening to.

  24. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Sure. It's always good for people on medication etc. to have a knowledgable medical doctor for support, just like dr Vernon points out in the interview.
  25. Suzie
    You are being offensive! Dr. Vernon has done immense good for the spreading the message of health. Not everyone who is healthy has to have a six pack and wants to spend a great amount of their time at the gym lifting weights. She wants to get the message out to the masses so people can improve their health which low carb will do very effectively. Besides, you can't really tell what she looks like from the video so who are you to judge? If your objective is a six pack and not health, then Mary would most likely prefer you get further advice from somewhere else.
  26. Good points Suzie. Let's talk openly and honestly. These are my honest reactions. Yes, I am judging, I think that's what we all naturally do, and I wish to point out these judgements so either I can learn more about why I am incorrect if that is the case, or I can teach others where they may be incorrect. The end goal is to make all of us better. We won't get there by biting our tongues or always being politically correct.

    It has been my understanding that optimal health is the goal in mind (which would obviously involve a combination of exercise, a super healthy diet, and lifestyle factors like minimizing stress and getting a good sleep). Perhaps that is too much of an assumption to make. Perhaps Mary isn't that interested in having a lean body as much as she's interested in helping others get there.

    I should tack on that I am grateful for people like Mary who have decided not to listen and blindly follow the recommendations and regimens of her peers, and instead do her own research and put enough faith in her conclusions to take them on herself and successfully recommend them to others.

  27. moreporkplease
    I don't mean to shock you Spencer but - wait for it - *women are different than men.* And older women are very different than younger men. Further, we aren't privy to Dr. Vernon's health issues. We rely upon her for her demonstrated medical knowledge and outstanding clinical techniques, which have effectively put many people's diabetes and heart disease into remission.

    Mark Sisson is a charming and upbeat person we all enjoy, but he is not a board-certified physician and specialist you can rely upon for medical advice. Nor does he claim to be. Dr. Vernon is a world-renowned expert.

    A recurring problem we have in the LC-Paleo community is that women scarcely exist to begin with, and the general attitude seems to be that older women should just shut up and die already because who cares about those elderly, fat, lazy, slothful broken people anyway? I hope we can help the community as a whole become more inclusive.

    And to do so means a lot of people may have to give us their emotional attachment to certain caveman metaphors that are not only scientifically questionable, but in the end block our progress.

  28. Suzie
    My grandmother was not thin. She never went to the doctor during her entire life except for childbirth and during her decline in the last 3 months of her life. The only exercise she did was daily walking. She was in her nineties when she died. I read that overweight (not obese) people live longer or at least as long as normal weight people. What about those healthly-looking marathon runners who damage their hearts? They all think that they are keeping themselves top shape! Are those muscular guys healthy who get that way by using steroids? Mary is a doctor who actually cures people of disease. She doesn't need to be anything more, certainly not someone who has to look as good as Mark Sisson.
  29. @moreporkplease, good points too.

    I don't think being a board-certified Dr or a world-expert means you can't be in great shape. However I think your point that Dr Vernon may have personal health issues that she would rather keep private is a sound one, and of course, this kind of blunt questioning may come across as digging too much. Maybe we should leave it at that.

    I definitely don't feel like the people you allude to, who think elderly women don't have a place or anything to offer. All I'm saying is that woman or not, my most immediate visceral reaction when I meet someone that gives any sort of health advice, whether it be a doctor, personal trainer, or anyone else, is how in shape do they look. And I think it is a common one.

  30. @Suzie

    1. Your grandma making it to 90 may be more a factor of genetics than exercise and diet. There's no way to say at this point. I don't think we have discovered the answer there yet.
    2. Marathon runners can be very healthy and usually eat a very clean diet, but the cortisol released from running such a long distance may counteract the effect of exercise. I wouldn't assume these runners are at optimum health. I think they do too much damage to themselves from excessive running.
    3. Not everyone with big muscles is on steroids or took them to get there. And the huuuuuuge guys that are on stage are often quite unhealthy, due of course to excessive drug use.

    Perhaps I have an image in my head of my own healthy person, and when others don't fit that ideal, I attribute less trust towards them. Do you think this could be the effect of marketing on our brains? This is the reason why you see a fit person on the box of some ab contraption. Everyone knows that person has never used that particular contraption to get into the shape they are in, and that they are only a model being paid to pose with it, yet many of us buy into it. I am curious what part of our brain/psychology acts like this. Perhaps it is a bias of some sort.

  31. Margaretrc
    Totally awesome interview! I'm encouraged that she, like you, is educating other physicians and not just the lay public. For every physician that buys into this approach and starts using it, there will be lots of people whose lives and health will be improved by this approach, in addition to all the people reached by your website and all the other low carb sites. Very encouraging.
    I'm intrigued by what she said about incretin. She didn't elaborate. Can you? Not sure there is much on the web that I, as a lay person, can access. Thanks.
  32. If someone is giving advice on being financially successful, they should have attained some level of monetary success. Likewise, if someone is giving advice on how to lose weight, they should have lost weight too, and Mary has done just that and she's kept it off.

    I guess that is where it is important to learn a little about people's story, and not stick to your snap judgement.

    On the other hand, if Mary had lost no weight and had gained weight, how would that change her image and her practice.

    @Margaretrc - great point, it's awesome that Mary is educating her peers so they can have a big effect on others.

    @Doc, I'll stop commenting about all this image stuff, it's probably too irrelevant to fill up these comments and don't want to distract from her message.

  33. Suzie
    I never said everyone who has muscles uses steroids. But you can't always tell by looking at them can you? Because you can't get past your image of perfection, you are judging a book by its cover. That is just stupid.
  34. To everyone giving Spencer a hard time: ease off, okay? Listen to his heart, respect his honesty. He's simply sharing his honest reaction to seeing someone who is offering health advice yet "seems" to have issues of their own in that area. If you did a street survey, you'd probably find it a common reaction. We all like to claim we don't "judge", yet we can't help forming conclusions on first appearances... it's just natural to do, try as we might Not to do it.

    And lest you think I am a young, hunky six packer guy... I am a 60 yr young, female, low carber who is ECSTATIC when I can lose one pound a week. I've lost 125 pounds already, but it's taken me many years. I'm the poster child for the metabolically challenged, menopausal female who struggles to lose, regardless of how "good" we think we are doing.

    But come on... how are we going to have an atmosphere of open and intelligent discussion if we jump down someone's throat for sharing their opinion. Spencer was respectful and calm, even when blasted. He gave thoughtful and insightful responses to all points. At least give him credit for his courtesy and honesty. I appreciate people like Spencer. And yes, I'm a fan of Dr Mary Vernon, lest I be misunderstood. :-)

  35. I wanted to comment on the issue of long-term low carb. I have lost weight successfully and stayed healthy eating a low carb diet, however after a year of this I started gaining weight. The first suggestion is that it might be carb-creep, but after a bit of research I added some carbs back in, in the evening. I found that my sleep improved and I felt warmer. I hadn't noticed a decline in my sleep and temperature, but the improvement made me realise that these conditions had developed while maintaining a low carb diet (which I love). I have adjusted this a bit to have some higher carb days once or twice or week, always avoiding wheat which I am sensitive to. Although I have lost weight I still carry a spare tyre. I take on board Mary's comment about not achieving a Barbie figure, especially now I am approaching 50. Any thoughts on the issue of long-term low carb? Mary obviously thinks it's fine but my experience questions this.
  36. Suzie
    Yes, I judge people too. However, Dr. Vernon doesn't have to be perfect for me to take her seriously. Am I the only one here who thinks she's okay just the way she is?
  37. Suzie
    I have been low carbing many years. If I do anything else I regain weight very fast. My success in keeping off my weight has been to weigh myself everyday and just make sure it stays off. I cut back on my food immediately and sometimes I fast. Weight has always been a struggle. For me, there are no other options to low carb because I don't want to be fat or hungry.
  38. Margaretrc
    @Loretta, good points, maybe, BUT, I am hard pressed to understand Spencer's comments anyway--I don't see any "issues" that would make her advice suspect. Dr. Vernon looks fine to me and clearly does not have any of the diseases she treats. She is doing what she is telling her patients to do and has been doing it for 13 years. She is not obese, is quite likely at a healthy weight for her, and is certainly healthy otherwise. Why would anyone require someone doling out diet and health advice/treatment to be of model quality in looks? Sorry, but I don't get it. To me, it's the sum total of her results that is important. If she said her patients didn't get better, if she were sick herself, there would be reason not to take her advice serioiusly. That's not the case. But if healthy good looks are what Spencer feels he needs to see to take advice about diet and health seriously, then he need look no further than the good doctor, himself, no?
  39. FrankG
    Having just been on Gary Taubes' blog: where some vicious troll is pointing fingers at everyone including Gary himself, Jimmy Moore and Robert Lustig calling them "fat" and the rest of us "zombies". I am not that surprised to see some open discussion over here concerning Mary Vernon's physique.

    Without meaning to be impolite to commentators here, or to Dr Vernon herself, I wanted to say that we actually see very little of her in this video to be making any kind of judgment, but from what we do see and to my thinking, she has a very healthy glow... she certainly did not strike me as person who is struggling with poor health -- quite the opposite in fact and I'd be honoured to accept dietary and other medical advice from her. She looks great!

    To offer a counterpoint: I've not only been recently active on Gary Taubes' blog but also Stephan Guyenet's blog, and to be honest, as a 50+ year old man who has struggled with obesity for the past 28 years (I was lean up until my late 20s) and now finally enjoying very much improved health in the last 3+ years since reading about LCHF -- I am more than a little annoyed to find myself preached at in a patronising manner by 20-30 somethings over there who have likely never seen more than 5lbs excess fat mass and yet consider themselves to know more about obesity than I ever could ;-) I doubt I will ever be back to the size I was in my early 20s but I am a darn sight healthier than I was 4 years ago.

  40. Science and results are what I *need* to take people's advice seriously. Having a fit body to go along with it reinforces that the person has been able to achieve the results they help others get. Is it necessary? No.

    Suzie and Jo: Dr Lustig talks about leptin resistance and its impacts on hunger and obesity here:
    In that talk he explains that doing low carb can put the body into starvation mode, and after initially losing weight, you may gain it back or simply halt further weight-loss. You ladies are both exercising in some manner too right? Besides the whole *it burns calories* argument (which actually isn't that significant), it optimizes your hormones. I don't have any links to studies for that but I'm sure you could find some without digging too much.

  41. FrankG
    @Jo #35 in regards long-term low carb and you adding some carbs back...

    As Dr Vernon discuses in this excellent interview (thank-you to both the Doctors), each of us may have a different tolerance for carbohydrates, and I see no reason why that individual tolerance level has to be "fixed" for life. For example: excess fat mass can increase Insulin Resistance (IR) which can result in reduced carbohydrate tolerance, but as you lose excess fat mass, the IR may be reduced such that you may find your tolerance for carbohydrates has been restored to a previous level.

  42. Suzie
    I lost weight a long time ago on low calorie - came off very fast and as soon as I ate anything that wasn't lettuce, it went back on just as fast. Once was enough of that. I know I have problems. I have been looking for solutions since I first got fat at 5 years old. I discovered low carb, and my appetite was under control for the first time in my life. Losing weight on low carb was actually kind of slow, but was able to keep what I lost off. I probably do have leptin problems, especially as I was obese as a young child. Even so, what is the solution beyond LCHF? Maybe there is some hormone thing that with testing would fix me right up (Dr. Kruse). I find I like the way I eat, and it works pretty well. I have started Dr Kruse's Leptin Reset, but because I've been messed up so long, I doubt that will fix me. Speaking of starvation mode - losing weight by low calorie (calories in/calories out) was starvation (never again!). Yes, I do exercise - walking and resistance training. I found I have to limit what I do or it makes me too hungry and I eat too much. LCHF saved my life!
  43. JAUS
    Wow, excellent interview! I'm very impressed by Dr Mary Vernon, she really knows her stuff. If I could choose only one clip about low carb to show others this would be it.
  44. Janknitz
    Awesome interview. She's wonderful! And you did a great job with the interview.

    Andreas, can you explain a little more about the incretin theory Mary spoke about and how it interacts with the insulin pathway? What kinds of medications are used to treat issues related to incretins?

  45. moreporkplease
    I hear you Frank G - the paleo/primal movement overall no longer is low-carb. After the Ancestral Health seminar, it seems to have swung into an interesting direction - one in which its youthful adherents believe they are now invincible cavemen who can eat all the steak, pizza, potatoes, rice, fruit and whatever they want.

    Calories in-calories out is false, they agree, and then go farther to say that if you just magically eat as much grass-fed meat and potatoes as you want - you'll be "shredded" like Mark Sisson and basically never age. The whole outlook is very Peter Pan, the usual "I'm 25 and immortal" attitude.

    Alas that the science is not with them, and no diet will prevent eventual aging and death. Their magical thinking would be charming if they weren't so abusive to everyone else. As for "primal" itself - when Mark suggested that folks start drinking feces(!), I think that whole movement jumped the shark, sadly.

  46. FrankG
    @Spencer #40... I'm confused by your comment regarding Dr Lustig's presentation where you say "In that talk he explains that doing low carb can put the body into starvation mode".

    I've watched this particular video a couple of times now and -- apart from the slides being out of synch at times -- I find it an excellent talk. However I recall nowhere where he says anything about low carb putting the body into starvation mode?

    Is this the presentation you meant to post and if so could you please provide some context or a time frame for where he discusses this? Many thanks

    I find it puzzling because from my perspective: one of the most important points about LCHF is that the body is well fed and has no need to respond as if in starvation -- because (unlike with a calorie restricted approach) it isn't starving ;-)

  47. Suzie
    I think Dr. Lustig talks about the fact that fat cells produce leptin and when you lose weight you have less leptin. That happens when you are starving or when you diet sucessfully. When you become leptin resistant the brain can't see the leptin anymore so it thinks you are starving. It wants you to gain weight. Dr. Lustig did talk about Leptin and its relationship to starvation in one of his talks, perhaps the one at AHS.
  48. @Frank I've been skimming through trying to find it and haven't. I'll watch the whole thing again eventually and take notes. For now, just ignore that I said that
  49. Suzie
    Also, I do not recall Dr. Lustig saying low carb makes you leptin resistant.
  50. Janknitz
    BTW, here's what dieticians think about Low Carb: http://healthline.healthology.com/diet/video2803.htm


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