Obesity is like drowning


This is a great post by David Katz, MD. He says that obesity is “much more like drowning than a disease”:

Huffington Post: Obesity as a Disease: Why I Vote No

My only problem with his view is the obvious one. He blames surplus calories, but that’s not a problem unless we want to eat too much. Unless our appetite regulation does not work.

Get rid of all refined sugar and starch and most obese people can eat all they want and still lose excess weight. It’s been demonstrated in study after study. The trick? They no longer want to eat too much.

The problem is that our entire food supply is full of sugar and starch – it’s hard to find a processed food item without it – and it’s making us too hungry. Unless we cook our own meals from real food ingredients it’s getting harder and harder to avoid it.

It’s like a giant flood, everywhere. No wonder people are drowning.


  1. martinus
    I like the analogy with drowning. The argument that you got fat because you ate too many calories is like saying someone drowned because he swallowed too much water. Both completely true, and both completely useless because they don't say why.
  2. ZellZ
    I find his tone off-putting. He's writing about compassion, but I sense much judgement, just under the surface of what he writes. His tone is akin to: "why don't you fat people just stop feeling sorry for yourselves, get up off your fat backsides & just move more & eat as Dr. Dean Ornish (My Friend!) wants you to eat, fatties???" Sure, he didn't Write it in Those words, but it comes across that way to Me. And what about the fact that FORTY PERCENT OF THIN PEOPLE have metabolic illnesses, too, according to Dr. Robert Lustig???? That is a Sizable percentage of thin & normal weight people who are suffering. Of course it's much easier to target the Obviously sick ones, the fat ones (& 80% of fat people have metabolic impairments, according to Dr. Lustig), but focusing on fat people ONLY not only makes the stigma of obesity more intense, but it also gives a free pass all the normal weight folk who somehow think they are not going to ever have to deal with heart disease, strokes, diabetes & so forth, just because they can stick to a diet & somehow lose & keep off the weight. As for Dr. E's contention that fat people can lose all the weight they want to (or need to), just by cutting out refined sugars & starches, I'm not inclined to buy this view Either, nice as it sounds. I think obesity often is a more or less a Permanent condition once you have it. You can maybe lose some weight, but not much & all too often it comes *flooding* back. That is the Truth & I don't see this Dr. Katz taking Any note of it. Any food program or diet can Never be a panacea for bodies that have become adapted to being very large. At the most, all one can do is try to tamp down on the damage done, reverse some of it & do one's best. Sad to say, a fat person who is judged ruthlessly as being "lazy" and "gluttonous" might be a fat person who actually has done (& is Doing) much hard work by giving up All simple sugars & starches for a very long period of time. That takes strength & dedication! However, for many fat people who give up all the simple carbs you won't Necessarily see the results on the Outside of their bodies. A person may still be Quite Heavy, yet still in much better health than before giving up the simple carbs. One can't look inside this person's body & see the improved triglycerides, the good cholesterol raised & the reduction in visceral fat. Likewise, we can't look inside thin people & see all the visceral fat & other bad stuff lurking within. This is all quite personal for me. I don't like being told that I am drowning, when really: I am holding on to a raft, in fact. All others can see, though, is what I look like on the outside & I am judged accordingly. Meanwhile, all the normal weight people are like walking time bombs. Many are also in the long, slow process of "flipping" as Dr. Lustig writes. They won't Always be thin. Ok? I was once Thin. Quite Thin. And it was in trying to eat rabbit food that I got screwed up. And I got screwed up by feeling bad about myself, about how I looked (even though I looked Great) because I didn't look like a model. And I got screwed up by being Very prone to an addiction to sugar. And sugar was fed to me from a very young age in great amounts, but not even close to what kids are eating today, perhaps. And the more I ate, the worse I felt & the worse I felt the more I ate and my weight just kept going up & up. There was no way I could control it. Don't you think I Tried? Don't you think I was DESPERATE????!!!! But Addiction is stronger than anything else. It took me a long time to get where I am now with Improved health - but I am Not thin or even close to it! Vegans can have metabolic illnesses. Thin people can, too. And yet, one can be fat, but much improved in one's health. Does Dr. Katz care? He, like most, will just look at me and see a drowning woman. I am not the poster child of the lchf diet, that's for sure. I don't have tons of energy. I don't have a thin new shiny body. I just have some immense improvements, along w/all the continuing fallout that is from eating too much sugar, simple carbs, junk food. The only thing keeping me from Totally drowning is the fact that I kicked my intense, unrelenting, extremely aggressive sugar addiction, which was years in the making & just kept getting stronger & stronger as the years went by. I am Deeply Grateful the lchf diet for helping me do kick the habit (& Now I want to eat more fruits, more veggies, & even some whole grains, Maybe, because trying to do 20 carbs a day has now become extremely restrictive to me, so I want to branch out but Safely). One thing I Never want to do is go back to the HELL of sugar addiction. And I don't need to eat as Dr. Dean Ornish would have me eat, to keep the Sugar Monster at bay. But I Do appreciate the pages in Dr. Lustig's book, "Fat Chance", where there are many "green light" whole foods to eat. I'm Not sure that *I* can eat all of them: the whole grains & such, but I am willing to experiment & see what my body is capable of handling. Oh yes, and exercise. But it's got to be fun & at my own pace. And consistent. This all comes from Dr. Robert Lustig's book, "Fat Chance". I like this approach way more than Dr. Katz's. I don't know, maybe it's just me. Maybe it's just the tone. Dr. Lustig is pretty straight-forward, but I sense respect from him, for all us sufferers. And he Doesn't let thin people off the hook! (And he Does say Dean Ornish's way of eating is Fine for those who can stand to eat that way - so he's Really Honest. And I Appreciate that). Now, Gary Taubes, he would not recommend I try to experiment w/whole foods, but you know? I have to live my life not hating what I eat & I am beginning to hate just eating totally low carb all the time. So, I'm going to eat a mango & not fall to pieces over it & hopefully I won't gain weight, either. IF I am drowning, it's in all the diet advice that is out there.
  3. Christopher
    One more thing. What I find curious is that, especially in USA, most of those nutritionists/obesity/diet experts are medical practitioners. They are not biochemists, let alone human biochemists/physiologists. Listening or watching You-Tube videos of them explaining, say reasons for insulin resistance, adipose increase et cetera clearly shows that they have not an understanding of basics of human biochemistry. I suppose there is a developed trust in so called 'doctors' in general public on which they feed and make money.
  4. EnglishRose
    Yes, we are drowning in a sea of processed foods.
    What has worked for me (a sugar addict) is first move to three unprocessed healthy meals a day and keep fruit/chocolate only for after meals. Same times every day, regular as clockwork no snacks at all.

    Then remove the fruit/chocolate. I then had 3 weeks of "candida die off"/withdrawal which was fascinating, difficult and worst os all on day 21 which is amazingly late. Then suddenly woke up feeling fine and "off" the addictive substance. I always over ate fruit, 6 - 8 bananas, never one, massive loads of cherries and strawberries, 1000 calories of nuts and raisins at once. I was using fruit like chocolate.

    I kept in my brown rice and baked potato for the 3 weeks without chocolate/fruit.[I am female - i think that does make a difference with diet and eating and moods, PMT etc etc]

    Then I took out the potatoes/rice.
    Did not miss them. No carb or sugar cravings. Never hungry (I eat a lot of meat, fish, eggs, veg.) (Also I have never liked diary or milk or cheese but I have some butter on veg still. I gave up bread years ago as it makes my throat swell so that was no issue and I never had tea or coffee and drink only water so those aspects are easy for me and not for many people).

    Anyway my suggestion is just practical as to what might work for some other women - how to move yourself in a way that works to 3 meals a day no snacks. then cut out the fruit/chocolate, then the rice/potatoes and most importantly of all how that then feels like a change for life, no temptation to snack, no longer wanting the junk food and chocolate or even fruit and feeling full whilst losing weight. It works.

  5. Murray
    Drowning is a helpful metaphor, but the metaphor falters when pushed. Yes, most people do not have a pre-existing dysfunction before getting obese. But the imbalance and types of food eaten do cause, among other things, addiction and appetite dysregulation in many who eventually become obese as a result. Further, it appears prolonged continuation results in further dysregulation such as diminished carb tolerance, metabolic syndrome and diabetes.

    Drowning happens all at once. It is not as though submerging in water compels one to swim deeper and overrides the natural impulse to resurface for air. If drowning were stretched out for years and we detected the override of natural impulse to seek air, we might say the person was in a state of disease. Obesity seems to be the obverse of anorexia, which is viewed as a disease. The tragedy is that it appears that in most cases excess fat gain is initiated by a prolonged pattern of dietary choices unsuitable for that person's metabolism and could be prevented without medical intervention. The farther along, the more difficult to reverse, the more diseased the person becomes.

    What I admire about the LCHF people is that they have seen through the dogma of nutritional authorities and guidelines, which is plainly based on non-disinterested interpretations of data that bear different interpretations. Gary Taubes has done important work in debunking bad nutritional science (thanks in part to his science education) and presenting evidence that hormone dysfunction causes excess fat gain. ZellZ, I know Gary and he would not recommend avoiding whole foods. Lots of data supports excess insulin as a culprit and reducing insulin as a strategy to shed body fat. What foods and how much stimulate excess insulin varies person to person. And other factors can disturb insulin metabolism apart from diet. Bodies are complex.

  6. ZellZ

    Yes, I don't think Gary Taubes would be against whole foods & I do apologize for giving that impression. What I meant was his view (which I have read in his book, "Why We Get Fat") is that for people who have a lot of weight gain, they might run into problems even w/green leafy vegetables! From the carbs in those vegetables, I am assuming he means. Gary Taubes writes that the longer one has been ill, overweight & struggling, the less likely a hflc diet will result in weight loss. It will not work for everyone, at least for weight loss - or Enough weight loss to once again have a normal weight. I *think* I am getting it right, what he says. He doesn't hold out false hope. I would imagine that many if not all fat people go to a lchf diet to lose weight, first & foremost, even if they are also deeply concerned about related health conditions. Now, those conditions Can improve, even w/modest weight loss. Modest weight loss will still look like a "drowning person" to Dr. Katz (ie: a Fat person), though & to the person him or herself, they may feel very frustrated that they can't lose any more weight. That is my circumstance. Taubes would say to me (I'm guessing) to keep doing lchf, but I don't know if I can, anymore. I feel a desire for more fruits, for more veggies, for the occasional corn on the cob, with lots of butter & salt. I highly Doubt Taubes would recommend those whole foods for one such as me. But I am tired of so much meat & vegetables mainly. I don't know how long I can keep doing strict lchf. The thing is: I Was drowning, but now I have a raft: some degree of real weight loss & improved health. But you can't SEE it (unless you knew me at my heaviest). This constant emphasis on weight loss from everywhere & everyone might even be the very thing that pushes a person Off their chosen raft, too (lchf, or whole foods diet, abstaining from sugary & simple carbs).

  7. ZellZ
    And when I write "more fruits" what I mean is: doing a strict lchf diet, for a long time, I would sometimes allow myself desserts such as blue berries (only a very few, in a modest amount of high fat, plain yogurt). But now I want to eat mangoes, water melon, cherries, plums, peaches, etc. (Not like EnglishRose says she did, in extreme amounts, though). Actually, one of the Benefits of my having abstained from all simple carbs/sugars and most fruit for so long is that a plum now tastes incredibly decadent. I had one the other day. Wow, it was so sweet I could only finish Half of it! From a crazed binger of many years, eating cartons & cartons of Ben'NJerry's & tearing through boxes and boxes of icebox cakes & Entenmann's, that really Is an achievement, (that a plum now tastes like candy) I must say! The plum was Too sweet for me!!!!!
  8. ZellZ
    In essence: I don't know what is More dangerous for me:

    1. to continue to make myself do the lchf diet, until, possibly, I get SO sick of it that I become vulnerable to the extreme risk of having a regular dessert (I ain't talking fruit, here!) OR
    2. to experiment w/whole foods that would be deemed "too many carbs" on a strict, ketogenic diet, taking the risk that I will start to regain the weight I Have lost, plus the improved health I have already achieved.

    I guess the answer is obvious. Either strategy holds risks for me at this point, but I really think the strategy to eat more whole foods like fruits & a greater quantity of vegetables might keep me safe from the dietary evils that lurk everywhere.
    As EnglishRose says, we are "drowning in a sea of processed foods".
    I'm only human. I don't want to go back to bingeing, but the risk is always there. I have never found that my cravings have Completely gone away. So I must find new strategies to keep them at bay (more water comparisons, lol).
    One thing I enjoy on the hflc diet is that it IS High Fat. If I eat more whole, complex carb foods, will I have to reduce the amount of fat I eat? If so, will that happen naturally, as I eat more complex carb foods OR will I start to take in too much fat And too many carbs (albeit, from whole food sources), which doesn't sound good.
    I don't count a thing & that is never going to change.
    So, I'm very confused at this point.
    The lfhc diet works so well because people don't have to count calories (or even pay much
    attention to carb grams IF they really stick to the allowed foods). And all that high fat is VERY satiating!
    So I have LOVED the hflc diet for a long time, but now I am feeling like my body wants a change & I want to respect that w/o compromising my health.

  9. Deane Alban
    I loved Dr. Katz's opening line from the movie Jerry Maguire : "You complete me!" Drugs need diseases; diseases need drugs.

    I don't think it's a coincidence that a new weight loss drug was released at the same time as this change in obesity status.

    This is just another way the medical establishment can recommend more drugs and more gastric bypass surgery both a lot more profitable than educating patients on how to lose weight. And most doctors don't have a clue about that anyway.

  10. Jan
    Obesity is more like a ticking time bomb with the myriad of problems it can bring to our health, the cost to the NHS here in the UK as more demand is put on it due to health problems related to obesity.. There is so much sugar now almost hidden in foods that you buy. I agree the best thing is cook our own meals from good sourced healthy supplies.

    All the best Jan

  11. ZellZ
    "What type of fast food will the aliens prefer when they arrive and will it be the ultimate undoing of their civilization?" (Humor is Always good, no? This article is Extremely Amusing & we all can use a laugh, right? It's actually about daydreaming): http://www.nytimes.com/2013/06/23/opinion/sunday/how-to-daydream.html...
  12. Ondrej
    According to Reinhard Engels - founder of the NOS diet (http://nosdiet.com/) - regarding "fattening" carbohydrates:

    "As a friend of mine put it "I refuse to believe that bread, the biblical staff of life, the food that sustained our ancestors for so many generations, is bad for you."


    For those of you who are not so up on the bible, consider this: the obesity rates of France, Italy, and Japan are much lower than obesity rates in the United States. Though I don't have precise statistics, I'd bet money that the majority of calories consumed in these countries come from bread, pasta, and rice (respectively) -- the staples for which their cuisines are famous. And we're not talking brown rice, or whole grain bread, or amaranth pasta. We're talking the very refined stuff Atkins and his fellow gurus insist is so evil.

    The simple fact is that most people in the world for most of history have gotten most of their calories from carbohydrates, and most of them were skinny (too skinny!). Percentage wise, we eat far fewer carbs than they did. They were too poor to eat much protein or fat. Only rich people had meat regularly. Fat was a luxury; you hunted for eyes of it in your soup.

    What our skinny ancestors didn't eat was much sugar. They ate at social meals, not in between. And they were lucky if they had enough for firsts. Sound familiar?

    I'm not saying it's ideal to eat a ton of refined carbohydrates. I'm willing to concede that brown rice is (nutritionally) a better default starch that white rice, and I even happen to like it (short grain, at least). But it's not the chief issue, from a weight management perspective. The chief issue is not to eat too damn much, of anything. And the No S Diet helps you do that."

  13. ZellZ
    Eyes in soup? Doesn't sound so good.
    Don't eat too damn much of anything? Tell that to obese six month olds, please.
    (And to all the people struggling to do just that, but constantly failing. I guess they Want to be fat? Sure they do). Plus, let's Not forget what Dr. Lustig says: FORTY PERCENT OF *THIN* PEOPLE ALSO HAVE METABOLIC DISEASE. The same as the 80% of fat people who have it. Maybe you need to tell the Thin people not to eat so damn much? Or maybe not to eat (and drink) so damn many simple carbs & sugars, methinks....
    In fact, why don't you read Dr. Lustig's book, "Fat Chance"? Now, it's Not the bible,
    I grant you. However, the bible only matters to Any degree for those who are Christian....(and plus, even Christians have myriad Interpretations of it). So let's leave the bible out of it, for the general populace, who may be anything from Buddhist to Atheist.
    Targeting Atkins as a Guru is silly. He "merely" & brilliantly offered a way of eating that can counteract all the simple carbs that have caused so much damage to so many in the Current environment we all swim in. Not hard to grasp, really, that sometimes an Extreme Remedy must be given for an Extreme condition.
    Reply: #14
  14. Ondrej
    How does Dr. Lustig explain the above mentioned populations (Italy, France, Japan) that eat a higher percentage of carbs than US, are skinnier and have more longevity.
  15. moreporkplease

    "Though I don't have precise statistics, I'd bet money that the majority of calories consumed in these countries come from bread, pasta, and rice "

    How much money would you like to lose? :D I say this to you in the nicest possible way. Before you bet, please know it's easy to google a pile of consumption stats from various studies & gov't agencies. . . .I'm happy to take you to the cleaners big time. :)

    Do you know the French only eat about 3 oz of bread a day? And that the consumption of bread in France has been declining for a couple of decades? I suggest you review actual recent consumption stats from reliable agencies before you continue this line of argument. The stats you claim not to have are easy to find...and they destroy your argument.

    Best wishes. :D

    Replies: #18, #19
  16. ZellZ
    Dr. Lustig is big on 3 things, as far as I can tell:
    1. Exercise
    2. Fiber
    3. No Sugar (save for fruit & once a week splurges of desserts if one can do this w/o being addicted to sweets - or Bread!).
    Sugar is Extremely addictive & we now eat more of it than we ever did. Refined flour is also bad. Places that have traditional diets no doubt eat much fiber, get a lot of exercise & have people who have not become sickened on Western food. Even our whole foods are being tampered with. Meat has a lot of nasty stuff added to it, breads & grains become "simple" from too much taken out of them. Food in general, whole food, is good, according to Dr. Lustig. There are good, safe carbs. I don't think white bread is one of them. Especially not for people who are already sick from too many carbs. I see the Atkins diet as a Tool. It's a way to heal from the bad, addictive foods we have so much of but it's not a panacea. One can do Atkins in a bad way too, by eating a lot of processed meats & Atkins bars & diet soda & too few veggies. (Yet even this is no doubt far better than bingeing on junk, eating fast food stuff, etc). But you are just attacking Atkins in a willful, unreasonable way. Atkins can work when nothing else will, but we have to remember that THIN PEOPLE ARE GETTING METABOLIC DISEASE TOO. So probably Atkins would be good for Them, not just fat people. Eating a low carb diet, one's appetite Naturally starts to decrease, I guess because there is less insulin around to screw things up. Insulin hyper secretes from all the simple carbs people eat, all the sodas, cookies, cakes, candies, bagels & bread.
  17. Christopher
    Since there is a talk about our ancestors i.e.
    1) "I refuse to believe that bread, the biblical staff of life .."
    2) John McDougall's trump argument is that "...all successful civilizations obtained bulk of energy from starch..."
    I say, (without going to details , which You probably know anyway) yes it is true that bread was biblical stuff of life and during so called recorded human history most civilizations main energy source were carbohydrates. BUT bread, corn, wheat, et cetera was a food of the poor and laborers. Elite and ruling classes ate meat - in most cases meat of sacrificed animals during religious festivals, which were held almost weekly and were design,as they are now - as we all know, to keep masses under control. Peasants ate wheat, corn (and had life expectancy +- 35 years) fed wheat, corn to animals, took animals to the temple - priest ritually killed animal, took meat home after all was done and ate it with his/her family. And it is this upper meat eating classes which build civilization with slave-wheta fed labor. Please read history and archaeology of Sumer, Ancient Egypt, Mezo-America, Hebrew history (even in the bible it is clearly said that priests and kings main food was meat of sacrificed animals - by the way I do not belong to any organized religion) it is all in there. John McDougall needs to read more.
  18. Ondrej
    @ moreporkplease if you read my post you'll see that I'm quoting Engels not making a statement myself.

    Regardless, can you please list your source where the French only eat 3 oz o bread per day (I guess they throw away the rest of the bagette)?

    Dr. Attia, a staunch low carber, disagrees with you:


    What about the Italians and Japanese? Are they all N=1?

  19. Ondrej
    FYI, Engels statement is not just about bread, it's about carbohydrates, which clearly are not fattening as low carbers contend.
    Reply: #20
  20. Christopher
    "...which clearly are not fattening as low carbers contend."
    Ondrej please do not prove to every human being capable of rudimentary reasoning that You do not have, for some reason, a basic grasp of human energy metabolism. Please do not humiliate yourself - unless You do it on purpose, just to have fun.
    Reply: #21
  21. Ondrej
    Personal attacks will not disappear the fact that France, Italy and Japan eat high carbohydrate and are skinnier and healthier than US thus torpedoing the carbs make you fat myth.
    Reply: #43
  22. Ondrej
    BTW, according to New York Mayor Bloomberg Dr. Atkins was fat when he died from a heart attack.

    He said ". "Atkins is dead. I don't believe that bull---- that he dropped dead slipping on a sidewalk," Bloomberg suddenly said. "I actually went to his house out in Southampton for a Pataki fund-raiser two years ago," Bloomberg told the firefighters. "The guy was fat - big guy - but heavy. And the food was inedible. I took one appetizer and I had to spit it into my napkin."



  23. ZellZ
    Ondrej has a beef against Atkins, even though it's helped so many. Hey, Ondrej, eat as YOU wish to. No one is forcing You to eat the Atkins way, but many have & do & Love it & get better from it. And let's review: FORTY PERCENT OF THIN PEOPLE HAVE METABOLIC SYNDROME. So, being thin is no guarantee of being healthy.
  24. ZellZ
    If you read Dr. Lustig's book, you would discover that many diets can work to help people get better: the Ornish diet And the Atkins diet both work for many people. Does that make your head explode? Most people can't seem to grasp that many diets can be healthy if they sharply curtail sugar & include fiber & people exercise. Also, those who have never gotten sickened by an excess of simple carbs & Especially fructose, are different than those who have. Those who have need a diet that will help them heal & many chose Atkins. Bread is glucose. It's not as bad as fructose, according to Dr. Lustig. Sugar is both fructose & glucose & it's the fructose that is really bad. So, yes, people can eat bread & not everyone will get sick, but that in no way proves that Atkins is a bad diet. Your desperation to try to attack Atkins is based on nothing much but....desperation.
  25. EnglishRose
    Zell is right.
    In fact many commentators including Lustig make it clear there are plenty of routes to good health. My view and Lustigs is that sugar and fructose are particularly bad. Personally I don't think it makes too much difference if someone never eats baked or sweet potato or prefers white to brown rice, if they are eating in essence whole natural foods like that and lots of veg and protein or even if they are 100% vegetarian only eating natural veg, beans they will feel good.

    I think it helps for there only to be two way of eating camps - standard Western diet full of junk and mostly or only eating wholefoods. All of us in the latter camp are on the same said. Whether you are traditional Japanese eating your bit of rice with fish and veg or an Eskimo on 100% meat/fat or grubbing for roots in Africa

    I also suspect some of us including children of alcoholics in particular have big big problems with sugar. We all know some of us are more likely to be addicted to sugar and others can have the candy bar in the house and never eat it for months.

    Women may differ too as traditionally they were probably grubbing for roots and finding insects and berries all day and eating more regularly whilst minding children whilst men were off hunting and perhaps not eating for days.

    All of us are really on the same side. Most English people eat far far too much carb and nothing ilke enough protein. If they moved to a handful of brown carb, one of veg and one of meat 3 times a day they would be better. I at the moment as I am losing weight am not eating my brown or wild rice./baked/sweet potato but still have a good few vegetable carbs.

  26. Christophe
    A bit simplistic view, don't you think? we have to separate starch from added sugar.
    It's hard to blame bread and rice which have been feeding the world for more than 10000 years !!
  27. murray
    Curiously, anthropology shows the diseases of civilization, including obesity, have been around for about 10,000 years. Farmers figured out high-starch is the way to fatten livestock (the Biblical fatted calf) and even Roman Gladiators figured out that the way to bulk up on body fat (so that glancing sword slashes would not be fatal) was a high-starch diet. (Body builders have always been on the nutritional vanguard it seems.)

    Of course the trap is that correlation is plausible hypothesis, not causation. This is my concern with Paleo reasoning. I am with Konrad Lorenz: "It is a good morning exercise for a research scientist to discard a pet hypothesis every day before breakfast. It keeps him young." It also makes for more variety in what one eats for breakfast.

  28. Dr. Jason Fung
    While Dr. Katz is an eloquent and passionate writer, his solution to 'drowning' in calories is to teach people to 'eat less and move more'. The same failed paradigm of the last 40 years of nutritonal wasteland we have already endured. Dr. Katz seems to have very little understanding of what actually makes us fat (Insulin) other than "junk food and too little exercise made us fat". As some commentators note, there is also much judgement in his writings - along the lines of "you're fat and it's your fault - eat less and move more - fattie!" and his solution is so simplistic as to be completely ludicrous.
    Reply: #29
  29. Christopher
    But as You know Dr Fung, this is the party line (Dr Katz statement) and if some one is not a independent medical practitioner, if you do not hold partly line forget about your funding or career or both. Those of us who work in the field know that 90% of published papers pertaining to human nutrition describe experiments set up in such a way that to prove pre-existing concept - to ensure grant money for the next 2-3 years of completely meaning-less research.
  30. Christopher
    "Eat less exercise more", "all calories are equal" is a clever design strategy. It will never solve the problem of obesity thus will ensure endless supply ever-increasing money from Metabolic Syndrome Industry. As ZellZ pointed put up to 40% of people with metabolic syndrome are of normal weight but those people take drugs for e.g. blood pressure, cholesterol et cetera. It is all money game. I would say that 99% of family practitioners have no doubt that saturated animal fat is responsible for obesity and obesity is responsible for metabolic syndrome. It is how they are thought in med schools. Pleas go to your local med school and amuse yourself by asking final year med student what our brain uses for energy; she/he will say 'glucose' and if you say what about ketone bodies; she/he will say: ketone bodies are toxins produced when someone has diabetes type 1 or advanced type 2 - Jerry Seinfeld would not make better stand-up comedy out of modern metabolic classes in most medical schools, including those in the most so called prestigious Universities
    Reply: #31
  31. FrankG
    Unfortunately this is all too true :-( On my last two visits to a new Endocrinologist I spent the first half of each appointment with an intern, rotating through as part of their Medical Training -- a different intern in each case. Both times talk inevitably turned to cholesterol and their concern over my "slightly raised" LDL-C and both times the talk became somewhat tense as I pointed out my stellar HDL-C and very low Triglycerides. I have much less of issue with them having a difference of opinion regarding how to interpret these blood lipid results, than I do with their very telling and apparent complete lack of any knowledge that there was indeed any controversy about cholesterol. They had clearly been schooled in nothing but the "party line".

    It is one thing for long-qualified Doctors to be stuck in a rut (although professionally this should not be tolerated and my previous, past-retirement aged but very sharp Endo, was every bit as up to date on the research in this area as I find I have to be myself) but for fresh-faced graduates to be that way is pretty sad...

    Once again I find myself reaching for one of my favourite quotes

    “It is important that students bring a certain ragamuffin, barefoot irreverence to their studies; they are not here to worship what is known, but to question it.”
    ― Jacob Bronowski

    Reply: #32
  32. Christopher
    Sad thing is Frank that the only thing most of today's medical students question is, which state/country/hospital will give them the highest salaries - they do not need to question anything else - drug companies have all the answers for every question they have. Few years ago I was given to teach biochemistry to 3rd year medical students - I gave up after 2 weeks.
  33. Christopher
    low carbs/low fat debate (inspired by FrankG praying monks)
    Reply: #34
  34. FrankG
    "It's a fair cop..."

    And some of the logic used to try and buoy up low fat is just as convoluted :-P

    Reply: #35
  35. Christopher
    Frank, let us not elaborate any further...
  36. new bacteria
    They claim that It's not your fault you're fat: Obesity could be caused by gut bacteria rather than over-eating


    Read more: http://www.dailymail.co.uk/health/article-2250450/Obesity-caused-gut-...

    What is your oppinion about that?

    Reply: #38
  37. Christopher
    The interrelation between diet-microbiome-human physiology has been known for long time. The number of bacteria cells in our body is greater that the number of the cells of our body. Beautiful work exploring relation between diet-bacteria-obesity has been done by Prof. J. Gordon from Washington Uni., MO. more than 10 years ago. Microbiome will always react to diet change, and our body from genes level up to biochemical pathways will always react to change in microbiome. Life is an energy game. On set of microbiome will co-create, let's call it energy saving environment, another set - energy spending environment. BUT because diet influence this interplay we are the masters of the game. Just one example, as you know, medium chain fatty acids are strong antibacterial agents, severely reducing growth of most (if not all) tested human pathogens yet at the same time supporting the growth of so called good bacteria (e.g Lactic acid bacteria). By changing diet we change bugs in our gut. So let's not accuse bacteria for not be able to change what we put into our mouths-they only can grow on the stuff which we give them.
  38. Stephen
    Dr. Katz is in the set-point camp. That explains his thinking.
  39. Stephen
    Chris Kresser (http://chriskresser.com) posted a link to this interesting article about mid-victorian (1850-1880) diet and health.


    In short, they ate a diet of largely unprocessed whole foods and were very healthy. The only thing wrong with the western diet is its modern variant.

  40. EnglishRose
    Yes, although sugar crept in... the Addicted to Pleasure - Sugar episode http://www.youtube.com/watch?v=lG1CM7zXK5w looked at the sugar trade and what the Victorians in the UK started to eat - tea breaks, heavily sugared tea for the masses etc.
  41. JL
    Looking for help, so methods the have worked for people similar to me. American in France who was thin and sportive all her life that has been gaining visceral fat since age 45. After not being able to run like I've done all my adult life due to knee - cartilage usure, at 56 I now am reaching obesity no matter what I do. I have always eaten healthy, yes with periodic cookie or ice cream (periodic meaning a few times during the summer for ice cream or sweet carbs twice a week in the morning or afternoon, two-three cookies). I don't drink sodas and never have more than a few times a year. I eat vegetables and fruits daily; yes, I'm a 5 food groups person. Don't eat carbs very much, but hard to avoid in France (though I do a real good job of it). But here's the glitch, I'm definitely the apple-shaped, male body type, never had a gut, but never had a small waist even as a teen or young adult. I'm built like my father, solid, tall and thin (or at least I was). I also have always had a very slow metabolism, but because I ran a lot (4-5 times a week, over a hour each time and a few competitive runs a year), I was able to keep my weight to what I'm supposed to be nearer to 65 kg. Now, with menopause finally set, much less exercise, stress and poor sleep habits, despite eating properly, I'm 86 kg. I've tried no carbs (it gets me to 78-79 kg quickly, within a month or two), but I can't maintain the no carb-low carb. I've done all veggie for 21 days (only lost 500 g). Everyone says swim, but it stresses me and I really don't like it as a sport, never did. I run again because it's just what I've always done, but it doesn't help (not 4-5 times a week though, more like 2 x 30, to keep my knees in check). I've tried dancing on my Wii Fit (and though I'm not regular, it seems to give the boost lose; more effort with less time, so I think I need to add that regularly). All this to say, has anyone found a way to naturally be active and lose visceral fat - belly fat while not having some super structured regime? I'm so not into a 9 to 5 lifestyle, but willing to go to bed earlier and waking up earlier; that's about it.
  42. JL
    Old comment, but thought I'd reply as one living here. In these countries, people smoke a lot more as well and drink lots of coffee (strong), plus also take lots of antidepressants (at least in France), and walk and bike more (though they don't exercise more, but move regularly). Recall that stress is a big factor in weight gain, one that doctors overlook; who has had their doctor check cortisol levels? Also, persons from the European countries you mentioned have (had, because it's changing) better regulated lives; however, though they sleep little and late; so you have to look at the entire picture. Obesity is rising in France and in these countries, why because like elsewhere in the West, they are eating more processed foods and living busier more stressful lives.

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