Sunday, January 23, 2011

The New Paradigm of Obesity

So I've been thinking about what Gary Taubes is saying about obesity and what it means. What I have come to is that there is an alternative paradigm to how we traditionally view obesity. The current paradigm is obesity is caused by eating too much and not exercising enough (calories in, calories out). Now I've beat the dead horse on that on a previous blog but I wanted to talk about what could be a new paradigm.

As Gary Taubes is trying to say, obesity isn't a disorder of energy imbalance, or eating too much and exercising too little. Obesity can be thought of (and at it's root is) a disorder of fat accumulation. The body accumulates more fat than it needs. Period. So the question is, why? Is it simply because we are lazy gluttons? Or is the mode of the body to shuffle more calories to fat storage than required a driver of eating more and moving less?

He uses the metaphor of a child growing. The calories taken in by the child are not the cause of the growth but are driven by the growth. Indeed, we can stunt a child's growth by starving them. Could we not think of calorie restriction (conscious calorie restriction) as 'stunting' the body's drive to gain weight? So that as soon as calories are added back into the diet, the body's drive to gain weight continues to add fat back on?

Now most people I know who have had success restricting carbohydrates (but not calories) report that they are not as hungry. They are eating enough to satisfy themselves. And yet they lose weight.  As well, the studies that have honestly tested Atkins show a couple things. People lose more weight either by voluntarily eating less calories (they are not told to restrict them but they do so naturally) or they lose more weight eating more calories than someone losing the same amount of weight on traditional calorie restricted diets. Could we not potentially explain this phenomenon that whatever (insulin and insulin resistance) is driving the body to grow and therefore driving the behavior of eating more and exercising less has been removed from the equation and therefore the body is able to get more energy from the food ingested and is able to make up the rest of the required energy from the body? I don't know of another explanation. I'd like to hear what other people say.

So a lot of the criticism I've read of Taubes' books has said, well it's just calories in calories out. Then they go on to quote studies that had people supposedly following a low carb diet but really aren't when you look at the tables outlining the macronutrients that they ate. But what about those studies that show people eating low carb voluntarily eat less. Is that not showing that the drive to eat more and more calories is not there in people eating low carb?

It seems reasonable at least to look at the evidence that is there that people eat less when they don't have significant carbohydrate in their diet. Instead, the mainstream says it's all eat less and exercise. They ignore that there may be a biological reason that people eat too much and don't want to move. Why must it be weakness of character? My personal experience is that of someone who, when he restricts carbohydrates, loses weight without hunger and, when he does not, he is only able to lose weight through shear will power, fighting hunger and the drive to eat, and usually giving into tempation very quickly.

In a future post I'll go through the objections to a low carb diet. The ones that just turn my stomach with their stupidity.

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