The cover of Time magazine 3/2/15 features an Anglo baby (so remarkably cute one wonders whether he isn't a computer generated composite of everything we like about babies) with the statement (not question, statement) THIS BABY COULD LIVE TO BE 142 YEARS OLD.
The largest commercial weight loss program (with >40% of market share) in the world has adopted a strange new strategy: Switch the focus AWAY from weight!I'm not, like, a branding expert, or anything, but, didn't they kind of invent worrying about weight? Isn't that sort-of the Name of The Company?
My new book came out on Amazon yesterday, and as I breath a long sigh of relief, I'm reflecting on how I reached that milestone and how technology made it both easier and more difficult to achieve. If you are a writer looking to self-publish an eBook on science or any other complex subject, you might want to consider what I've learned over the last few months.
In previous posts, I've discussed the concept of protein leverage. This is an idea, put forward by two Australian scientists, Stephen Simpson and David Raubenheimer that many species, including humans, regulate appetite with a higher sensitivity to protein than other nutrients. We each need some amount of calories, carbohydrate, fat and protein each day. Simpson and Raubenheimer showed through a host of experiments that it seems we are willing to overeat energy (excess carbs or fat) in order to get enough protein.
Picture this: an anxious patient sits in the doctor's exam room. He has handed his health questionnaire to the receptionist detailing his diabetes, cholesterol problems, and hypertension. The nurse has checked his height and weight and recorded the numbers in his chart. He is ready for advice from the obesity doctor, hoping to learn how to get rid of some of the 100 pounds that has crept onto his body over the last few decades. The doctor enters and says, "Wow, Mr. Jones, that's quite an exercise problem you have! How long have you been suffering from this lack of exercise condition?"That would be a strange beginning, wouldn't it?
Many of my patients came to their first visit in the clinic and told me they were “a ticking time bomb.” Men, especially, seemed to have a view of themselves as a collection of risks that, left unchecked, would, without fail, cause them to have an early heart attack. When I asked them about how dangerous obesity, specifically, was to them, many patients would tell me that it can take ten or twenty years off their life…unless I could help them. Which, of course, was why they’d come to see me.In some cases, I agreed with them. They were thirty years old, weighed 400 pounds and had a medication list like a nursing home patient. Those guys, I worried about. But many of my weight management patients were 50-100 pounds overweight at age 50 and on just a couple medicines.
Working as an occupational medicine physician in 2003, I became interested in metabolic syndrome. I had a number of requests coming from corporate clients to address the rise of obesity and diabetes in the workforce. Human resource directors, wellness teams and CEOs were keenly aware that the health costs of their employees were driven more by lifestyle factors than anything else and I thought I might be able to help. Using the Diabetes Prevention Program as a model, I pitched and implemented a "metabolic clinic" for one of my client companies which performed yearly blood tests and wellness screens.
Portia De Rossi became famous playing Nelle on Ally McBeal in the 1990s and more recently as Lindsey Bluth on Arrested Development. She's a talented, funny actress, but more importantly: Portia De Rossi can write!Her 2010 anorexia memoir, Unbearable Lightness, is the best of the first-person examinations of how this disease plays upon the minds of its victims and the subtle nuances of its manifestations. What's refreshing about Ms. De Rossi's account is not its candor (it is candid, but several ANA books have been that), but the fact that it's written by someone who understands and pays attention to narrative.
Taking Andy Warhol's quip, "In the future, everyone will be world-famous for fifteen minutes," (which seems, like so many quotations, to have been stolen or mis-attributed) as a point of departure, Albert-Laszlo Barabasi hypothesized that perhaps the internet was the place where this prediction might be close to accurate. In his 2010 book "Bursts," Barabasi looks at many phenomena related to dispersion, starting with Einstein's thought experiments and predictions for a power law to describe the "random" movement of dust particles in water.
The realization that everything would be okay regarding the obesity epidemic occurred to me in a doughnut shop. It was the last week of my employment as a weight loss doctor and for years, my clinic had been a junk food free zone. This was not because I set rules based on a notion that junk food is bad for a person. I didn't and I don't really have much worry about sugary snacks. It just happened as a sort of accidental byproduct of what we were doing. If you talk about diet rules all day and see how hard the patients are working to eat better, it just feels wrong to have a big box of doughnuts in the break-room...or powdered sugar on your slacks.
Insulin does not control weight loss.Kevin Hall performs both theoretical and experimental studies in human metabolism at the NIDDK of NIH. This week, he and colleagues published an article in Cell Metabolism entitled, "Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity."I think it's going to piss some people off.For this reason, I decided to get my facts straight before writing about the study. Dr. Hall gave me some time on the phone earlier today. But before I get to his explanations, let me set up why, in diet research circles, this study is likely to have a large impact.
A new
patient sits across from me in the exam room, confused and frustrated at her
lack of progress trying to lose weight for the last 30 years. 200 pounds too
heavy, diagnosed with type 2 diabetes, high cholesterol, hypertension, sleep
apnea, infertility and osteoarthritis. She needs knee replacements, but is too
heavy to be approved for the surgery.
Protein trumps carbohydrate and fat as the regulated parameter driving human food consumption:Kevin Hall and Carson Chow published their estimation (in 2010) that the rise of obesity prevalence in the U.S. since the 1970s can be attributed to an increase in consumption of just seven calories per day per person. This is calculated by taking the average increase of energy stored in the heavier adult bodies of the present day, divided by the very long time frame it took for the change to occur.
