The Obesity Code: Unlocking the Secrets of Weight Loss (Why Intermittent Fasting Is the Key to Controlling Your Weight)

by Jason Fung

Greater compliance was supposed to be one of the main benefits of the Atkins approach, since there was no need for calorie counting. However, following the severe food restrictions of Atkins proved no easier for dieters than conventional calorie counting. Compliance was equally low in both groups, with upwards of 40 percent abandoning the diet within one year.

Food is a celebration, and feasting has accompanied celebration throughout human history. This is as true in year 2015 AD as it was in year 2015 BC. Birthdays, weddings and holiday celebrations—what do we eat? Cake. Ice cream. Pie. Not whey powder shakes and lean pork. Why? Because we want to indulge. The Atkins diet does not allow for this simple fact, and that doomed it to failure.

So the carbohydrate-insulin hypothesis was not incorrect, but clearly something else was going on. Total carbohydrate intake was not the entire story. Sugar seemed to be contributing much more to obesity than other refined carbohydrates.

Similarly, natives of the Japanese island of Okinawa eat a diet that is nearly 85 percent unrefined carbohydrates. The dietary staple is sweet potato. They eat three times as many green and yellow vegetables, but only 25 percent of the sugar consumed by residents of nearby Japan. Despite the high intake of carbohydrates, there is virtually no obesity,

Currently, 99 percent of commercially grown wheat is dwarf and semi-dwarf varieties, and it may be that there are health implications of eating these new varieties of wheat.

Those who have been obese their entire lives find it extremely difficult to lose weight. In contrast, people with recent weight gain have a much, much easier time dropping the excess pounds.

If insulin resistance did not develop, the high insulin levels would rapidly lead to very, very low blood sugars. The resulting severe hypoglycemia would quickly lead to seizures and death. Since the body doesn’t want to die (and neither do we), it protects itself by developing insulin resistance—demonstrating homeostasis.

Men with no previous history of obesity, pre-diabetes or diabetes were given a ninety-six-hour constant intravenous infusion of insulin. By the end, their insulin sensitivity dropped by 20 percent to 40 percent.

Let’s assume breakfast is taken at 8 a.m. and dinner at 6 p.m. That means that they have balanced ten hours of eating with fourteen hours of fasting. The periods of increased insulin (feeding) are balanced by periods of decreased insulin (fasting).

So why was obesity slow to progress? The decisive difference is that there was a daily period of low insulin levels. Insulin resistance requires persistently high levels. The nightly fasting caused periods of very low insulin, so resistance could not develop. One of the key factors in obesity’s development was removed.

What would happen if daily eating opportunities are increased from three to six—which is exactly what’s happened since the 1970s. Moms everywhere knew that eating snacks all the time was a bad idea: “It’ll make you fat”; “You’ll ruin your dinner.” But nutritional authorities have now decided that snacking is actually good for us. That eating more often will make us thinner, as ridiculous as that sounds. Many obesity specialists and physicians suggest eating even more frequently, every 2.5 hours.

We obsess about what we should eat. We eat foods that practically didn’t exist ten years ago. Quinoa. Chia seeds. Acai berries. All in the hopes of making us slim. But we spare not even a single thought as to when we should be eating.

However, the overall difference is extremely small.12 Eating six small meals per day causes the metabolic rate to go up six times a day, but only a little. Eating three larger meals per day causes metabolic rate to go up three times a day, but a lot each time. In the end, it’s a wash.

The third myth is that eating frequently keeps blood glucose from becoming too low. But unless you have diabetes, your blood sugars are stable whether you eat six times a day or six times a month.

In order to accommodate all those eating opportunities, societal norms have also changed. Previously, all eating was done at mealtimes at a table. Now, it is acceptable to eat anywhere. We can eat in the car. We can eat in the movie theatre. We can eat in front of the TV. We can eat in front of the computer. We can eat while walking. We can eat while talking. We can eat in a box. We can eat with a fox. We can eat in a house. We can eat with a mouse. You get the picture.

So, do you really think we should eat six meals a day? While movies such as Super Size Me get all the headlines, and while people screech about portion control, the main culprit lies completely hidden—the insidious snack.

The 2013 Dallas Heart Walk organized by the AHA featured Frito-Lay as a prominent sponsor. The Heart and Stroke Foundation in Canada was no better. As noted on Dr. Yoni Freedhoff’s blog,2 a bottle of grape juice proudly bearing the Health Check contained ten teaspoons of sugar. The fact that these foods were pure sugar seemed not to bother anybody. Researchers

Subjects given mandatory snacks5 would consume slightly fewer calories at the subsequent meal, but not enough to offset the extra calories of the snack itself. This finding held true for both fatty and sugary snacks.

Many people in France (a famously skinny nation) drink coffee in the morning and skip breakfast. The French term for breakfast, petit déjeuner (little lunch) implicitly acknowledges that this meal should be kept small.

Every morning, just before we wake up, a natural circadian rhythm jolts our bodies with a heady mix of growth hormone, cortisol, epinephrine and norepinephrine (adrenalin).

Many people are not hungry in the morning. The natural cortisol and adrenalin released stimulates a mild flight-or-fight response, which activates the sympathetic nervous system. Our bodies are gearing up for action in the morning, not for eating. All these hormones release glucose into the blood for quick energy. We’re already gassed up and ready to go.

A large breakfast is thought to reduce food intake throughout the rest of the day. However, such does not always seem to be the case.10 Studies show that lunch and dinner portions tend to stay constant, regardless of the amount of calories taken at breakfast.

The vast majority (73 percent) of children regularly eat sugary cereals. By contrast, only 12 percent regularly eat eggs at breakfast.

Are you hungry at breakfast? If not, listen to your body and don’t eat. Does breakfast make you hungry? If you eat a slice of toast and drink a glass of orange juice in the morning—are you hungry an hour later? If so, then don’t eat breakfast. If you are hungry and want to eat breakfast, then do so. But avoid sugars and refined carbohydrates.

ONE OF THE most pervasive pieces of weight-loss advice is to eat more fruits and vegetables, which are undeniably relatively healthy foods. However, if your goal is to lose weight, then it logically follows that deliberately eating more of a healthy food is not beneficial unless it replaces something else in your diet that is less healthy. However, nutritional guidelines don’t state this.

In 2014, researchers gathered all available studies on increased intake of fruit-and-vegetable and weight loss.15 They could not find a single study to support this hypothesis. Combining all the studies did not show any weight-loss benefit either.

aptly termed diabesity. That high insulin levels cause both obesity and type 2 diabetes has profound implications. The treatment for both is to lower insulin levels, yet current treatments focus on increasing insulin levels, which is exactly wrong. Giving insulin for type 2 diabetes will worsen, not improve, the disease.

In 2011, the United States Public Interest Research Groups noted that “corn receives an astounding 29 percent of all U.S. agricultural subsidies, and wheat receives a further 12 percent.”

Insulin is the major hormonal driver of weight gain. Insulin causes adult obesity. Insulin causes newborn obesity. Insulin causes infant obesity. Insulin causes childhood obesity. Where would an infant get high insulin levels? From his or her mother.

Both Drs. Caballero and Nader, rather than questioning their prior beliefs, felt that their treatments did not go far enough—a stance that is psychologically much, much easier to maintain.

True socialism

By the year 2000, sugar-sweetened drinks provided 22 percent of the sugar found in the American diet, compared to 16 percent in 1970. No other food group even came close.1

By 2014, Coca Cola had faced nine consecutive years of sales decline as health concerns about sugar mounted.

Since 2007, 22 million Chinese were newly diagnosed with diabetes—a number close to the population of Australia.5 Things are even more shocking when you consider that only 1 percent of Chinese had type 2 diabetes in 1980.

It had previously been thought that complex carbohydrates were digested more slowly, causing less of a rise in blood sugar, but this is not true. For example, white bread, which is composed of complex carbohydrates, causes a very quick spike in blood sugar, almost as high as a sugar-sweetened drink.

Glucose was given the value of 100, and all other foods are measured against this yardstick. Bread, both whole wheat and white, has a glycemic index of 73, comparable to Coca-Cola, which has a value of 63. Peanuts, on the other hand, have a very low value of 7.

The body handles excess glucose consumption through several well-defined metabolic pathways, such as glycogen storage and de novo lipogenesis (creation of new fat). No such system is present for fructose. The more you eat, the more you metabolize. The bottom line is that excess fructose is changed into fat in the liver. High levels of fructose will cause fatty liver. Fatty liver is absolutely crucial to the development of insulin resistance in the liver.

Over the ten years of the Northern Manhattan Study,9 Dr. Hannah Gardener from the University of Miami found in 2012 that drinking diet soda was associated with a 43 percent increase in risk of vascular events (strokes and heart attacks). The 2008 Atherosclerosis Risk in Communities Study (ARIC)10 found a 34 percent increased incidence of metabolic syndrome in diet soda users, which is consistent with data from the 2007 Framingham Heart Study,11 which showed a 50 percent higher incidence of metabolic syndrome.

Despite reducing sugar, diet sodas do not reduce the risk of obesity, metabolic syndrome, strokes or heart attacks. But why? Because it is insulin, not calories, that ultimately drives obesity and metabolic syndrome.

Sucralose13 raises insulin by 20 percent, despite the fact that it contains no calories and no sugar. This insulin-raising effect has also been shown for other artificial sweeteners, including the “natural” sweetener stevia. Despite having a minimal effect on blood sugars, both aspartame and stevia raised insulin levels higher even than table sugar.

Artificial sweeteners may decrease calories and sugar, but not insulin. Yet it is insulin that drives weight gain and diabetes.

Conflicting reports such as these often generate confusion within nutritional science. One study will show a benefit and another study will show the exact opposite. Generally, the deciding factor is who paid for the study.

Western diets are characterized by one defining feature—and it’s not the amount of fat, salt, carbohydrate or protein. It’s the high amount of processing of foods.

The Nurses’ Health Studies I and II monitored the dietary records of thousands of women over many decades, and confirmed the protective effect of cereal-fiber intake.23, 24 Women who ate a high-glycemic index diet but also ate large amounts of cereal fiber are protected against type 2 diabetes. In essence, this diet is simultaneously high in “poison” and in “antidote.” The two cancel each other out with no net effect.

Carbohydrates in their natural, whole, unprocessed form, perhaps with the exception of honey, always contain fiber—which is precisely why junk food and fast food are so harmful. The processing and the addition of chemicals change the food into a form that our bodies have not evolved to handle. That is exactly why these foods are toxic.

THE WORD VINEGAR originates from the Latin words vinum acer, meaning sour wine. Wine, left undisturbed, eventually turns into vinegar (acetic acid).

Diluted vinegar is a traditional tonic for weight loss. Mention of this folk remedy is found as far back as 1825. British poet Lord Byron popularized vinegar as a weight-loss tonic and would reportedly go for days eating biscuits and potatoes soaked in vinegar.26 Other ways to use vinegar are to ingest several teaspoons of it prior to meals, or to drink it diluted in water at bedtime.

Two teaspoons of vinegar taken with a high-carbohydrate meal lowers blood sugar and insulin by as much as 34 percent, and taking it just before the meal was more effective than taking it five hours before meals.28 The addition of vinegar for sushi rice lowered the glycemic index of white rice by almost 40 percent.29 Addition of pickled vegetables and fermented soybeans (nattō) also significantly lowered the glycemic index of the rice.

Interestingly, peanuts also resulted in a reduction of glycemic response by 55 percent.33 It’s not known how acetic

There are essential fatty acids, such as the omega 3 and omega 6 fats, and essential amino acids, such as phenylalanine, valine and threonine. But there are no essential carbohydrates and no essential sugars. Those are not required for survival.

Another criticism leveled at the low-carb diets is that much of the initial weight loss that dieters experience is water—which is true. High carbohydrate intake increases insulin, and insulin stimulates the kidney to reabsorb water. Lowering insulin therefore causes excretion of the excess water. But why is this bad? Who wants swollen ankles?