Amputation
Nerve Damage
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THE OBESITY CODE COOKBOOK
not eating. If your body doesn’t count calories, why should you? A calo-
rie is purely a unit of energy borrowed from physics. The field of obesity
medicine, desperate for some simple measure of food energy, completely
ignored human physiology and turned to physics instead.
“A calorie is a calorie” soon became the statement du jour. It also gave
rise to a question: Are all calories of food energy equally fattening? The
answer to that is an emphatic no. One hundred calories of kale salad are
not as fattening as one hundred calories of candy. One hundred calories
of beans are not as fattening as one hundred calories of white bread and
jam. But for the last forty years, we have believed that all calories are
equally fattening.
And that’s why I wrote The Obesity Code. In that book, I drew on what
I learned over ten years of helping thousands of patients lose weight
through my Intensive Dietary Management program. Nutrition is the
key to metabolism, the process of breaking down food molecules to
provide energy (calories) for the body and using that energy to build,
maintain, and repair body tissues and allow the body to function effi-
ciently. To answer the all-important question—what are the underlying
causes of weight gain?—I started at the beginning, unraveled the calories
model, and explained what’s really going on: Obesity is a hormonal, not
a caloric, imbalance. And what we eat and when we eat are two major
influences on our ability to manage weight gain and weight loss.
Insulin
In our body, nothing happens by accident. Every single physiological
process is a tight orchestration of hormonal signals. Whether our heart
beats faster or slower is tightly controlled by hormones. Whether we
urinate a lot or a little is tightly controlled by hormones. Whether the
calories we eat are burned as energy or stored as body fat is also tightly
controlled by hormones. So, the main problem in terms of obesity is not
the number of calories we eat, but how they are spent. And the main
hormone we need to know about is insulin.
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introduction
Insulin is a fat-storing hormone. There’s nothing wrong with that—
that’s simply its job. When we eat, insulin production goes up, signaling
the body to store some food energy as body fat. When we don’t eat, insu-
lin production goes down, signaling the body to burn the stored energy
(body fat). Higher-than-usual insulin levels tell our body to store more
food energy as body fat.
Everything about human metabolism, including body weight,
depends upon hormonal signaling. A critical physiological variable such
as body fatness is not left up to the vagaries of daily caloric intake and
exercise. If early humans were too fat, they could not easily run and
catch prey, and they would be more easily caught themselves. If they
were too skinny, they would not be able to survive the lean times. Body
fatness is a critical determinant of species survival.
Figure 3: Weight Gain or Loss Depends Upon the Hormone Insulin
As such, we rely on hormones to precisely and tightly regulate body
fat. We don’t consciously control our body weight any more than we
control our heart rate or body temperature. These are automatically reg-
ulated, and so is our weight. Hormones tell us we are hungry (ghrelin).
Hormones tell us we are full (peptide YY, cholecystokinin). Hormones
increase energy expenditure (adrenalin). Hormones shut down energy
expenditure (thyroid hormone). Obesity is a hormonal dysregulation of fat
Fed State
Storing Food Energy
Burning Food Energy
Fasted State
Eat Food
Increase
Insulin
Store Sugar in Liver
Produce Fat in Liver
Burn Stored Sugar in Liver
Burn Fat in Liver
Decrease
Insulin
No Food
“Fasting”
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THE OBESITY CODE COOKBOOK
accumulation. We get fat because we’ve given our body the hormonal sig-
nal to gain body fat. The main hormonal signal is insulin, and that level
goes up or down according to our diet.
Insulin levels are almost 20 percent higher in obese people compared
to people within their
