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  • So what we're going to talk about today is really why?

  • intermittent fasting and low carbohydrate diets work Whereas the Calorie counters

  • It just doesn't seem to work right and the problem with the calorie

  • theory is [that] it's just like raw and

  • Because we don't really understand obesity

  • That's why we can't cure it right, so I'm sure many of you have seen this show. It's called the biggest loser and it's on

  • North America, it's in Australia

  • It's everywhere right and what people do is [they're] contestants that compete to lose weight, and they get put on a diet

  • It's a calorie reduce diet and they do a lot of exercise, and you've seen Jillian Michaels screaming at everybody, right?

  • So it's a lot of exercise, and they don't show it on the show, but there's actually a fairly severe caloric restriction as well

  • It's not a low carbohydrate diet

  • It's more of a kind of everything in moderation

  • sort of an approach, so the problem of course is that this show has been running for a long time and

  • Certain of the Contestants have come out and said well

  • [you] know this really doesn't work now the reason more haven't come out is because they're essentially under a legal gag order, right?

  • they're actually not allowed to say any of this stuff, but certain contestants have actually come out and

  • So this contestant Suzanne said well they never do a reunion show why they've all gain that weight again

  • and

  • It's not it's not

  • Unique to the biggest loser [a] lot of diets and we've all done these Calorie reduce diets

  • it does the same for everything it does fine for about six months, but then after that it just

  • Keeps coming back your weight plateaus then it starts to come back and everybody knows this right because everybody's done this diet

  • The question is why?

  • Right and that's what we really have to understand and that's what I mean by we have to solve the two compartment problem

  • And I'll explain that in a second so the biggest loser diet despite the fact that we all know it doesn't work is

  • actually ranked very highly so Usa news for example just this past year put the biggest loser diet at

  • Number three for weight loss and number 11 overall so really a very good diet and why not it's a eat less move more

  • Sort of approach, right cut your calories in increase your calories out and hey presto. You're going to lose weight

  • So that's why it does so well because all the doctors recommended and so on

  • The thing is that there have been some studies that have been done [on] these contestants, and it's very interesting to [look]

  • Scientifically at what actually happens to these people as they do this sort of eat

  • Less news more approach now the biggest loser of course is that approach on

  • Steroids [rates] or eating a lot less, and you're moving a lot more, and that's why you get these dramatic weight losses

  • So one season they actually took these contestants made them signed consents

  • And then actually did metabolic studies on them and what's interesting is that at first it looks amazing, [right]?

  • [and] [we've] all seen [that] show right the before on the after it looks amazing and

  • the studies really bear that out, so if you look at the before [and] after if you look at the

  • composition of weight loss so at week [six] and week 30 at the end of the

  • Show is week 30 you can see that. They've lost a lot of weight right. This is 60 kilograms right and this is

  • Fat mass so most of it is fat right everybody says [aw], you're going to lose muscle. You lose muscle another losing mostly fat

  • There's a little bit of muscle loss, but it's mostly fat

  • and this is their body fat percentage you can see it's follows a pretty steady trend downwards and

  • the average went from

  • 329 pounds to 202 pounds so an amazing result right body fat [went] from 49% to

  • 28% so at the end of the show you get these great results

  • You have the end of the show everybody wins and they pretend like everything's fine, but we know that it isn't

  • And why not? What's the problem? It sounds like it should work, right?

  • You keep doing what you're doing, and you'll keep losing weight

  • But you don't and the reason and we've known this for [at] least a hundred years is

  • that your metabolism starts to slow down, and this is what happened to the metabolism of all these contestants, and you can see in the

  • Solid bar that's their baseline rate of metabolism

  • Before they start at this and the open circles is that afterwards you can see that in virtually every case

  • These people are cutting the amount of calories they expend by a lot

  • okay, so you can look at some of these dramatic examples, so this fellow for example [list] starts out by

  • Earning Thirty five hundred calories a day and he's dropped all the way to about seventeen hundred [calories] a day, right

  • And it's not just him. It's everybody

  • if you take the entire group of people

  • the average

  • Decrease in metabolism is over seven hundred calories a day

  • right, so [if] you start by burning Thirty five hundred

  • Which is a lot, so you start at two thousand you're going to drop down to like

  • Twelve Thirteen hundred by the end of the show so you wonder why you're not losing weight?

  • well

  • It's because your metabolism has slowed down so much that if you're burning thirteen hundred and you are eating

  • [1,500] remember that's still a lot less than you used to eat

  • You're going to gain the [weight] back

  • That's exactly what we all know happens

  • you feel cold [you] feel tired if you're hungry, [you] feel like shit and

  • The weight is going back up

  • Right and that's the problem right we all know that's the problem. It's the decrease in metabolism

  • So you can try to make up for it with more exercise, right?

  • And that's what they pretend that you can do so you can see that baseline. There's a certain amount

  • Which is resting metabolic rate certain amount of exercise?

  • During the show they burn a hell of a lot of calories as exercise you see that the gram tops your total energy expenditure

  • Is better but when you stop exercising for like you know five hours a day?

  • Then your exercise goes down, but look at what's happened to your basal metabolism

  • This is your resting metabolic rate. It's already gone down by week six okay, so don't kid yourself

  • This is happening all the time

  • But by week [thirty], it's gone down even or and that's the whole problem you get this

  • Metabolic Slowdown and because you're not burning as much energy. You don't have that you know liveliness

  • You don't feel very good

  • And you can see this

  • In this graph you can see this is the biggest loser contestants, and you see that the basal metabolic rate just keeps on going down

  • But there's a similar

  • Extreme measure that doesn't seem to have this problem and the question is why?

  • So you can look at bariatric surgery so bariatric surgery is stomach stapling surgery, right?

  • So you cut your stomach into the size of a walnut you

  • Really just can't eat and you can't eat for months and months and months and guess what the weight goes down, right?

  • That's not a surprise

  • the surprise is that it works to keep weight off in the long term yeah, there are a lot of problems with this okay, so

  • Let's be clear. I'm not recommending it for anybody, right?

  • but if you look at the resting metabolic rate

  • with a similarly sort of extreme measure it goes back up the

  • [question] is why so this is another?

  • Study of the long-term effects of bariatrics and you can see that a baseline and a follow-up. This is several [years] [later]

  • The resting metabolic rate and the total energy expenditure how much energy you're burning has really not gone down

  • Right as opposed to the eat less move more where it keeps going down keeps going down until you fail, right?

  • That of course is the saddest part of all right the saddest part of the entire thing is that we know about this

  • metabolic slowdown this was shown in

  • 1915 so we've known about it for a hundred years

  • what I think is sad, is that we give people this really horrific advice to eat less and move more and

  • Then when they fail, we blame them for it

  • Right and that's basically. You're blaming the victim because here's this poor fellow or poor lady

  • Who's victimized?

  • Because they're suffering from obesity from type 2 diabetes you give them really bad advice

  • Which you know is going to fail because we've all done it it fails every single time and then when the weight goes back

  • You say yeah, you should have listened to me better. You should have had more willpower

  • you shouldn't have eaten that bagel or whatever it is you tell people right and that's really the saddest [part] of all is that we

  • Try to pretend that the advice that we give is really good and the failure lies with all of you

  • Right, but doesn't doesn't make any sense right? How can like?

  • forty fifty percent of the population

  • Be so morally bankrupt that they let this happen to them is it not more

  • Logical that the advice that we gave was just really crappy that seems to me much more sensible

  • So we're going to explain why this

  • sort of discrepancy exists

  • So in order to do that you have to understand what happens when you eat, okay?

  • [so] what happens when you eat? Is that insulin goes up? So most foods almost all foods have a

  • mixture of macronutrients [fat]

  • Carbohydrates and protein so your insulin goes up to a varying degree and insulin

  • Basically is the hormone that [tells] your body to store fat

  • So it stops your body from burning fat you start to store some of the sugar and store some of the fat

  • Okay, and this is normal. This is a normal situation

  • so

  • Carbohydrates get turned into glycogen which are chains of glucose so chains of glucose in the liver?

  • Is basically a storage form of sugar okay? And when you have too much of that then your liver produces?

  • Lipids which is called

  • De Novo lipogenesis, and it basically stores fat okay, so when you don't eat when you're fasting

  • So fasting is merely the absence of eating your insulin levels fall

  • And that's a signal to start pulling some of that energy out

  • Right so you're going to start by pulling some energy out from the glycogen

  • Which is your stored [sugar]?

  • And you're going to pour some pull some energy out [of] the stored fat so you can think of it the glycogen

  • Like a refrigerator right you're storing food energy

  • And the reason it's like [a] refrigerator

  • Is that it's easy to access so [you] can get put food in easily you can take food out easily, right?

  • It's just food energy and the fat is more like your freezer

  • Okay, so you can store more of it, but it's in your [basement]

  • You know it's hard to get to it's hard to get out

  • It's hard to put in so you generally prefer to use your refrigerator

  • and it's the same idea you have two storage forms of energy one easy to use and one not so easy to use the

  • refrigerator though has a limited capacity

  • [so] if you put if you have too much stuff you have no choice

  • But to put it in your freezer

  • Now the reason that the calories don't work is that they operate on what I call a one compartment model

  • Okay, so that means they pretend that all your calories goes in to your body

  • And it's all the same all your calories are the same

  • they're stored in one giant compartment like this sink and

  • When it comes to taking out energy it all comes out of the same thing

  • right therefore if you follow this sort of very simplistic

  • Incorrect model what you see is that if you simply reduce the calories going in?

  • You'll reduce your weight and if you increase the calories out you'll increase the rate

  • but the entire premise of this sort of calories in calories out model is

  • completely fictitious

  • because we know that's not what happens in the body the body doesn't have some giant vat of

  • Calories right you can store sugar you can store fat. It's not some giant vat of calories

  • That's held somewhere in your liver, right?

  • But that's what they all pretend it is so if you have the entire wrong idea of why this should work?

  • Then it's not going to work

  • What instead is?

  • A better model is a two compartment model that is there are two places in the body where you can store food?

  • You've got your fridge

  • And you've got your freezer your calories goes in into your fridge calories goes

  • From the fridge because that's the easiest place it goes, but there's a third thing that you have to consider

  • And that is how much food goes back and forth between the freezer and the fridge because that's what we're really interested in

  • this

  • the fat, but that's the one that's much harder to get to

  • Right and the question is what's controlling this?

  • because that's really the key and

  • It turns out that the main player is insulin we know this because insulin

  • inhibits lipolysis

  • Right what that means is it stops you from getting the fat coming out? That's a job

  • That's a normal job. So if you have a lot of insulin

  • right so normally if you eat a huge meal your insulin is high it's going to tell the body to move all the

  • Storage in this way if your insulin is very high then you can't get the food back out this way

  • And that's the problem

  • So if you have a lot of insulin resistance for example which keeps your insulin levels very high it's like that

  • Freezer is kind of locked away in the [basement] behind the lock you know steel bar. You can't get at it

  • so what happens now when you start reducing your calories if

  • you start reducing your calories in and

  • You can't get at your storage

  • What your body is simply going to do is reduce the calories out?

  • That's what it does right because it's not going to keep losing weight until you die

  • That's just ridiculous right, so if you look at the women's health initiative

  • Which was a huge fifty thousand person study. They reduce calories by

  • [350] Odd

  • per day for like seven years and they estimated that

  • People would lose 30 pounds women would lose 30 [pounds] per year

  • Right so in seven years. They should have lost 210 pounds right of course that didn't happen

  • [how] much did they lose not even a single pound it was ridiculous because?

  • What happened of course is that their body is if you're not affecting me in insulin you can't get at that fat?

  • You're just going to reduce [your] calorie though, and notice here of course that we're not breaking any laws of thermodynamics

  • right

  • Calories in calories out yeah, you're accounting for all the calories

  • [but] what's important is the compartmentalization of energy right?

  • That's what we're talking [about] not the total energy, but where it goes

  • Right because that's what we want to know if you eat, and you just burn [it] off

  • Who cares that'd be great?

  • But if you eat and all of it goes into fat well now you care a lot, right?

  • But it's not that calories [are] imbalance if you eat an extra 500 calories your body burns it all off as fat

  • Bob burns it all off as heat. Yeah who cares you don't have any extra body fat, but if you get 500 extra calories

  • Boom the insulin is telling it all to shunt into here. Well, that's a problem and

  • That's really the problem of the two compartment syndrome

  • So if you look at what happens during fasting?

  • What happens because everybody worries about this right? Oh, what [about] protein you're burning your muscle, right?

  • So this is a study by Kevin Hall

  • from the nih

  • And he basically looked what happens during fasting and this is what happens, right?

  • So for the first couple of days of fasting what you see is that carbohydrate oxidation goes off?

  • It goes way up right in other words. You're burning sugar you can see that fat doesn't actually move for a couple of days

  • You're not burning a hell of a lot of fat

  • Right and then as you run out [of] the glycogen remember that the glycogen is

  • You're easily accessed energy, but limited in terms of how much you can store once it all burns out

  • then look

  • Fat oxidation goes off now. You're burning fat for energy

  • That's perfect that's exactly [what] we want to do, but what happened to protein are you burning muscle?

  • Hell, no, it goes up slightly, okay at the very beginning then drops

  • So protein is not a storage form of energy

  • Why would your body burn it for energy, right?

  • You hear this argument all the time you're going [to] burn muscle

  • Right so it's ridiculous right because you're telling