All About Calories

There are a lot of online back and forth debates over calories so I am going to skip all of that here as you can Google that BS for yourself. I won't talk about what a calorie is or whether they matter. Instead, I will be discussing calories in the context of obesity exclusively. 

You can not treat, what you don't understand so, I am going to focus on one thing - making you understand obesity. Once you understand what obesity is and what causes it, you can better treat it effectively without getting duped by a scammer or quack. First, as of this writing, there is no known cure for obesity but that doesn't mean you can't effectively treat and prevent it. You just can't do it with snake oil.

What is obesity? Obesity is a very complicated metabolic condition so I am going to break it down to the only thing that matters. Obesity is the chronic under expression of leptin (leptin resistance). Leptin is a hormone secreted from fat cells that helps to regulate body fat. It is a "starvation hormone" as it responds to long term nutrient availability. This under expression of leptin is triggered by metabolic abnormalities because leptin uses various metabolic markers to determine nutrient status. People with metabolic syndrome have an under expression of leptin which becomes worse as the condition progresses, and this is why they become obese over time. 

Everyday someone comes up with a new definition and cause for metabolic syndrome. Most are only half truths and the other are outright lies. A lot of these people do this out of sheer ignorance but others do it in order to sell you their "cure". Regardless of all the BS you come across on the internet, metabolic syndrome has only one definition - a cluster of biochemical and physiological abnormalities associated with the development of cardiovascular disease and type II diabetes. Metabolic syndrome also only has one cause and no known "cure". This is why every "cure" you have come across, has failed. 

Metabolic syndrome is caused by abnormal blood glucose regulation. Though many things can interfere with proper blood glucose control, 90% of the metabolic syndrome we see in modernity is lifestyle related. Diet and exercise are the main lifestyle factors that contribute to this condition. Metabolic syndrome is not a true "disease". It is a metabolic adaptation towards "starvation". This means metabolism is now adapted to behave as if you are starving. People with metabolic syndrome break down their bodies, and everything they eat, into glucose (hyperglycemia) and they store and spare body fat (obesity). This is exactly what would occur if you were starving. But why is this happening if you aren't truly starving?

The abnormal blood glucose regulation which causes this "starvation" response is initiated by large disparities between high (postprandial) and low (fasting) blood glucose. When you eat a high carbohydrate diet, postprandial blood glucose rises abnormally. This causes a prolonged overexpression of insulin in order to clear it. Because insulin had to be overexpressed, glucose clearance continues into the fasted state, dropping blood glucose too low. It is these lows that trigger the "starvation" mechanism. Large drops in blood glucose are always interpreted as starvation by the body. The body likes to keep its blood glucose well regulated, within a narrow range, so these fluctuations are detrimental to that goal.

These disparities in blood glucose deteriorate insulin function (insulin resistance) over time, causing metabolic syndrome and ending in type II diabetes. Type II diabetes is the end stage of metabolic syndrome. At this stage, the body tries to keep its blood glucose as high as it can, fasted or not, as a protective mechanism against lows. So in essence, type II diabetes is an adaptation towards hyperglycemia and insulin resistance is what helps perpetuate this goal. Insulin resistance occurs in multiple tissues to varying degrees and rates. This includes glucoregulatory systems including the hypothalamic/pituitary/adrenal axis (stress response) and energy utilization (leptin). This is why people with metabolic syndrome create excess blood glucose and have excess body fat.

That’s it. That’s the basics without all the unnecessary filler. Anything else is just plain BS. Everything you need to know is written above. If you want to prevent metabolic syndrome, you have to prevent blood glucose disparities. If you want to reverse metabolic syndrome or put your type II diabetes into remission, you have to lessen blood glucose disparities and then wait and see if you can regain proper insulin function over time.

So what does all of this have to do with calories? As of this writing, obesity is "treated" in the same way as weight gain. In fact, obesity is usually referred to as "weight gain" or "overweight" even though it is not. Obesity is no more "weight gain" than cachexia is "weight loss". Just like you can't treat cachexia with a surplus of calories, you can't treat obesity with a deficit. Normal weight gain or loss, which responds well to caloric information, are the normal fluctuations in primarily water and muscle and to a lesser degree fat. Body builders and some athletes have high body weight but are not obese. Obesity, on the other hand, is high body fat and low muscle mass (sarcopenia). But people, including your doctor, will continue on the trajectory of trying to "diet your obesity away", through caloric restriction. This is done to your detriment. Let's go through the current "treatment" for obesity. 

• Caloric restriction/fasting – These diets restrict calories from all sources.
• Low carb/ketogenic/carnivore* – These diets restrict or eliminate calories from carbohydrates exclusively.
• Low fat/"heart healthy"* – These diets restrict calories from fat, particularly saturated fat.
• Protein sparing modified fasts* – These diets restrict calories from both carbs and fat.
• Vegan/vegetarian/plant based* – These diets restrict or eliminate calories from animal protein and fat exclusively.

*All of these diets may also restrict total calories, along with their targeted ones. 

So, it doesn't matter what fancy name the diet mongers give their diet or how technical they are in describing it to you. It doesn't matter what they promise it can achieve or how different they claim it is from other "diets". That's all a sales pitch. Every diet's foundation is based on one or more of the above five principles. Period.

The person, who doesn't understand obesity, believes that the calorie restriction, in all these diets, is what will induce "weight loss" and so it doesn't matter how the calories are restricted or from what source as long as they are restricted. This is why they believe that all diets work. In reality, all diets work and all diets fail but not because of what you may think. It is often stated that all weight gain and loss is mitigated through calories and this is somewhat true because calories always affect insulin in the short term. So in reality, all weight gain and loss is mitigated through insulin. 

• All diets work because of one thing - their effect insulin. All diets lower insulin levels to some degree. This causes an immediate water weight loss. The initial stress response causes some muscle loss as well. 
• All diets fail because of one thing - their effect on leptin.  All calorie restricted diets further suppress leptin and this causes the inability to lose body fat. 

Since poor insulin function deteriorates leptin expression over time, we can hope that by improving insulin function, leptin expression will be regained and fat will be lost. Well, that's not the case. A temporary lowering of insulin does not correct its function and all diets are temporary. It is impossible to sustain caloric restriction in the long term. Obesity requires a long term solution. Lowering insulin levels also does not correct blood glucose dysregulation and unless this is corrected, insulin will continue to function poorly at any level. This means that lowering insulin works much better in reversing simple weight gain than obesity. It doesn't appear to make a dent on obesity, at least not significantly enough to no longer be obese. After all, in order to fix obesity you have to reverse the metabolic adaptation towards starvation. This cannot be accomplished with more starvation.

All of these diets have one other thing in common - they promise weight loss but they can never promise fat loss because none of them do a thing to improve leptin expression. Nada. Nothing. Zilch. Zero. It's as if you did nothing at all. Protein sparing modified fasts are the only diets that have had better success in addressing leptin but, the long term prognosis is poor as many iterations of these diets include leptin's kryptonite -  total caloric restriction. Low carb diets come in at a close second and have better long term success because they usually do not include total caloric restriction. Unfortunately, most of the calories, in these diets, come from fat instead of protein and this effects results. 

Worse still, the loss of body fat itself effects leptin expression adversely. So, in essence, the cure creates more of the disease. In summary, your metabolism will only allow your fat mass to be challenged up to a certain point and then it will prevent any further fat loss by under expressing leptin. This occurs to the obese at a much higher weight set point than the healthy. After all, they need this fat mass to protect them from starvation. This is why the healthy can become lean but the obese only become less obese as they remain in endless weight plateaus. That is if they are lucky and don't begin gaining weight instead.

This means you have to be realistic when following any diet. Instead of focusing on only the "diet", you need to focus on correcting blood glucose regulation because that's the culprit of metabolic disease. Hyperglycemia causes heart disease, kidney damage and neuropathy. Hypoglycemia causes type II diabetes. You need to follow a diet that prevents/minimizes blood glucose disparities so you can preserve its proper regulation through proper insulin function. This is not done through total caloric restriction as you can have very little calories and still experience blood glucose disparities depending on what type of calories you are consuming. Remember, diet isn't the only thing that disrupts proper blood glucose regulation, starvation does too. 

Some diets affect leptin adversely much more than others. Calorically restricted diets/fasting (starvation) are the main culprits of a doubling down of leptin under expression. So ditch the caloric restriction and focus on types of calories instead. The calories in each macronutrient is what send the information required to determine your metabolic state. You do not want to be in a metabolic state that catabolizes muscle and stores and spares body fat. 

You need to target insulin and leptin. The best way to do this is by starving the body of glucose and moderating its fat intake which affects insulin and keep protein adequate which affects leptin. Protein is the antidote to starvation. So the best diets are low in carbs, moderate in fat and adequate in protein. You need to be at a caloric surplus to gain muscle and a deficit to lose "weight" but you need the right macronutrient combination to lose fat. Muscle and water do not perpetuate type II diabetes, body fat does.