1. Reducing calories does not mean you will be hungry and you will lose weight.
You cannot "out calorie" a bad diet. Calories do not have much of an effect on blood glucose regulation, so your metabolism does not change and continues on its trajectory towards obesity.
Hunger and further weight gain is a common effect of anyone who tries to be on a long term caloric deficit. Since the focus of the food that is being eaten, is calories, their affect on blood glucose goes ignored. So, you can still have a diet, which consists of "low calorie" yogurts, wheat thins, sugar free soda and 'Healthy Choice' TV dinners. This type of diet is obesogenic irrespective of calories because it is still disrupting proper blood glucose homeostasis. Macronutrient composition is still king when it comes to the effects on blood glucose.
Eat meat and vegetables. Why? Because those are the only two items in the food supply that will not disrupt your blood glucose. When eating a diet that is focused on blood glucose regulation, if you are still forced to track caloric intake, because you can't eat to satiety, then the calorie tracking will work as long as it's used to avoid excess and not to sustain a deficit.
Why would you need to avoid excess if calories don't mater? Because excess disrupts insulin/glucagon ratios and that affects blood glucose but it is not determined through calories. It is a direct hormonal reaction of the digestive process. The same thing occurs if you eat all of the time, instead of an excess in one sitting. This is why we do not recommend snacking, of any kind, on this blog.
2. Pregnant and breastfeeding women require more carbohydrates.
Children, pregnant women and/or breastfeeding women should follow their healthcare professional's recommended diet, since these people have specific requirements based on preexisting or newly developed conditions.
Having said that, humans are extremely adaptable and versatile when it comes to diet. In hunter/gatherer populations, women have successful pregnancies and breast feedings with diets that range anywhere between 80% carbs to 0% carbs. As long as the woman is eating enough nutrients, she should have no problems with less or no carbohydrates.
3. Does gastric bypass always work as a treatment for obesity?
Gastric bypass staples the stomach, but does not address blood glucose dysregulation. Gastric bypass can temporarily affect blood glucose through the restriction of total food consumed, which is the exact mechanism of calorie restriction. This effect on blood glucose can lower insulin levels and the person appears to lose weight but what they are really losing is mostly water and lean muscle mass. This is why you see many gastric bypass patients left as globs of fat. The fat is not being burned. It just sort of stays there until it is surgically removed.
Also, the person is not being properly taught what made them obese in the first place. They are still hanging on to the calories theory and they once again start regaining the weight as they focus on how much they are eating instead of what they are eating. The what is what affects blood glucose. These people will not only go right back to their usual eating habits, and regain the weight, stapling the stomach does not reverse the obesogenic adaptation of their metabolism. It actually make it worse so when they regain the weight, they regain it double. They continue having an obesogenic hormonal profile, but with a smaller stomach.
This doesn't mean that gastric bypass isn't beneficial for many. Some of these people are on death's door and this surgery bids them more time to try and get it together. It's just that, unfortunately, most never do.
4. Is hunger the main determiner of whether weight is lost and kept off?
The main determiner of whether weight is lost and kept off is how much proper blood glucose regulation you can regain and sustain. The premise is that if you can regain and sustain proper blood glucose regulation, you will regain insulin sensitivity and proper insulin expression. This in turn will break leptin resistance and body fat will be burned as leptin is a slave to insulin.
Leptin effects hunger, but not always in a negative way. Sometimes hunger is a sign that the body is burning body fat and requires additional fuel. How can you know the difference? Easy - results.
- Hunger while losing weight - Leptin is working very well. Even though you are hungry, and eating in response, you aren't gaining weight as leptin knows nutrients are coming in and it is safe to burn body fat.
- Hunger while gaining weight or being stalled - Leptin is not working properly. It is signaling for fuel, even though there is plenty in storage for use.
5. I was told that if you have issues with dairy, you should consume raw milk.
I know there is a huge debate about this and I don't wish to partake in it, as this blog is not about this type of nonsense, since it does not pertain to metabolism. So, my advice below is the only one I will give and then I'll move on from this topic.
I can only recommend that you use common sense. The selling of raw milk is illegal, in many states, and there is a reason for it. Milk is extremely perishable, since it is the most nutritious food on the planet. This means that every living thing is gunning for it, including bacteria and parasites that can make people very sick. The minute milk leaves the safety of the cow's immune system, it's up for grabs, so handling, transporting and storing raw milk is a delicate practice, which can turn deadly if it's not done properly. Even experienced dairy farms have had their share of contaminated milk. This is why pasteurization was created. It allows people access to safe milk, even if they don't live on or near a farm.
If you live on a farm and can drink the milk, as it's being squeezed directly from the cow's udder, you will be fine. If you don't, you take your chances. If you are having issues with dairy, stop consuming it. It makes no sense to trade in one potential issue for another. Though milk is the most nutritious food on the planet, you can live just fine without it. It is not essential for adults. It is only advantageous.
6. Is all weight loss healthy, regardless of how it's achieved, since weight loss is always the goal?
This is a very interesting question and the crux of long term weight management. Before I begin, let me clear something up in that statement in order to set up the context of my reply. Weight loss may be the goal, but how healthy it is depends on exactly what's being lost. Excess body fat is what's always healthy to lose. There is a difference between weight and body fat. It seems like people continue having a difficult time differentiating between the two. Weight is water, lean muscle mass and fat and body fat is well, just body fat. A healthy metabolism loses body fat, specifically. That's the "weight" you want to lose.
You may have heard this warning before, usually from mainstream medicine - "Don't lose weight in an unhealthy way." You will usually hear this if you tell your doctor that you are restricting carbohydrates or are fasting for a certain amount of time each day. Sometimes you might even hear it from a dietitian, if you tell them you are avoiding all sugar. They are correct. You can lose weight unhealthily, but unfortunately, these mainstream naysayers have it ass backwards. Their idea of why some weight loss methods are "unhealthy" is total BS.
Let's break this down to understand what's really unhealthy. Restricting carbs, fasting for a short duration and eliminating all sugar from the diet, will have 0 negative effects on metabolism, so all of the "weight loss", obtained from these protocols, is being lost in a healthy way.
But, let's say that someone decides to eat only 'one meal a day' (OMAD) and fast for the other 23 hours. They see they lose "weight" and continue doing this. Their one meal is restricted in carbohydrates, "keto style", because they found a "keto doctor" online and is taking their advice. Now they are part of the anecdotal charade, on the comments section of their favorite "low carb" page, since they lost more than 50 pounds doing this "keto/OMAD" diet.
A lone "troll" pipes up, in the comments, and makes the claim that this weight loss was achieved in a "unhealthy manner". The other obese commenters beat the troll right out of the page, since all they care about is that a fellow obese person lost a lot of weight, giving them hope for losing theirs. They don't need a Debbie Downer, at this party, taking that hope from them and telling them they are doing "something wrong". They all gear up for a 7 day "group fast". After all, if one of them lost more than 50 pounds on a 23 hour, daily fast, imagine all of the weight that will be lost if the fast is stretched for 7 whole days!
Then reality bites. None of them lose a pound, except for one, who loses a total of 3 pounds! Three years later the person who lost 50 pounds, gained 100 and disappears from the page. The troll who was mocked into hiatus, for saying the weight was lost unhealthily, silently smiles in the background, vindicated. The "doctor" that runs the page, keeps raking in the money and can care less about the personal plight of his followers. After all, there will be other anecdotal claims made, on his page, burying any "discrepancies", deep down under thousand of comments.
How did this happen? Because the troll who made the comment that this weight was being lost in an unhealthy way, was absolutely correct. I know to the obese "the ends justify the means", but the means always come back to haunt them. Losing weight through starvation methods, only causes metabolism to double down on its obesogenic adaptation, irrespective of the initial weight loss. There's a series of intertwined causes, which come together to create the perfect storm for this to occur.
- Too much loss of lean muscle mass - This is especially true if the obese person is also suffering from metabolic syndrome/diabetes. Hyperglucagonemia and over expression of the adrenal stress response helps break down the body, and everything that's eaten, into sugar and ultimately converted into more fat, at a rapid, unregulated rate. This means lean muscle mass is lost, while more body fat is gained, irrespective of the initial weight lost. The lost weight was mostly lean muscle mass, so the person is now fatter by volume and body fat is one the main catalysts that progresses the condition. This technically means they have more "disease" now, than when they started, but since they only care about what the scale says, they miss the forest for the trees.
- Doubling down on body fat gain - The obese person's fat mass is already adapted to over express a starvation response to any stimulus that signals to it a need to grow in number and size. Starvation is that perfect signal. Now the person can actually gain body fat easier. Now when their weight set point is challenged, below their starting point and no where near lean, they stall or begin gaining again, even more than before.
- Diets restricted in protein like online fad, "keto" diets.
- Fasting for excessive and chronic periods of time, which limits the ability to obtain enough nutrients and calories from only one meal. Technically calorie restriction because that's what fasts of long duration ultimately are.
- Re-feeding after long stretches of fasting. That's the perfect time for the body to acquire more body fat, so it can prepare for the next long fast. It does this by under expressing leptin action, in the brain, and over expressing insulin action at the fat cell.
- High energy intake. This is especially true of people who fast for long stretches, while also eating "keto". Their re-feeding consists of nothing, but high energy (fat), which goes directly into their fat mass.
This is why diabetics gain weight, rapidly and easily, once they acquire the disease. Metabolic syndrome/diabetes sufferers already have hyperglucagonemia and an exaggerated adrenal stress response, which spares fat mass, rather than burn it. Their leptin is already under expressed in the brain through abnormalities/damage in the hypothalamus from chronic leptin resistance and the taste of sweet. They just made it all worse by forcing the body into a "fake famine".
So yes. You can certainly lose weight in an unhealthy way, because it's not about what you can lose, it's about what you can keep lost. If you can't keep body fat lost, then it's as if you lost nothing, because you are making your metabolism unable to lose it next time. There's going to come a time when you really need to lose body fat, and not because you want to be ready for bikini season, but because you are developing diabetes. When that time comes and you can no longer lose any fat.....well, you know what occurs then - neuropathy, retinopathy, nephropathy, anemia, sepsis, cardiovascular disease, fatty liver disease, Type I diabetes, dementia and finally death.
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