Six common beliefs addressed, Part 96 - Quack Edition

It if walks like a duck and acts like a duck, it is most likely a quack. 

There is a slew of so called "doctors", out there, that range from homeopaths to functional medicine doctors to chiropractors to primary care physicians, all putting their two cents into this way of eating. This is not to mention the circus of "specialists", who follow them, that range from dentists to cardiologists and everyone in between. We aren't even immune from all the coaches, trainers, armchair scientists, philanthropists, advocates, journalists and even the occasional engineer who also likes diving into the mix. Basically low carb is like one giant cluster %^&*. 

It seems like everyone has something to say about low carb diets and metabolism. That would be great. If only they were correct. This is precisely why low carb diets are not taken seriously and it took the American Diabetes Association (ADA) about 80 years to include them into its list of acceptable diets for diabetics. So, if low carb is not taken seriously by anyone, don't blame conventional medicine and blame its proponents instead. Some of which, by the way, should be in state hospitals because they are total loons. 

The problem with all these low carb people is that none seem to understand obesity. They just view obesity, as "being extra fat". Even the ones with an MD behind their name view obesity this way, which is pitiful. It's people's ignorance that helps them continue their "work". They purposely target people who are already at their wits end and are willing to listen to any snake oil salesman that comes their way. Then when the protocol doesn't work, the "doctor" has no answer for them, nor any alternative. 

Let's go through some of the most common pseudo science and misinformation that these doctors offer and clear them up. That way when you see any low carb doctor, out there, mentioning any of the things listed below, you will have a heads up to their BS.

• Drop your blood glucose, cure your disease - These doctors all jump on lowering blood glucose because it's so easy to. But metabolic dysfunction is not a "disease" of high blood glucose. It is a metabolic adaptation towards starvation which is triggered by large disparities in blood glucose, resulting in poor blood glucose regulation. This causes chronic insulin over expression/action which results in "insulin resistance". Insulin resistance culminates in metabolic syndrome which is basically a high glucose, insulin and body fat set point.
• Drop your insulin, cure your disease - These doctors are obsessed with insulin, but insulin is not an obesity hormone. It's actually an anti obesity hormone, if it's made to function for you rather than against you. So, don't let them solely demonize insulin, as insulin levels are not the only abnormality in overweight/obesity. You can have normal to low insulin levels and still have abnormal insulin expression/action. This means tissues and organs are insulin resistant, to varying degrees, while the fat mass becomes very insulin sensitive.
• You are very "insulin resistant" - No, you are simply insulin resistant, but not in your fat mass. You are very insulin sensitive at the fat mass. You are resistant in other tissues and organs to varying degrees.
• Obesity is the same as weight gain - Obesity is an adaptation towards starvation. Weight gain is normal and highly controlled. It includes lean muscle mass and water weight. Healthy people's weight gain is capped off and won't budge after a certain point. The same goes for its loss. This is not the case with obesity which is solely body fat. The overweight/obese will continue to store fat, well beyond their threshold. Their stored fat is also spared and never burned enough to allow it to lower. Instead, their body will not only store whatever they eat but also break down lean muscle mass into glucose and then convert it to fat in order to store even more. This is why obesity is sarcopenic.
• The metabolism of the obese is the same as a healthy persons and therefore, should respond to the same interventions - I know they want to make you believe that your metabolism works just like a healthy athletes, but that is simply not true. Overweight/obesity changes the rules. It is an adaptation that causes for metabolic hormones to behave differently than they would for a healthy athlete.
• The carb-insulin hypothesis excuse - No, carbs are not the root of all evil. These doctors want you to believe that carbs are the culprit to all your woes, but have no answers for you when you remain at 300 lbs, while following "keto" at 0 carbs. There are many things that contribute to obesity because there are many things that dysregulate blood glucose. Being obese is one of them. It's not just one thing. That's why obesity is not resolved by only addressing one thing. Aside from that, this hypothesis was debunked decades ago. Continuing to believe it, in this day and age, is akin to still believing in witchcraft.
• If restriction doesn't work, restrict some more - If you reduce your carbohydrates and are still obese, reducing protein won't make you slim. This is like playing 'Whack A Mole' without actually aiming for the mole. If the reduction of carbs is not working, it's not because you need to reduce them further or you need to reduce protein as well. What you need to reduce is your blood glucose dysregulation. You can start off doing this by reducing your fat intake and getting off the couch.
• If a little works, then a lot works better - Once you restrict carbohydrates and implement a fasting and exercise regimen, to your lifestyle and it's not working, you need to revisit your protocol and analyze where it can be going wrong.For instance, you might be restricting carbs, but still including sugar and grains in your diet. You might be fasting, but snacking through it. The answer is not to restrict more carbs and do more fasting. You have already topped out the benefits that you will ever get from these protocols. Doubling down on them won't achieve lasting, sustainable results.
• You have "leptin resistance" - Leptin is the most misunderstood hormone of all because it is a starvation hormone. Obese people are leptin resistant and it is only partially related to "leptin levels". In many obese people, leptin levels appear to be completely normal. This is because this hormone is purposely being under expressed in the hypothalamus, in the obese, regardless of its level.The obesity resistant have leptin sensitivity because their leptin expression is intact - not their leptin levels, but leptin expression. The obese do not possess this. Whatever benefits the healthy obtain from leptin, such as lots of fat burning and reduced hunger, is not the case for the obese.Leptin is a slave to insulin, not to what you eat. There is no diet that affects leptin in the long term. Leptin is only affected by two things - long term nutrient availability and exercise.
• Behavior has nothing to do with obesity - Overweight/obesity is a lifestyle choice. That is why it can only be treated through lifestyle changes. Behavior is a big contributor to overweight/obesity. I know that the diet realm is mostly dominated by women and has become a matriarchy, where it's all about "positivity" and "not blaming". But, on this blog, we do not see overweight/obesity, as something that is solely happening at the physical. It is also happening at the mental. We do not coddle obesity.
• If you can't beat them, join them - This is basically throwing in the towel. Once these doctors realize that their protocols don't work long term, or at all, they simply tell their followers to be happy with just being "healthy at any weight". No. That's a lie and it's a message that is not accepted on this blog. On this blog, overweight/obesity equates to not being healthy. Period.
• Calories are absolutely useless - Calories are mostly useless, not absolutely useless.These doctors tell you what you want to hear and every overweight/obese person wants to hear that calories are absolutely useless, so they can continue to eat unrestrained. The overweight/obese also like to hear that calories are all that matter, so they can continue to eat their junk with some restraint. Well, neither is true. For some obese people, macronutrient composition is simply not enough. They persistently continue to exhibit obesogenic behaviours that can only be reduced by adding caloric tracking to the mix. This tracking is not used to "sustain a deficit", but rather to prevent an excess or prevent a deficit, as these people cannot judge their own food intake. Some have no satiety signaling and often also suffer from disordered eating habits. These disordered eating habits can cause them to eat too much or not enough. Completely removing caloric tracking, as a tool, causes a disservice to these people.
• Exercise is not needed for weight loss - Again, these doctors tell you what you want to hear, so their Patreon accounts can continue to rise. The overweight/obese love to be told they can sit on the couch, all day. This has nothing to do with them being sloths. This has to do with a metabolism that is purposely holding onto energy, so it can divert it to the fat mass instead of work. This can be easily resolved by advising these folks to do low impact exercises that don't exceed their capacity, but still achieve results. You can not achieve proper leptin expression without exercise. No leptin expression - no fat loss.
• Your diet should be a mostly fat diet - You cannot replace carbohydrates with fat and expect to be lean. Impossible. Fat, like carbs, is an energy macronutrient that is stored into the adipose. I know all these ex/pro-vegan/vegetarian doctors want you to consume a load of fat, since the load of carbs they had promised would save you, is now killing you instead. They continue to do everything they can to find a way to keep you away from meat, so they went from carbs to fat. It doesn't work that way. Eat protein - get lean. Eat carbs and/or fat - stay fat.
• Cholesterol is completely benign - False. It is not completely benign. It is only benign if it is functioning properly and doing what it's supposed to do. This is completely determined by genetics. To throw out a blanket statement like "cholesterol is never bad" is malpractice. Of course, since these doctors are all considered quacks anyway, they are never held accountable for this misinformation.
• If it didn't fully work for obesity, it might partially work for everything else - Overreaching is a sign of desperation. When these doctors are left with a group of disgruntled patients that are still overweight, while on their protocols, they turn to nonsense such as telling you that they have reduced your risk of autoimmune, cancer, neurodegeneration and ingrown toenails. False. All of it. As long as you are still overweight/obese, you are at risk for all of those diseases and then some. You can't bait and switch. These doctors promise weight loss, but when they can't deliver, they decide to gaslight you, with other crap you never went to them for to begin with. If they couldn't even help you lose weight, what makes you think they can deliver on anything else? 

For this reason, this blog does not represent, is affiliated with, nor follows any doctor, program, group, protocol or any other nonsense that exists out there. There are a few carbohydrate restricted protocols, which we recommend, that have been designed by low carb doctors and/or advocates, but we only recommend their diets. Nothing else. Whatever else they speak on, is none of our concern. 

Each one has their own hypothesis, beliefs, etc and we don't care. We only go by what is currently known about overweight/obesity and metabolic function. Nothing else. If their diet is compatible with that, then we recommend it, but their BS is not included, as it's not a package deal.