Six common beliefs addressed, Part 205

1. The diet industry seems to be unaware of leptin. 

Like all other metabolic hormones, leptin has had its “Fifteen Minutes of Fame”, in the diet sphere, for all the wrong reasons. This is a shame because leptin is central to obesity. These diet mongers are constantly focusing on targeting one metabolic system or the other in the exact same useless way – by eating less. So here are some basic things that are known about leptin, as of this post, without the BS:

• Leptin sends a signal to your brain that helps you feel full and less interested in food. Because of this you may hear leptin described as a "satiety hormone", in weight loss circles, though this is not a correct description. Inducing satiety is still believed to be the Holy Grail for combating obesity, since the consensus is that the obese are fat due to being "hungry all the time". But when you get away from the shenanigans, the reality is that leptin is better described as a “starvation hormone” because it determines how and when your body turns fat into energy. When leptin is working properly, it signals satiety through the burning of fat. It doesn't signal it just because it's present.
• Leptin is mostly made by your fat cells but your stomach also releases some when you eat. Leptin circulates in your bloodstream and travels to your brain where it delivers the message that you have enough fuel so you don't need more (satiation). But the real magic is that leptin now signals to the brain that it can burn the fat you have stored.
• Leptin suppresses appetite, in a healthy manner, when it burns fat for fuel. Again, the suppression of appetite is overly emphasized as it is believed the obese eat uncontrollably. The reality is that when you have proper leptin expression, it helps you maintain a healthy weight by balancing the amount of food you eat with how much fat you burn. The amount of food eaten is inconsequential to this process. The important process is in how much fat you burn. We know this from starvation studies where people were chronically over or under fed. The overfed simply burned more fat and refused to eat. They put on a capped amount of temporary weight and never became obese. We see this effect in healthy people who are struggling to put on weight and simply cannot, no matter how much they eat. The underfed simply burned less fat and their appetites tapered down with time. They lost a capped amount of temporary weight and then refused to lose more. We also see this effect in the overweight/obese who are struggling to lose weight and simply cannot, no matter how little they eat. So the real problem with obesity is not in how much you eat but in how little you burn.
• Fasting for several hours can cause your leptin levels to lower. The more you fast, the less hungry you become. This is the unhealthy way that leptin suppresses appetite. As you can see less hunger is not always a good sign so it shouldn't be a primary goal in weight loss. You could be hungry or not hungry and still not burn fat. Again, the problem is in how little you burn.
• Chronic inflammation and high levels of triglycerides can make it more difficult for leptin to cross the blood-brain barrier.
• People with leptin deficiency are prone to early onset obesity. They need daily doses of a leptin-like protein to control their weight. This same treatment cannot be given to people with "leptin resistance" as their problem is not insufficient leptin but poor leptin expression. It is still being researched whether this poor leptin expression occurs at the fat cell, the brain or both. Until this is known, leptin cannot be targeted with medications for the treatment of obesity.
• Leptin also works with other systems in the body, including immune cells. A strong immune response is a good thing when you’re sick, but chronic inflammation from an overactive immune system causes health problems. People who have obesity and high leptin serum levels often have chronic inflammation. This is linked to cardiovascular diseases, insulin resistance and cancer.
• There are no obesity treatments which use leptin at the current moment for the issues discussed above, but it has been used in obesity research. Over the counter "leptin" supplements are just caffeine riddled junk food. Remember, the problem is not leptin serum levels but its expression on fat cells and the brain. Supplements do not resolve this. If they did, the pharmaceutical companies would already have a leptin medication for the treatment of obesity but they do not. Obesity is still a condition with no known cure.

As you can see, leptin is quite complicated as are all systems in our bodies. Maybe in the future some breakthrough will be found where this hormone can be targeted for obesity treatments but as of today, there just isn't enough information on how or why it malfunctions to cause obesity. The research appears to be pointing towards the most likely explanation that leptin is not malfunctioning at all but acting in accordance to a metabolic profile of starvation which is set in motion by other factors, like blood glucose dysregulation.

2. Overeating eventually leads to obesity.

In a healthy person, "overeating", in of itself, cannot lead to obesity as their metabolism truly regulates the balance between what’s coming in and what’s going out. We do know that "overeating" does have an effect on the glucagon/insulin ratio of people who already have metabolic syndrome. This effects blood glucose homeostasis, progressing the condition further. So there is a clear and distinct difference when it comes to "overeating" between the healthy and the metabolically impaired.

We have evolved with mechanisms that prevent "overeating" so the conversation shouldn't be about "overeating" but about what you're burning. The path to obesity is set in motion through blood glucose dysregulation, not total calories (overeating). We have fail-safes to prevent "overeating" but there are no fail-safes to prevent blood glucose dysregulation. Blood glucose dysregulation stops the "burning" of fat.

This blood glucose dysregulation occurs from consuming a completely normal plate of pasta with no "overeating" required. The blood glucose dysregulation from the pasta will cause you to become overweight over time. In response, you will reduce the pasta in order to try to "control your weight". You think its calories but in reality, the less pasta you eat, the less blood glucose dysregulation you experience. This makes you not gain more weight and so you falsely believe that eating less, across the board, is helping you but in reality you're only reinforcing the starvation response that you already induced with the blood glucose dysregulation caused by the pasta. You haven't gained more weight but you also haven't lost a pound and you will gain more in time. This will cause you to double down on eating even less and your metabolism will double down on keeping you fat. You are on the road to diabetes, all while preventing "overeating" but ignoring your blood glucose dysregulation. You will go from overweight to obese rather rapidly.

This is why we refrain from throwing around ambiguous terms like "overeating". You have to be able to define what you mean by "overeating". What are you "overeating" and according to what criteria? The only criteria should be your macros, calculated by your body fat percentage and goals because the only thing you should be concerned with is "under burning" fat, instead of "overeating" calories.

3. I cannot lose weight. I have tried everything. I have been at this for decades with no headway. I am now a senior citizen and tired of struggling with my weight. I don’t want to spend the rest of my years like this anymore. I don’t want to be lied to anymore. I am at a time in my life where I can take the truth. Will I ever be able to lose weight?

I cannot make predictions of this sort with finality but I can say that you can safely assume you will never lose weight. At least, not body fat. For some, proper leptin expression will simply never occur. This is most likely the result of hypothalamic damage, which is still being researched in obesity.

At this point, you would have to take draconian actions in order to lose body fat. After all, everyone can lose weight. These actions would be unhealthy and not recommended on this blog. For instance, if you starved and physically worked yourself at concentration camp levels, you might lose weight, if you don't die of malnutrition/stress first, but you would be putting your health at risk. It’s simply not worth it, as the weight loss would not cure your obesity. It would only reinforce it.

You could also go through bariatric surgery, which is simply a way of making your stomach believe it’s in a concentration camp. I personally, wouldn't ever recommend this type of mutilation, especially for a senior. Remember, even bariatric surgery is temporary so you will eventually get out of the "concentration camp" and the only way you can lose weight and keep it off is by staying in there permanently.

The only thing you can do now is continue a healthy diet and lifestyle that is antiobesogenic so that you can minimize blood glucose disparities and ward off pathology for as long as you can. Obesity, in of itself, is not directly pathological. It is only a symptom of a metabolic abnormality that puts you at risk for pathology. But if you can control the abnormalities, eliminating them all, even if you have to remain overweight, is still success.

4. Losing inches means your losing body fat. 

No. The inches lost have to actually be body fat in order for them to count. Usually you can tell this is the case if you are losing inches consistently and not gaining them back. The inches that matter most are the ones around your middle. This loss occurs over time and in the long term. Fat is never lost in the short term.

If you lost inches rapidly, because you reduced your weight by four or five pounds, then those lost inches were only water weight bloat. When you reduce water weight bloating, you reduce inches but those don’t matter.

5. "Keto" ice cream has too much fat.

When it comes to novelties, you have to shift your focus from calories, carbs or fat to the taste of sweet itself. The taste of sweet is what’s harmful. That's why every diet on the planet allows desserts, in accordance to their macronutrient and/or caloric goals, and this has done nothing for the diet to succeed. In fact, a good predictor of whether a diet has the potential of being successful or not is in the amount of allowed desserts.

The amount of cream found in "keto” ice cream, or any ice cream for that matter, is not very significant. Ice cream is sort of like whipped cream, but the ice takes the place of air. If you actually melt a serving of ice cream, you will see it doesn't consist of much cream, so the fat content is not the problem. The problem with traditional ice cream is the sugar content. "Keto" ice cream contains no sugar. So why would it still be considered obesogenic? Where is the obesity coming from if not from its macronutrients? The obesity is in the sweet taste itself.

Overweight and obese people are particularly sensitive to gaining more body fat from any fat storing trigger that their body receives. Sweet taste is one of those triggers which works through dopamine. Dopamine is a very powerful metabolic regulator. So you have to be very careful when consuming these types of items as their sweet taste will cause you to store all of the fat in them and in everything else you eat that day.

Taste carries metabolic information. This evolved through the availability of certain foods at different times of the year. Sweet taste is information to store for winter. The winter that will never come. The sweet taste found in these novelties is also much stronger than any sweet taste we would have found as hunter/gatherers, aside from honey, so its effect on your dopamine is even greater than any natural food source would have. Also a sweet natural food source would not be accompanied by fat. The combination of sweet and fat, further disrupts dopamine and enhances fat storage.

So, be cautious when incorporating these desserts in your diet. You should really be limiting your exposure to sweet taste if you are serious about tackling your obesity. This is especially true if you also have disordered eating behaviors and cannot keep the consumption of these novelties under control.

6. I am never hungry. Because of this, I can fast for long stretches but I was told this was not a good practice. But I like to use my hunger as a signal to eat or not. 

Hunger is not the right way to gauge food intake for the overweight/obese. Overweight/obese people are either chronically hungry or chronically never hungry. Healthy people aren't chronically anything. Their hunger fluctuates normally, up and down, as their body maintains its weight homeostasis. The overweight/obese have a satiety signaling that is completely dysfunctional and shouldn't be taken seriously. Interestingly, the overweight/obese people who are never hungry, tend to have the most stubborn body fat and often have intractable obesity. This is not surprising if we again remember how obesity works.

Obesity is simply a starvation adaptation that perpetuates through chronic blood glucose dysregulation, which abnormalizes insulin and chronically under expresses leptin. The less hungry you are, the less frequently you eat and so the more you starve. The more you starve the more you "teach" your fat cells to store and hoard. You are adapting them towards obesity.

Unfortunately, because of the calories model of obesity, the overweight/obese person thinks that their ability to starve themselves, without hunger, is a great thing. They will deem themselves much luckier than the unfortunate obese person who's always hungry. Of course, they will constantly wonder how in the world can they still be so fat when they hardly ever eat. Well, chronic "hardly ever eating" makes the overweight/obese fatter over time. Everything they do eat, will be stored much more efficiently and at a greater rate than the always hungry fat person or the healthy person. I have said it before, the only starvation that works for the obese, is the starvation that ends in death. As long as something is coming in, they will remain fat.

This is why it's so very important to take control of this and eat at set meal times only. This practice is a very good control mechanism against the erroneous information you are receiving from your faulty "hunger" signals. Having consistent and predictable meal times will also help normalize your satiety hormones as you better control your glucose/insulin homeostasis through the reduction of the stress response. Taking control of your diet is not just choosing what to eat but also when to eat.