In which I share some of my research about diet and overweight. It turns out dietary fat is fine; it’s the refined carbohydrates – white flour, white sugar – and the HFCS that are fucking killing you and making all those children fat and sedentary.

On January 5th, I started a weight-loss contest with a group of online friends. I weighed 160 pounds. I’m 5’4″ tall, so my ideal weight range is 122 – 150 lbs. I was officially overweight. My gut stuck out farther than my boobs, I was shaped like an old person, and I was tired and lazy.

I tracked my caloric intake, and pretended to be enthusiastic about exercise even though I’ve never particularly liked it. I hit the dietary target of 20% protein, 30% fat, and 50% carbohydrates pretty regularly, although if you’re a vegetarian on a calorie-restricted, low-fat diet it’s really hard to get enough protein.

I limited my fat intake brutally. I drank fat-free milk, bought low-fat cottage cheese and yogurt, cooked with spray oil, ate lots of beans and legumes, and had huge salads just like they tell us to. After all, “everybody knows” that to lose weight, one must restrict calories and exercise more. And that’s what I did.

The only problem is that, as logical as they seem, both of those medical theories have been disproven in study after study. Low-fat diets do not lower disease risk or help in weight loss. Exercise does not help with weight loss because it universally increases hunger, in study after study, making semi-starvation diets impossible to stick to and any weight loss achieved temporary and useless.

And you don’t know that these low-fat/exercise theories of health have been overturned because 1.) the AMA just, you know, hasn’t gotten around to admitting that they accidentally backed the wrong theories for seventy years; 2.) giant corporations who sell tons of low-fat foods don’t want you to know about it; and 3.) the media tends to be conservative about diet recommendations that don’t make their advertisers money.

Anyway, I’m getting ahead of myself. Before I learned all that, I successfully followed my semi-starvation diet for eight weeks before I totally fucking lost control of it and found myself eating an entire bag of potato chips without conscious thought and arriving at Mexican restaurants before I even knew I’d decided to go out to eat. I’d lost 14 pounds, but found myself hungry all the time and obsessed with food.

Then, and rather serendipitously, I started reading a book sample I found on my Kindle called Good Calories, Bad Calories, even though I couldn’t remember what it was about nor when I’d downloaded the sample. [All the blockquotes in this post are from this book, and they should be treated as sidebars, not inline text.] When I finished the sample, I bought the book and read the entire thing in four days. The book is by a noted science journalist – he can make really dense material utterly gripping – and is about stuff “everybody knows” about diet, metabolism, and Western diseases.

Everybody knows, for instance, about the first law of thermodynamics. Applied to your body it means you have to burn off all the calories you eat or you’ll get fat. Period. If you eat more than you burn, you get fat.

The prevalence of overweight in children six to eleven years old more than doubled between 1980 and 2000; it tripled in children aged eleven to nineteen.

In other words, all fatness is due to gluttony and sloth. Which are moral failings, not physiological ones.

Well, it turns out that that’s simply not true. The body doesn’t work that way. If it’s not hungry, it won’t eat, and if it gets too many calories, it just burns them off with activity or heat and maintains a particular body weight naturally. If you’re not eating foods that fuck up your insulin, you just don’t get fat. You won’t overeat, and if you do, you’ll just burn off the excess. The body’s smart like that.

We know this is true because even the obese have a set point; they gain until they reach it, and then they maintain it even if their caloric intake remains the same once that point is met. We also know this because of all those lean people who eat far more calories than they can possibly burn; we all know a very thin person who can eat literally whatever s/he wants. If the body really did work the way we “all know” it does, that thin person would have to be a triathlete and eat less than you do. Which s/he doesn’t. So: not all calories are created equal. Some are fine; others make you fat.

If the thrifty-gene hypothesis were true of any species, it would suggest that all we had to do was put them in a cage with plentiful food available and they would fatten up and become diabetic, and this is simply not the case.

Medical science knows for a fact that the obese do not eat more calories than lean people.

Read that again:

Medical science knows for a fact that the obese do not eat more calories than lean people.

Which means that the first law of thermodynamics, as applied to the human body, fails. Calories in minus calories burned does not equal fat stores. Which means that all those fat people aren’t fat because they’re morally bankrupt, weak, or selfish. They’re fat because of something else.

Whatever the accepted wisdom, making obesity a behavioral issue is endlessly problematic. “Theories that diseases are caused by mental states and can be cured by will power,” as Susan Sontag observed in her 1978 essay Illness as Metaphor, “are always an index of how much is not understood about the physical terrain of a disease.” This is certainly the case with obesity. One goal of any discussion of the cause of obesity must be a way to think about it that escapes the facile and circular reasoning of the overeating/sedentary-behavior hypothesis and permits us to proceed in a direction that leads to real progress, to find a way of discussing the condition, as the philosopher of science Thomas Kuhn might have put it, that allows for a “playable game.”

As it turns out, there’s a lot of documentation about diseases and Western diets. Documentation that says that many indigenous cultures had vanishingly small incidences of cancer, stroke, or diabetes when eating their normal diet, but twenty years after the introduction of Western foods – primarily white flour and sugar – universally had disease rates similar to or higher than Westerners. (Oh, and guess what? Cultures with fattening rituals use refined carbohydrate diets – and not high fat diets – to create the desired obesity. Just sayin’.)

Tanchou was a French physician who served with Napoleon before entering private practice and studying the statistical distribution of cancer. Tanchou’s analysis of death registries led him to conclude that cancer was more common in cities than in rural areas, and that the incidence of cancer was increasing throughout Europe. “Cancer, like insanity,” he said, “seems to increase with the progress of civilization.” He supported this hypothesis with communications from physicians working in North Africa, who reported that the disease had once been rare or nonexistent in their regions, but that the number of cancer cases was “increasing from year to year, and that this increase stands in connection with the advance of civilization.”

So how is it that everything we believe about diet and exercise and disease and weight is wrong? Well, it was something of an accident. In the 40’s, it seemed that the intake of dietary fat had to be implicated in heart disease, because the plaque buildup in the arteries was fatty. Through various social and scientific mechanisms, the fat-is-bad idea became the accepted theory and we began to recommend low-fat diets. This was before we knew anything about cholesterol, or that there were different types of cholesterol, or what parts they play in metabolism. It just seemed to the medical community that we had to stress a low-fat diet to curb the disturbing rise in heart disease.

Well, when you cut fat from your diet, you have to get your calories from somewhere else, and that somewhere else is the world of carbohydrates. Unfortunately, we’ve been processing the hell out of our carbs. Instead of lentil stew, we have white bread. Instead of an apple, we have a soft drink. Instead of eggs and bacon, we have corn flakes.

Which seems innocuous enough, except that refined carbohydrates, sadly, don’t act like other foods in the body. They do strange and terrible things to insulin, and cause you to crave more of them to keep your blood glucose alarmingly high. They cause insulin resistance. They won’t kill you immediately, but they will do weird stuff to your metabolism that will eventually manifest as disease.

I won’t go into the science, both because I’m not qualified and because it’s already been done elsewhere [please read this NYT article for a fantastic introduction], but in a nutshell it appears that our current obesity, heart disease, and diabetes epidemics are the result of our massive consumption of refined carbohydrates, and that the low-fat diet recommendation actually contributed to this situation by telling us that pigging out on bread and pasta is okay.

Which, it turns out, it is not. When you eat these kinds of refined carbohydrates, you throw your metabolism into a frenzy that, after about twenty years, leads to insulin resistance and from there a host of related diseases including, you guessed it: overweight, diabetes, heart disease, and stroke. (It appears that the younger overweight, obese, and diabetic are simply less efficient at handling this kind of metabolic load than the lean. The thickening of middle age is indicated as a result of a lifetime of this condition rather than an actual consequence of ageing.)

Embarrassing for the medical community after seventy years of blaming the diseases of overweight on dietary fat intake, to say the least. Which is why if you look at the latest dietary recommendations, you’ll see they still suggest you get half your calories from carbs… although now they’re beginning to say those carbs should be legumes instead of white breads, and vegetables instead of sugary drinks.

If blood-sugar levels increase—say, after a meal containing carbohydrates—then more glucose is transported into the fat cells, which increases the use of this glucose for fuel, and so increases the production of glycerol phosphate. This is turn increases the conversion of fatty acids into triglycerides, so that they’re unable to escape into the bloodstream at a time when they’re not needed. Thus, elevating blood sugar serves to decrease the concentration of fatty acids in the blood, and to increase the accumulated fat in the fat cells.

There appears to be a large body of research proving that semi-starvation diets are ineffective for the treatment of obesity. Low carb diets – diets that are by definition higher in fat and protein – work better because people will actually stay on them, as they don’t feature the constant and unbearable hunger (a condition considered to be a failure of self-discipline, rather than the body’s normal reaction to under-nutrition).

You’re hungry on a diet because you’re starving yourself. The body is smart and doesn’t want to starve. It also doesn’t really want to carry around a bunch of unnecessary adipose tissue, either, and will drop it naturally when conditions are favorable. You don’t have to eat less and exercise more; you have to stop fucking with the insulin that regulates your metabolism.

Please note that doctors and scientists studying obesity have always prescribed low-carb diets for weight loss. The obesity community, even while lost in the whole idea that obesity must be a character flaw instead of a genetic inability to metabolize the insane amounts of blood glucose resulting from these empty calories, has always known that it wasn’t dietary fat that was the problem, but low-quality carbohydrates.

And so I quit obsessing on my 1,200-1,550 daily caloric target, and decided to eat as much of whatever I wanted as long as it contained zero refined carbs. My mantra became “no white rice, no white flour, no white sugar.” I went to my favorite Mexican restaurant and happily gorged on the greasy, cheesy chile relleno platter, but I ignored the rice. I quit eating bread and cakes and candy and cookies altogether, since they’re all white flour and white sugar. (If I want something sweet, I have a chunk of an 85% cocoa chocolate bar. There’s sugar in it, but very little. Or I have a latte with sugar-free syrup.)

No pasta. No sushi rice. I quit drinking cranberry juice in my cocktails because it’s sweetened with HFCS (which is metabolized so strangely that it basically goes right to your liver, where it’s turned to fat and immediately stored: it never even makes it into the blood as usable glucose). I replaced hash browns with black beans at breakfast. And I started drinking whole milk again, because it has fewer carbs than that blue water they call non-fat milk.

Glucose goes directly into the bloodstream and is taken up by tissues and organs to use as energy; only 30–40 percent passes through the liver. Fructose passes directly to the liver, where it is metabolized almost exclusively. As a result, fructose “constitutes a metabolic load targeted on the liver,” the Israeli diabetologist Eleazar Shafrir says, and the liver responds by converting it into triglycerides—fat—and then shipping it out on lipoproteins for storage. The more fructose in the diet, the higher the subsequent triglyceride levels in the blood.

The research on this fructose-induced insulin resistance was done on laboratory animals, but it confirmed what Reiser at the USDA had observed in humans and published in 1981: given sufficient time, high-fructose diets can induce high insulin levels, high blood sugar, and insulin resistance, even though in the short term fructose has little effect on either blood sugar or insulin and so a very low glycemic index. It has also been known since the 1960s that fructose elevates blood pressure more than an equivalent amount of glucose does, a phenomenon called fructose-induced hypertension.

I was no longer dieting, but I still lost five more pounds. My activity level remained the same, which is to say pretty sedentary, and I was eating more fat and more calories than I had in months, and I was losing weight anyway. I lost an inch off my waist in the first week, after two months of a traditional semi-starvation diet. Which blows the whole calories-not-burned-are-stored-as-fat theory right out of the water, if you ask me.

I found that after that first week, my food intake – that caloric target I’d been meeting for months by sheer will alone – balanced itself. I spontaneously started eating about 1,300 calories per day with no effort and no cravings. When faced with a plate of delicious Mexican food, I found that I would quit eating when full.

I no longer get seriously, urgently hungry, and I can function for hours after a missed meal with little more than the idea that I should eat when I get the chance. A fog I didn’t know was present has lifted. I have ankle and wrist bones again. For the first time in my life, I have had the experience of just wanting to go burn off some energy in the form of a walk or a bike ride. My hip bones have reappeared from beneath their blanket of pudge. I never wake up hungry any more.

And when I walk through a grocery store, I now see what I’m looking at: the vast majority of the products are comprised entirely of refined carbohydrates. Bread, cereal, diet food, frozen foods, snacks, soda, candy, pasta, chips. Most of the store is filled with un-food. The dairy, eggs, meat, legumes, and produce sections are actual food, but everything else in the store is contributing to the West’s epidemics of obesity, heart disease, cancer, stroke, and diabetes.

The poorer you are, the more likely you are to eat a diet high in refined carbohydrates, because they’re the cheapest calories. Which is why the poorer you are, the more likely you are to be fat.

As a vegetarian, I can’t just fry up a steak and eat it with some broccoli; I still get a lot of my calories from carbohydrates – legumes and vegetables and fruits – and I find myself enjoying strange meals sometimes (like a huge bowl of fried tofu and steamed veggies in a decadent homemade Alfredo sauce, with heavy cream, butter, and grated parmesan), but avoiding empty calories means that what I do eat is going to have some nutritive value.

A calorie-restricted diet that cuts all calories by a third, as John Yudkin noted, will also cut essential nutrients by a third. A diet that prohibits sugar, flour, potatoes, and beer, but allows eating to satiety meat, cheese, eggs, and green vegetables will still include the essential nutrients, whether or not it leads to a decrease in calories consumed.

And I’m losing weight without hunger or discomfort. And I feel great.

And I want you to stop eating refined carbohydrates, too. Do your due diligence. Go troll around the PubMed studies, or buy a book, or do whatever you need to do to educate yourself, but be aware that when it comes to diet, the things we all know are true are not true.

You’re not fat because you’re lazy or gluttonous. You’re fat because you’re eating a typical Western diet, packed with refined carbohydrates that mess with insulin and blood sugar and cause metabolic disorders. Cut out the white bread, the pasta, the soda, the beer, and the candy, and see if you don’t drop some inches. It’s SCIENCE!

Oh, and I totally won that diet competition. Yay!

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My growing collection of links about carbohydrates and metabolism is here.