Subtitles section Play video Print subtitles So what we're going to talk about today is really why? intermittent fasting and low carbohydrate diets work Whereas the Calorie counters It just doesn't seem to work right and the problem with the calorie theory is [that] it's just like raw and Because we don't really understand obesity That's why we can't cure it right, so I'm sure many of you have seen this show. It's called the biggest loser and it's on North America, it's in Australia It's everywhere right and what people do is [they're] contestants that compete to lose weight, and they get put on a diet It's a calorie reduce diet and they do a lot of exercise, and you've seen Jillian Michaels screaming at everybody, right? So it's a lot of exercise, and they don't show it on the show, but there's actually a fairly severe caloric restriction as well It's not a low carbohydrate diet It's more of a kind of everything in moderation sort of an approach, so the problem of course is that this show has been running for a long time and Certain of the Contestants have come out and said well [you] know this really doesn't work now the reason more haven't come out is because they're essentially under a legal gag order, right? they're actually not allowed to say any of this stuff, but certain contestants have actually come out and So this contestant Suzanne said well they never do a reunion show why they've all gain that weight again and It's not it's not Unique to the biggest loser [a] lot of diets and we've all done these Calorie reduce diets it does the same for everything it does fine for about six months, but then after that it just Keeps coming back your weight plateaus then it starts to come back and everybody knows this right because everybody's done this diet The question is why? Right and that's what we really have to understand and that's what I mean by we have to solve the two compartment problem And I'll explain that in a second so the biggest loser diet despite the fact that we all know it doesn't work is actually ranked very highly so Usa news for example just this past year put the biggest loser diet at Number three for weight loss and number 11 overall so really a very good diet and why not it's a eat less move more Sort of approach, right cut your calories in increase your calories out and hey presto. You're going to lose weight So that's why it does so well because all the doctors recommended and so on The thing is that there have been some studies that have been done [on] these contestants, and it's very interesting to [look] Scientifically at what actually happens to these people as they do this sort of eat Less news more approach now the biggest loser of course is that approach on Steroids [rates] or eating a lot less, and you're moving a lot more, and that's why you get these dramatic weight losses So one season they actually took these contestants made them signed consents And then actually did metabolic studies on them and what's interesting is that at first it looks amazing, [right]? [and] [we've] all seen [that] show right the before on the after it looks amazing and the studies really bear that out, so if you look at the before [and] after if you look at the composition of weight loss so at week [six] and week 30 at the end of the Show is week 30 you can see that. They've lost a lot of weight right. This is 60 kilograms right and this is Fat mass so most of it is fat right everybody says [aw], you're going to lose muscle. You lose muscle another losing mostly fat There's a little bit of muscle loss, but it's mostly fat and this is their body fat percentage you can see it's follows a pretty steady trend downwards and the average went from 329 pounds to 202 pounds so an amazing result right body fat [went] from 49% to 28% so at the end of the show you get these great results You have the end of the show everybody wins and they pretend like everything's fine, but we know that it isn't And why not? What's the problem? It sounds like it should work, right? You keep doing what you're doing, and you'll keep losing weight But you don't and the reason and we've known this for [at] least a hundred years is that your metabolism starts to slow down, and this is what happened to the metabolism of all these contestants, and you can see in the Solid bar that's their baseline rate of metabolism Before they start at this and the open circles is that afterwards you can see that in virtually every case These people are cutting the amount of calories they expend by a lot okay, so you can look at some of these dramatic examples, so this fellow for example [list] starts out by Earning Thirty five hundred calories a day and he's dropped all the way to about seventeen hundred [calories] a day, right And it's not just him. It's everybody if you take the entire group of people the average Decrease in metabolism is over seven hundred calories a day right, so [if] you start by burning Thirty five hundred Which is a lot, so you start at two thousand you're going to drop down to like Twelve Thirteen hundred by the end of the show so you wonder why you're not losing weight? well It's because your metabolism has slowed down so much that if you're burning thirteen hundred and you are eating [1,500] remember that's still a lot less than you used to eat You're going to gain the [weight] back That's exactly what we all know happens you feel cold [you] feel tired if you're hungry, [you] feel like shit and The weight is going back up Right and that's the problem right we all know that's the problem. It's the decrease in metabolism So you can try to make up for it with more exercise, right? And that's what they pretend that you can do so you can see that baseline. There's a certain amount Which is resting metabolic rate certain amount of exercise? During the show they burn a hell of a lot of calories as exercise you see that the gram tops your total energy expenditure Is better but when you stop exercising for like you know five hours a day? Then your exercise goes down, but look at what's happened to your basal metabolism This is your resting metabolic rate. It's already gone down by week six okay, so don't kid yourself This is happening all the time But by week [thirty], it's gone down even or and that's the whole problem you get this Metabolic Slowdown and because you're not burning as much energy. You don't have that you know liveliness You don't feel very good And you can see this In this graph you can see this is the biggest loser contestants, and you see that the basal metabolic rate just keeps on going down But there's a similar Extreme measure that doesn't seem to have this problem and the question is why? So you can look at bariatric surgery so bariatric surgery is stomach stapling surgery, right? So you cut your stomach into the size of a walnut you Really just can't eat and you can't eat for months and months and months and guess what the weight goes down, right? That's not a surprise the surprise is that it works to keep weight off in the long term yeah, there are a lot of problems with this okay, so Let's be clear. I'm not recommending it for anybody, right? but if you look at the resting metabolic rate with a similarly sort of extreme measure it goes back up the [question] is why so this is another? Study of the long-term effects of bariatrics and you can see that a baseline and a follow-up. This is several [years] [later] The resting metabolic rate and the total energy expenditure how much energy you're burning has really not gone down Right as opposed to the eat less move more where it keeps going down keeps going down until you fail, right? That of course is the saddest part of all right the saddest part of the entire thing is that we know about this metabolic slowdown this was shown in 1915 so we've known about it for a hundred years what I think is sad, is that we give people this really horrific advice to eat less and move more and Then when they fail, we blame them for it Right and that's basically. You're blaming the victim because here's this poor fellow or poor lady Who's victimized? Because they're suffering from obesity from type 2 diabetes you give them really bad advice Which you know is going to fail because we've all done it it fails every single time and then when the weight goes back You say yeah, you should have listened to me better. You should have had more willpower you shouldn't have eaten that bagel or whatever it is you tell people right and that's really the saddest [part] of all is that we Try to pretend that the advice that we give is really good and the failure lies with all of you Right, but doesn't doesn't make any sense right? How can like? forty fifty percent of the population Be so morally bankrupt that they let this happen to them is it not more Logical that the advice that we gave was just really crappy that seems to me much more sensible So we're going to explain why this sort of discrepancy exists So in order to do that you have to understand what happens when you eat, okay? [so] what happens when you eat? Is that insulin goes up? So most foods almost all foods have a mixture of macronutrients [fat] Carbohydrates and protein so your insulin goes up to a varying degree and insulin Basically is the hormone that [tells] your body to store fat So it stops your body from burning fat you start to store some of the sugar and store some of the fat Okay, and this is normal. This is a normal situation so Carbohydrates get turned into glycogen which are chains of glucose so chains of glucose in the liver? Is basically a storage form of sugar okay? And when you have too much of that then your liver produces? Lipids which is called De Novo lipogenesis, and it basically stores fat okay, so when you don't eat when you're fasting So fasting is merely the absence of eating your insulin levels fall And that's a signal to start pulling some of that energy out Right so you're going to start by pulling some energy out from the glycogen Which is your stored [sugar]? And you're going to pour some pull some energy out [of] the stored fat so you can think of it the glycogen Like a refrigerator right you're storing food energy And the reason it's like [a] refrigerator Is that it's easy to access so [you] can get put food in easily you can take food out easily, right? It's just food energy and the fat is more like your freezer Okay, so you can store more of it, but it's in your [basement] You know it's hard to get to it's hard to get out It's hard to put in so you generally prefer to use your refrigerator and it's the same idea you have two storage forms of energy one easy to use and one not so easy to use the refrigerator though has a limited capacity [so] if you put if you have too much stuff you have no choice But to put it in your freezer Now the reason that the calories don't work is that they operate on what I call a one compartment model Okay, so that means they pretend that all your calories goes in to your body And it's all the same all your calories are the same they're stored in one giant compartment like this sink and When it comes to taking out energy it all comes out of the same thing right therefore if you follow this sort of very simplistic Incorrect model what you see is that if you simply reduce the calories going in? You'll reduce your weight and if you increase the calories out you'll increase the rate but the entire premise of this sort of calories in calories out model is completely fictitious because we know that's not what happens in the body the body doesn't have some giant vat of Calories right you can store sugar you can store fat. It's not some giant vat of calories That's held somewhere in your liver, right? But that's what they all pretend it is so if you have the entire wrong idea of why this should work? Then it's not going to work What instead is? A better model is a two compartment model that is there are two places in the body where you can store food? You've got your fridge And you've got your freezer your calories goes in into your fridge calories goes From the fridge because that's the easiest place it goes, but there's a third thing that you have to consider And that is how much food goes back and forth between the freezer and the fridge because that's what we're really interested in this the fat, but that's the one that's much harder to get to Right and the question is what's controlling this? because that's really the key and It turns out that the main player is insulin we know this because insulin inhibits lipolysis Right what that means is it stops you from getting the fat coming out? That's a job That's a normal job. So if you have a lot of insulin right so normally if you eat a huge meal your insulin is high it's going to tell the body to move all the Storage in this way if your insulin is very high then you can't get the food back out this way And that's the problem So if you have a lot of insulin resistance for example which keeps your insulin levels very high it's like that Freezer is kind of locked away in the [basement] behind the lock you know steel bar. You can't get at it so what happens now when you start reducing your calories if you start reducing your calories in and You can't get at your storage What your body is simply going to do is reduce the calories out? That's what it does right because it's not going to keep losing weight until you die That's just ridiculous right, so if you look at the women's health initiative Which was a huge fifty thousand person study. They reduce calories by  Odd per day for like seven years and they estimated that People would lose 30 pounds women would lose 30 [pounds] per year Right so in seven years. They should have lost 210 pounds right of course that didn't happen [how] much did they lose not even a single pound it was ridiculous because? What happened of course is that their body is if you're not affecting me in insulin you can't get at that fat? You're just going to reduce [your] calorie though, and notice here of course that we're not breaking any laws of thermodynamics right Calories in calories out yeah, you're accounting for all the calories [but] what's important is the compartmentalization of energy right? That's what we're talking [about] not the total energy, but where it goes Right because that's what we want to know if you eat, and you just burn [it] off Who cares that'd be great? But if you eat and all of it goes into fat well now you care a lot, right? But it's not that calories [are] imbalance if you eat an extra 500 calories your body burns it all off as fat Bob burns it all off as heat. Yeah who cares you don't have any extra body fat, but if you get 500 extra calories Boom the insulin is telling it all to shunt into here. Well, that's a problem and That's really the problem of the two compartment syndrome So if you look at what happens during fasting? What happens because everybody worries about this right? Oh, what [about] protein you're burning your muscle, right? So this is a study by Kevin Hall from the nih And he basically looked what happens during fasting and this is what happens, right? So for the first couple of days of fasting what you see is that carbohydrate oxidation goes off? It goes way up right in other words. You're burning sugar you can see that fat doesn't actually move for a couple of days You're not burning a hell of a lot of fat Right and then as you run out [of] the glycogen remember that the glycogen is You're easily accessed energy, but limited in terms of how much you can store once it all burns out then look Fat oxidation goes off now. You're burning fat for energy That's perfect that's exactly [what] we want to do, but what happened to protein are you burning muscle? Hell, no, it goes up slightly, okay at the very beginning then drops So protein is not a storage form of energy Why would your body burn it for energy, right?