Weight loss, tricks, keto diets and calorie nonsense
Today I heard on the radio that eating a handful of nuts daily is associated with longevity, short term weight loss and long term weight control. Really! All that fat! All those calories! And yes, ‘tis true.
When we eat processed food, we circumvent the natural satiety mechanisms that start with the gut. When we eat, our gastric fundus and intestinal stretch receptors start the process that informs the hypothalamus about food intake. The hypothalamus is crucial for weight control, it is where “set weight” is located. That is what level of fat our brain wishes our body to house. It is where appetite control is located and this is affected by many different hormones.
Highly processed foods are usually devoid of fibre and volume, they pack in the calories in small volumes so that the stretch receptors are not activated until more calories are ingested. I know of a research study that offered developed two diets with the same number of calories, sugar, fat, and carbohydrate content — one ultra-processed and the other unprocessed. People on the ultra-processed diet gained weight, the other did not.
As said, a lot more than primitive stretch receptors is informing the brain. There are gut hormones that are secreted before and after meals, such as ghrelin, glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and cholecystokinin (CCK), among a slew of others. These peptide hormones are all secreted from gut cells into the blood or vagus nerve, or both, and alert the brain that there is, or is not enough NUTRITION and ENERGY to maintain body weight at its set point.
The interface between all these receptors and chemicals is a highly regulated and precise system that regulates body weight for survival of the species in this environment. This environment has changed over the past 100 years but our genetic makeup for survival of the fittest has not. We don’t fully understand why all over the world human beings are being regulated at a higher set point. It is happening in China, in Russia, in the West. Everywhere; and it starts in childhood.
Most likely, there are many players or instigators involved, such as food-supply changes, sedentary lifestyle, ambient temperature (central heating), foetal programming, air quality, and global warming and climate change, to name a few.
There are many players in the obesity and appetite field. Obesity Researchers investigate the underlying mechanisms of the increased prevalence of obesity over the past 100 years.
Obesity Medicine specialists and endocrinologists translate this research into medical and drug treatments for adults and children who are “overweight” such as the wonder drug Semaglutide (Ozempic) that tweaks a pancreatic hormone GPP-1 and affects energy expenditure. This and other medications have been shown to help “reverse” the metabolic adaptation to this environment.
Nutritionists, doctors, therapists, pseudo-experts and quacks translate this research into diet plans such as the Keto diet to prevent obesity as much as possible, together with lifestyle change. Added to this are psychological interventions that are proposed to affect our use of food for emotional regulation.
What Works?
The body is smarter than the pill. The body’s normal reaction to a lack of calorie intake is to reduce resting energy expenditure until body weight increases back to “set point levels.” The new drugs like Semaglutide interfere with that metabolic adaptation to energy deficits and allow us to think of obesity as a metabolic disease. Drugs will hold the disease in check for just as long as they are taken.
As for diets. We all know the relationship between diets, cravings and rebound binge eating. Setting that aside for one moment, diets also don’t work long-term with only 5% of dieters managing to sustain weight loss. Nutritionists and slimming consultants worldwide must stop focusing on fat and calorie control, using diet sheets that will provoke short-term weight loss. There has been a lot of publicity (and money made) about the Keto diet – so is it different from the rest?
Apart from all the health claims made about the Keto diet, it is a diet like any other. The ketogenic diet can fool the brain temporarily by using protein and fat to elicit satiety with less food intake in calories. After a while, however, gut hormones and other factors begin to counteract the weight loss with a reduction in resting energy and total energy expenditure, and other metabolic measures, to get the body back to a certain body weight set point.
The ketogenic diet works in part because it helps dieters to eat less ultra- and highly processed foods. If you can adjust your eating to reduce these foods (and eat nuts) ANY diet will do much the same for you. But Keto has no better long-term outcome than any other diet.
We have to make changes for life that involve closing the metabolic gap that the body generates to defend fat mass. That means at the heart of it, eating foods that do not cause frequent big insulin spikes and working on diversifying the bacteria in the gut to reduce inflammation. Effortful? Yes. But what choice is there.
To be able to make those changes takes understanding, stop using stigma as an excuse to deny that obesity is a problem, make many small changes and get families on board. There is no quick fix for a metabolic “disease state” and there is no medicine that will work forever.