The Obesity Code: Unlocking the Secrets of Weight Loss (by Jason Fung)

[Dominique]

I know several community members (for instance, @divedragon and @OCDOC) swear by Dr. Jason Fung. According to his website, he has just published a book called "The Obesity Code: Unlocking the Secrets of Weight Loss". Has anyone bought it/read it?

[OCDOC]

Hi @Dominique 🙂    Email flag brought me here..thx for the mention!

I wouldn't say I 'swear' by Dr Fung's work. I do believe his way of explaining things is fun and informative.

I have indeed read The Obesity Code. It's basically a re-formatted summary of his extensive blogs, and has less 'personality' than his spontaneous musings (ie it has been edited). It's more of an explanation/theory of why the civilized world has become insanely obese over the last 50 years, and what (in theory) can be done about it.

It's not much of a 'how to' book; the section on Intermittent Fasting (basically skipping a meal or 2 here and there) is cursory. He doesn't stress enough (imo) that IF is impossible unless one's body is accustomed to reduced carbs in general. IF's premise is simple..let your body burn its fat without noise from food intake for a while. Unless your body is already 'trained' to burn fat directly, it's impossible.

All-in-all, one can get the information (although more haphazardly) on his website and youtubes.

TY again for the mention D  Rob K

[OCDOC]

@Dominique

You may or maybe not enjoy this blog posting from JF re his book:

https://intensivedietarymanagement.com/how-not-to-write-a-diet-book/

Take care 🙂  Rob

[TigerlilySC1]

I am going to start reading it today via. audible while I do my steps!

[Daves_Not_Here]

Hi @Dominique and @TigerlilySC1 -- I'm rejuvenating this older thread because I just started reading The Obesity Code , and want to get other's opinions on it.  @Dominique , I'm thinking you may disagree with Fung's narrative because he feels insulin plays a primary role in weight maintenance, and my impression is that you do not.

What I'm taking away from the book is that Fung feels the following do NOT play a significant role in long term weight maintenance:

• How much you eat
• Exercise

And, he feels the following are the key levers to pull to affect your weight, particularly homeostasis and your weight "set point":

• Macro-nutrient ratios to affect insulin response
• Feed timing to affect the frequency and duration of insulin elevations

Thoughts from others who have read this book?

[TigerlilySC1]

I agree with how you see his philosophy except that he doesn't say exercise plays no role.  He just doesn't support the notion of calories in calories out.  This is not how we metabolize food/calories.  But one of the positive effects of exercise is helping insulin resistance.  So it has a positive effect when it comes to hormones.  It also makes our lymphatic system work.  Improves circulation. And a host of other benefits, too many to mention.  

I have since started listening to the Diabetes Code.  If the first book is to nice the second one will scare you into making changes now.  I have started walking seriously!

[SQUEAKY]

Thanks Dave for bringing this thread to the forefront again.  I was not aware of these books and now have the Obesity Code and Diabetes Code in my Amazon wishlist.  

[GershonSurge]

@Daves_Not_Here,

I'm interested in hearing more. Please let me know if Fung mentions the Growth Hormone (GH) released by the pituitary gland, somatostatin (I think it's released from the liver), and Insulin Growth Factor (IGF or IGF1).

From my early research, it seems that when the insulin levels are low, the liver releases IGF that stimulates the release of the GH from the pituitary gland. This does cause muscle growth, but in too large a quantity, it stimulates cancer growth. One of the treatments for cancer is to take somatostatin either by pill or injection to suppress the release of the GH. Eventually, this causes all sorts of problems. The Growth Hormone also causes fat cells to divide and grow.

Diary products have IGF-1, which is a variant of IGF and has been linked to increased incidence of cancer and faster cancer growth. 

[Daves_Not_Here]

@GershonSurge - don't know yet if it's in the book, but Fung contends in a podcast with Ben Greenfield that fasting elevates HGH, such that muscle catabolized in the initial hours of the fast is more readily rebuilt.  He credits this mechanism for fasting's muscle sparing effect.

My anecdotal experience is that my waste and neck continue to shrink while my biceps don't, and I'm not lifting.

[GershonSurge]

@Daves_Not_Here,

One of the members of Dr. McDougall's staff has been interested in intermittent fasting. I don't want to say which one in case I'm remembering incorrectly. He does say there is some merit in it. The reason he doesn't pursue it further is they can get the same or better results another way.

Take a look at my trendweight. I think I discovered something important during the last four weeks. 

[GershonSurge]

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@Daves_Not_Here wrote:

@GershonSurge- don't know yet if it's in the book, but Fung contends in a podcast with Ben Greenfield that fasting elevates HGH, such that muscle catabolized in the initial hours of the fast is more readily rebuilt.  He credits this mechanism for fasting's muscle sparing effect.

My anecdotal experience is that my waste and neck continue to shrink while my biceps don't, and I'm not lifting.

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Sorry to be a grammar-nazi, but I couldn't resist. Sorry your stools are getting smaller. That typically happens with those on a keto diet. 

[Daves_Not_Here]

@GershonSurge -- My Duh on misspelling waist -- I'll bet I've done that more than once.  

Intermittent fasting by a McDougaller?  I'm curious what they hope to gain - maybe to promote autophagy?  It's pretty easy to fast if you already are in ketosis (I actually did a 3 day Extended Fast last week, and it was almost effortless), but I would think it is tougher for someone who fuels on carbs - seems like there would be hunger and a "mini-bonk" when depleting glycogen.  

Looking at your Trendweight, it looks like you squarely hit your target -- what was your discovery?

[Baltoscott]

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@GershonSurge wrote:

... 

Take a look at my trendweight. I think I discovered something important during the last four weeks. 

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Hmm, weight stable, fat trending down, LBM trending up.  Nice.  Curious to see if you can carry the trend from 3 weeks to 3 months.  

Do you think it is a shift from primarily walking to doing more full body exercise?

[GershonSurge]

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@Baltoscott wrote:

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@GershonSurge wrote:

... 

Take a look at my trendweight. I think I discovered something important during the last four weeks. 

---

Hmm, weight stable, fat trending down, LBM trending up.  Nice.  Curious to see if you can carry the trend from 3 weeks to 3 months.  

Do you think it is a shift from primarily walking to doing more full body exercise?

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Great summary. Here is what I changed:

• My style of weightlifting. Lifting heavier was causing problems with my back and stomach muscles. Now, I only use enough weight so I don't need to involve my stomach. I also take 30-second breaks between sets. 
• I slowly jog for 27 minutes a day. Nothing special about the time. It's how long it takes me to make the loop. I consider the jogging and weightlifting to be warmups.
• All the rest of my activity is low-intensity exercise with a target heart rate between 180 minus my age (115) and ten beats below that (105). This is known as the Maximum Aerobic Function. This baths my whole body in oxygen, which kills cancer cells. I'm getting better at hitting this target without checking my Fitbit.

To answer your question about the trend continuing, I'll know better in three months. I don't think it will. According to the tape measure, my body fat is 13.5%. My scale indicates about 1.5% higher than the Aria, so I may be around 15%. What I think may happen is as I become more efficient at doing the activities I'll gradually lose weight to only that needed to do the activities. I may go slowly go down as low as 143 lbs, which is what I was when I graduated from high school.

@Daves_Not_Here,

Keep in mind, Dr. McDougall has been a practicing board-certified internist for almost 50 years. Taken in context, there isn't a single "McDougall Diet." There are many versions depending on a person's medical condition. The one you hear about is good enough for the biggest problem (losing weight), but there are other conditions that need a specialized version. These are all tucked away in various places in his writings. 

Fasting is used for the walking dead, and he sends the patients down the street to True North to fast under careful supervision. There are other diets for those with lethally high blood pressure or cholesterol.

He also has a special diet for those with cancer. It's not so much about the food as it is about the level of compliance. He has been successfully treating all forms of cancer except for pancreatic cancer since 1980. This is the version I'm following because of my history of neuroendocrine cancer. It's considered incurable, but the diet cured it. Taking it a step further, a person should be exercising almost continuously throughout the day. 

Time to go get four hours of sleep (another part of the cure).

[GershonSurge]

@Daves_Not_Here,

A McDougaller would have no reason to fast because their body has recovered from the devastating effects of other ways of eating. Dr. McDougall refers those who need to fast to True North. Sometimes, he prescribes the Kempner diet, which is white rice and refined sugar. The sugar is needed to keep the protein percentage down. 

I think autophagy takes place more rapidly than we can conceive. The process is like transforming a Lego car into a Lego helicopter. There are over 200,000 known enzymes in each muscle cell, and they change every nano-second. It may be that the biceps can be converted to triceps in the time between sets. It might even happen quickly enough to strengthen the muscles needed to avoid falling after tripping. I've found that if I can imagine something happening in the body, sooner or later, I discover it does happen.

What I discovered with my work focused exercise is my small muscles are becoming more clearly defined. My traps have disproportionally larger than my biceps. I lost three inches off my stomach measurements in only two weeks. My leg muscles have gotten significantly stockier. I can see my veins more clearly in my arms meaning I've lost the fat surrounding the muscles and probably inside the muscles. 

Your question about fasting is an interesting one. The real concern is who can survive a famine the best. Fortunately, the Atkins Foundation did a study that suggests an answer to the question. They put a group of people on a 300 calorie diet for two or three months in a controlled environment. Both groups lost surprisingly little weight. In fact, both groups lost less weight than McDougall documented for those attending his 10-day live in program where they could eat freely.  The headline said that people lose more weight on a HFLC diet. My response was people on a LFHC diet have more resistance to starvation. 

There may be a mechanism that supports this. You've probably heard of non-soluble carbohydrates. The flora in the intestines of a McDougaller are capable of transforming these to fat in starvation conditions. This is a new finding and not supported by a lot of studies. When a person is starving, the intestines stop moving things forward. Perhaps, in an effort to keep the non-soluble carbs for use.

There are days I don't eat much, and I seldom lose weight on these days. This suggests to me that my body is experiencing adaptive thermogenesis. I'm trying to enter this state all the time while maintaining my weight as it is conducive to a long lifespan. The McDougallers, et al., are hinting by example that people will live longer if they are at a lower weight than most people find attractive. I find skinny and alive more attractive than muscular and dead. 

[Daves_Not_Here]

We interrupt this McDougal interruption to temporarily revisit our original topic - The Obesity Code.

Fung's contention is that there is a different response when eating at a large calorie deficit versus fasting.  Even when eating at a deficit, the feeding still elevates insulin which blocks fat oxidation, increases hunger, and lowers metabolism.  However, when fasting, insulin remains low, fat is liberated, hunger is stifled, and metabolism is raised.  Fung contends this is logical and adaptive for our evolution: if food is present but limited then we would want to preserve fat and increase consumption.  But, if food is completely absent, then we need the mental and physical energy to go get some more.

My anecdotal experience supports this -- last week, I fasted for 3 days, had almost no hunger but had higher energy.  In fact, I lightly exercised all 3 days and could have easily extended the fast to a 4th day.

Pardon the interruption.  We now return you to your regularly scheduled McDougall interruption which is currently in progress. 🙂

[Dominique]

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@Daves_Not_Here wrote:

@Dominique , I'm thinking you may disagree with Fung's narrative because he feels insulin plays a primary role in weight maintenance, and my impression is that you do not. 

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Yes, you are correct. While I agree with Fung that hormones play a role once you’re obese, making it harder to get back to a healthy weight, they’re not the cause of obesity, as he implies. He’s basically saying: you’re obese because your hormones are out of whack, whereas it’s more like: your hormones are out of whack because you’re obese.

Or what do you think of his "proof" that insulin is the cause of obesity: 

I just don’t buy it. Is there some kind of insulin lottery, with unlucky people being fattened by it and lucky ones saved from its evil impact?

Fung also says that calories don’t matter, which he describes as the "Caloric Reduction as Primary (CRaP)" hypothesis. You said elsewhere you still think weight loss is about calories, which I believe is well illustrated by your 50 lbs weight loss last year, when you meticulously tracked your calories and were able to see your weight drop exactly as predicted.

I think all his mumbo jumbo about hormones, fasting etc. is just a way to trick his patients (he’s running an obesity clinic) into achieving the caloric deficit they need to lose weight without realizing it’s all about calories. If he’s having success doing so, that’s fine!

PS: arguments between Atkins and McDougall, two doctors advocating extreme diets at opposite ends of the spectrum, are always great fun to follow for a middle-of-the-road guy like me .

[Daves_Not_Here]

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@Dominique - I find I am persuaded by Fung's point of view.  I believe that energy balance (Calories In, Calories Out) regulates our weight, but hormones (insulin, cortisol, ghrelin, leptin) regulate our energy balance.

To reiterate an overused analogy, to say we gain weight because we consume more calories that we burn is like saying Bill Gates is rich because he earns more than he spends.  The statement is obviously true but doesn't speak to the real question - "why?".  Why does Gates earn so much more than others?  Why do some find satiety and homeostasis at 150 pounds, while others do at 300?

As to whether there is an insulin lottery, the answer is yes.  Some people are more insulin resistant than others.  But nearly all patients who are put on insulin for diabetes immediately gain weight as a result.  I've seen this in 100% of my friends and relatives when they start taking insulin.

I'm also persuaded by Fung's description of our "two compartment" model of energy storage, and how insulin signals fat storage versus oxidation.  I believe it is a more descriptive model than the simplified model of our body as a single control volume governed by the laws of conservation of mass and energy.  

As to Fung engaging in "mumbo-jumbo" to "trick" his patients, it seems pretty straightforward to me, and I don't see malicious motives or an intent to deceive.  The book is filled with discussion around metabolic rate, calorie deficit and how these affect weight loss.  But he takes it further and gets to "why".

P.S. On your P.S. about Atkins versus McDougall, I'm starting to think their approaches are two sides of the same coin -- both approaches call for the elimination of highly refined carbs and added sugar, and I think that's what makes either work.  The difference is in the energy source: With McDougall, you burn carbs for fuel.  With Atkins, you burn fat for fuel.

[Daves_Not_Here]

Here is a great Ted Talk by Peter Attia that describes a theory of insulin resistance that I find persuasive.

[Daves_Not_Here]

Here is an Healthline article that provides 6 arguments as to why different kinds of calories cause different effects, and result in different weight loss  outcomes.