Public Service Announcement: This is why you are FAT

M

MTB doc

Sergeant of the Hide
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Minuteman
May 30, 2019
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#1
Today was a typical ER shift with all the usual stuff. My last patient was one that I see very frequently just with many different names. He came in for chest pain and had hypertension, elevated blood sugar, central obesity and high chol/triglycerides. This is known as metabolic syndrome. Over the past 4-5 decades this diagnosis has skyrocketed. The average overweight person has been on numerous diets only to ultimately fail and gain the weight back (plus more). The person is made to feel that it is his/her fault for failing, when in fact they are set up to fail because for so long they have been told the wrong shit. When I was in medical school they taught the wrong shit about nutrition and they continue to do so to this day. The food pyramid released by the USDA could not have been more wrong.

There is a ton that can be written about this subject, but the main concept to understand is that 'when' we eat is just as (if not more) important than 'what' we eat. The main culprit to blame when we get fat is INSULIN. When we eat, we take in more food energy than we can immediately use. The part we do not use WILL be stored away. Insulin is the absolute key hormone involved in this storage. Insulin stores this energy in 2 ways. Carbohydrates are broken down and stored (as glycogen) in the liver and muscles. However, there is a meager limit as to how much can be stored this way. The rest of the carbohydrates are converted to FAT and stored. So the equation looks like this: Eat Food----> Increase Insulin-----> Store Glucose(sugar) and Produce and Store FAT.

When we do not eat for an extended period the equation runs in reverse: No Food-----> Decrease Insulin-----> Burn Stored Sugar and Burn FAT
So our bodies are basically in one of two modes: either storing energy and storing fat or burning energy and burning fat.
Of importance to note is the decreased insulin. This MUST happen for us to be able to burn fat. High insulin levels block our body's ability to burn fat. Guess what happens if we are shoving food in our face every 2, 3 or 4 hours? Our insulin levels remain high and we remain in a state of making and storing FAT. Our balance between storing fat and burning fat is way off.

What's the answer? The answer is to get our body in the burning fat mode for a longer period of time than the storing fat mode. There are many different protocols but probably the easiest to start with is the 16:8 plan. You have an 8 hour window out of 24 hours to eat all the food for that day. The remaining 16 hours are spent in the not eating (fasting) state. The effect this has on the body with regard to how we store and burn fat is nothing short of dramatic. It's not a diet. It's eating essentially how we were designed to eat. For anyone interested in further info, probably the best source IMO is Dr. Jason Fung. You can read his book or pull up some of his youtube videos.
 
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#4
W54/XM-388 said:
That may be kind of hard for some of us that are away from the house for 13+ hours a day working.

Right now I usually do 9 hours then Eat, then 6 hours or so, then eat then 6 hours or so and eat again.
Click to expand...
That was my prob! When I started my business 30 yrs ago I was 220 with 6 percent body fat. Worked outside 14-15 hrs a day and get home late and eat a lot. As the years went on I would add a few pounds a year. Now I’m 260 pounds. Definite not easy. I think the soft drinks and Gatorade put it on for me mostly though.shit, I gotta lose a few!
 
#5
@MTB doc

I've been on a beta blocker since I was 14 for HBP, added calcium blocker in my 20s. Been a guinea pig for a dozen other BP meds over the years including catapress( what a nightmare). I wasn't fat, but I am now.
Night shift for 30 years hasn't helped I'm sure.
Been on a dozen different diets. Some worked well, but always ended in an unscalable wall, with doctor telling me my BP was fantastic and no adjustment to my meds were necessary......then I gain the weight back.

Thanks for posting.
 
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#6
SD- metabolism is an incredibly important part of the balance. We all vary with regard to this. That basal rate can be the difference between weight gain and weight loss.

W54- is your 13+ hours of work extremely physical? If so, 16:8 may not be the best protocol for you.

Armor- you would benefit from reading Dr. Fung's book- The Complete Guide to Intermittent Fasting. It was written basically for you.
 
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#7
I have been overweight by BMI standards my entire life. I won't go into my entire history, but at one point I was 315 lbs
I lost 100 lbs in 3 months, I did not do what you suggest ;) I also kept that weight off for 20 plus years.

I am going to say different strokes for different folks

The lifestyle (not diet) that you live needs to be one that you can live with. The reason why diets fail is exactly that, because people look at them as diets that are temporary, or they really are fad diets that no one can live a normal life with for 30 years so they break from the diet for obvious reasons.

My wife does what you describe, she eats dinner no later than 5 pm, usually does not eat breakfast until she has been awake for a bit, so maybe not quite 16 hours, but a good 14 hours, she isn't losing any weight :)

I can tell you with 1000 yard sniper precision what causes me to lose weight and what causes me to gain weight, and the timing of my meals has nothing to do with it.

but carry on, I might want to subscribe to your news letter f you say something that rings true to what I have experienced in my own life....
 
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#8
Kenny,

I'm in total agreement with you on different stroke for different folks. Not everyone falls under the metabolic syndrome category. Like you, I know exactly what I need to do to be at race weight for mountain bike racing.

Definitely no newsletter from me planned. Sorry for how long the above post was. I hate to read wordy shit.
 
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#10
Agreed that if something like this works for you (or works for someone) and you can live with it forever, then its a workable plan with positive results.

For me, I need to avoid refined sugar in all it's many 1000's of names used in ingredient lists
and
I also need to limit animal based protein and fat

I won't bore you with the details, but I think you already know ;)

oh and we can't forget exercise, that is a must no matter what you eat. I don't mean running 22 miles every day, just take a walk, but do it everyday. Sitting is the new smoking....
 
#11
For me it came down to purely calorie counting. Losing weight was just amount of calories in vs calories burned. I used a rough number of 3500 calories = 1 lb of weight. So if I wanted to lose a pound every week, I'd want burn 500 calories more than I ate that day.

Now, everyone hates feeling hungry, that's why we eat most of the time. And certain foods do make me feel less satisfied, then other foods. If I wanted to get full eating sour patch kids, I'd darn near eat about 1000 calories or more of it before I felt satisfied. That's not a good way to spend my calories. So not eating sugar, made me crave sugar less, which helped me eat more filling foods that had less caloric contents.

So there's certain desserts I eat to fill my sweet tooth, which is usually fruit with a little bit of whip cream. Fills my craving with a lot less calories then a slice of cheese cake.

Also eating out, the amount of butter/oil they put on the food is just insane. It doesn't make you really feel any more or less full. It does taste slightly better, but the caloric contents are almost 2x. Some hamburger joints, the bun alone is like 500-600 calories or more. A burger w/o fries could end up being 1300-1500 calories, when a home made burger without all that extra butter/oil could run you about 750 calories. Pretty dramatic 750 calories there.
 
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#12
Littlepod, you're right, eating out is one of the biggest offenders. It's crazy how quick the calories add up.

As multiple people mentioned, the refined sugars are one biggest problems that has happened in this country. There is no bigger stimulator of insulin than refined sugar.
 
#13
MTB doc said:
Today was a typical ER shift with all the usual stuff. My last patient was one that I see very frequently just with many different names. He came in for chest pain and had hypertension, elevated blood sugar, central obesity and high chol/triglycerides. This is known as metabolic syndrome. Over the past 4-5 decades this diagnosis has skyrocketed. The average overweight person has been on numerous diets only to ultimately fail and gain the weight back (plus more). The person is made to feel that it is his/her fault for failing, when in fact they are set up to fail because for so long they have been told the wrong shit. When I was in medical school they taught the wrong shit about nutrition and they continue to do so to this day. The food pyramid released by the USDA could not have been more wrong.

There is a ton that can be written about this subject, but the main concept to understand is that 'when' we eat is just as (if not more) important than 'what' we eat. The main culprit to blame when we get fat is INSULIN. When we eat, we take in more food energy than we can immediately use. The part we do not use WILL be stored away. Insulin is the absolute key hormone involved in this storage. Insulin stores this energy in 2 ways. Carbohydrates are broken down and stored (as glycogen) in the liver and muscles. However, there is a meager limit as to how much can be stored this way. The rest of the carbohydrates are converted to FAT and stored. So the equation looks like this: Eat Food----> Increase Insulin-----> Store Glucose(sugar) and Produce and Store FAT.

When we do not eat for an extended period the equation runs in reverse: No Food-----> Decrease Insulin-----> Burn Stored Sugar and Burn FAT
So our bodies are basically in one of two modes: either storing energy and storing fat or burning energy and burning fat.
Of importance to note is the decreased insulin. This MUST happen for us to be able to burn fat. High insulin levels block our body's ability to burn fat. Guess what happens if we are shoving food in our face every 2, 3 or 4 hours? Our insulin levels remain high and we remain in a state of making and storing FAT. Our balance between storing fat and burning fat is way off.

What's the answer? The answer is to get our body in the burning fat mode for a longer period of time than the storing fat mode. There are many different protocols but probably the easiest to start with is the 16:8 plan. You have an 8 hour window out of 24 hours to eat all the food for that day. The remaining 16 hours are spent in the not eating (fasting) state. The effect this has on the body with regard to how we store and burn fat is nothing short of dramatic. It's not a diet. It's eating essentially how we were designed to eat. For anyone interested in further info, probably the best source IMO is Dr. Jason Fung. You can read his book or pull up some of his youtube videos.
Click to expand...

Interesting write up. I think at least some of it has to do with the type of foods we eat and or genetics.

Im slender and can eat pretty much what ever I want whenever I want and dont seem to gain weight. But I eat a healthy, pretty much organic diet.

Others put on weight no matter what. Much of this obesity problem is due to a high level of fast food consumption. "Super Size me."
 
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#14
I've been fat I would say since the 3rd/4th grade. I'm 31 today (today is my bday lol) I had ADD as a kid and was also medicated. my mom still tells me to this day that she regrets putting me on that medicine which is when the weight gaining started. I stopped taking it in the 7th grade just because I got tired of taking a pill everyday that I personally didn't feel any effects from. fast forward to my senior year. I weighed my heaviest a 345 lbs. I was degusted at the way I looked. granted I carried it better than most but at the end of the day, I was still 345. I made a goal that I wanted to be 250 by the time I walked across the stage for my HS graduation. Graduation morning, I weighed 250.2 butt ass naked on the bathroom scale. I was seeing a "nutritionist" at the time and was prescribed a weight loss pill. don't recall the name, maybe adapex or something? anyways between that and eating better foods with exercise the weight fell off quick.

I've maintained that weight ever since. I bounce between 250 and 260. my issue is no matter what I eat, when I eat, how much I eat, I don't lose or gain. I have a desk job and I literally eat fast food for breakfast and lunch every day. I know, this is horrible and I'm not making excuses for myself but, I often wonder how the hell I'm not 345 or bigger again. my days aren't packed with high intensity activities either. I wouldn't say I go home and lay down but I'm not power walking everywhere. I'm not huge on cokes or sugary foods. I pound water throughout the day, easily a gallon give or take a few ounces but I just like drinking. I rather feel full with liquid than feel guilty for eating something bad. I do stay hungry almost if I had a metabolism of 75 lb 10 year old kid but I know that's not the case lol.

I've threaten to try the Keto diet mainly because it includes a lot of the foods I like. I'm not a picky eater, clearly but Carbs are hard to just drop. I'm Fat because I chose to live a lifestyle that keeps me this way. I have no one to blame. it does sometimes make me wonder if I have any other issue(s) that keeps me from gaining weight with the diet I consume currently? your thoughts?
 
#16
D34- I think it is very unlikely (but not impossible) that you have a condition that is preventing you from gaining more. Hyperthyroidism is the obvious entity that could do this, but this is easily checked.

People often ask me about the Keto diet. I feel through the medical literature as well as through personal experience that the keto diet has quite a bit of merit to it. The difficulty with the keto diet is being able to stay in ketosis and maintain it over a long time. The vast majority of people will need to eat less than 50gm of carbs per day, and for many that number will be closer to 20. It's do-able, but it ain't easy. One of the biggest benefits of the keto diet is what I mentioned about insulin. When you are in ketosis, your insulin levels remain very low and this opens the door for the body to derive it's energy from your stored fat.

I did the keto diet not to lose weight but to see how it affected me from an athletic standpoint. There are some well written books regarding endurance sports in the setting of ketosis. The upshot of most of the studies done to date seem to show that endurance levels are indeed very sustainable (with even less fatigue) for low to moderate intensities, however, there is a drop off in performance for many people (myself included) for very high intensity activities (MTB racing for me).
 
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#17
fdkay, thanks for posting that video. The government food pyramid has done orders of magnitude more damage to people in this country than the combination of ANY and ALL gun related issues.
 
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#19
Wade, I'm gonna respectfully disagree with you. While you're right that nobody actually bases their eating percentages off of it, the concept of the good and bad food groups which were put forth had and continues to have a profound negative effect. Over time it has resulted in a billions of dollars industry regarding the whole diet food/low fat concept. There are physicians out there today who are still pushing the "saturated fats are the enemy" when in fact this is not true.
 
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#20
Ive had to go on a very low sugar diet for a very different reason, and its been an eye opener how much processed sugar is in the American diet where you dont expect it. I read the labels on everything and select products based on low sugar and never any with corn syrup or refined sugar. Its in things you dont expect and where its really not needed. Breads, ketchup, salad dressing, deli meats, even saw potato chips the other day loaded with sugar. Lots of foods that look healthy and are billed as healthy just loaded with it. There is a huge learning curve cutting it out of your diet. Have a friend who fled from South africa. He said that was one of the big surprises moving here- he had never had bread that was sweet until he moved to the US.
 
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#22
I like to row to stay in shape...

Me rowing...
tenor.gif
 
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#23
People just lack discipline. Myself included when I put on weight over last winter. I stopped working out for a while, ate unhealthy, ate too much. Only thing that works for me is hard work and consistency. It was either buy new clothes, which I couldn't afford, or lose weight. Easy choice with the right amount of discipline.
 
#24
In my early 40's I was racing bikes and in excellent shape. I suddenly started loosing weight, having night sweats and no heat tolerance. I was absolutely miserable and they ran test after test on me and finally one doctor recommended having my thyroid checked and set up an appointment with an endocrinologist. I was diagnosed with hyperthyroidism and we discussed options. One was to go on medication and the other was to make lifestyle and dietary changes and I opted for the latter. Started seeing a nutritionist who put me on a high calorie diet eating a intervals throughout the day. Had to stop training until my weight increased and took awhile to get my endocrine system back in balance. Have it checked on a regular basis and still slightly elevated but manageable.
 
#26
MTB doc said:
What's the answer? The answer is to get our body in the burning fat mode for a longer period of time than the storing fat mode. There are many different protocols but probably the easiest to start with is the 16:8 plan. You have an 8 hour window out of 24 hours to eat all the food for that day. The remaining 16 hours are spent in the not eating (fasting) state. The effect this has on the body with regard to how we store and burn fat is nothing short of dramatic. It's not a diet. It's eating essentially how we were designed to eat. For anyone interested in further info, probably the best source IMO is Dr. Jason Fung. You can read his book or pull up some of his youtube videos.
Click to expand...

18:6 is life...
wade2big said:
I agree that people eat too much too often. The government’s food pyramid isn’t to blame though as nobody pays attention to it anyhow. Nobody.

How often have you tried to eat according to it. I will answer for you. Never.
Click to expand...

Boom.
 
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#28
MTB doc said:
Littlepod, you're right, eating out is one of the biggest offenders. It's crazy how quick the calories add up.

As multiple people mentioned, the refined sugars are one biggest problems that has happened in this country. There is no bigger stimulator of insulin than refined sugar.
Click to expand...

It probably depends a lot on the person as well.
For me, what really ruined my health was not sugar because I had been trying to limit that for a long time, but rather Carbs.
Even "healthy" ones like rice and such. Eat too much of those, get a bit too heavy and next thing you know life sucks.

In my case if I have some sugar the effects are kind of short lived as opposed to if I eat some heavy carbs like rice or pasta or potatoes.
The carbs will boost my blood sugar and everything associated with it way higher than sugar will & keep them there much longer.

I do a mix of office work with warehouse work and packing work, so it's a lot of running around but not as much heavy physical work.
 
#29
A reasonable diet requires 24/7 awareness. A major portion of the food industry is our enemy. If the politics of their marketing was focused on health and not profit Americans on the average would be thinner.

I was a fat kid, had to loose weight in '73 to be able to play JV high school football in '74. I had to a get down to 168lbs, which is what I average now +/- 2lbs. I lost interest in most traditional stick/ball sports and became focused on cars and motorcycles during high school because of automotive shop class. When I started riding off-road motorcycles my competitiveness forced me to seek better conditioning to excel against my riding buddies. At the same time I also loved high performance cars, their engines, and racing.

I started looking at feeding my body like an engine. You put in poor fuel, the wrong fuel, too much fuel, have not enough, too much, or improper timing curves...… and your engine performs far from it's true potential. Cheap or improper oils/additives and you have internal issues. So I adapted basically a quality, volume, and demand mindset when fueling my body.

When I started formally racing off-road motorcycles in '79, first motocross then cross country/desert 100 mile events and that forced me to seriously up my physical conditioning game to compete and survive.

This mindset has stayed with me, until we had kids and the wife filled the pantry with carbohydrates, and I was working 60-70 hour weeks it took about 5 years to see 217lbs on the scale one day. I went on the Atkin's diet and knocked off 42lbs in less than 4 months.

Ever since, I watch carbs and sugars closely, try avoid restaurants, and any fast food. I cook a lot and mostly use olive or avocado oil and focus on proteins and vegetables..... Most importantly I avoid over-eating like the plague. There was a point in time I was too busy with work to eat anything in the morning, then a business lunch and consume too much, then home late and eat too large a dinner and too late.

Being over-full stuffed like Thanksgiving day all the time SUCKS...... so 15 years ago I started snacking on healthier stuff throughout the day and ate light lunches and dinners. If I'm at a function with a buffet line I'll only get a small plate with one or two items usually meat and a vegie, if it's a formal dinner setting at a restaurant I'll get an appetizer or two verses a main course. I can't tell you how good it feels to never over eat, my stomach has shrunk to a point that it's very easy to get over-full. The opposite of never being starved is also nice. You can eat a lot of different things, the key to success is moderation.

And..... with the cost savings of not over eating my ammunition inventory has increased.

Regarding exercise in my advancing age, I've been tracking daily steps for over 10 years now. First with a Fitbit, now with the Samsung app on my phone. My goal is 15K steps a day. Make it a habit to track steps, with set goals, and you'll force yourself to be more active. Simple things like taking the stairs instead of the elevator/escalator make a big difference over time. Sitting is your enemy.

Sorry for the long-winded shorthand response.
 
#30
MTB doc said:
Wade, I'm gonna respectfully disagree with you. While you're right that nobody actually bases their eating percentages off of it, the concept of the good and bad food groups which were put forth had and continues to have a profound negative effect. Over time it has resulted in a billions of dollars industry regarding the whole diet food/low fat concept. There are physicians out there today who are still pushing the "saturated fats are the enemy" when in fact this is not true.
Click to expand...
I get what you are saying but the fat asses at the drive through are not partaking in a low fat diet by anymeans. This is the actual western diet of today. It is a scavenger diet. Has nothing to do with the food pyramid and everything to do with convenience mostly. People are lazy.

I do agree that the food pyramid is ass backwards but it would be dishonest to state that even if the food pyramid would be corrected today that it would have any effect on the weight and health problems today. It would have none.
 
#32
Before we had our first, I was up to 278lb (I’m 5’-10”). I work a desk job, I wasn’t exercising enough, and I really liked fast food - but really it was just plain overeating and not exercising. I did a Keto/paleo’esque weight loss program and dropped 70lb in a matter of 4 months. The first 45lb was in the first 45 days. It was kinda crazy, but it taught me the finer points of the 16:8 idea, though it wasn’t spelled out that way, and staying away from useless carbs, refined sugar, and overly processed foods.

After our second, we got pregnant sooner than we planned (not a mistake, but definitely a surprise!) and my wife started eating like I used to, so I joined in and half ate poorly and bumped back up to 250lb from my lowest 207lb over the past year plus to this past 4th of July. After that holiday, I got back on the horse and started walking everyday and eating a lot cleaner again.

I’m down to 214lb this week and feeling better, looking better, and all my high-end fishing and hunting apparel fits great again. I don’t eat breakfast and until I get down to 200lb, I’m only eating a high protein and fiber shake at lunch and a appropriate portioned dinner of meat and vegetables. I haven’t cut out cheese as that’s my treat food and it doesn’t affect me as harshly as it does most people, but it’s working. I know I’m in a calorie deficit, but I don’t count them at all.

For me, it’s a little bit of everything mentioned above melded into a lifestyle change I just have to keep consistent with. Fast food and sugar are no longer urges for me. I like to drink ice water.

Just gotta find what works for everyone personally.
 
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#35
Yeah, and I'd like to add that if you have low testosterone (either naturally or due to taking pain meds for 6 months or longer) then that can cause metabolic syndrome and you will NOT be able to lose that weight no matter what you do. Not to mention you feel shitty ALL the time. I was developing metabolic syndrome, I was only lacking the diabetes...

Once I started taking the T shots though, the weight fell to normal, fast, and I was off the BP meds and everything went back to normal. I still have a high pulse but I always have, and damage to my body has caused some weight to pile back on, but I can shed that no problem the moment I heal (when?) and can actually "do" stuff.

So if you're on pain meds for sure, or if you just feel tired and don't have a sex drive, get tested for low T. If you've got metabolic syndrome or are developing it, there's a possible silver bullet fix here. You'd be surprised at how many doctors don't realize opiates affect T levels like that. Make sure to get the right test and done at the right time too for the right results... There are multiple T tests and usually they need to be done early AM for best results (and between shots if you're taking those already).
 
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#37
I was mildly Type 2, and then, I wasn't. I am 77 1/2" tall and weigh 155-160lb. The VA Docs tell me I have the best numbers they've ever seen. I have very little appetite, eat on a schedule so I don't forget, and my energy levels are neutral. When I exercise, I work on a rising scale, and eventually end up doing twice the max. None of it seems to matter re: my weight.

It confuses me, but then I ask myself, why care; my numbers are excellent, I'm just at the bottom edge of my weight for height 'good' zone, and I am not feeling any of my previous Cardiopulmonary symptoms.

Maybe I'll figure it out. Maybe I don't have to...

I suspect a lot of folks don't 'fit the mold'; and that it drives the Docs bananas.

Meh...

Greg
 
#38
Fasting is good on many levels . I work a 4 day week and I'm up at 3:30 am and don't eat until 9:30 or 10 am and try to eat last meal by 6 pm or earlier . Friday I usually fast for 20 + hours before eating . Saturday sometimes the same. I also avoid any food that comes in a box . Processed food is loaded with sugar and sugar substitutes , So I avoid those too.
I was always very active and trained for racing motocross . Lots of distance on the bicycle . Martial arts and lifted weights .
I was consistently 155 to 160 since high school . Use to drink lots of pop and a couple of beers every night after work. I didn't have any weight issues until i was 52 and started having a hip issue .
I had to stop riding motocross and gave up martial arts . Then I gained some weight .
So I quit drinking pop and no beers after work . Changed my eating habits and did some research on fasting and watched a lot of documentaries on processed foods and how and when to eat .
I am back at a consistent 155 to 158 and have zero problem maintaining that weight at 56 yrs old .
There has been a tremendous amount of research done in the last 10 or so years on western eating habits .

I am glad to see many more people are aware of processed food and the problems with sugar in their diets.
Than even just a few years ago .
 
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#39
Rerun7 said:
It’s way more simple.

People are fat for one reason. They eat more calories than they burn - period.

Until you get that under control it doesn’t matter when you eat the calories, what foods you eat, etc.

More calories than you need = excess fat
Click to expand...

As they say in the fire service... “calories in, calories in.”
 
#40
Booze is my downfall which connects to comments regarding sugar and carbohydrates

I eat little food but drink more than I should. My sugar levels are low, about 82, but losing weight at 58 years old is not working for me. I exercise (Peloton bike) 5 days a week for 30 minutes per time.

I have essentially given up with losing weight. I would sell a kidney to lose weight
 
#41
people are fat because they want to be, it has money to do with all the long talk, its a thing of choice. some people stress eat and some eat because they are idle.... IMO i don't there are more fat people in the country.
 
#44
I will tell ya where my belly came from...the "all you can eat prime rib loft"....my salad, dinner roll, half of the wifeys meal and 10 more plates of prime rib later...they threw me out...:(
 
#46
Nik H said:
Booze is my downfall which connects to comments regarding sugar and carbohydrates

I eat little food but drink more than I should. My sugar levels are low, about 82, but losing weight at 58 years old is not working for me. I exercise (Peloton bike) 5 days a week for 30 minutes per time.

I have essentially given up with losing weight. I would sell a kidney to lose weight
Click to expand...
Lift weights and build muscle
 
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