Can I lose weight? Really? What are the trade offs?

Yes, you can. No apologies to Mr. Obama.

As usual, it is simple but not necessarily easy. To lose weight, you must "burn" more calories than you consume. Well, not really because it's biology and not thermodynamics. You have to give your body the building blocks it needs to repair and rebuild itself - hint: you are made of proteins and fats, but you're not made of starch. If you are large this can be relatively easy, especially on a low carbohydrate diet, as it removes most of the body's ability to add fat mass by removing the main source of fat increase: carbohydrates. Many people have said it's all about calories, and it is, but not all calories are created equal. This is a major point of contention between the low fat and low carb outlooks. Since the calories are handled differently you can't just count 'em up to where you "stop" and expect results. Gary Taubes talks about this in a recent video interview on YouTube.

High carb, low fat diets have been the rule in this country for decades, prescribed by doctor after doctor in the battle against the bulge. They have failed, have proven unable to combat the epidemic of obesity, diabetes and heart disease.

The diets have failed. Not by any fault of the dieters, but because the premise of the diet was flawed from the get go. See Big Fat Lies on Youtube - it's a movie trailer that nutshells the "Lipid Hypothesis" and how it came to drive our beliefs about dietary fat and cholesterol.

I think this point is important. Dieters are often blamed when they fail to lose weight. Others who are lucky enough to be slim assume that dieters are weak of will, lacking in restraint, enjoy food too much or otherwise do not adhere to their doctors' instructions. Surely, there are some people who just eat too much, but most people who want to lose weight want to very badly and try very hard to do it. Their failure remains a confusing and disturbing mystery to them.

It must also be said that there are people who are fat who are healthy. In fact, being of "normal" or below normal weight correlates more strongly to mortality then being in the "overweight" category of BMI. This is a Hot Topic, but the data do not show that having a BMI between 25 and 30 is any worse than being in the "normal" 20-25 range. And there are people who like being fat, and people who like fatness in others, and these are matters of taste and not subject to reason. However, if you have elevated triglycerides then you should do something about your diet whether or not controlling your triglycerides brings your weight down or not. More about triglycerides later. If you like being well padded, just add some calories from protein or natural, healthy fats to keep from going into caloric deficit. But get those Trigs down!

Millions of us suffer from being overweight, pay through the nose for drugs, medical care and hospital stays. Most of these costs are entirely avoidable, if people knew how to control their blood sugar through diet. With or without exercise. Yes, I did say that. With or without exercise. It's all about blood sugar. The Sugar Hypothesis describes how blood sugar control, or lack thereof, affects weight, diabetes and heart disease. This blog post by Dr. Michael R. Eades, author of Protein Power, explains the results of this study into plain language. Over 17,000 men were given a fasting glucose test and several other measurements were done. Those who had the highest blood glucose readings had increased all-cause mortality (2.37) and heart disease deaths (3.70). That's nearly two and a half times as many deaths of any type and nearly four times as many from heart disease in that group as in the normal group. The glucose intolerant group died more than the normal group, but less than the diabetics.

Blood sugar levels directly correlate with your risk of heart disease, and drive whether you gain weight or become diabetic. This is why controlling blood sugar is so important. Blood sugar drives insulin, which in sufficient quantity causes problems like insulin resistance, insomnia and even depression. Insulin is the mechanism by which we get fat. Diabetes is insulin gone horribly wrong, in Type I by disappearing and in Type II by being too abundant. Before one is obviously obsese, diabetic or suffering from heart disease the system has alreadby begun to fail. But by short-circuiting the cause of the problem - sugar - the body can be returned to a state of normal or near-normal health simply by removing the sugar. You know the old joke, "Doctor, Doctor! It hurts when I do this!" "Well, don't do that." It really is almost that simple.

You do not gain fat by eating fat. This statement is in direct contradiction to the prevailing medical opinion, but it's true nevertheless. Your body gains weight from extra carbohydrates. Insulin is the vector for doing this, it removes excess glucose from the blood by stuffing it into cells. Once your muscle cells have become insulin resistant, your fat cells are the last resort. Insulin is the only way blood sugar can be reduced fast enough to avoid the kind of damage suffered by Type I diabetics. In contrast, there are five ways your body can increase blood sugar if need be. This tells us that historically, and from an evolutionary perspective, it was much more often necessary to raise blood sugar than to lower it. Insulin is like a light switch, if it's in the OFF position, the bulb doesn't light up. Insulin does a lot of things in the body, it's glucose regulation feature is a minor part of its job. Allowing it to elevate just to control blood sugar seems like sticking your hands into the fire to warm them up. They'll get warm, all right, but the rest of it won't be good at all.

Most Americans eat much more sugar and starch in an average meal than their bodies can burn as energy. This is largely because the carbohydrates we eat are refined, that is concentrated, rather than because we are greedy pigs. Our bodies expect more volume per calorie than these products deliver, so we don't feel full until we've eaten more than we need. Even "whole grain" products deliver more starch than we can deal with. Here's a link to a telling study done in China that attempts to correlate a vegetable-rich diet with good health. It failed, so the scientists involved blamed the unexpected result on cooking oil, while failing to notice that cooking oil use was not different in any of the studied populations. Even in China, starch makes you fat. Another analysis of the same study points out that wheat eaters in China get fatter than people whose primary starch is rice.

The burn window is about three hours. Glycogen stores are one place your body can put glucose, but they are limited, and fat stores are not. You do not add fat cells, just increase their sizes, when you consume more carbohydrate than you burn off.

By contrast, extra fat calories consumed can actually be wasted, so it is possible to eat more fat calories than you can use without gaining any weight. You won't lose, but you won't gain. The metabolic pathway that does exist to convert dietary fat to body fat is inefficient. This Story from Dr. Eades' blog, illustrates this beautifully.

Protein can be converted to glucose, so it is probably possible to gain weight eating nothing but protein. However protein, like fat, is very satiating, so it would probably be difficult and unpleasant to do that - you would feel full and naturally stop eating. A pair of studies, contrasted on Dr. Eades'blog, demonstrates that low carb eaters naturally and unconsciously reduce their calorie consumption because fat and protein are more satiating than carbohydrates.

The assumption underlying this site is that the reader is interested in weight loss. If you don't want to lose weight, or maybe drop your triglycerides, this aggregation of resources and information will be at best of academic interest. I do have a bias - pro low carb.

There are some tradeoffs if you really want to lose weight, and not everyone is willing to deal with them. In my world, the obvious tradeoff is cake. No more cake. At least not very often. You have to give up things that taste good (for good reason) and for many this is too much of a sacrifice. A carbohydrate, back before agriculture put them everywhere, all the time, was a rare and precious thing. A thing that let you store up some energy for the lean times, a thing that made it more likely you'd survive a lean time. The complete irony of it is that carbs, once the life-savers, are now the killers, literally too much of a good thing.

More on the nitty-gritty of metabolism.