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The best of these posts has been developed into a book entitled What Is Fat For? Now available, on Amazon as ebook,with print and audio, read by yours truly, coming very soon. Much additional material... Read More »

Insulin does not control weight loss.

Kevin Hall performs both theoretical and experimental studies in human metabolism at the NIDDK of NIH. This week, he and colleagues published an article in Cell Metabolism entitled, "Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity."

I think it's going to piss some people off.

For this reason, I decided to get my facts straight before writing about the study. Dr. Hall gave me some time on the phone earlier today. But before I get to his explanations, let me set up why, in diet research circles, this study is likely to have a large impact.

A new patient sits across from me in the exam room, confused and frustrated at her lack of progress trying to lose weight for the last 30 years. 200 pounds too heavy, diagnosed with type 2 diabetes, high cholesterol, hypertension, sleep apnea, infertility and osteoarthritis. She needs knee replacements, but is too heavy to be approved for the surgery.

Ben Goldacre, whom I hold in high esteem, has repeatedly contended that anyone espousing diet philosophies to others is practicing quackery. Eating does not require scientific scrutiny, nor does it take any specialized knowledge to get healthier: walk a little, ride a bike, eat your veggies....who needs a doctor to tell them to do those things? In fact, on his website, which I encourage all to visit, he sells T-shirts with a picture of a large rubber ducky and underneath the caption is simply, "Nutritionist."
Protein trumps carbohydrate and fat as the regulated parameter driving human food consumption:

Kevin Hall and Carson Chow published their estimation (in 2010) that the rise of obesity prevalence in the U.S. since the 1970s can be attributed to an increase in consumption of just seven calories per day per person. This is calculated by taking the average increase of energy stored in the heavier adult bodies of the present day, divided by the very long time frame it took for the change to occur.
Any discussion of carbohydrates in the diet must deal with the Atkins conception of weight loss, because it is so commonly used and it rests in the middle of the debate about the causes of weight gain. Anyone trying to figure out why we've become obese needs to decide, at some point, whether Atkins had the cause and effect of obesity and diabetes correct.

It's easy to dismiss Dr. Atkins. His books are self-promoting (he named the diet, which pre-existed him by 150 years, after himself) and full of hyperbole:
When you are a weight loss doctor, your friends and colleagues cannot help but comment on your work. Many conversations contain the question, "Isn't it all just....(carbs, laziness, fast food, inactivity, genes, fructose - fill in speculation here). I began to avoid the subject of my job like it was my dirty secret, but it came up fairly regularly nonetheless. Of the many completely wrong-headed things that non-obese people wonder, the one that came up most often was, "how does a  person let themselves get that way?"