Fasting is when you restrict your intake of food and drink for a period of time. It’s a common part of some religious beliefs, but even if you’re not religious, you’ve probably practiced it at least a few times in your life without really thinking about it. For instance, your healthcare provider has likely told you to fast before having a medical procedure or blood test ( Sanvictores, 2021). During feeding, you store food energy as body fat. During fasting, you burn body fat for energy. If you balance those two, your weight will remain stable. If you are predominantly feeding, you will gain weight. If you are predominantly fasting, you will lose weight. So, here’s my best single tip for weight loss. It’s so simple and obvious that even a 5-year old could have come up with it. Don’t eat all the time.

The “insulin causes obesity” hypothesis is easily tested. If you give insulin to a random group of people, will they gain fat? The short answer is an emphatic “Yes!” Patients who use insulin regularly and physicians who prescribe it already know the awful truth: the more insulin you give, the more weight people gain. Numerous studies have already demonstrated this fact. Insulin causes weight gain. If you have been diagnosed with class III obesity, bariatric surgery may be an option for you. Surgery is a severe but highly effective solution to long-term, significant weight loss. It works by changing your biology instead of just your mind or your habits. All bariatric surgery procedures alter your digestive system in some way. They restrict the number of calories you can consume and absorb. They also change hormonal factors in your digestive system that affect your metabolism and hunger. The Cleveland Clinic says that when the body stops expecting food regularly, it may adapt to use the fat that a person already has and the sugar that it receives when someone does eat more efficiently.

The Bottom Line on The Obesity Code

Insulin resistance causes your body to produce more insulin, creating a significant spike in insulin levels. The effect is an even greater storage of fat in the liver and an even greater insulin resistance. This item received a score of 0 out of 4, indicating that the strength of the claim is greatly overstated. The claim is refuted by a large volume of compelling evidence, including several studies cited in TOC itself, which we reviewed above. Overall (average) score for claim 1

This item received a score of 1 indicating that the strength of the claim is substantially overstated. Although most of the evidence that is cited is from reputable sources, these sources do not provide robust evidence to support the claim. Rather, bits of data from case studies, cross-sectional analyses, and other less-compelling forms of evidence are used to draw conclusions about insulin and its role in obesity that are not well supported by the overall scientific literature. Parmar, R. M. & Can, A. S. (2021). Dietary approaches to obesity treatment. [Updated 2021, Oct 12]. In: StatPearls

The fourth is that fat grows inexplicably. This couldn’t be further from the truth. Nothing in our bodies happens by accident. Hormones control everything within your body. You may have experienced a bias that obesity is a personal choice or a moral failure. If you’re seeking medical advice for obesity, chances are you’ve already tried to manage it several times on your own. Sugar is the chief villain. Its most common forms are glucose and fructose. Glucose drastically drives up blood sugar levels. Your body is then forced to churn out more insulin, which contributes to sugar getting into the cells. Fructose has a different effect. It goes directly to the liver instead of being stored in the cells. The liver then breaks the fructose down and ultimately stores the excess as fat. The result is often a fatty liver, which contributes to insulin resistance. Fatigue. Sedentary lifestyles have a snowball effect. Studies show that the longer you sit still, the wearier and less motivated you become. Sitting makes your body stiff and contributes to aches and pains that discourage movement. It also causes general stress, which adds to fatigue. Once we understand that hormonal imbalances can affect weight gain, we can begin to treat it. If we believe that excess calories alone cause obesity, then the treatment is to reduce calories. But this method has been a long-term failure. However, if too much insulin contributes to obesity, then it becomes clear that we need to lower insulin levels.

Hormones are central to obesity as is everything about human metabolism, including body weight. A critical physiological variable such as body fatness is not left up to only the vagaries of daily caloric intake and exercise. If early humans were too fat, they could not easily run and catch prey and would be more easily caught themselves. If they were too skinny, they would not be able to survive the lean times. Body fatness is a critical determinant of species survival. The second fallacy is how your metabolic rate is steady. This false idea comes from the common belief that you regularly burn a certain number of calories. But this belief cannot consider all the variables of your metabolism. You need to be aware of your total baseline energy expenditure, which can vary by 50%. One trial, published in 2016, did involve daylong zero-calorie fasts three days per week in adults with obesity, again using continuous calorie restriction as a comparison. This is within the range of intermittent fasting protocols that TOC recommends. Over eight weeks, both groups lost about the same amount of weight (7.1 vs. 8.2 kg) and body fat (3.7 vs. 3.7 kg). There was no significant difference in metabolic rate between groups. The researchers also followed the volunteers for 24 weeks after the diets were complete, and found that there may have been modest differences in fat regain between groups that were either significant or non-significant depending on how they measured body fat (percent fat mass vs. total fat mass). Overall, this study offers little evidence that intermittent fasting is a superior weight loss method vs. continuous calorie restriction. The question is not just how to balance calories; the question is how to balance calories and our hormones especially insulin. There are really only two ways that insulin increases. Either:Examples of limitations include bodybuilders and athletes, who have more muscle and may have higher BMI scores even though their fat levels are low. It’s also possible to have obesity at a “normal” weight. If your body weight is average but your body fat percentage is high, you may have the same health risks as somebody with a higher BMI. Scherger, Joseph E. (2019). "The Diabetes Code". Fam Med. 51 (3): 286–287. doi: 10.22454/FamMed.2019.998853. S2CID 76663782.