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Insulin Resistance

Weight Loss Made Simple-ISH

I have about 45 minutes each work day during which I choose to listen to podcasts relevant to the work I love to do with my patients.  A recent fave podcast broke down a question common in any medical practice: how does a given individual LOSE or GAIN fat in their body? The approach is so logical and so comprehensive that I found it immensely appealing and just had to share it, so here goes.

Podcast in question is Dr. Peter Attia’s podcast, called The Drive, which has many free episodes of great interest. For subscribers he offers additional content, both episodes where he answers questions, and great show notes. I want to talk about Episode # 22, an “Ask Me Anything” podcast on Fat Flux.  Non-subscribers can get some of the content here:  https://peterattiamd.com/ama22/ .

Fat Flux, Simplified: Fat Loss

When everything is in balance, and everything stays the same, it must be that all the energy coming in is equal to the energy going out.  When you want to change the amount of fat in your body—and let’s just say we’re focusing on losing fat not gaining it—you’re really talking about the SIZE of your fat cells.  (If you want to decrease the NUMBER of fat cells in your body, liposuction is really your only choice, cosmetically a choice but not helpful for metabolic health.)

“I’m an athlete who wants to lose fat and gain muscle…”

“P.S. I’m over 50 and one or more of the following is also true about me: high blood pressure, my waist is bigger than my hips, my waistline is bigger than my hips, I’ve been overweight for more than five years, I can lose weight repeatedly—but I always regain it, my triglycerides are high on my cholesterol test, my blood sugar is a little high, I am a woman who has had babies weighing 9 lbs or more.”

If ANY of the above P.S. statements could be yours, you probably have a condition called “metabolic syndrome,” a precursor to type 2 diabetes. I heartily congratulate you on wanting to turn your health around, because that is exactly what you will do when you are successful at losing fat and gaining muscle. If you can turn belly fat into a bulging bicep, it will be easier for you to maintain a normal weight over time. You will make your doctor happy with your next lab tests, and maybe even get off your blood pressure medications. You will sleep better, have a better sex life (!) and keep your brain healthy as you age.

Cutting to the Chase

You won't solve the problem with exercise alone. Exercise will help, but 80-90% of the benefit comes from changing your diet.

Metabolic Syndrome = Insulin Resistance

“You’re telling me I have a condition I’ve never heard of, but it’s dangerous because now I’m likely to get diabetes, or heart disease…or cancer?” I'd hoped to raise the subject more delicately, but it was hard to avoid my concern about the metabolic problems in her recent tests. Marilyn had been teetering on the edge of diabetes for years, and already had high blood pressure. On some level she always thought that if she really had to she could fix that diabetic problem—if it ever happened.