The Diary Of A CEO with Steven Bartlett - The Fasting Doctor: “Fasting Cures Obesity!”, This Controversial New Drug Melts Fat, Fasting Fixes Hormones! Skip Breakfast!
Episode Date: January 22, 2024There seems to be endless ways to lose weight and yet none seem to work, but could it be that there was one health metric that held the key to long term weight loss? Dr Jason Fung is a nephrologist (m...edical expert specialising in kidneys) and world-leading expert in intermittent fasting and low-carb diets. He is the author of bestselling books such as, ‘The Obesity Code’, ‘The Diabetes Code’, and ‘The Complete Guide to Fasting’. In this interview, Steven and Dr Jason discuss everything from the history behind dieting myths, how insulin causes weight gain, why you don’t need breakfast, how obesity is genetic, and the power of fasting. You can purchase Jason’s book, ‘The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally’, here: https://amzn.to/47K90z0 Follow Jason: Twitter - https://bit.ly/429c5rw Instagram - https://bit.ly/3Szn6iJ YouTube - https://bit.ly/4b0zfnT Follow me: https://beacons.ai/diaryofaceo
Transcript
Discussion (0)
Quick one. Just wanted to say a big thank you to three people very quickly. First people I want
to say thank you to is all of you that listen to the show. Never in my wildest dreams is all I can
say. Never in my wildest dreams did I think I'd start a podcast in my kitchen and that it would
expand all over the world as it has done. And we've now opened our first studio in America,
thanks to my very helpful team led by Jack on the production side of things. So thank you to Jack
and the team for building out the new American studio. And thirdly to to Amazon Music, who when they heard that we were expanding to the United
States, and I'd be recording a lot more over in the States, they put a massive billboard
in Times Square for the show. So thank you so much, Amazon Music. Thank you to our team. And
thank you to all of you're trying to lose weight,
what you need to do is Dr. Jason Fung, the founder of Intermittent Fasting,
whose influential work could be the key to a healthier and even longer life.
Every continent is seeing this increase in obesity, but we put the blame on the individual.
The problem is there's something wrong with the message we're giving people. And I can go over a few examples.
First of all, exercise is really good in a number of ways.
But in terms of weight loss, it's actually a very, very small effect.
The whole idea that you need to eat as soon as you get up is just false.
We know from twin studies that 70% of your risk of becoming obese is due to genetics. but it doesn't explain why the population became much more obese.
And we know that you can't cure obesity by saying eat fewer calories.
It's about fixing the hormones that are behind the calories.
If you want to lose body fat,
you actually need to extend the period of time that you're not eating.
So you do some intermittent fasting.
There's all this data showing that fasting activates the body.
It increases your energy, your concentration.
A treatment available to everybody for free,
and it will be healthier for us.
So I need some advice then.
What does your fast look like?
What food should I be giving my body, and in what proportions?
The first thing you've got to do is...
I've got to talk to you about these new injections people are getting to
lose weight. I think... Dr. Jason. Hey, Stephen, how are you? I'm really, really good. This book here, The Obesity Code, Unlocking the Secrets of Weight Loss.
Why did you write this book? What was the sort of driving motivation behind committing what must
have been a very long part of your life to this subject matter?
It was actually a very interesting sort of journey of discovery for me. So I did my
training in nephrology, which is kidney disease. So I'm a kidney disease specialist. And I thought
about weight loss sort of very conventionally, sort of calories in, calories out, just watch
what you eat sort of thing. And that's what's taught to all doctors is that it's extremely
unhelpful for people. It doesn't work at all.
It doesn't work for patients
and it doesn't work for doctors even, right?
So doctors who wanna lose weight,
they don't use calories in calories out
because it doesn't really work.
And we all know this.
Every person has sort of counted their calories
and almost all of them fail to succeed.
So the whole point was
how to get people to lose weight. And so I started to look into the literature and I started to read
about it and so on. I got very, very interested in it. And again, I started to become very unhappy
with the discussion about calories in, calories out, because the whole point was that people had this idea that it was
energy balance, right? And there's this sort of energy balance equation, which is
calories in minus calories out equals body fat, right? Because body fat is a way to store calories.
But that's not a very helpful sort of description of how to approach the problem, right?
The problem is not that people didn't realize that they had to eat fewer calories or increase
their calorie expenditure.
The problem was why were they eating more calories than they could expend, right?
And it's because the body is being told to store energy.
That's the way it is.
That's why you're taking in more calories or you're storing more calories
is because your body has hormones that tell you to store calories.
So there's a hormone called insulin, for example.
And if you give people insulin, so inject them with insulin,
which is a drug for type 2 diabetes,
almost everybody gains weight. So if you give somebody insulin, they gain weight. If I gave
you insulin, you would gain weight. It has nothing to do with the, you know, your willpower, for
example. If I gave you insulin, you would gain weight. Why? Because I'm giving your body the
instructions to store energy. So you're saying that weight gain and obesity in particular
isn't a function of calories in, calories out.
It is a function of hormones.
It's a function of hormones.
And it's sort of, you have to think about it in sort of levels, right?
So calories in, calories out is true.
So body fat is a storage, it's a way to store energy, which is calories, equals calories in, calories out is true. So body fat is a storage, it's a way to store energy, which is calories,
equals calories in, calories out.
But that's not the real question.
The question is why are you storing more calories
than you're expending?
And it's because you're telling your body to do so.
So for example, if you take another equal,
I'll give you an analogy.
Say alcoholism is alcohol in minus alcohol out, right? Same idea.
Or if you have a room, it's the number of people, how full it is, is how many people enter the room
or exit the room, right? So same idea, right? It's absolutely true. So alcohol in minus alcohol out.
Equals how drunk you are.
Equals how drunk you are. So alcoholism.
So can you simply cure alcoholism by telling an alcoholic, oh, just drink less alcohol
than you expend?
It's like, yes, you can say that.
And it's absolutely true, but it's not useful in any way because you've never gotten to
the really, the deeper understanding of why that person is taking in more alcohol, right?
You have to get to that next level and say,
you know, it's like going one level deeper.
Why?
Why are they drinking more alcohol?
Well, maybe they're depressed.
Maybe they're addicted.
Deal with the addiction.
That is the way to deal with alcoholism.
You can't cure it just by saying drink less alcohol
the same way you can't cure the obesity by saying eat fewer calories because you're not understanding why the body is storing more energy.
With the amount of information we now have, the amount of science we have, one would expect that obesity levels would be coming down.
Yeah, unfortunately, if you think about the way most people think about it, it's mostly still in calories. Even in the academic centers, they all think about sort of calories, how to get calories down, how to reduce calories. And I always say, well, it's not about the calories, right? It's about fixing the hormones that are behind the calories. Because you can choose to eat fewer calories. Yes, that's true. But you have to ask
yourself, why are people eating so many calories, right? Well, it's because they're hungry. You
can't choose to be less hungry. And therefore, you have to really talk about controlling the hunger
and controlling the hormones, which are behind the calories that you eat. And that's going to
be much more successful to you.
If you take two different foods,
equal number of calories and you eat them,
the hormonal response to those calories are completely different.
So you eat two slices of white bread and jam,
all that energy, so insulin spikes up
because it's very high in refined carbohydrates.
All that energy goes straight into your body fat and you've left none of it for energy for your day. By 1030,
now you're ravenous and you go get yourself a low fat muffin. Again, pure carbs, insulin spikes up,
all of that goes straight into your fat stores. Why? Because you told it to. Remember that when you eat white bread or muffins or
refined carbohydrates, you're going to have this insulin spike, which is going to tell your body
to store energy. If you eat an egg, you don't get that spike in insulin. So that energy that you've
taken, those calories are there. You can use it. And so what happens? That keeps you full during
the day. If you're telling your body to
immediately store those calories as body fat, well, guess what? Over time, you're going to
gain body fat because you told your body to do that. If you eat the egg and insulin's not spiking
up, well, you haven't told your body to store that energy. So it's going to be around for you
to use all day long. And you won't be hungry. And you're not going to be hungry because your body's like, why do I need to eat again? Because you basically have taken the energy that you need. I've got it
available, right? It's sort of like if you go to the grocery store, right? You can store food in
the refrigerator. Suppose you go to the grocery store, put all your food away, lock it away in
the refrigerator. Now you have nothing to eat,
right? You're going to say, oh, I need to go out and get some more food, right? Same thing with
your body, right? So if you take food, but you've also spiked up your insulin, you're going to lock
away all that energy immediately into your fat stores. It's not going to be available for you
to use. Well, you're going to say, I'm going to go out and get more. So you haven't controlled the hunger that's going to
lead to the caloric intake, which is going to lead to the weight gain. People look at this through
an evolutionary lens and say, you know, we just didn't have this much food. So it's the abundance
and ease of access to food. It's the fridges that we now have. It's the, you know, we never had
fridges in our home. So people point at it and go, well, that's why people are getting, gaining weight. And, you know,
we're suffering with obesity at epidemic levels, which is because there's more supply.
And the brain is taking advantage of it because once upon a time, if we didn't eat that jam and
toast, then we would have, you know, maybe not have been able to find food for another two
weeks or something. Yeah. I don't think that's the whole story because if you think about it
and people, again, make that assumption that we don't have any control over our body fatness,
right? So they say, well, it's available. So you're going to take it, right? In fact, that's not true because we actually have a number of different hormones
that tell us to stop eating, okay?
So if you eat,
you cannot simply keep eating and eating and eating, right?
If you go to an all-you-can-eat buffet,
at some point you have to stop because you're full, right?
So there are systems, very powerful systems within our body
that tell us to stop eating. So you eat food. There are stomach stretch receptors, for example.
So as your stomach stretches out, it sends a signal to your brain and says, stop eating.
If you eat a lot of protein, it activates a hormone called peptide YY, which tells you to stop eating. If you eat a lot
of dietary fat, you activate a hormone called cholecystokinin, which again tells you to stop
eating. And these are very powerful. If you look in the wild, there are no obese antelope. There
are no obese lions. Why? Because how much body fat you carry is actually very important.
If you are obese as an antelope, you're going to get eaten.
If you're an obese lion, you're not going to catch any food.
So therefore it's going to correct itself. So if I overeat now, my body will basically overcompensate
by burning off the extra calories.
Absolutely.
So if you eat a huge meal, right?
Do you eat, you know, you go to a big wedding or something like that, you eat a huge meal.
The next day, you're probably not that hungry.
If you eat a giant steak,
so you're activating all these satiety hormones,
peptide YY, cholecystokinin, you're eating all this food.
Well, you may not be hungry for the next day.
So that means that my body has some kind of baseline weight. Yeah, it will know whether you
should eat more or less. So there's this concept called the sort of body set weight, which is a
sort of thermometer. That is your body sets a weight that you should be at. And if you go above
that weight, or if you eat too much, it will activate hormonal systems to bring it back down.
If you don't eat enough,
it will also activate hormonal systems to bring it up.
So it's like a thermostat that you have in your room.
For example, you set the room temperature.
If it's too hot, the room activates the air conditioning.
If it's too cold, it activates the heat.
Your body actually acts the same way. If you gain too much body fat, your fat cells, for example,
will produce leptin, which is another hormone. The leptin tells your body to stop eating.
That's really interesting. So in the case of obese people,
their set point must just be really high.
Yes. And that's the crux of the matter. Why is that set point being overridden?
Just like if you have a room that's too hot and you look and you say, the thermometer is set for
room temperature. Why is it so hot in here? Then you can say, okay, well, what's the problem? And
the problem is not, you know, heat in versus heat out, right? That's a very simplistic way.
Same thing. If your body has too much body fat, you got to then think about
why are you overcoming the normal compensatory mechanisms
that are happening, that are stopping you from eating?
A lot of it relates to processing of foods, of course.
So if you take out,
so remember I talked about stretch receptors
in the stomach, right?
So you eat natural foods.
There's a natural break.
It stretches the stomach.
You stop eating.
Well, what's one way?
Pull out all the fiber, process the foods,
turn it into say a very fine dust.
That means it's absorbed extremely quickly
into the blood stream.
So that means that you've got pure carbohydrate
basically mainlining it
into your IV, like an IV. Your glucose spikes way up, your insulin spikes way up. It's completely
unnatural, right? If you eat pure carbohydrate instead of eating it with proteins and fats,
it's going to shoot way high. That's unnatural. And that's gonna overcome the natural tendencies
for you to stop eating.
So, you know, you've basically overcome
that protective mechanism
because you've ultra processed the carbohydrates.
If you don't eat any protein,
if you don't eat any fat,
you're not activating peptide YY,
which is the satiety hormone.
You're not activating cholecystokinin. All of a sudden you're eating, you know, 500 calories of white bread,
but you have zero satiety. Or if you drink a Coca-Cola or a soda, for example, I've always,
you know, thought about this. It's like, how can you take a thousand calories, for example,
in one of those giant sodas you get at the ball game or something
and don't feel full at all. Whereas if you took a steak, that's a thousand calories. You'd be like,
I'm pretty full. I don't really feel like eating. You drink the soda. You're like, I really feel
like eating some chips or popcorn or something. Why? Because it has zero satiety. Interesting.
So if I'm, if I've got a baseball stadium,
what I want to do is I want to make sure people get a soda
because then they'll also buy the chips.
But if they just eat the chips,
maybe they won't buy anything else.
But the soda is going to increase my revenue
because it'll basically just pass right through them.
It'll pass right through them.
They're going to store all that energy,
those calories, but they're going to want more because you haven't made them full, right? So
the whole point is that you have to think more than about the calories. There's more there than
just the calorie story. There's this whole hormonal balance.
You're saying that overeating isn't just a choice, it's a hormone-driven behavior.
It's a hormone-driven behavior. I mean, the whole thing about obesity is quite interesting to me because if you think
about obesity, if you think about in the United States, which is where I get a lot of my data from,
you know, you have maybe 70% of people overweight or obese, and it's going up every year. It's been
going up every year since 1977. And if you think about that, it tells you
that the problem is not willpower. The problem is not the people. The problem is the environment
that they find themselves in, the food environment that they find themselves in. Because you can take
an analogy. Say you have a hundred children. One of them fails. Well, that might be the child.
They didn't study. What if 70 of them fail? Would you say it's
each and every one of them's fault? Or would you say it's more likely that it's the teacher's fault?
I think it's more likely that it's the teacher's fault. So if we have a hundred Americans and 70
of them are obese, the problem is likely not an individual willpower problem. The problem is likely
that there's something wrong with the
message we're giving people, the information we're giving people, and the food environment that we're
finding ourselves in, which is dominated by this sort of calories in, calories out thinking.
And what's really unfair, of course, is that we put the blame on the obesity or overweight
on the individual. And we say, well, they let themselves
go and they didn't watch themselves. They weren't careful. It's their fault. And that's the stigma
that comes with this whole calories in, calories out thinking, because we say it's their fault
because they could choose what they eat. It's like, yes, they could choose what they eat,
but they didn't choose the food environment that is telling them to eat all this ultra
processed food that is making all this ultra processed food available to them, that is telling
them that all this ultra processed food is good for you. So leptin is this hormone that essentially
brings down my hunger, makes me less hungry. Is it therefore possible that people are becoming
leptin resistant? There is leptin resistance. The question again is
why? And the way to think about it is it's sort of this sort of balance, right? So insulin,
if you give people insulin, like if you think about causes of obesity, what causes people to
gain weight? Well, if I give you insulin, you'll gain weight. If I give me insulin, I'll gain
weight. So insulin causes weight gain, whereas leptin will cause the opposite. So it's sort of this seesaw.
Body fat is nothing more or less than a store of energy, right?
And you only store energy when your body tells you.
Our entire body runs on hormones, right?
Nothing happens without the hormonal system being activated.
So insulin is pushing us to gain weight.
Leptin is pushing us to lose weight.
And what's happening is that
one is sort of overcoming the other. Insulin is overcoming the le lose weight. And what's happening is that one is sort
of overcoming the other. Insulin is overcoming the leptin. If obesity isn't about a lack of
willpower and it isn't just a case of people being lazy or all those things that sometimes
some people stereotypically assert, I've also heard the counter-argument that obesity is a
function of our genetic makeup and we inherit obesity from our parents, you know.
Is there any truth and merit in that?
It's yes and no.
So yes, there is a very strong sort of genetic predisposition to obesity.
So if you take, you know, somebody with a family history
and look at the genetics,
about 70% of your risk
of becoming obese is due to genetics. And we know that from twin studies, for example.
What do we know from twin studies?
If you take twins and raise them sort of in different environments, you know, they actually
turn out very similarly. So we know that there's a genetic component to obesity. So when they sort of do the calculations,
they say about 70% of obesity is sort of genetically related.
So if you take a twin that comes from originally a family that were obese
and you put them with a family that are not obese,
the child will still likely become obese,
even with the family that are not obese.
Yeah.
So this was done and obviously they had twins
that were sort of separated at birth.
Compare them after they've grown up
and say what's the sort of correlation
between the weight of the two.
And it's about 70%.
So you have somebody who's very overweight
and twin A goes into one family,
twin B goes into a second family.
Twin B is gonna be more prone to gaining weight
even if they're with a thin family, right?
So the environment has some role,
but the genetics have a very large role too.
70% approximately.
About 70% is genetic.
So there is.
However, the part that's important
is that that doesn't explain why we have obesity
in the last 40 to 50 years,
because the genetics of the world population
has not changed.
So if we're seeing more obesity now,
and remember, this is not a USA problem.
It's a worldwide problem.
We see it in Asia.
We see it in Europe.
We see it in America.
We see it in South America.
We see it everywhere.
We see it in Africa.
So every continent is seeing this increase in obesity.
Therefore, this recent change within the last 50 years is not due to a change in genetics. So while yes,
it's true that there is a strong genetic component, that explains my risk of say obesity compared to
yours, but doesn't explain how the population of the United States, for example, all of a sudden
became much more obese in general. So you're saying this is really about a predisposition, which basically
means your genetics make you more or less likely for some reason, which is a genetic reason,
to become obese when you make certain lifestyle choices. But that is a predisposition, which means
that, and I guess your work asserts that the predisposition relates to
your hormones response to the foods that we eat. So really it's really a genetic response to foods,
which is based on your hormone response. We all have a certain genetic sort of
predisposition to obesity, right? So all of us have a certain risk. Some people, obviously they
eat whatever they want and they don't gain weight. We all know people like that, right?
And some people sort of look at a muffin
and they gain weight.
So you have that genetic predisposition.
So that explains the difference between two people,
but it doesn't explain the difference
within an entire population.
Like if you take the entire population of the earth
or even of America or whatever,
the genetics haven't changed sufficiently
of that entire population
to say why there's more obesity now than before.
So we're inheriting our parents' hormone response.
Yeah, but the hormone response that we have
is going to be dependent a lot on genetics,
but the food choices we're making
are different than our parents. So
they're eating different things. If you think back about what your grandmother ate and stuff,
it's different than the food environment that we find ourselves in right now. And that food
environment is creating this sort of, is sort of increasing the risk over time. That's the sort of what we need to try and figure out and why we need to
have a deeper discussion as opposed to calories, because we've been having this sort of calories
discussion for, you know, 30, 40 years. It just hasn't been very helpful.
You call it a deception. You say in part two of your book, you say the calorie deception.
And you say there are five wrong assumptions about obesity and weight loss.
The calorie in, calorie out are independent of each other,
so won't trigger one another.
And this interesting point about the basal metabolic rate
being stable, is that in essence because people,
you know, people will often say I have a low metabolism.
It's kind of like a word in culture.
If someone is obese, often the diagnosis is they
have a low metabolism. Is there any merit in that? Is that true? Oh, absolutely. The question,
so when you think about, so body fat, you think about the energy balance equation, body fat equals
calories in minus calories out. This often leads people to say, well, just eat 500 fewer calories and you'll lose a pound of fat per week. It's
unquestionably false because every single study that we've done over the last 50 years shows that
if you eat 500 fewer calories, then over time, depending on what foods you're eating, eventually
your body will just burn 500 fewer calories. So that's your basal metabolic rate, the number of calories that your body is expending in one day. So we see this in
almost every single study. We've known about it for like 80 years at least. You eat fewer calories,
your body burns fewer calories. Well, that's going to limit how much weight you're going to lose,
right? So this idea that
just eat fewer calories will automatically lead to weight loss is completely false because we
know that eating fewer calories leads also to burning fewer calories. So you eat 500 less,
your body burns 500 less, and you're not losing any body weight. So I go on a diet, let's say, because I'm trying to
lose weight. My metabolism lowers to meet the calorific restriction that I've imposed on myself.
What then happens when I come off the diet? Does my metabolism stay low?
Yeah. So that's that yo-yo dieting effect. So say you start with 2,000 calories in, 2,000 calories out.
You're not gaining weight.
You're not losing weight, right?
Now you decide, okay, I'm going to go on a diet.
So you go down to 1,500 calories,
thinking that you're going to burn 2,000
and the body fat's going to provide 500, right?
That's how you balance that equation.
However, if you eat the wrong foods
and you're eating all the time,
so you're eating 10 times a day, eight times a day, like people say you should, you're eating
low fats or you're eating tons of carbs, you're spiking your insulin. Insulin prevents you from
burning body fat. Okay. So we've, again, we've known about this for 80 years. So now you eat
1500 calories, but you're keeping your insulin levels really high. So fewer calories, but lots of high carb foods, eating all the time.
Insulin stays high.
You're taking in 1500.
Your body is now burning 2000, but you can't burn any body fat.
So the calories that are stored in your body fat cannot be sort of taken out.
It's like it's in the bank and the bank is closed.
You can't take it out.
So what's going to happen? Well, you don't have a balanced equation. So that cannot happen. So
what happens is that in order to balance that equation, because your insulin levels are high,
you're eating 1500 calories coming in. Your body can only burn 1500 calories. Your metabolic rate
has just now gone down by 500 calories. And guess what?
You're not losing any body fat. So that's an example of how the whole, the calories idea is
completely wrong. Because if you continue to do that, what's going to happen over time is that you
get tired because you're burning fewer calories. You don't have enough energy to generate body heat. So you're cold, you're tired, you're hungry. So you say, okay, I'm going to go to 1800 calories.
So now you're eating 1800 calories, but you're only burning 1500 calories. Guess what? You gain
weight. And you say, but how can I gain weight? I'm eating less than I did. Yes, you are eating
less than the 2000 calories you used to eat you're eating 1800 but you're
eating the wrong foods it's very high insulin foods so therefore you're going to gain weight
in fact everybody says that and and all the all the nutritionists all the doctors just they just
don't believe them they say you're lying you're cheating you're eating more than you think
so this explains something that happened with one of my friends which always puzzled me
he swears by the calories in calorie out thing. I've spoken about him a few times. He
posts about it online as well. And he actually managed to get a pretty much like six pack abs,
pretty much. And at the time it appears that he was eating a lot of Domino's pizzas,
a lot of pizzas. And I was thinking, how's this guy eating all these pizzas pizzas but he's using this calories in calorie out thing and then when the pizza stopped yeah there was
this yo-yo effect yeah where he managed to get to basically what I'd describe as a six-pack
there thereabouts and then um stopped eating stopped the diet per se and then there was this
big yo-yo effect which I imagine is what you said there.
What he's done is he's lowered his metabolism. And when he goes up just a little bit,
it all comes back. It all comes back. And then some. And then some. Yeah, absolutely.
So this form of dieting is actually over the long term probably going to make you gain weight.
Oh, it's very detrimental. And that's what yo-yo dieting, we all know it's very detrimental. And that's what yo-yo dieting, we all know it's very detrimental, but think about it differently, right? So let's take a different example with the same calories,
which is why I keep saying, you have to think about more than the calories. You have to think
about what the hormones are because that's the instructions to your body. Food contains calories,
energy, but it contains instructions as to what to do. So let's take an example. You're eating
2000 calories in, 2000 calories out. Now you go on a example. You're eating 2,000 calories in, 2,000 calories out. Now
you go on a diet. You want to, you take in 1,500. But what you do is you do some intermittent fasting.
When you fast, insulin is going to fall. That's the whole point. Insulin is a hormone that goes
up when you eat. It goes down when you don't eat, right? So when you eat, insulin goes up. Your body
wants to store energy. When you don't eat, insulin goes down.
Your body says, I have no energy.
I have no food coming in.
Please take it out of storage.
So now you take 1500 calories,
but you do intermittent fasting.
So you're allowing your insulin levels to fall.
Now, 1500 calories are coming in.
Insulin levels are low.
Your body wants to burn 2000 calories.
It says, well, insulin levels are low.
Let me take 500 calories from my body fat.
Guess what?
You have 500 coming from your body fat.
You have 1,500 coming from your foods.
You burn 2,000.
It's a balanced equation.
So instead of the opposite situation,
and you see that the calories are the same.
You went from 2,000 in to 1,500 in.
But what the difference was that you allowed insulin
to fall, which allowed you to burn body fat, right? It's the hormonal signal that says,
please take energy out, open up the doors so that body fat can come out. And this is the piece
that's missing because people are all like, well, I'm this, I'm that. And it's like, well, why can't
you burn the fat that's on your body? Because there's 200, 300,000 calories of body fat. Why can't you access it? It's because you
haven't activated the right hormones so that you can access it. So now if you do intermittent
fasting, you eat 1500 calories, you take 500 calories out, your body's burning 2000. Now,
all of a sudden, if you go off your diet and you go
back to 2000 calories, guess what? You don't gain weight. You don't lose weight. Same as before.
Whereas before you go even to 1800 calories, you lost weight. But the difference was not the
calories. It was always 2000 to 500. The difference was you paid attention to the hormones that you're
telling your body.
And the insulin is sort of the primary hormone.
There's actually a lot more.
There's, you know, there's cortisol is a very important hormone.
There's other hormones.
You mentioned burning calories there.
One of the thoughts around the calories in calories out model is that you can just exercise.
And if you burn a thousand calories exercising, then that
gives you a little bit of a reserve there to eat more, for example. Yeah. And it's probably a very,
very small effect for a couple of reasons. So we know that if you exercise, and I say this,
exercise is really good for you in a number of ways.
Flexibility, strength, core, all kinds of things.
So very, very important.
But in terms of weight loss,
it's actually a very, very small effect.
Why?
Because one, the amount of calories you burn during exercise are simply not that high.
So if you look at, you know, if you do walking,
I mean, if you did eight hours of high intensity
exercise, yeah, you're going to burn a lot of calories.
But most people I deal with, which are sort of middle-aged and higher, you're talking
about sort of a quick walk or, you know, 45, half an hour, three times a week sort of thing.
And if you ever go on the treadmill and you ever watch that calorie counter on the treadmill,
you know, it goes up very, very slowly, right?
You'll do half an hour
and it'll be up to like 120 calories
or something like that, right?
So that exercise really didn't burn off very many calories.
It's the amount that you'd get
in a couple of cookies, for example, right?
So it's just numerically, it's just very small.
So if you're taking in,
if your body is normally using 2000
calories with your brain generating body heat, your heart, your lungs, your liver, they're using
2000 calories. And now you go up to 2100 calories. Well, percentage wise, it's not a huge deal,
right? The other problem with exercise is that it tends to actually cause you to eat more. So again, we've had decades of
study for this. If you exercise, during the exercise, you have reduced appetite. So you have
exercise, it's called exercise-induced anorexia. So in the middle of a basketball game, you don't
suddenly go, oh, wow, I'm really hungry, right? Because your blood is flowing in your muscles and so on.
You're not thinking about the hunger.
So hunger actually goes down during exercise.
But after exercise, we see this rebound.
So we see that people are actually more hungry after exercise.
And if you're hungrier after exercise, it's going to cause you to tend to gain more weight.
In fact, there's this very interesting study that was done a few years ago in Harvard, where they measured the sort of calorie difference
that you get for children in certain activities. So they said, okay, what if a child is watching TV?
What's the average caloric difference? And it was like plus 100 calories per hour. So for every hour of
TV, they're sort of positive 100 calories over time. Right. And that makes sense. You're just
sitting there. When you look at mild exercise, it's about the same. It's about positive 100
calories. So the only way that happens is that if that exercise is causing you to eat more,
right. And you say, well, why are you eating more?
It's like, well, because you're hungry.
Like the exercise is inducing you to eat more
and that's gonna make it difficult to lose weight.
You say in the book in chapter four
that 95% of weight loss is diet.
Yeah, and that's the reason why exercise
is very hard to exercise enough to lose weight.
And that's not to say that you shouldn't exercise.
You really should exercise.
Everybody should exercise.
But if you're trying to lose weight,
you still got to focus on the main topic,
which is the foods that you eat,
which is not just the calories.
It's about the types of food that you eat,
which is going to affect the hormonal balance. And also how often you eat, which is not just the calories. It's about the types of food that you eat, which is going to affect the hormonal balance and also how often you eat. If you're eating all the
time versus if you're eating only eating very infrequently, then you're going to have a different
hormonal balance that is going to affect your weight as well. An American survey of more than
60,000 adults and children revealed that in 1977, most people ate three times a day.
By 2003, most people were eating five to six times a day.
Yeah. Yeah, this is the whole idea of sort of eating all the time. And this I find fascinating
because it was this sort of inadvertent change in our diet that we never talked about,
right? So in 1977, we told people eat lots of carbs, okay? So we know that, that's in print.
For sure, the American government said eat 55 to 60% carbs, eat less fat. What happened is that,
you know, in 1977, people ate breakfast, lunch, and dinner. No snacks. If you wanted an
after-school snack, your mom said, no, you're going to ruin your dinner. If you wanted a bedtime
snack, your mom would say, no, you should eat more at dinner, right? No problem. But what happened
is that as we started to eat sort of a lot of carbs, what happened is exactly as what we discussed
before. You eat two slices of bread in
the morning with jam. You have no satiety. Insulin spikes way up, glucose spikes way up, but then it
crashes. So you get hungry again. Then you get hungry at 1030. So you go around looking for a
low-fat muffin. And it was because your sugars are going down, your insulin's going down. So now you're eating
mid-morning snack. Then you eat a big plate of pasta. Then you get ravenous at like three o'clock.
So you go find yourself some crackers or something like that, right? And then now you're having a
mid-morning snack. You're having mid-after-student snack. Then you're having a bedtime snack. And
that's the average American by 2003 is eating five, six times a day.
But they're saying, hey, I'm eating so low fat. This must be the right way to eat. This must be
good for me. So now the snacking becomes institutionalized. Whereas pre-1977 snacks
are an indulgence, right? It's not something good for you. It's something bad for you, but hey,
once in a while you indulge. Then it becomes institutionalized
as something that every single one of us should be doing.
And we should never be without food
for more than an hour and a half.
Let's think about this very simply, okay?
So if you eat, your insulin is gonna go up,
your body's going to store calories
because you told it to.
If you don't eat or if you fast,
your body is, your insulin is gonna go up, your body's going to store calories because you told it to. If you don't eat or if you fast, your body is, your insulin is going to go down. You're going to bring those calories back out of
storage, right? So you're going to burn calories. You eat, you store calories. You don't eat,
you burn calories. Very simple. So why would you want to eat all the time? That makes no sense at
all. If you want to lose body fat, you actually need to extend the period of time
that you're not eating. In other words, extend your fasting period and get rid of all the snacks
in order for you to have enough time that your insulin is low. When insulin is low,
it's going to allow fat burning, which is going to allow you to pull those calories back out.
You're cited as being really the founder of modern
intermittent fasting. And I've heard people talk about intermittent fasting on this show
over and over and over and over again now, but the internet says that it really came from you.
I know that intermittent fasting has been happening for thousands of years, but
the idea of it as a tool for weight loss, they say it came from you. Because in 2013, 2014, really nobody was talking about it from a medical standpoint. Like what's
happening in the body? Why is it good? Why is it bad? And really I was for years, sort of this one
voice in the wilderness that was saying like, Hey, this is a tool for us. If you want to lose weight
because it's important, then you can just set
aside a period of time that you don't eat. At the time, people thought it was extremely bad for you.
And I looked through all the literature and I said, well, why is it bad for you? And they had
all these reasons. There's all these myths about intermittent fasting and how it's going to cause
you to gain weight and be tired and hungry and all these sorts of things. I said, well, no, there's actually a lot of data here over the last, you know, 2000 years that
we've used intermittent fasting and they're simply not true. And I can go over a few of those,
but that's why there was nobody talking about it at the time. And that's where I started to
sort of bring it into the sort of public consciousness that this is a tool. That's all
it is. Were you attacked for that at the time?
Oh, absolutely. Like I got, I got attacked from all sides. I got, you know, doctors were coming
after me. Dietitians were coming after me. Everybody thought I was going to do so much harm.
And the funny part was that, you know, as I think back, as I spoke to a lot of colleagues,
a lot of colleagues would say to me, you know what? I used to do that when I was in training.
We did that all the time.
We'd go 24 hours without eating
because we're in the OR or we're in the ER or we are busy.
So we did that constantly and nothing bad happened.
And I remember thinking, you know what?
As a doctor, I actually tell people to fast all the time.
If you have to go for surgery, you need to fast.
If you're after surgery, you need to fast. If you do go for surgery, you need to fast. If you're after surgery, you
need to fast. If you do fasting blood work, you need to fast. So why is it that I'm actually
telling people to fast all the time, and yet for weight loss, you shouldn't fast? That doesn't make
any sense. And physiologically, from a body standpoint, it doesn't make any sense.
One of the things people talked about was, you know, it's going to make you eat
more later. It's going to make you more hungry. Your basal metabolic rate's going to go down.
This was one of the big myths of intermittent fasting. That's going to cause the so-called
starvation mode, right? And this is the idea that your basal metabolic rate will fall so low
that when you do start to eat, you're going to gain weight again. So I said, well, let's think
about this. You can do a
study where you take somebody, say you, for example, and you could fast them for four days
and measure how many calories they're burning, their basal metabolic rate on day zero before
the fast and measure them four days into the fast and see how many calories you're burning.
So on day zero, they say you're burning, say, 2,000 calories a day. On day four of zero
food, you don't eat any food for four days. They measure how much calories you're burning. Your
body is burning 2,200 calories. Your basal metabolic rate didn't go down. It went up.
Your body's activating itself during fasting, which is fascinating because if you're trying to lose weight, dropping that mesometabolic rate is death. Like if you drop that metabolic rate,
it's so hard to lose weight. That's what the calorie restricted diets did. That's what the
low fat diets did, the eating all the time did. But when you actually fast, your metabolic rate
went up. And we see this in study after study. And the reason is actually
basic physiology. It's actually medical physiology, like first year medical school stuff.
When you don't eat, what happens in your body from a hormone standpoint is that your insulin
is going to fall. You're going to allow your body to start using the calories that are in the body.
At the same time, other hormones go up.
So the sympathetic tone goes up,
which is your fight or flight response.
Your cortisol levels go up because again,
it's an activation and your growth hormone goes up
because those hormones are gonna start telling your body
to start pulling calories out.
So you're actually activating yourself.
Think about in the wild, If you see a hungry wolf,
is that wolf just sort of, you know, all like lethargic?
No, he's activated.
He's actually more dangerous than any other wolf
as opposed to say a lion who just ate.
Because when you just eat, you just want to lie there.
You know, you want to digest your food.
You have no energy.
So people say, well, your metabolic rate's going to go down if you fast.
No, the truth is actually the opposite.
It goes up.
You've got me thinking about food as an instruction I'm giving my body.
Because if I eat this food, it's going to have this impact on my hormones,
which is going to have this impact on my body.
So if we view food as an instruction to the body,
we talked a little bit about the timings of eating,
a little bit about fasting.
I want to get into that a little bit more, but breakfast, I read that you didn't think most people need breakfast. Yeah. The whole idea that you need to eat as soon as you get up
is just false. So there's this whole thing about breakfast. Now you will always break your fast. Think about the actual word,
right? Break fast. It's the meal that breaks your fast, which tells you that in the English language,
we accept that your body should have a fasting period every day. Why? There's a period of time
that you're supposed to feed, you eat, insulin goes up, you store calories. Then there's supposed
to be a period of time that you fast.
That's after dinner until the next day's meal,
which is breakfast, right?
So say you stop eating at 6 p.m., you eat at 8 a.m.,
that's a 14-hour period where your body is not eating,
it's fasting, and therefore it's gonna use calories, right?
But the word breakfast tells us that that's
actually a normal pattern, this normal cyclical pattern. You feed, then you fast, right? If you
eat all the time, your body's just going to store energy and never have a period to burn energy.
So, okay, well, what's going to happen? You're going to gain weight.
I've read as well that breakfast eaters averaged 539 extra calories per day
compared to those that skipped breakfast. And that's a finding that's consistent with other
trials that was on page 132 of the obesity code. Yeah. So the more often you eat in general,
the more calories you take in. So if you eat three times a day, you're six times a day,
then, you know, if you eat three times a day compared to two times a day, you're six times a day, then, you know, if you eat three times a day
compared to two times a day, for example, you'll in general eat less because it's harder to eat that,
you know, big meal. So say you eat once a day versus three times a day. If you eat once a day,
it's not always easy to eat three meals worth of calories all in one sitting because you get full.
Do you fast? Oh, I do that regularly. Yeah.
And what does your fast look like? Because I've heard of all these different types of fasting,
36 hours, 72 hours, 14 hours. There's no rules for fasting. You could do,
you know, it could be 16 hours. So 14 hours, remember, is sort of a baseline, 12 to 14 hours,
right? That just means you're not eating after dinner. That's it. And so
if you want to lose weight, that's probably not strong enough to make you lose weight because 12
to 14 hours is sort of just this baseline that people had in the seventies. So you can go to 16
hours, for example, and you shrink that by either eating breakfast a little later or eating dinner
a little earlier.
But you can do more than that.
You can do, say, a 24-hour fast.
You could eat two meals a day, say, eat between 12 and 6.
That's a six-hour eating window.
Or you could eat once a day, which is like a 24-hour fast.
Or you could even go multiple days without eating.
Because again, your body is smart.
Like your body knows what to do.
If you have all those calories sitting on your body,
right? A hundred thousand calories sitting in body fat and you don't eat for three days. Well, you need 6,000 calories. Well, you have a hundred thousand, 200,000. So what's the problem? Take it
out of your body fat. Let your body eat your body fat. That's what fasting is doing for you.
And it's totally natural because that's what it's there for. That body fat fasting is doing for you. And it's totally natural because that's what it's
there for. That body fat is not there for looks. It's there for you as a source, as a store of
calories. So fasting just lets you use that. There's nothing wrong with it. People talk about
hunger, for example, but again, hunger is very interesting because people think it's the amount
of time that you haven't eaten.
But it's not true.
It's actually hormonally mediated.
So if you think about hunger, I actually found this really fascinating.
So if you look at studies of when people are the most hungry and the least hungry,
on average, people are the most hungry at 8 p.m. and the least hungry at 8 a.m.
So in the morning time, you are actually the least hungry that you will be all day. That's just an average. And at 8 p.m. in the evening time,
you are the most hungry. So 8 a.m. is the period of time that you've gone the longest without food.
So why are you the least hungry? It's because it's hormonally mediated. When you wake up at 5 a.m., your body actually
has this surge of hormones, growth hormone, cortisol, and sympathetic tone, which is already
getting you prepared for the day. It's starting to release some of the stored glucose from your
body fat from your sugar stores at 5 a.m. So your body has already prepared you for the day ahead
without you even doing anything.
That's why people in general are not hungry at 8 a.m.
I've got to talk to you about these new injections
people are getting to lose weight
and the role that they must be playing
in our hormone balances.
What are those bloody things called?
GLP-1s.
GLP-1s, there's another name for it, isn't there?
Yeah, well, there's the drug name which is uh ozempic is the uh is the american name
and these are all in a class called glp ones and essentially again very interesting because
they essentially really reduce the appetite which goes to show you that, and people lose weight, like a lot of weight, and they keep it off.
I know very smart people that are using them.
Yeah.
Like a billionaire friend of mine that's very big in a certain industry
uses a Zen pick.
Elon Musk came out and said he uses a Zen pick as well.
I don't have any problem with the Ozempic
because again, if you think about it,
what it's telling you,
the lesson it's teaching you about weight loss
is that it's not about controlling the calories
because the Ozempic doesn't burn any calories.
It's about controlling your hunger.
It's about that one level deeper.
Why are you taking so many calories?
So if you simply reduce the hunger,
you're going to naturally eat fewer calories,
which is gonna cause weight loss.
And that's what this Ozempic does.
It really reduces your appetite to very low levels.
How?
It's this hormone called GLP-1,
which is a natural sort of hormone.
It's released mostly in the intestines and the
distal intestine and the small intestine. And in response to certain foods, it goes up, right? So
when you eat, the body has a homeostatic mechanism. So again, remember, you know, people think that
we're just eating machines. We eat until, you know, we explode sort of thing, but that's not true. When you eat, you actually
activate the GLP-1 along with other hormones. There's multiple hormonal systems. The GLP-1 is
the one we're interested in. You activate GLP-1, which then sets into motion the instructions for
you to stop eating, right? So the act of eating sort of sets in motion that whole feedback loop
to stop, right?
So this is homeostasis, which is trying to keep things at a proper level.
Does that mean if you eat slower, you'll eat less?
There's probably not.
It'll give it more time to come out.
Yeah, probably it's true.
You know, although it's probably mostly true that if you eat really, really fast,
that you don't have enough time
for this sort of homeostatic mechanisms to kick in.
So you don't have enough time to stop eating.
But the GLP-1s then go to the brain.
So they do certain things.
They help with digestion.
So they increase insulin response.
And then they go to the brain.
It crosses the blood-brain barrier.
So the GLP-1s gets released by the act of eating,
goes into the brain, crosses and is active
in the sort of mid-brain area
that tells your body to stop eating.
What these GLP-1s do, of course,
is that it gives you the hormone
that tells you to stop eating,
even though you haven't eaten.
It's sort of,
that's the way the drug works. So then what people tell you is that, you know, they're just not hungry. And if they're not hungry, then they don't eat. And when they don't eat, of course,
insulin falls and you start to burn calories and lose weight. But it wasn't about controlling the
calories. It was about controlling the hunger. That was the important part of it. It's the
hormones, right? Every successful drug to gain or lose weight, right, is a hormone. It's a hormone
base because that's instructions to the body. Food is energy and food is instructions. You change the
instructions and you change the hormone. This whole history of fiber thing has been so interesting to
me because in the last six months, so many of the nutritionists I've spoken to have really
impressed upon me that we are fiber deficient. And I'm wondering how that happened. Well, I think it
was part of the processing thing. So taking out fiber is a great way to make foods more appealing, if you will. So what happens is that
if you take flour, for example, and you have a lot of fiber in it, then the digestion is slowed.
So what you get is a slower rise. So you take flour and you put a lot of fiber in it. Well,
instead of having this huge spike in insulin,
which you're gonna get,
it's a much slower spike in insulin.
When you have the huge spike in insulin,
it basically overloads your system
and it makes you feel, you know,
gives you this big hit.
Sort of like if you have like cocaine, for example,
you know, it's turned into a very fine powder,
then you snort it.
So you get this massive sort of spike. Same thing with, you know, it's turned into a very fine powder, then you snort it. So you get this massive sort of spike.
Same thing with, you know, carbohydrates.
If you don't have any fiber, you pull all the fiber out by processing, you get this
massive sort of unnatural spike in your body.
It says, oh, that's great.
It tastes great.
I really love it.
And you get people who are sort of addicted to it because that big spike is then
going to release dopamine. And dopamine is a pleasure hormone. So you eat cookies or whatever,
highly processed foods, you get this sort of pleasurable response. And that makes you crave it.
If you have a lot of fiber, it acts almost sort of like an antidote to that carbohydrate because
you're slowing down that release. What foods are high in fiber?
Well, mostly unprocessed foods. So the things like beans, and if you're eating whole grains,
for example, compared to others, then it's going to have a reduction in the speed of absorption.
So it's, again, not about the calories necessarily, or even necessarily about
the carbohydrates, because you're still eating the same amount of carbohydrate, but you're slowing
down the speed at which is absorbed, which is going to change the instructions that you give
your body. If you have a massive spike in glucose, you get this massive dopamine surge, right? And
your body's like, yo, love it it then the next time you're like okay
give me that refined carbohydrate what about protein because we we tend to think of protein
as something that you know is super great for weight loss yeah protein is probably uh sort of
inter it's not bad i mean the main thing is cutting down the carbohydrates, but in the obesity code,
I really talk about cutting the processing down
because proteins usually don't come as pure protein, right?
In nature, you never find like,
you know how you have like whey powder protein
or whatever you get.
The only way you can do that
is by processing the heck out of food
to get some kind of pure protein.
It doesn't exist in nature.
Like it almost doesn't exist in nature.
Maybe there's a few examples.
But when you eat meat, you think, okay, there's a lot of protein.
But that's actually a lot of fat in there too, right?
If you eat anything else that has protein, it's rarely all protein.
You know, very lean meats like chicken breast and
stuff are going to be higher in protein, but there's still a lot of other stuff in there.
And it's very rare that somebody will eat just all pure 100% protein. It tends to be hard to eat,
like the fat brings a lot of flavor and so on. So it's a bit of an unnatural way to eat. Sure,
if you're to eat a lot of protein,
it does spike insulin.
So it does have some effect to gain weight,
but it's actually a very inefficient macronutrient.
That is, there's three macronutrients.
There's carbohydrates, there's fat, and there's protein.
Your body stores energy or calories in two ways.
There's glucose, which is carbohydrate,
and it stores it as body fat, which is fat, right? It doesn't, protein is not a way for the body to
store energy. So when you're eating a lot of protein, it's very difficult for it to turn it
into a storage mechanism. Like, you know, so you eat glucose and you eat fat, you can store glucose
and you can store fat, but you eat protein,
but you don't really store it as a source of energy.
So if all foods then increase our insulin levels, I guess the best solution is to fast.
Fasting is certainly one way, but just changing the foods to other ones, because if you look at
the insulin release in processed foods versus unprocessed foods, there's a huge difference.
So if you eat sort of highly refined foods like white bread, for example, then you're going to
have a very different response in insulin compared to sort of a whole food. So unprocessed foods in
general, your body knows how to handle. Like we've been
eating them for thousands of years. But certainly anytime you eat, your insulin is going to go up.
You're giving your body instructions to store energy. So the solution is to eat less often.
What if you do a juice fast?
Juice fast, of course, is not a real fast because you're taking a lot of sugars.
What do you think of juice fasting?
Generally, I think it's less effective than regular fasting.
And it really depends on how much juice you take.
If you take a lot of juice, you could easily get, you know,
thousands of calories plus a lot of sugar.
If you do it, you know, cucumber juice and stuff that's very low in sugar and kale juice,
then it could be very, very healthy for you because there's vitamins and stuff there. So it all depends on how it's done. However, the fasting
is a way for you to sort of clean out the body. So you can clean out the glucose. If you have excess
body fat, you're going to use it, right? So again, way to clean it out. And then there's this whole
process called autophagy, which is just fascinating. And autophagy is this, so it's been very topical
because in 2016, one of the key researchers was given the Nobel prize in medicine. So it's a very
important process that's been relatively recently discovered. And what they discovered is that when
you don't eat protein particularly, but when you fast, your body activates this thing called
autophagy and it breaks down some of the
subcellular organs, which sounds really bad. Subcellular organs.
Yeah. So, you know, these are sort of like the organs within the cell. So it's not like the
liver, but there's something called organelles within a cell and some of that is broken down.
So basically these proteins and so on within the cell, your body gets rid of that.
And you think, oh, well, that sounds really bad.
But it's not.
It turns out that it's very, very good for you
because it's an opportunity for your body
to get rid of all this old protein, old junky protein.
And at the same time, remember that you're fasting,
your growth hormone levels are shooting up through the roof.
So like a two, three day fast, your growth hormone levels are shooting up through the roof. So like a two,
three day fast, your growth hormone levels might go up five times. So you're getting rid of all
the old stuff. Then when you eat again, you're actually got growth hormone to produce new
proteins. So in essence, you're getting rid of the old, you're bringing in the new. It's basically
the process of rejuvenation. Could this be a very important way
to get rid of some of the chronic illnesses of aging? And there's lots of data, you know,
talking about, you know, Alzheimer's disease. There's people talking about cancers. There's
people talking about just general aging. You know, Dr. Chris Palmer talking about mental disorders. We're all talking about insulin
and overeating and diet as a really important component of not just diabetes and weight,
but all of these diseases, mental illnesses, you know, chronic illnesses like Alzheimer's disease,
neurologic illnesses. And there's all this data that suggests that autophagy and fasting as a way to activate autophagy
could be actually extremely beneficial for you,
which is fine when we used to do it.
And what's so interesting
is that people seem to have already known about it.
Like you see it in almost every major religion. There's periods
of fasting, right? And it's like, why did they do that? Because it was good for them. Through trial
and error or whatever, they realized that, hey, periodically abstaining from food makes us
stronger. If you eat all the time, constantly, day in, day out, week in, week out,
month in, month out, that's not that good for you. There are periods that you should feast,
and there are periods you should fast. So religion set days or weeks or months even
where you should fast. So it's like, whoa, why did they do that? And are they just way ahead of us
in terms of understanding the human body? Like we get so, you know, enamored of our own, you know,
intelligence and science and so on that we think they're, you know, that they didn't know what
they're talking about. Maybe they knew more about what they're talking about and science is just
catching up and saying, oh, this process of autophagy that you activate with fasting,
this could be really important for longevity, for other things. I'm not saying you should do it like
every month or whatever. If you look at the way that people do it, they don't do it like,
you know, they don't do like five days a month or something. They do it once a year,
once every few months. How long does autophagy take to kick in? Is it 72 hours, did you say?
Nobody knows, but probably it's, and it depends on probably how much protein you eat. Protein is the key sort of, when you eat protein, autophagy just stops. So low protein, you can activate it,
and it's probably somewhere around 20 to 30 hours. So you'll see a lot of religions, for example,
they'll have like a 24 hour fast,
right? One day that you're not supposed to eat or something like that. And maybe that's the way
to cleanse your body, not just of the glucose and the fat, but also the excess proteins that
are old, they're junky. I mean, you think about renovating your bathroom or something like that,
right? The first thing you got to do, you got to throw out the, you know, 1970s tub and the
avocado green toilet. That's the first thing you got to do. You got to get rid of it. You got to
break down before you can rebuild better. Well, autophagy might be that way to break down some of
the stuff that you actually can't break down any other way. If your body's full of all this junky
protein, you can't get rid of it.
Is there an evolutionary explanation for the role of autophagy, do you think?
I think there is actually. I think there's a huge number of reasons why people do it. One of it,
this whole idea that fasting actually activates the body, for example, is very interesting because
I think it's like, if you're a caveman, for example, or a interesting because I think it's like if you're a caveman, for example,
or cavewoman, and it's winter and there's nothing to eat, if your body starts to shut down, then
evolutionarily, you're going to die, right? Because you have less energy, you can't go out and hunt.
So our body's just not that stupid. So what it does is says, okay, well, I'm going to give you
more energy. So I'm going to activate the body, but then I'm going to change where you're getting your energy from. You're not going to get the energy from the food. You're going to give you more energy. So I'm going to activate the body, but then I'm going to change
where you're getting your energy from. You're not going to get the energy from the food. You're
going to get it from your body fat stores, which is your stored food, right? You stored food for
a reason. So that's why I think some of the fasting has a lot of evolutionary benefits
because it increases your energy. It lowers the glucose. So if you look at the blood glucose,
the blood glucose goes down. So in times of stress and so on, your body actually naturally fasts.
If you get sick, you get a flu or something, you stop eating. First thing you do, right? You just
want to drink some water and stuff. Why? Because your body wants to lock down the glucose because
the bacteria love glucose. Your body can run on fat the glucose because the bacteria love glucose.
Your body can run on fat,
but the bacteria want the glucose.
So you fast to lock down the glucose.
So there's a lot of evolutionary reasons
why the fasting might be good for bacterial infections,
taking care of things, increasing your energy,
increasing your concentration at a time
that you're not, like when you're not eating,
you're actually getting more mental capacity and more energy because you need it in order to go hunt.
Interesting. What is the most interesting thing or the most, you know, you use the word
interesting a lot or fascinating. What is the most fascinating thing that we haven't talked about?
I think to me, the most fascinating thing is, other than for
intermittent fasting, because a lot of the stuff we thought about, it was wrong. In fact, the
opposite. But the most interesting thing I think is in the field of type 2 diabetes, because it's
such an important disease. If you look at the number of people being affected with type 2 diabetes, it's skyrocketing.
So we had, since the 1970s, an increase in obesity. Then we had an increase in type 2 diabetes. And I
think the most fascinating thing, the most promising thing I've heard in a long time is that
you can actually start to reverse this disease by changing the diet.
And I think what's interesting is that you have to understand
that type 2 diabetes is largely a dietary disease.
And so we treated it with drugs for a long time.
And if you give drugs to a dietary disease,
well, you're never going to fix it
because you haven't identified the core problem and fixed it.
You need to change the diet to fix that dietary problem,
then the disease goes away. And now we have data on intermittent fasting, for example, and also
low carbohydrate diets. Dr. David Unwin published his data in the UK on reversing type 2 diabetes
with reducing carbohydrates, which is showing that you can reduce about 50% of the people
and put them into a completely drug-free remission state,
like basically cure 50% of those type two diabetics
who are at risk of cancer, at risk of heart disease,
at risk of strokes, at risk of blindness,
at risk of kidney disease, nerve damage, infections.
All these people you can fix just by changing their diet,
either cutting down their carbohydrates
or using intermittent fasting.
And it's free and anybody can do it.
I'm not talking about a drug that costs thousands of dollars.
I'm not talking about a surgery
which is only available to the 1%. I'm talking about a
treatment, which is intermittent fasting, which is available to everybody in the entire world
for free, and yet has the power to completely reverse their disease and make them so much
healthier. So the question is, why don't we do it?
I couldn't answer that question for you. I try to do my part to tell people, but, you know.
Did you know I was going to ask you that question?
No.
I was going to ask you, why don't we do it?
No, but what is systems, incentives, money?
I think it is.
I think it's, you know, the real reason is I think that people are slow to catch new ideas.
Like when people hear about new ideas, and I'm talking about academic doctors and so on,
there's an intrinsic resistance to change.
So I started talking about intermittent fasting,
say 2016, when the obesity code was published.
I talked about reversing type two diabetes
around the same time.
And they're just very slow to say,
hey, this makes a lot of sense
because for them, they've invested so much
in this calories in, calories out model.
They've built their entire careers on saying that it's your fault that you're fat, right? It's the
foods that you ate. It's the calories that you ate instead of trying to get to a deeper understanding.
So people are very reluctant to change. In fact, I mean, it's been 10 years and you see the public,
the interest in intermittent fasting has skyrocketed.
And yet most doctors still won't prescribe it. They won't talk about it. They know nothing about
it. There's how much teaching do doctors get about intermittent fasting and why it might be helpful?
Probably zero. Like why? We have this amazing tool and people, you know, doctors call it a fad,
right? It's a fad diet. Well, it's been around for 2000 plus years. That's a long doctors call it a fad right it's a fad diet well it's been around
for 2 000 plus years that's a long long long fad right it's it's proven effective if you don't eat
you're going to lose weight what's simpler than that if you don't eat you're going to use up your
blood glucose your diabetes will get better what's wrong wrong with that? It's not hard to understand. The diabetes code,
I've got the diabetes journal here in front of me.
And put simply, it talks about step one being
to put less sugar in
and step two being burn the sugar off.
Yeah.
And step one, which relates to putting more sugar in
is all about low carbohydrate diets, right?
Cutting down the carbohydrates.
Yeah, that's one effective way of cutting down the type 2 diabetes.
In fact, the American Diabetes Association
and their sort of nutritional journals,
they talk about it having the most scientific evidence of any diet.
There's no diet with more evidence for reversing type 2 diabetes
than cutting down the carbohydrates.
And then step two about burning the sugar off,
and that's where fasting comes into the picture. Yeah. I mean, if you think about it, it's not that
hard to understand. Everybody can understand it. You don't eat, you're going to lose weight, right?
I mean, it's such a simple, powerful tool, but it threatens the whole apple cart. All these doctors, all these professors,
which have built their entire reputations, all these systems that are in place for people.
Yeah, personal trainers work on a different level because they talk about more exercise.
And calories in, calories out. I think when we talk about calories on this show sometimes,
I think the people that get quite offended tend to be personal trainers
because I think they would say they've got case studies
of telling one of their clients to monitor their calories
and they saw a reduction in weight.
So for them that means it works,'s calories in, calories out model.
Again, it is that, but it's a simplistic understanding. That's my whole point. It's
sort of like if I were to say to you, why did the Titanic crash, right? And most people would say,
well, it hit an iceberg. Well, that's very simplistic. That's not the right answer. The right answer is it was going
too fast, right? If you think the right answer to why did the Titanic crash is because it hit an
iceberg, you'd say the solution is to hit less icebergs, which is the same as eat less calories
or drink less alcohol. That's a very superficial understanding. You have to get to the deeper
level, which is say,
why did the Titanic hit that iceberg?
It was going too fast and there was all these icebergs and it was going too fast for where it was.
So then you say, it needs to slow down.
Now you've identified that deeper understanding,
same as with calories.
You can say, eat less calories.
And for some people it'll work.
But for some people it's like,
why are you eating so many calories? Is it because you're hungry? Why are you hungry? Is it because all those calories
that you're eating are going immediately into storage? You're eating white bread and jam and
sugar and all of it's going directly into storage, which is leaving you hungry, which is making you
eat too many calories. So in the end, yes, you are eating more calories, but that's the sort of
first order thinking and not the second order thinking that we need eating more calories, but that's the sort of first order thinking and not
the second order thinking that we need to be doing. And that's what the Ozempic and so on
starts to address is the hunger issue. And this is really what all your work addresses. And it's
really the first time I've heard someone talk to me about obesity and weight gain through the lens
of hormones. Never really, I've never heard heard that before and reading through your work was
really illuminating because it allowed me to change my frame and it's as you say when we're
just focusing on the surface it's very easy to fail because we need to understand the first
principles of what's going on underneath the surface for that long-term success to stand a
chance of occurring and i think everyone listening to this who's struggled with weight or
obesity or whatever else can relate to this idea that something's not working in, you know,
if there was any diet that worked, there wouldn't be a thousand of them.
Yeah. And I think the other thing is to understand that it's not the personal failing that we make it out to be,
which is, I think, extremely unfair
because obviously there's something within the system,
within the food environment,
within the system of how we're framing it,
which is making a lot of people overweight,
but it's not because they don't have willpower
or because they're weak
or these other number of reasons
that we stigmatize
obesity because we look at it from that calories in calories out framework right we say you're
eating too many calories you must be weak as opposed to you're eating too many calories what
why is it that you're eating too many calories why are you hungry all the time in a word then
if you had to describe
what you think about this idea of calories in, calories out, what is that word? I would say
that it's shallow. It's correct if you don't think about it too hard. Anybody who focuses
in on thermodynamics and calories hasn't really thought about the problem enough.
That's what I think.
So in the end, it is correct.
Just like alcohol in, alcohol out,
you know, hitting the iceberg.
Yes, it did hit an iceberg.
That's why, but it was going too fast, right?
Or alcohol in, yes, if you drink less alcohol,
you'll cure your alcoholism,
but you won't cure the PTSD that caused you to drink.
Correct, but not helpful.
Exactly.
That's exactly right.
It is correct, but it's sort of not getting to that root deeper cause that we need to
in order to help people.
And that's causing us to blame them.
So what we're doing, which I think is
very unfair, is blaming the victim. Like, do you think this person who's trying to lose 50 pounds
needs you to tell them they need to lose 50 pounds? Absolutely not. That's only going to be
the 10,000th time they've heard it. It's interesting because one of our guests talked about the role of compassion and kindness in weight loss. And now through the lens of understanding cortisol,
now I can understand how kindness and gratitude and being happy, you know, for lack of a better
word, can help us lose weight. And when we're not happy, when we're resentful, when we're low in gratitude, when we're bitter, we're more likely to gain weight.
And other things help too, because if you think about things like a sense of community, it's very important.
Lowest cortisol levels.
Lowest cortisol is a way for you to relieve stress, right?
Talking to other people.
We did, of course course limit that during covid and of course
we saw a lot of problems but one of them was loneliness and all these sort of things but again
i always think about um you know people you know the way they are so if you look at a lot of
religions for example it's like oh they were so far ahead of us. What did they do?
They brought people together every week.
Oh, you're building a sense of community.
Fasting.
Oh, they all got together and fasted.
They all shared.
They're lowering their cortisol.
They're lowering their insulin levels.
They're staying healthy.
And we in our big McMansions, right?
We eat the ice cream for dinner and we
live alone in this giant house and we wonder why we're not as as as happy as you know our
grandparents or parents before them because they understood the power of some of these things that
we're trying to get back to like the the weirdest thing is that I'm not trying to tell people something
that's weird and unusual, and you never thought about this before. I'm trying to tell them about
something that everybody in human history has been exposed to, which is intermittent fasting.
That's been a part of our human history, whether it's through religion or whether it's through
inadvertent whatever, or whether it's through his cleansing and purifications and all this sort of
stuff. People have exposed it, even in the English language, breakfast, break your fast.
You need to feed, then you need to fast, then you need to break your fast. So I'm not telling
people anything different. Jason, thank you so much. We feel like we could talk for hours because
I'm so, there's so many sort of, I was thinking about it like spider webs, but there's so many
little branches we could go off on as it relates to hormones and the impact of hormones on the
human body. You have this other book as well called the PCOS plan, preventing and reversing
polycystic ovary syndrome, which is a whole nother conversation for another time but these books are so wonderful because they provide a new lens on
an old conversation and a conversation that's lacked the depth that's required to make any
significant progress on these subjects as we've seen obesity levels and other issues with weight
have gone in the wrong direction for the last couple of decades and i think it's a more systemic
understanding of these issues that will give us any chance of reversing it. And
that's exactly what your work does. Everyone knows where to find you. Dr. Jason Fung will link all of
your work in the description below. We have a closing tradition on this podcast where the last
guest leaves a question for the next guest without knowing who they're leaving it for. And the question that's been left for you is what is your greatest
gift to the world? I think if, if, if, you know, I suppose it's sounds very arrogant. But I really hope that my work helps people sort of reverse the type 2 diabetes because that is really sort of one of the most close things that I deal with because I deal with it professionally sort of every day. And helps break the stigma of, not just the stigma, but the understanding that stimulates more thinking about weight loss, how to lose weight more than calories in, calories out.
I mean, it's so sort of pie in the sky because there's a whole worldwide sort of institutionalized, fossilized almost thinking around calories.
It's all about calories sort of thing.
So for me to upset, it seems ridiculous.
But I hope that I can at least start that conversation to say, hey, let's think about
these things.
Let's think about the hormones.
Let's think about reversing type 2 diabetes.
Let's think about all getting together
and helping each other to become so much healthier,
not through drugs and not through more surgery
and not with weird and new things
that you've never heard of,
but with the tried and the true sort of oldest thinking that has
been there, right? To me, I sometimes think about this and I get crazy. Why do I think I can even do
that, right? It's just ridiculous. It's so much hubris, but I can only try, right? Because I see
in my own practice how much good it's done for some people.
So it drives me to say,
I need to bring it to more people.
I need to explain it to them.
If they want to be helped, they will be helped.
But if they don't want to understand this,
okay, I'm not trying to force myself to do anything.
But that's what I hope my greatest gift will be.
But at the same time, I sort of think,
that's just, you're crazy if you can think you can do that. Well, it's the crazy ones that change the world, Dr. Jason.
It's the crazy ones that change the world. And even with, you know, your conversation around
intermittent fasting has changed many, many lives that you'll never get to meet. I imagine
many, many millions, many, many millions, because it's even brought the conversation to this show
before you entered the room,
many, many months and months and months
and almost a year ago,
people started talking on the show
about intermittent fasting.
And that's in many respects
due to the work that you've done
to further that conversation.
And now your work continues to highlight the fact
that type 2 diabetes is a reversible disease in many cases.
And I think, again, that's going to save, you know, tens of millions, if not hundreds of millions of lives over the coming decades and years.
So thank you for what you do, Dr. Jason.
It's a huge honor to get to sit with you today.
And I feel wiser and more enlightened and like someone has turned the lights on in a certain part of my knowledge because of this conversation so i thank you for that tremendously thank you so much it's been great
do you need a podcast to listen to next we've discovered that people who liked this episode
also tend to absolutely love another recent episode we've done
so i've linked that episode in the description below. I know you'll enjoy it.