A few months ago, several of the bloggers/writers I follow were involved in an online debate about two competing theories that attempt to explain the current epidemic of overweight and obesity. The theories:
- Carboydrate/Insulin (as argued by Gary Taubes)
- Food Reward (as argued by Stephan Guyenet)
The whole dustup was about as interesting to me as debating how may angels can dance on the head of pin.
Regular readers here know I’m an advocate of the Carboydrate/Insulin theory. I cite it in Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet and The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer (2nd edition). But the Food Reward theory also has validity. They’re both right, to an extent. They’re not mutually exclusive. The Food Reward theory isn’t as well publiziced as Carbohydrate/Insulin.
Dr. Guyenet lays out a masterful defense of the Food Reward theory at his blog. Mr. Taubes presents his side here, here, here, here, and here. If you have a couple hours to wade through this, I’d start with Taubes’ posts in the order I list them. Finish with Guyenet.
You’d think I’d be more interested in this. I’m still not.
Moving from theory to real world practicality, I do see that limiting consumption of concentrated refined sugars and starches helps with loss of excess body fat and prevention of weight regain. Not for everbody, but many. Whether that’s mediated through lower insulin action or through lower food reward, I don’t care so much.
h/t Dr. Emily Deans
5 responses to “Food Reward versus Carbohydrate/Insulin Theory of Obesity”
I think it’s way too premature to develop mechanisms when it’s not even clear if the physiology is even there. While I think that there are a lot of suggestive data behind the low carb approach, in clinical trials that look over long periods (years, not months) it doesn’t seem to hold any special advantages across a population. It’s possible that it’s better in specific populations like diabetics, different body morphs, etc, but that needs to be evaluated over long term. The long term data seems to suggest that the best approach is the one the patient is willing to stick to.
Most formal weight-loss diet studies only last 2-6 months. The longest I’ve seen is two years (e.g., Shai’s DIRECT trial in NEJM, July 2008). Dr. Andreas Eeenfeldt lists about 16 studies showing at least short-term superiority of carb-restricted dieting, if superiority is measured simply by amount of weight lost. The list is here: http://www.dietdoctor.com/weight-loss-time-to-stop-denying-the-science
Was there some cherry-picking? I would assume so.
From personal experience, the only theory that holds validity is the one that states that food addiction is a very real addiction and that food affects two key neurotransmitters: serotonin and dopamine. I have had physical and psychological withdrawal symptoms when trying to change my eating habits. They can only be described as identical to those experienced by someone, who is withdrawing from a chemical addiction. I won’t give credence to any particular program, as there is faulty logic involved in the “one-size-fits-all” approach, especially since we do not know the percentage of genetic influence for each person. This would explain the recidivism rate among chemical addicts, who have tried to withdraw from their addictive substance, as well as food addicts, who have tried to withdraw from the serotonin and dopamine-enhancing foods when trying to lose weight. It’s a day-to-day struggle, while battling the co-morbid disease processes.
Peppy, when I experimented with the Atkins diet about 10 years ago, I was persuaded I was a carboholic. These days, I eat about a third as much carbs as I used to, and don’t miss the other two thirds.
Except for sweets.
There is always in increasing trend in obesity these days as more and more people turn into a sedentary lifestyle…
The latest write-up coming from our personal web site