"Which Comes First: Overeating or Obesity?"
Conventional treatment for obesity, founded on the First Law of Thermodynamics, assumes that all calories are alike, and that to lose weight one must simply “eat less and move more.” However, this prescription rarely succeeds over the long term. According to the Carbohydrate-Insulin Model of obesity, the metabolic state of the fat cells play a key role in determining body weight. High intakes of processed carbohydrate raise insulin levels and program fat cells to store too many calories, leaving too few for the rest of the body. Consequently, hunger increases and metabolic rate slows in the body’s attempt to conserve energy. From this perspective, conventional calorie-restricted, low fat diets amount to symptomatic treatment, destined to fail for most people. Instead, a dietary strategy aiming to lower insulin secretion promises to increase the effectiveness of long-term weight management and chronic disease prevention.
David S. Ludwig, MD, PhD is an endocrinologist and researcher at Boston Children’s Hospital. He holds the rank of Professor of Pediatrics at Harvard Medical School and Professor of Nutrition at Harvard School of Public Health. Dr. Ludwig is co-director of the New Balance Foundation Obesity Prevention Center and founder of the Optimal Weight for Life (OWL) program, one of the country’s oldest and largest clinics for the care of overweight children. For more than 20 years, Dr. Ludwig has studied the effects of dietary composition on metabolism, body weight and risk for chronic disease – with a special focus on low glycemic index, low carbohydrate and ketogenic diets. Described as an “obesity warrior” by Time Magazine, Dr. Ludwig has fought for fundamental policy changes to improve the food environment. He has been Principal Investigator on numerous grants from the National Institutes of Health and philanthropic organizations and has published over 175 scientific articles. Dr. Ludwig was Contributing Writer at JAMA for 10 years and presently serves as an editor for American Journal of Clinical Nutrition and The BMJ. He has written 3 books for the general public, including the #1 New York Times bestseller Always, Hungry? Conquer Cravings, Retrain your Fat Cells, and Lose Weight Permanently.