by Barbara Berkeley, MD
Our parents ate pie and cookies. Our grandparents drank whole milk and ate butter, cheese and eggs. We come from ethnic traditions that venerate pasta, spaetzle, dumplings and chicken fat. And yet, obesity...once rare....is now rampant.
We spend a great deal of mental energy trying to unravel the puzzle that surrounds our now super-overweight nation. Most of the endless, circular reasoning is in the service of trying to figure out how we can still eat the things we used to. There MUST be a way! It's simple, right? We just have to eat less of this stuff. We just have to burn more calories. We just have to practice moderation. We just.....
But none of these approaches appears to work.
Why not?
Here's what I believe.
If you are gaining weight easily, something has fundamentally shifted in your body. You've changed in some way. And this change is preventing your body from balancing calories automatically---as it was designed to do. Here's the key: once this change occurs, you must accept that you are now different vis a vis the food you eat. You won't be able to go back to eating the way you once did, or to the way your relatives might have. You must accept this reality and take a new view.
Here's a simple fact. The body balances everything automatically. It adjusts your core temperature up and down regardless of the outside thermometer and without your thinking about it. It keeps your blood sodium (salt) between 130 and 140 regardless of whether you eat pastrami and pickles or consume a low sodium diet. And in those who are at normal weight without thinking about it, the body is defending a base weight regardless of intake or output. I have used my younger years as an example of this. These were the days when I could eat absolutely anything in any quantity and was as sedentary as one could imagine. Yet I weighed 110 pounds. This halcyon period lasted into my 40s. And then.....bam! Things changed and never went back.
But we don't just change, right? It must have been be something I was doing differently.
Wrong. Think of the concept of allergy. We are just fine eating peaches until one day we eat a peach and develop a terrifying swelling of our lips and tongue. After a shot of epinepherine in the emergency room, we realize that we will not be eating peaches ever again. Just like that.
As a clinician, I've observed that my overweight and obese patients have changed just as fundamentally. Perhaps some were born with this intolerance to our modern eating style, but many acquired it over time. The central intolerance appears to be to carbohydrates. But unlike the allergy analogy, our intolerance to carbs seems to have more to do with the mechanisms that normally work to dispose of these foods. What appears to have gone wrong is a confusion in that system. When the body "sees" these carbs, it is suddenly overwhelmed by them and defaults by storing them in a landfill: the fat mass. This fat mass then becomes inflamed and sick, like a low grade fire burning in a garbage dump. A cycle of ill health ensues.
It's my job to speak truth (at least my version of it) to those who come to me for help. And what I've observed and believe to be true is this: your body has lost the ability to process carbohydrates, so you will need to keep your consumption very low if you want to avoid regaining your weight. Things have changed! Eat fruits and vegetables because these carbs alone will rarely cause a problem. But limit other carbs very strictly. If you carefully monitor yourself, you can figure out what carbs and at what volume trigger fat storage. Undertaking this little science experiment is key for your long term maintenance. But you cannot assume that because you are thinner, your body is now able to process a substance it doesn't understand anymore.
If my hypothesis is correct, it would be vitally important to discover what is causing this bodily change in so many. I've discussed various possible causes in these pages in the past, but we certainly don't know the answer right now.
But for most of us, the cause of the problem doesn't matter. What's important is that we understand that we ARE changed and will remain so. If we resolve to eat more primally and to respect the new state of our body---rather than constantly trying to avoid the reality---we can solve the problem and protect our long term health.