The 5 SECRETS To Losing Weight & BURNING BODY FAT! | Mark Hyman & Rangan Chatterjee

Don't try and think willpower will be enough because in the long term it rarely will be.

So what you're saying is what you eat is probably more important than how much you eat.

It is definitely a major factor.

What we've been taught is that all calories are the same. They're actually not. So food is not just energy, it's actually information.

But why we eat, so look the best way I can describe it is We used to only eat to fill a hole in our stomachs. Now we eat to fill a hole in our hearts, right? When we're lonely, we eat. When we're bored, we eat. When we're stressed, we eat. When we feel disconnected, we eat. And that's okay. But you've got to understand that, right? A lot of the time this is going on in the background. We don't take time to understand that. we keep looking for the latest diet book to give us the solution. Look, the times in which we're living, Mark, I guess are the perfect way to describe this. So, you know, in the pandemic with these lockdowns, with these restrictions, many people have put on weight. I don't know about the American media, but the UK media have these terms like the Corona Stone, the Quarantine 15, right? So the people, Recognize that they're not- COVID-19. Yeah, I didn't know that one. But yeah, and so a lot of people, and especially when they're seeing the evidence for what that does to their risk of complications, they're getting quite stressed and they're looking for a new diet book to help them get on top of things. But what if that's the wrong place to look for some people? So the research suggests that about 80% of us change our eating behaviour in response to stress. 45% of us or so will eat more, 35% or so will eat less. So that's almost half the population eating more in response to stress, right? So if that's you or me, if we're eating more in response to stress and we're putting on weight, do we need a new diet book or do we need better strategies managing stress? It's the same with sleep, for example, like sleep. A lot of people are sleep deprived at the moment. A lot of people are worried, they're anxious. We know from the data that if you sleep, let's say five and a half hours a night compared to eight hours, you're gonna eat on average 22% more calories the following day. So five days of not sleeping well, you may eat a whole extra day's worth of calories just from not sleeping well. And, you know, I'm sure your audience may be familiar with this, but what happens when you don't sleep well? Well, well, ghrelin, your hunger hormone goes up, so you're always feeling your satiety hormones go down so you never feel full. You're more emotionally reactive in your brain. You find it harder to say no to temptation. So some of my patients, Mark, I can remember this 44 year old lady who every January would go on a brand new diet. She'd have a bit of success. Then by March she was back to where she was before. She was even heavier. that wasn't the worst thing. The worst thing was actually that her self-esteem had gone. And that's the funny thing about the diet industry, Mark. It's the only industry where we don't blame the diet we're following. We blame ourselves. We feel like we're worthless, which speaks to what you said before, which is why I think the first paragraph in the book says it's not your fault.

Right.

So really trying to understand that, hey, you know what? This is not your fault. So That 44 year old man.

And by the way, you know, the message that we're all here, which is losing weight is about eating less and exercising more, implicit in that statement is that it's your fault. If you can't control your hunger and you can't get your lazy butt off the couch, it's your fault. And that is the biggest propaganda that's been put on our population that undermines people's self-worth, like you're saying. and undermines their ability to actually understand how their body works and lose weight in a way that is integrity with their natural biological systems, which they're not doing. And so, keep going. I think this is really an important point around the blame, not blaming the victim.

Yeah, for sure. I mean, just to finish off on sleep, so that lady, that 44-year-old lady, I helped her lose significant amounts of weight sustainably without her even trying. I didn't actually have to focus on her diet, I just got her sleeping eight hours a night. And actually, what she was sleeping eight hours a night, it was like a ripple effect. She she made better choices in every other aspect of her life. And again, the point of this book is to help people find the right approach for them. For someone else, it might be changing what they eat. For someone, it might be why we eat. But but if we personalize that approach, we're much more likely to be successful rather than trying to follow a one size fits all. But what you said about blame Mark, there's another section in the book, which I think really speaks to this. And that's You know, I know you know the ACEs study with Dr. Vincent Felitti and how he's shown... What does ACEs mean? Adverse childhood experiences. So if we have been, you know, if we have gone through, you know, there's a list of what these... Child.

Abuse, beating, emotional abuse, abandonment, physical, mental.

Emotional, then we're significantly more likely to be overweight and obese later on in life, which kind of makes sense if you really think about it. But again, this is missing from the conversation around weight loss. And I detail a case study in the book. I remember really well this lady I saw. I think I saw her when she was about 19 or 20. And she was really struggling to lose weight. She was carrying a lot of excess body fat. And she said, Dr. Chachi, what's interesting is I never used to. Like this, this only happened in the last few years. I'm not entirely sure what's happening. and we tried various things. We weren't getting anywhere. And as I got to know her better, Mark, I could. I started to pick up that there was something else going on here. We started to unpick that when she was 16, she was in an abusive relationship.

Right.

With it. With it. With a. With a man. And I. I could tell that there was real unexplored, unresolved emotion with that. I sent her for some therapy, and in those therapy sessions, it turned out that. she was being abused when she was 16. And then her strategy to not be in that position ever again was to put on weight. And what I mean by that is this, she never wanted to be in an abusive relationship again. So her subconscious mind basically thought, hey, listen, if I put on weight, I'm no longer gonna be unattractive, I'm no longer gonna be attracted to men. Therefore, I will never be in an abusive relationship again. and it was only when we sat, we managed to unpick that in therapy over a course of months and even into years, once she had processed that emotional trauma, right? The weight started to come off. But there was no point beating her up saying, you,'re being lazy, you're not following the diet, you're not moving enough. That wasn't the right approach for her. And Mark, I tell you one of the most gratifying things, because I nearly didn't write this book, because I thought, why go into a divisive area like weight loss? you start writing about weight loss and you start getting attacked because you're like, you know, we can talk about body positivity shortly. I'm largely in agreement with people saying we shouldn't, I'm definitely in agreement saying that we shouldn't shame people who are carrying excess body fat, which is different from not being able to talk about what are the consequences of that from a health perspective. It's two separate arguments. But since the book came out, Mark, I've had so many messages particularly on Instagram from people saying, Dr. Chesi, I just want to thank you for writing that section. And one lady in particular said, I can now see why the last 20 years I've not managed to stick to anything. I was also abused when I was 16 and reading that section has made me phurn up a therapist. I've now got a session booked and I'm now going to get back on top of my life. And that's why we write these books, Mark, it's because just for that one person who read that, and now is going to take action and realize that she's not a failure. For me, that's worth it.

Amazing. Yeah, I think it's important to sort of this why is so important. It's underappreciated. And I often joke and I see, you know, often we don't ask the right questions. We ask, what are you eating? Not what's eating you. And I often would ask my patients when they want to open the fridge or the pantry to get something, I say, Ask yourself two questions. what am I feeling and what do I need? Am I lonely? Do I need to call a friend? Am I hungry? Do I need to eat? Am I tired? Do I need to sleep? Am I angry? Do I need to get it off my chest? What is really driving it? And it's often different for different people, but it's that other layer that we don't think about, which is in our way, that is those beliefs or those mental obstacles or those missed cues. Talk about some of the sort of hunger cues and how we kind of get off track with that and how we can start to regulate our hunger. Because what most people say to me is, I don't know how I'm going to do this because I'm hungry and I get cravings and it's hard and I don't know what to do. And it's really a struggle.

I mean, the first thing as you were just touching on there is really identifying what are you hungry for, right? Because as I mentioned, we're often eating to fill that hole in our heart, not our stomach. And I had this really nice exercise in the book that I think your audience will probably really like. It's called the 3Fs or the Freedom Exercise. and, you know, let's say someone's listening to this, Mark, and they're sitting on their sofa in the evening, it's 8:30 at night, they've got the television on and they feel like having some ice cream, right? Let's say, because that's pretty common for people to feel like that in the evening. Okay, so the first F is feel. Just take a pause for a minute. You can write it down if you want or just think, what am I really feeling? Am I hungry for food or am I hungry for something else? Right, so it could be, oh actually I'm really stressed today. I've been on Zoom calls all day and I've not managed to go out yet. Or it could be, I've had a row with my partner or the children's bedtime took too long. Or as many people are facing now, Mark, I'm lonely. You know what? I've not seen anyone and actually that food is providing a bit of nourishment for me. So first F is feel. What are you feeling? The second F is feed. How does food feed that feeling? Okay, I'm feeling stressed. When I eat ice cream for 20 minutes or so, I feel less stressed. Okay, now you're building in awareness, right? So, without that awareness, it can be very hard for somebody to change in the long term. And the third F is finds. Now that you know what the feeling is, now that you know how food feeds that feeling, can you find now a non-food behavior to feed the same feeling. So, if you're stressed out, it could be maybe I'll run myself a bath instead of having ice cream, or maybe I'll do 10 minutes of yoga from YouTube, or as we were saying before, if you're lonely, maybe actually you're better off phoning a friend or phoning your parents. For many of us, we use food instead of something else. And I've used that kind of, I've used that exercise with patients for many years now. and it's hard to change straight away, right? You can't necessarily change it the first time, but you just start to build in that awareness. So day after day, week after week, I was actually doing an interview last week and the journalist said to me, she said, Dr. Sherry, that's so interesting because two days ago I was driving home from work and I went into a fast food restaurant and had fried chicken and fries, right? Even though I'm trying not to, right? I had it. And that exercise now really makes sense to me because I enjoyed it in the moment. I felt disgusting afterwards. I didn't sleep well. I woke up with a headache the next day. And she goes, Now that you've just told me that exercise, now when I'm in that position next time, I'll just take a pause and really try and figure out what's going on. So, you know, as you said about hunger, the first thing is, what are we truly hungry for? Now, if we are hungry for food, that's okay. Right? If we're hungry for food, it's going to be very hard to resist eating if you're always hungry. Very, very hard if you're fighting hunger, which I know, Mark, you've always spoken about in your books is like, you know, let me help you eat in a way where you're not constantly fighting hunger, where you feel satisfied and full. And in the book, I write about something that I call Blissy Foods. So, Blissy Foods are, you know, these are the food products that are about as far away as possible from the real foods that both you and I like to promote people can eat. And so what are these Blissy foods? Right? These Blissy foods are products that tend to have been designed by the food industry with these clever combinations of fats, sugar and salt to be quite literally irresistible. And a lot of people don't really understand the neuroscience of this and what's really going on. So our brain is wired to uniquely respond to certain properties in food. So certain kinds of carbs, starch, sugar, protein, fat, salt, even the umami flavor that you get in cooked meats and broths and seaweed. When you eat these foods in certain combinations, your brain releases a chemical called dopamine. And dopamine is the learning molecule. Dopamine helps to, you know, dopamine does many things. It creates these feelings of intense reward in your brain, these really feel good, intense feelings of rewards, so much so that if you keep eating these, yeah, you keep eating those foods, very soon the dopamine starts to get released in anticipation of eating those foods. So not even when you're eating them, the sights, the smell, being in the same location as you were before when you ate them. And actually, I find it useful to explain this to patients because then they understand, oh my, my biology is changing. My my my my neurochemistry is actually starting to change. So that's why it can be so hard to resist when you're being exposed to those foods. And Mark, I had this patient in her 30s who was trying her best to eat well, right? She would buy cookbooks. She'd be motivated in a kitchen to cook. But you know what? In her job, it's really interesting. In her job, she'd often finish about 7:30 p.m. this is pre pandemic. And she would drive home and at one of the roundabouts, do you guys have, do you call them roundabouts? We do in the UK.

Yeah, yeah, yeah.

Yeah, she would drive it and this roundabout, there would be a very well-known fast food restaurant there and the smell off that food would permeate the air around that roundabout. And she said, Dr. Chassy, I'm trying my best, but at least two times a week, I'm tired, I'm stressed out after the day, that smell hits me and I have this overwhelming feeling that I have to eat it so I stop and eat it. And I explained to her about dopamine and then I said to her, I said, listen, is there an alternative route for you to drive home? And she said, yeah, but it will take me a good 10-15 minutes longer. I said, you know what? For the next few weeks, I honestly want you to try this as an experiment. Take the other route home. And so she started taking the other route home. She doesn't pass the junk food store, right? Temptation's not there. And I promise you, that was the only change we had to do because suddenly she's no longer having to fight temptation. She gets home, cooks a healthy, wholesome meal, and over the next few months, she lost significant amounts of weight and she didn't feel as though she was even trying. So again, with this personalized approach, Mark, that was the right approach for her. It may not be for me, and may not be for someone else, but for her understanding dopamine allowed her to take a different route home.

Well, most of us don't really realize that the food that we eat has effects on our brain in ways that control our behavior and that it's not a moral failing or some problem with your psychology, although sometimes it is a trauma, but sometimes it's just damn biology that hijacks you and doing the things you said, you really literally can stop and end all those hunger cravings. So that's just great. You know, one of the things that you also talk about is our environment. And I think this is something that most people don't understand is you can self-sabotage by having the wrong environment. So, for example, if I'm trying to get off coffee and I have coffee in my house, probably not a good idea. Or if I'm trying to get off ice cream and I got a freezer full of ice cream, probably a problem. So talk about how do we structure our environments for making our lives more effective in terms of achieving our goals, whether it's weight loss or anything else.

Yeah, environment is arguably the number one thing to try and influence because our environment influences our behavior so much more than we think. We kind of feel we've got some sort of super willpower that we can resist all this temptation, but it's simply not true. Our environments influences our behavior so much. We know there's so much data on this. There's There's research showing that if you live within a half mile radius of your house, so there are six fast food restaurants compared to three, I think it's 40% more likely you're gonna be overweight or obese. I think in schools, if they ban snacking in classrooms and in corridors, the BMI goes down on average by 11%. No one's changing, you know, telling people what to eat, they're just, mean, they're just saying you can only eat in the eating space and the canteen, right? You can't eat everywhere else. So our environment really influences this massively. So what can we do? Well, I've always said control the environments you can control, you know, and I've heard you say this for years as well, Mark, you know, it's like let's not use willpower out there. I mean, it's hard out there. Make sure your house is a safe zone. So, you know, I have a rule that In our house, we don't bring in the foods that I'm trying to avoid by and large. Now, if they ever do come in, you know what? I'm human just like everyone else. I can know the science, I can know about dopamine, but you have that stuff in the house. If I'm tired and stressed and the TV's on in the evening, I'm gonna open the packet of chips or crisps, you know, or biscuits just like anyone else.

Yeah, biscuits means cookies in the UK for those listening.

Yeah, I'm so... Biscuits sounds healthy.

Biscuits sounds healthy. And you mean cookies.

I mean cookies, I mean cookies. Yeah, but then also, what is the food you are gonna expose yourself to in your environment? So, you know, make sure it's fruit that you've got out. Make sure it's like, you know, chopped carrots and hummus or whatever it is you wanna be inputting signals into your brain. You know, I'm not encouraging people to overeat more than they should be eating, but if you are gonna have food around, make sure it's the food that's really gonna help support your health and promote health and longevity, not the one that's gonna take away from that. your toaster, right? If you have a toast habit, put your toaster in a cupboard, right? Don't have it on the counter. It's just- Forget it.

Don't have the bread for the toaster. That's the big problem.

Yeah, so don't bring that into the house in the first place. But it's like, you know, if you, it's like trying to make the habits, trying to make the behaviors that you're trying to avoid, make it harder to do those behaviors, right? But then the behaviors you do want, right? Make it easy to do them. And, you know, we spoke about this on when I came on your show last year, Mark, with my last book on habit change and five minute snacks. But, you know, one of my favorite tips at the moment, frankly, for anyone here in the UK, we're in a third complete national lockdown. So pretty much everyone or most of the population are working from home, right? And it's really affecting people's mental health and wellbeing, especially in the dark British winter now. It's not like last March and April, when it was springtime, it is dark, it is cold, people are really struggling. But one of my favorite tips, and it's also in the book, is that in your kitchen, right? If you have a kettle bell or you have a dumbbell, and many people do these days, because in the lockdowns they all sold out everywhere. I say keep it next to your coffee machine, right? I can see you've got a coffee machine in the background there, Mark, in the image, right? Keep a dumbbell, buy it, buy your espresso machine. and here in the UK, if you, you know, many people will have at least three hot drinks a day, a cup of coffee or a cup of tea, right? So I'm saying, okay, every time you go into your kitchen to make a hot drink, if all you do is lift up that dumbbell and do five bicep curls on each arm, right? If you have three hot drinks a day, you will lift that weight 30 times in a week, that's over 200 times in a month, that's nearly a thousand times. And the beauty is, Mark, in the moment, it will feel like nothing. And why that's so powerful is it helps to build up your self-esteem, your resilience. You feel better about yourself. You know, it's not like a 40-minute workout. Great if you can do that. But these small things, it's that feel great, lose weight. Do that every day. You're gonna feel better about yourself and that's gonna ripple into other areas of your life. You're gonna want to make better choices around your food. and I love that I use that tip myself when I don't have to lose weight. I do it because it helps improve how I feel about myself.

Fat is the key to sustained weight loss.

Yeah.

Who would have thunk it, right? Aren't we not supposed to have fat in our diet? Isn't it bad for us? Doesn't it create heart disease and high cholesterol and all these other things that.

Yeah.

Are bad for us? Or is it actually? That's what we were all taught, right? That's the whole line. Our government. told us to eat 6 to 11 servings of bread, rice, cereal, and pasta today, to eat a low-fat diet, and fats and oils were sparingly only at the top supposed to be eaten. And yet that advice led to the worst obesity epidemic and diabetes epidemic in the history of mankind. That's like the food charts that we all saw in school, right? Completely opposite of what we should be doing. And so the science has caught up with this bad advice, and the advice unfortunately St. Louis was based on really shoddy science, on very weak evidence, on a few population studies, not really experimental studies. In fact, all the experimental studies that told us to eat low-fat diets, they actually didn't tell us that we should be doing that. They were actually contradicting the recommendations that were developed in 1980 by the UK and the USA. Really? So basically, if you looked at the actual randomized controlled trials, there weren't that many, but there was a few of them, They all said that eating low fat wasn't beneficial, but the... They were outside of the US.

Trials.

No, trials all over the world.

Trials in the US. They just didn't look at that evidence. So the guideline committees who were working on it didn't sort of dismiss that evidence. And they had this theory and they went with the theory, because it made sense, right? If you look at calories, for example, fat has nine calories per gram, carbs and protein have four calories per gram. So you think, well, gee, if it has more calories per gram, if you eat less of it, you're going to lose more weight. It's logical. But unfortunately, metabolism is not a math problem. It's a metabolic problem. It's a hormonal problem. It's not energy balance. The whole idea of calories in, calories out, this is the biggest crock of, you know what, that's been pushed on the American public because there's a message implicit in that, which is if you just told someone to lose weight by eating less and exercising more, if they don't do it, it's their fault. Just eat less, exercise more. If you don't, you're a lazy glutton. So, it's your fault, you're fat. But the truth is that it's not just about calorie balance. In fact, that's what the Global Energy Balance Network, which was actually funded by Coca-Cola, and they actually funded University scientists to kind of be the front people for this nonsense that's all about calories in, calories out has been completely discredited. The New York Times wrote a big expose of this, but what we've been taught is that all calories are the same. They're actually not. So food is not just energy, it's actually information. It gives instructions. So this is like a big breakthrough in science, right? So food is not just calories, it's actually information. So the information in food communicates with your body every single minute. So every bite you take, it turns on or off genes that create health or disease, that make you lose or gain weight. It turns on or off hormones that make you lose or gain weight or create health or disease. It's like a feedback for you. It's direct instructions and it works minute by minute. It's not something that takes a long time. It regulates inflammation. It regulates your hormones, as I said. It regulates your brain chemistry. It regulates even your gut microbiome, all the flora in your gut. that we now know are linked to everything from weight gain, diabetes, to heart disease, to cancer, to autoimmune diseases, and so many other things is the gut health. Even depression and ADD and autism may be linked to changes in your gut flora. So we now know that when you eat food, it's not just about the energy in it. Because if that was true, then you could just survive on soda all day and it wouldn't matter as long as you only eat 1,800 calories of soda. And I had this argument with the Vice Chairman of Pepsi We had dinner together. I'm telling you.

No way.

Yeah, we had dinner. And the guy in between us, because I was in here, he was sitting here, the guy was like being in the middle of a war zone. And I said to him, How can you say that eating 800 calories of soda is the same as having 1800 calories of broccoli or almonds? He says, well, as long as you have that amount of calories, it's not gonna be any different. I said, this is not how the body works. You're not getting the nutritional value from that, right?

Right.

Well, it's not even nutritional. So just like look at 1,000 calories, let's say 750 calories of broccoli is 21 cups, 35 grams of fiber, half a teaspoon of sugar, and tons of phytonutrients, phytochemicals that upregulate your genes that actually help you prevent cancer, that improve hormone metabolism, so many things, right? Same calories from a big gulp, 750 calories, 46 teaspoons of sugar, high fructose corn syrup, upregulates your liver to turn on a fat production factory that makes high triglycerides. Dr. Stores fat more, right? Dr. Stores fat, lowers triglycerides. I mean, raises triglycerides, lowers the good cholesterol, causes a fatty liver, raises hormones that make you, in women, make them grow hair on their face and have lost hair on their head. Men, they drop their testosterone, they have no sex drive and they lose their hair on their bodies. All this from the same calories The number of calories. Calories are the same, but the information in the food is very different. So now we have this concept that is actually really about the hormonal, I call it the hormonal hypothesis. I talk about in Eat Fat Get Thin, which is how do you change your hormones so you're not hungry all the time? Because that's the key. The typical advice, you eat low fat and your fat actually makes you satisfied. Because if you eat fat, you're not craving all the time, you're not hungry, and it actually is a brain actually food because it actually stops the addiction center in the brain from turning on. So you never feel hungry or have any cravings. It also speeds up your metabolism. Fat speeds up your metabolism. So it helps you burn more fat. It helps you burn more fat. It releases fat from the fat cells. Interesting.

Right.

So it makes you less hungry. It makes you burn more fat and it liberates the fat from the fat cells. So it's really a powerful whereas if you eat sugar, The opposite happens. You get hungrier because you increase insulin. You drop... I used to have so much sugar. It's terrible. I was addicted to it. All of us were. I mean, I was too. I was a vegetarian. I ate like tons of whole wheat bread and sugar and honey and everything. I mean, grape nuts and ice cream for breakfast. That was my life, right? So, when did you stop? When did the research become known or the facts of the data become known?

It's not even.

It's honest, that's why. Because you're a doctor and you were eating sugar. It's not. When did you start to realize it? When did this information about fat become, you know? Well, it's been mounting for decades, right? So it's building on a mountain of evidence. And in the book, I reviewed over a thousand studies or 500 quoted in the book that I referenced. They wouldn't let me put more because there was no room in the back of the book. Yeah, yeah. And it's all well documented. And the science of this is very powerful. One of my colleagues, David Ludwig, he wrote a book called Always Hungry. He's a Harvard professor. He's done a lot of the research that this is based on where he frankly gave two groups of people same calories, same calories but changed the percents of fat and carbs. And it was a very well controlled study. And in the first group, they had 60% carbs, 20% fat, 20% protein. The other group switched it, 60% fat, 20% carbs, 20% protein. So it's the opposite. And the group that had the high fat diet burned 300 calories more a.

Day by doing nothing at all.

Really, just by having more fat. By eating more fat, their metabolism sped up 300 calories. That's like running. Same amount of calories though. They ate the same amount of calories in. But they burned 300 calories. Right, because their metabolism sped up. Interesting. Right, so in other words, it's like running an hour a day without getting off the couch. Interesting.

Right?

That's powerful. Very powerful. Yeah, and I know for me, as I've seen myself and my patients, transformation is amazing and their cholesterol gets better. It's totally contradictory. Fat is supposed to raise your cholesterol, eating cholesterol is supposed to raise your cholesterol. But for the first time since the Dietary Guidelines came out in 1980, the US government in 2015 completely reversed their stance on fat. There's no more restriction. like January, first week of January 2016. This year. This year. Like a few weeks ago. A few weeks ago. They just changed this. They changed this completely. The whole guide. Completely. So they first time they said, forget about fat. You can use as much as you want. No, no limit on fat. This is the government. The government. The Dietary Guidelines Advisory Committee established these recommendations. This is a scientific group that establishes guidelines for the government. helps them shape policy. And then the government makes the policy. They kind of, they kind of, around this research or this. Yeah, they said, you know, don't worry about fat, don't worry about cholesterol. Eggs are back. Right? Eggs are back. You know, forget about the egg white omelets, just eat the whole egg. No way. Completely. And they said, there's, what they was, it made, it made me laugh. They said, cholesterol is no longer a nutrient of concern, quote, nutrient of concern. Like, Well, we got it wrong for 35 years.

No way.

So it's like, it's totally different. And they also said that we should, for the first time, they said we should reduce sugar. Now, the policy advisors who are the scientists said we should limit sugar-sweetened beverages because they're proven to be linked to obesity and diabetes. But the government, because of the food lobby, changed the wording to say, no, we should be restricting added sugar. So we should eat less added sugars. Now, what's an added sugar? It doesn't say added sugar on the label. So how do you know? Because the food labeling from the FDA is also influenced by the food lobby. So which is to say added sugar on the label, not just sugar. So you don't know. It's designed to totally confuse people. The truth is that this is a huge advance and now we actually have come to realize that this is not true. So the science around fat and how your body burns fat and what makes you fat is all really clear now. It's all based on this hormone idea of insulin, which is a fat storage hormone. So anything you eat that increases insulin, which is sugar, refined flour, I mean white flour raises your blood sugar more than table sugar. So if you had two slices of white bread, it raises your blood sugar more than a tablespoon of table sugar. People are like, I mean, whole wheat bread, it's just as bad. Unless the bread is so like dense that you can stand on it without it squishing, then you shouldn't eat it. You shouldn't eat it. No, like the German rye bread. I love bread though. Yeah, everybody loves it. The bread we eat isn't the bread we ate, right? So our ancestors ate very different. It's not the hard bread. It was very coarse. And we only had the grain mills that started in the 1800s. Before that, we couldn't eat refined grain. And now even whole wheat is super refined. It's just, you know. And are all grains bad as well, in your opinion? No, I don't think all grains are bad. You know, I joke, I say, you know, in the book I talk about, you know, an induction plan, like basically a way to get quick start to change you from like just being storing fat to burning fat to eating fat to makes you thin. And that's a 21 day plan. And after that, I talk about how you transition to what I call Pegan diet. Pegan? Pegan as opposed to paleo or vegan. It was kind of a joke because one day I was sitting- In between? Yeah, I was sitting on a panel with two friends of mine. One was a vegan cardiologist and the other was like a paleo doctor.

Sure.

And I was like, well, I don't know. I guess they must be a Pegan because I'm in the middle here. Okay. What does a Pegan diet look like? So, Pegan diet, you know, it's amazing, Louis, is that the principles of Paleo-Vegan are often very similar. So, both groups believe that we should be eating whole, unprocessed, unrefined foods. Yes. We should get rid of food additives, hormones, everything. No antibiotics, no hormones, no pesticides, no GMO. We should be having no MSG, no artificial sweeteners, no high fructose corn syrup. Everybody agrees that that's true. We also agree that everybody should be eating lots of fruits and vegetables. Yes.

Right?

Heavy on the plant foods. Yep. Basic principles. Both agree that we shouldn't have dairy, which is interesting. Yes.

Right?

We'll talk about that. Paleo, no dairy as well. No dairy, right. No dairy. I guess there's some of them that say like some specific cheeses or something. Yeah, you know, grass-fed butter. There's some things, but the proteins in dairy are very inflammatory. And the dairy again we eat isn't the dairy we ate. Hybridized our cows, all fertilized by one bull. It's not organic dairy. And it's not organic, it's not raw, it's not how our ancestors ate it. Even organic cows, they pump milk them when they're pregnant and they're just full of hormones. So, also, you know, it's just not always tolerated well by many people. What else did everybody agree on? Everybody agrees that we should be eating foods that are phytonutrient rich, that are nutrient dense, and we should be lots of nuts and seeds and lots of good oils like avocados, and olive oil. What's phytonutrient? What does that mean? Phytonutrient is a chemical that's in plant foods. Phyto means plant. And it's not a vitamin or mineral. It's not a protein, fat or carb or fiber. It's something else. So for example, like broccoli has glucosinolates, which upregulates detoxification. Catechins are in green tea, which are powerful detoxifiers of metal, powerful antioxidants. Tomatoes have lycopene, which is a powerful cancer preventer for prostate cancer. So anthocyanidins, you can have black rice, which has anthocyanidins, which are powerful antioxidants that are in black rice. It's emperor's rice.

Love that.

It's also very low glycemic. Sure. So I think the things that they disagree on are basically beans, grains, and meat, like where you get your protein from. Everything else is the same. Paleo and vegan is the same except for meat. beans and protein. I mean, beans, grains and protein. Beans, grains and protein. Okay. Right. And, I mean, you know, like, you know, meat. And so, you know, what I realized is that, you know, I think many people who are sick do better when you take out certain things that can be inflammatory or high glycemic. So, if you're, for example, carbohydrate intolerant and you're diabetic, which affects a lot of people, I talk about how do you find out if you're carbohydrate intolerant in the book. which is as a questionnaire you can tell if you actually know if you're someone who's carbohydrate intolerant, like someone who's gluten intolerant. That means if they eat a lot of starch, if they have like two cups of rice, even if it's brown rice or two cups of beans, it can adversely affect their sugar. So I talk about like having less, like having smaller portions of beans and grains and non-gluten grains in particular because gluten can be very inflammatory for many people. I think for some people who don't react to it, it can be fine but not in large amounts. and then I think, you know, meat is a big, is the big issue, right? The meat is the big issue. So should we be eating meat? We just, we were just had dinner the other night. Right. We both had meat, right?

We had fish.

We had fish. Black cod.

Yes.

Which was awesome. I had a mahi-mahi. You had a black cod, is that what it was? Yeah, I had the black cod. Yeah, yeah, I had the black cod. The guy next to me had meatballs. Yeah. Got next to me had carne asada. But, you know, so, so the issues around meat also, I think are, everybody agrees and fish, everybody agrees that if, if anybody eats meat, It should be humanely raised, it should be sustainably raised, it should be grass-fed, it should be not harming the environment. The ethical and the environmental issues around animal eating are big and they're real. I have many Buddhist patients. I have a Buddhist monk who's like an abbot who's a diabetic and he's never going to eat an animal. So I need to help him understand how to never eat an egg, how to eat a high, higher fat protein diet which is low glycemic. so we can do that.

Okay.

Right. So more nuts and seeds, you know, less rice, more beans, you know, just, there's strategies for doing that. Sure. And he did great. He lost 35 pounds, reversed his diabetes, and now I have, like, tons of bun people, you know, praying for me. That's great.

Yeah.

And, and then the, the, the meat thing is tricky because, you know, it's also an environmental risk if you're eating factory farmed animals. There's antibiotics in that. and is runoff from the pesticides and fertilizers that damages our water supply and rivers and lakes. There's climate change that happens from the methane produced. It's more toxic to the environment than carbon dioxide. There's high energy use. One-fifth of all our fossil fuels are used for growing animals for human consumption. Our water is being used up at incredible rates for feeding animals. There's basically, I think 70% of all water use and there's basically only 5% of the world's surface is fresh water.

Usable, right?

Is fresh water, right? 1% is in Russia.

Wow.

And at least 4% for the rest of us. And 70% of that is being used for feeding animals for human consumption. So there's real environmental issues.

Sure.

So I think, you know, a factory farming just should be not supported in any way and we need to change that. And that means we need to change our patterns of consumption around meat. We need to downsize our meat consumption. I call it having condiment.

Condiment.

Condiment. As opposed to like a condiment? Like condiment. You know, it should be a side dish or a dressing if you're going to eat it.

Sure.

And I think not a full plate of steak, you mean? You know, I think there's three issues with me, right? There's environmental issues, there's moral issues, and there's health issues. So we kind of talked about the moral. I think that's, people are entitled to their beliefs and they should be able to follow whatever they want and be healthy. The environmental issues are real. I think everybody would agree whether they're paleo vegan that we need to stop harming the environment. And I think even if you're not paleo vegan, everybody really believes that. In fact, the dietary advisory committee that was advising the government said we should limit meat consumption because of the environmental impact. Now, if you have grass-fed meat, if you have sustainably raised meat, it's not as abundant, you can't produce as much, and so we all have to eat less. It's more expensive. But that's okay. And I think that from a health point of view, when I really looked at the literature and I did this in Eat Fat, Get Thin, I looked at all the research that I could find on meat. I'm like, well, I don't know. I want to know for yourself, too. Yeah, I'm recommending to my patients. I'm a human, too, and I want to live a long time, and I don't want to be doing something stupid.

Yeah.

So I wanted to find out what does the science tell us about meat? So you did all the research? So I looked at all the research and I wrote 8,000 words in the book on meat.

Wow.

There's a lot of research in there. And I address all these issues, you know, environmental, moral, and the health issues were quite interesting. You know, when we look at the studies on meat and anybody can quote anything saying anything, right? Right. So you want the paleo people like a meat's healthy, here's all the research. And the vegan, like, meat's gonna kill you. Here's all the reasons. So it's like, and then you're at the average Joe, you're totally confused. And your average doctor, you're totally confused because we had no training in nutrition. And they haven't done the research themselves. So they're going off of their opinion or their theory. Yeah, they're like average people like the rest of us in terms of nutrition science. They don't know because it's not what we learn, right? I mean, I just at a Cleveland Clinic and we implemented a nutrition curriculum for the first time in the medical school there that's integrated in, which is so great. And I helped team Ryan, who's a congressman from Ohio, introduce Tim. He's great. Has he been on your show? He's been on here, yeah. introduce a bill called the Enrich Act, which was a bill that is funding $15 million to fund nutrition in medical schools. Nutrition education for doctors. That's what we need the most because doctors, a lot of the time, I feel like could heal a lot of their patients with food.

Oh my God.

Well, food is the cause of most chronic disease. It's the cure for most chronic disease and yet doctors know nothing about food and they just medicate a lot of the time. I mean, listen, it's so bad. I mean, I use food as medicine. That's what I Food is the most powerful drug on the planet. I mean, that's why last week I was in Cleveland at the hospital teaching 300 black women how to cook in a cooking class. Like that's what doctors should be doing. That's how I'm going to get that. That's real medicine, right? That's real medicine. Now, just a quick side note. What is your involvement with, what is functional medicine and what is your involvement at the Cleveland Clinic? Can I finish my meat? Yes, go ahead. I was still rolling on the meat. I was talking about functional medicine. And then we'll talk about Cleveland Clinic. Perfect, perfect. Because people want to know, like they're like, well, what about meat? They're like probably listening. Yeah, let's do it. So, the science. 8,000 words. I'm not going to give you 8,000 words. I'll give you a few hundred. Perfect. So, the science of meat was fascinating. So, when I looked at the studies that showed it was harmful, here's what they were. They were mostly population studies, meaning they looked at groups of people, followed them, and then they asked questions of them. What did you eat last year? What did you eat last week? What did you last month? And they basically do these food frequency questionnaires, and then they correlate that with the risk of disease. And I try to control for all the confounding factors, but it's very tough. So the people who ate meat, yeah, they had more heart disease and more cancer and more death. But what else was... They were smoking, they were drinking, they were sleeping. Exactly, exactly. So if you look at the data, they ate 800 more calories a day. They almost eat no fruits and vegetables. Tons of sugar. They had tons of sugar and processed food, lots of fried foods, drank more, smoked more, didn't exercise and didn't take any vitamins and minerals. Well, guess what? They weren't as healthy as the other people. so most of the studies were like that. Now, there was a few study that were interesting. I found one was a study of 11, 000 people who shopped at health food stores, and they found there were, like, a lot of vegetarians and a lot of meat eaters. Like, so who are the people who are, you know, like healthy meat eaters who only eat grass-fed meat or who? Because most of these studies were not on grass-fed meat either. They were on Factory Farm meat. Right. So, then again, how do you generalize that? Sure. But then there were these 11, 000 people, and they followed them for many years, and they found that the meat eaters and vegetarians, there was no difference in their health outcomes. Exactly the same. So if you're a meat eater who basically eats a healthy diet and has grass-fed meat versus a vegan or vegetarian, no difference. You have a healthy lifestyle. Healthy lifestyle. Then there's no difference. So there's other factors like how it affects your gut flora and so on. And I think, you know, those are more complicated issues. I address all of them in the book, but at the end of the day, I think it's okay if you.

Have no moral issues and you can.

Eat sustainably raised meat and not in great quantities.

And as part of your diet, I think it's okay. Right.

And eat smarter. You talk about our idea of calories being a little bit misconstrued, that the whole science of calories in, calories out, something I've talked a lot about, is kind of not really true. And then just so you know, Sean, you know, even though you and I have looked at the science and we're, you know, we're not phds in nutrition. You know, we don't work at big academic centers, although I do work at Cleveland Clinic. And there are, you know, endocrine societies and specialists and so forth. I look at all the data. But I know I was having a conversation with my colleague from Harvard, David Ludwig, who's been researching the science of calories and glycemic load and index for 30 years. And it's really clearly established through very carefully designed experiments, not just population studies, but carefully designed interventional experience with randomized control groups looking at different effects of metabolic health of different calories. He did one study where he literally found they were, if you ate exactly the same calories, but low carb and higher fat, you would actually burn 450 calories more a day than the control group eating exactly the same calories just because the different effects of these macronutrients on your metabolism. And, and what, what I, I, I was shockingly informed of by him the other day were two position papers by the Endocrine Society that reiterated that weight loss is all about calories. Why is this so wrong?

Yeah.

Well, first of all, in Eat Smarter, we go back and look at the inception of the calorie. And I'm very, I'm a big fan of doing this. Like, where did this whole thing come from? And looking at how this became such the focal point in nutrition. It really revolves around the calorie, which when it was invented, it wasn't even utilized. Nobody was looking for anything to measure energy in food, by the way. It was used in physics and engineering, but it made its parlay into the nutritional world thanks to Wilbur Atwater, which we have the Atwater system, which kind of goes on a lot of food labels right now, which is very skewed, by the way. But what really impressed it upon our culture, it was a massive bestseller in the early part of the 1900s. Dr. Lulu Hunt Peters, and it sold like 2 million copies, which is like a billion copies today. You know, it's just like everybody had this book. And she made the shift in that point as a popular paradigm in the culture of looking at food in terms of numbers, no longer looking at food in terms of food and the dynamic aspects that it has on our bodies as far as its relationship to our endocrine system and our neurotransmitters and all those other things.

Mm-.

And so she said from this point forward, we would no longer look at a slice of bread. We'll no longer say a slice of bread, we'll say 100 calories of bread. We'll no longer say a slice of pie, we'll say 350 calories of pie. And within that indoctrination, she also began the widespread association of food with morality and impressing upon culture as a character defect if you're not able to manage your weight and using terms like punishment and sin. And this was also during the time of World War I. So it's widespread food rationing going on, too. And so one of her quotes, and I went back and read this old fangled book. I just couldn't believe some of this stuff in here. But, yeah, she said that essentially, for every hunger pang you feel, you should have a double joy in knowing that you are preventing the pangs in another starving child.

Wow.

Or you support. Basically, you're supporting your country and making sure other people can eat. and this also is very important because it associated weight loss with hunger. You know it's working when you're hungry. And these things have continued to proliferate in our culture unchecked. Now, just going back to your point with calories in particular. Now, this is one of the most fascinating aspects of this because it's not that calories are not valuable. It's a measurement of energy. It's a tool of measurement, but it's different because A meter is a measurement of distance, but that's consistent.

Right.

Within the human body, it's completely eliminating the complexity of digestion. And so one of the fascinating things that I want folks to know and starting to really evolve the concept of calories is that the type of food matters. And one of the studies highlighted in Eat Smarter, this was from the journal Food and Nutrition Research, and they took test subjects and they had them to consume a meal of either whole foods or processed foods to see what it did on the rate of calorie burn. And it was shocking.

Yeah, yeah.

The whole food meal was what they called this whole food meal, multigrain bread and cheddar cheese. While the processed food meal was white bread and cheese product, which is cheese product, by the way, that's Kraft. All right, it's Kraft.

Well, you know, we can't actually call it cheese.

It's just product.

Yeah, it has to be 51% cheese. that's why it's called American slices, not American cheese. And it shouldn't be your first warning. It's a cheese-like substance.

Exactly. And so they compiled all the data. They had, you know, test subjects eat either or. And after they compiled the data, this, listen to this. This is what happened. The folks who consumed the processed food sandwich, even though it was the same amount of calories, the same amount of protein, carbs and fats on paper. The folks who ate the processed food sandwich had a 50% reduction in calorie burn after consuming that meal of processed food. It changed the way their body was managing the calories they consume and it caused their body to retain and hold on to more of that processed food energy. All right. That's just one aspect. And we go through about five or six of the different dynamics.

So what you're saying is what you eat. is probably more important than how much you eat.

It is definitely a major factor, you know, and if folks can start to make this shift and just evolve, take it up a notch, because we tend to get into this, unfortunately, like you just mentioned, you know, we have amazing colleagues who do work in this field. I just taught a neuroscience class at NYU yesterday. You know, I get to do all of these really cool things, but the science on food and metabolism and weight loss, it tends to be very lopsided, even for the quote experts, the best in the business, who are just like, you need, just need to be in a calorie deficit. You need to be in a calorie deficit and completely ignoring the complexity of the endocrine system and digestion. And also, one of the things we really dive into and provide the cutting edge research is the effect that your microbiome has on rate of calorie burn. Dr.

Absolutely. I mean, this is really functional medicine, right? Food is information. It's not just calories. When you eat and, and it's different than if you burn a calorie in the lab. I mean, if you burn a calorie, in a lab, and 500 calories of soda and 500 calories of broccoli are exactly the same. They both release the same amount of energy, and that's defined as how much energy it takes to raise one liter of water, one degree centigrade. That's a calorie, and it's fine. When you eat them, it's very different because when you're eating the foods, they're going through all sorts of different mechanisms that change what happens. So they alter your microbiome, which changes your weight. You literally can swap out bugs from a thin mouse to a fat mouse, and that fat mouse will lose weight because of the thin making microbiome, right? So you're feeding the microbiome, you're driving inflammation or cooling it off, which drives weight gain. You're regulating hormones like insulin, testosterone, estrogen by what you eat. You're regulating your mitochondria, which really about.

How much energy you burn.

You're regulating all these various factors that are, are so critical for weight regulation, your brain chemistry, your hormones. And you write all about this in Eat Smarter, which is why it's such smarter book because you actually address these scientific issues that still are staggering to me that most traditional doctors, nutritionists, academicians, and nutrition societies and the government all don't buy into. And it's really honestly, I hate to say this, but a lot of it has to do with the fact that the food industry wins by all calories being the same because then you can have 100 calorie soda, or 100 calorie bunch of blueberries, and there's no difference. But that's just absurd. Even a fifth grader or a kindergarten kid would understand that, you know, 500 calories of soda and 500 calories of.

Blueberries are pretty different when you eat them.

And it's your fault.

It's your fault.

It's your fault. It's your fault.

Your weight, you're overweight.

Right.

Because if you, if you just ate less and exercise more, everything would be great. Manage those calories.

Yeah.

And you'll lose weight. And the entire paradigm is really skewed. And I got to reiterate this because when you just mentioned the research in mice, for example, now we have paralleled research in humans. This is cutting edge data that is getting out to the world right now. And one of the fascinating studies, this was published in Cell, they was looking at, they looked at what's happening in mice depending upon their microbiome cascade. And they found that there's specific, I'm sorry, specific, I'm so excited, specific bacteria that is found in mice that actually reduced the amount of calories that they were absorbing from the food that they were eating. Now, you take that piece of data and marry that with the human data that we have now, and this was conducted at the Weizmann Institute of Science. And what they did was they were taking, this is well known right now, guys, but I want everybody to get it today, that once our bodies start to venture into being overweight and obese, our microbiome changes massively. and now we know that there's a kind of a bacteria cascade that is associated with being overweight.

All right?

It's like a fingerprint, all right? It's a very unique kind of dynamic thing, all of our metabolism, but there is a very specific spectrum that you see when folks start to become obese. And what they did was they took these human fat bacteria associated with obesity and put them into lean mice. And then the mice inherently gained weight their insulin sensitivity went down and they gained body fat versus taking the bacteria from a healthy human subject and putting into the mice and the mice continue to stay lean. Changing the bacteria in our bodies has a massive impact. And one of the other studies took two, took a set of twins. All right. And all they did was they had them on the same calorie reduced diet. But one of them had a microbiome associated with obesity, and one had a microbiome associated with leanness. on the same diet and they're twins.

Wow.

On the same diet, the one with the microbiome associated with obesity continued to gain weight while the other one didn't. So this is real stuff. So what do we do to fix this is where we really got to put our focus.

I agree. And I think, you know, I just want to sort of summarize a few key elements here that are worth underscoring. And then I want to talk about the three major things that cause problems when you want to try to lose fat. So if you eat ultra-processed food, by the way, it's 60% of our calories. It's most of what Americans eat, all the starch, sugar, processed food, anything sort of made in a factory that's not from real ingredients. One, if you're eating it, even if it's the identical same calories as whole food, your metabolism's slower. That's what you just said. Two, in another study, they found that if you let people eat ultra-processed food compared to regular whole foods, they'll eat 500 calories more a day. So they'll eat more and they'll be hungrier. And three, it changes your microbiome in ways that increase bad bacteria that cause weight gain. And of course, there's a lot of other things that drive inflammation, hormone, and appetite issues, which are really the things that really you talk about that are the three major things when it comes to fat loss. So let's dig into those three things, inflammation, hormone dysfunction, and apetite problems, which is, you know, I mean, I had a doctor call me about one of his patients for advice and he says, just this guy really exercises a lot of time. You know, really focus on eating healthy, but he's just hungry all the time. And I'm like, well, it's probably because of what he's eating that's driving his brain chemistry and his immune system and all the mechanisms that drive hunger. So we have to change that. And it's not that hard to do. so tell us about those three things.

Absolutely. And the thing that I really wanted to usher in and bring to the forefront because it sounds the most like ghostly, it sounds like cast with a ghost, like it's not even a real thing is inflammation and how inflammation has an impact on your body composition. And the data exists, it's just that a lot of folks don't know about it. And the way that it really manifests when we're talking about inflammation, is that it has this very detrimental impact on our organs that are related to our body's production and utilization of our fat, kind of fat loss related hormones. So namely, let's take our liver, for example. Your liver is incredibly important in regulating your metabolism. You know, we're talking about a relationship with how it manages insulin, even the production of fat. takes place in your liver too. The storing of glycogen can take place in your liver. You know, if your liver is, if your body's overburdened by glucose, your liver can literally convert that into fat right there on the spot. And so if something is damaging your liver, it's going to inherently damage your, your endocrine system and your process of metabolism. So inflammation, and I've just kind of shared some of the data in the book. Dr. Damaging your liver and what this is one of the most fast growing issues in our country is non alcoholic fatty liver disease. Yeah, this is really a kind of chronically inflame in inflamed situation taking place in our liver and also how do.

We, how do we get fatty livers? Because I think people should know we go to fancy restaurants and they give you foie gras, which is French for fatty liver. And, and how do they get the ducks to be like that? And how do they get us humans to have 90 million Americans with fatty liver?

Everybody should know by now. Very simple. The fastest way to, to damage your liver and to create that fatty liver. When, by the way, it's called non-alcoholic fatty liver disease because we associate it with alcohol. But sugar.

Sugar. Absolutely. Sugar, starch, flour. It's, it's so bad. It's so bad, particularly liver has to.

Take on, your liver has to take on the brunt of it because your liver is really, even the name live, it's responsible for so much. Like every minute, it's filtering your entire blood supply. You know, it's so important.

That's right.

But to take this one step further, and I'll just drop this little nugget so we can move on to the other topics, but also the master regulator often referred to, of course, you know, I've even taught this in my conventional University setting. But your hypothalamus, all right? Your hypothalamus is one of the major regulators and communicators with your thyroid, with your liver, with your adrenals. All the organs related to fat loss and fat storage, the governing kind of master gland, it's called the master gland is your hypothalamus.

That's in your brain.

You hate it.

Right. And now we've got data that this new term, neuroinflammation, inflammation specifically regarding the function of your hypothalamus can damage what's happening with your metabolism. But nobody's talking about that in these cookie cutter diets that you need to address the inflammation in your brain in order for you to lose weight.

Right.

So these are all. And the beautiful part is it's possible. It's not just possible. It's probable when you have the right information, and we avoid the things that create the inflammation. and namely you just mentioned sugar, but we go through a whole subset of the different things. Yeah, in functional medicine, we also look.

At, you know, food sensitivities and environmental toxins and the microbiome and all, there's so many things that drive inflammation. And if you're overweight, you're inflamed. And for those listening, you know, think, oh, you know, I'm a few pounds overweight, a little extra belly fat, you know, maybe I need to lose 10, 20 pounds, or maybe you're over more overweight or obese. you should really pay attention to what Sean's saying because right now during this COVID pandemic, what we're finding is those people who are overweight or obese or have even a little bit of extra fat are much more likely to get sick, much more likely to end up in the hospital, the ICU, and to die from COVID-19 because of poor metabolic health. And what's so beautiful about the body is that you think, oh my God, I've taken years and years to get here. Within a couple of weeks, you can change all of that. You might not lose all the weight in a couple of weeks, but you can change your inflammation markers, your hormones, your brain chemistry, literally in a couple of weeks of changing your diet and following the principles that are in Eat Smarter, which is Sean's new book, which you should all get a copy of.

It's about applying behavior change to everything. It's about applying the rules of behavior change to everything we want, whether that's weight loss, mental health, fiscal, whatever it is. Don't try and think willpower will be enough because in the long term, it rarely will be.

Yeah, you know, it's interesting. And we, you know, how much you're getting in the book. But one of the challenges I find with people is that, you know, they spend, you know, days and hours and hours, weeks researching, like, their vacation spot and rental and what the restaurants are going to go to and the rare planes are going to do and what they're going to bring and what they're going to pack and, and everything they need. And, and most people don't give five minutes of thought to planning their nutritional week. You know, what is my week gonna look like? Where's my food going to come from? what do I have to get? How do I have to prepare it? How do I not end up in a food emergency? How do I have the things around that actually work? And I do it now automatically, but I understand it's not something that people normally have. So I have, for example, in the morning, I'm doing like a shake now. I'm trying to like put on some muscle and I'm just focusing on this super shake that I've been creating, but I have all the ingredients on the counter and I make sure I have my bananas I buy that are my frozen fruit that I buy and it's in the freezer and I have everything ready. So and I buy extra jars of the macadamia milk. So, I have everything just all there. So, it's super quick and easy for me to do. But if I had to go shopping and I forgot this and I didn't do that, it would be very difficult. And so, I think sometimes it's even as extreme as people organizing their fridges with Tupperware with pre-cut vegetables and pre-cut fruit and pre-cut all these prepared things that are easy to make. And I see people who do that and it's like, wow, that's even next level for me. But I just make sure that you have to think about what you're doing. You have to plan what you're doing to plan your activity. And I think we don't schedule ourselves first. We schedule ourselves last. Then eating is an afterthought and it just becomes, well, I don't know, let me go get some this and something quick or package this or just eat crap, whatever is there. And I think that's a challenge for people. So I think it's important that the environment, as you say, is structured to succeed as opposed to fail. And I think that's the take home. The other thing I really want to get into, and this is challenging because right now during COVID people are isolated alone. They may not have been great chefs or cooks before, or you can't go out to restaurants. Sometimes they're not even takeout anymore. And people have been, I think, taught that cooking is difficult, that eating healthy is expensive. Is this true? And how do you address the issues of cooking and cost and feel great, lose weight.

Yeah, so there is a section on cooking and explaining just how important it is. It's that basic life skill that until recently, I'm pretty sure all families, all humans, all tribes would have had that ability. And it's something that is now optional. It can only have been optional because we have the ability to buy all these food so quickly, so cheaply, and our lives are so busy, they're stressed out. A lot of us feel we don't have time to cook and certainly in certain socioeconomic groups, I think we have to accept that actually it's not only it's not about money so much, it's about having the luxury of time to cook, which a lot of people will say, if I'm working two jobs, I don't have time to cook, right? So I think cost and time poverty is something we should be absolutely aware of. Now, I don't think, I think the research, and I think what we spoke about this when you came on my podcast recently, it's that it's simply not true that eating well has to be really, really expensive. Of course, there are certain things that are more expensive. There's no question, like wild salmon, for example, is probably more expensive But, you know, a kind of sardines is dirt cheap here in the UK. Um, do you know what I mean? There are ways that actually we can eat in a way that actually is whole food, but isn't super, super expensive. And I think where you live can really influence what's available, what you consider normal. You know, we mentioned environment before, but our friend circle, our own, our own sort of network of tribes. That's important as well. You know, the research by Nicholas Christakis has shown that, you know, someone in your social circle is obese, you're 45% more likely to be obese. If a friend of a friend is obese, you're 25% more likely to be obese. And if it's a friend off a friend off a friend, you're 10% more likely to be obese, which just shows just how powerful these social connections are. and the environment, even our friends and family environment is at influencing us. But it really isn't Mark as expensive as we think or some people think it might be to eat well, but you have to be able to cook, right? That is a basic, basic skill. And if you cannot cook, that's okay, right? Recognize it and go, learning to cook may be one of the most important things that you can learn to do, whether it's from one of your cookbooks, Mark, whether it's to go on YouTube. There is so many free and cheap resources now to teach people how to cook some basic meals. And, you know, the truth is, is that the pandemic for some people, not for everyone, but for some people, Mark, there's been a lot more time at home, a lot more time with family. And I know many people who have got into cooking during lockdowns, during these restrictions, suddenly they're not commuting for two and a half hours a day and they're actually buying cookbooks and they're learning how to cook recipes. I've got to say, Mark, you know, my new routine on a Sunday afternoon, which really has been has come in in the last year, I love nothing more than this on a Sunday afternoon after lunch, right? I clear out the kitchen. I put I'm a bit old school. I put on a CD and I've got a CD player in the kitchen. I put on one of my favourite CDs and I cook a big batch of butternut squash soup to last us for the week, right? I've got lentils in it, butternut squash, it's got leeks, onions, ginger. I'm trying to think about the price of it, but you know lentils are dirt cheap, right? Two or three butternut squashes are not that expensive and apart from that it's stock, leeks, onions and ginger. It's kind of like that not only is it not expensive, but those one and a half, two hours are some of the most enjoyable times I spend in the week. I've got some great tunes on. I'm chilling. My daughter may be there drawing on the kitchen counter. We may be chatting at the same time. And at the end of it, there's the smell, there's the feeling that you really connected with the food. And then, you know, oh, that's going to go in the fridge. So in the week, if we ever need something for a meal, we can just go and heat that up. And so I'd really encourage people to find what works for them. Where is that moment in your week where you can actually find a bit of time to batch cook? If you are trying to cook something from scratch three meals a day, seven days a week, that's where it can become really challenging. Not only is that a huge cognitive load, 21 times now I need to think about what I'm going to eat in just one week.

Right?

So batch cook, cook more. And one of the tips in the what We Eat section is eat dinner for breakfast. Right? It's such a simple thing that people haven't thought of before. It's like eating, you know what it's like, Mark? The breakfast foods that we often start our days with are literally setting ourselves up for mood swings.

Oh, it's terrible.

For mood swings and if you cook a bit extra at night, heat it up in the morning, have some salmon, sweet potatoes and broccoli in the morning sometimes if that's what you have the night before. And often people find that they're just not hungry until lunchtime. There was this case I had, this exactly, someone who was having what he thought was healthy granola every morning. You know, sugar-filled granola.

Yeah, yeah, yeah, yeah, yeah.

He thought it was healthy and he didn't really need to lose that much weight, but he found that his concentration was going, his focus was going, he'd get a bit shaky by 12 o'clock. And he started having, and he, this guy was vegetarian, right? And I remember it so well. He said, well, what shall I have? I said, well, what do you have in the evening? He goes, well, I love roast, roast vegetables. I said, okay, what do you have with it? He says, goat's cheese. I said, okay, why don't you start there? So the next morning he has goat's cheese with roast vegetable. and he said it got to 2:00 p.m. before he was even hungry. And he said, I didn't realize before that my concentration wasn't good and my energy wasn't good. It's only when I had a real food breakfast that I realized, oh wow, I've been functioning suboptimally for years. And so, you know, you know this as well as I do, I mean, there's plenty of tips on how people can do this inside the book. But, you know, I really want to encourage people to take this rounded approach. If you have tried already and focused on one area, and it's not been sustainable for you, let me help you figure out why that is. Maybe there's something else that you've not tackled that's actually the underlying root cause.

Yeah, it's so important because we don't, we just sort of stay on the surface and don't really figure it out. I just love your story of cooking. I think most of us feel so disenfranchised from it. But with COVID now, it's an opportunity for us to really dig in and, and try new things and to be with family and to be with the people you love and that we have more time. And I think if people can reclaim their kitchens, it's really the key to weight loss. I mean, I always tell the story of this family I worked with in South Carolina who was living on food stamps and disability in a trailer with a family of five and were massively overweight. The father was diabetic on dialysis. The mother was 100 plus pounds overweight. The son was probably 100 pounds overweight, almost diabetic at 16 years old. all I did was cook a simple meal with them, show it how fun it was to do it together. We, you know, they didn't even have cutting boards and knives. I had to give them that afterwards. And they ended up losing, you know, 200 pounds together as a family in the first year. And the son actually went back and gained weight because he had to go work at Bojangles, which is the only place his kids could get work, which is a junk food or fast food restaurant in the South.

And.

But then he went on to lose 138 pounds, went to medical school, and it was really all through the simple Act. of cooking one meal. And I think if you can imagine if we could go into everybody's home and show them how to shop and cook one simple meal, the basic cooking techniques, how to cut things, how to peel, I mean, they know how to peel an onion, they know how to peel garlic, they know how to make a salad dressing from simple olive and vinegar, they know how to stir fry, they know how to, I mean, it was just, it was stunning. Everything they'd had was from a box, a package or can that was either heated in a microwave in the oven or, you know, it was just, it was terrible. And I made me really realize how powerful it is just to empower people with the simple act of cooking real food at home. And it's much, much cheaper. And I gave them a guide on good food on a tight budget, which is how to eat well for less. And they were able to do it within the budget that they had for.

Five people on disability and food stamps. Yeah, I mean, that's so powerful, Mark, when you stories like that. And, you know, when I, when I filmed the first series of BBC One's Doctor in the House, where I'd go and live alongside families for four to six weeks, It was a common theme. I'm gonna say in at least half of the families that I went and stayed with, they didn't know how to cook or it was something they used to do and they've lost the habit. And I remember in the first season, the lady with type 2 diabetes, I remember just again cooking them a meal, a basic meal, chopping things together. You know, these guys were used to getting McDonald's several times a week. And I remember so, you know, you mentioned cost. I can remember that so well in 2015, my first day filming ever Mark, right? So I go to this family's house in Shrewsbury in the UK. First day I meet them and we start off because I'm going to stay at their house that night for the first night, which they didn't know. I didn't realize that. And the father said to me, he said, hey, I said to them, hey guys, I'd love to find out a little bit about what you guys eat normally. And the dad said to me, okay, well, look, why don't you come along and I'll show you. So he points to his car seat. So I get into his car. We drive for 15 minutes out of town, right? One five, 15 minutes out of town. We go into a McDonald's drive-thru and this is a family of four. So husband and wife, I think the daughter, you know, the daughter and the son were like, teens, 15, 16, 17, something like that. He ordered four double meals from McDonald's. Right. And the cost was 48 pounds. So let's put that in perspective. 48 pounds. I don't know what the exchange rate is at the moment. Must be at least 65 to 70 dollars. Dollars.

Right.

And he said, we do this. And what was interesting, Mark, is as we were driving there, He said to me, Hey, Doc, this is actually really embarrassing. Now, you coming with me, but this is what we do four to five times a week. So what's interesting is several things. He's spending 65, 70 dollars on four double meals from McDonald's, right? Which when they ate, they were hungry 30 minutes later, and they were moody afterwards, right? But the second thing is, and this speaks to what we were talking about before, is that when he's driving there with me sitting next to him, he suddenly says, Hey, Doc, you know what? This is really embarrassing, right? But he only realized that with me sitting in the car next to him because if it's just him and his family, he can do it. No one's questioning him. I wasn't judging him. I wasn't questioning him. But the simple act of me being there was like a mirror to him. And he goes, Man, we do this four or five times a week. You know, and that's, that's really interesting from an emotional viewpoint, isn't it?

What's really going on there? Yeah, it's so powerful. I think we don't realize how much we get into habits unconsciously and just do those things without thinking. And then it leads over the course of our life to just dramatic changes in our health and our well-being. And it's, you know, what kills me and I think you experience the same thing is how close people are to feeling good, right? If the feel great part I mean, the lose weight part, you know, is slow. You can do a pound a week, maybe, but when it's more, depending on what you're doing, you know, initially you might lose more. But the field grade part can happen pretty quick. And I, I think, you know, most people, when they start to shift their diet and they start to change their habits and they start to understand how to sort of reprogram their biology for well-being and health, that they were, they were like, well, wow, I didn't know how quickly I could feel better. I didn't know I was feeling so bad till I started feeling so good. And it's, it's so rewarding for me to see that the that the simple act of eating real food and regulating your life in a way that supports health has such dramatic downstream benefits on mental health, on mood, on relationships, on work, on productivity, on just parenting, on everything that you care about in your life. If you don't have your biology well regulated, you're a victim to the whims of all these influences that are outside of us, which is you know, the food we're eating is information, as we learned from our mentor Jeff Bland. And it is a instruction manual that is telling everything in our body what to do. And, you know, we often think that our emotional states, our psychological states, or our relationships are not triggered by food, but it can be really dramatic, you know, and just to sort of recap a little bit about what our friend David Perlmutter wrote about in his book, brainwash where he was on the podcast, he talked about how people are eating the processed food that we're all eating now, 60% of our diet. It disconnects the frontal lobe from the limbic brain, which means the limbic brain is the reptile brain that is reacting, responding, it's angry, you know, fight or flight, all that. It disconnects that from the frontal lobe, which is the adult in the brain. It's sort of the higher self. And so, all of a sudden, you've got this dysregulated reptile in your brain. it's not being supervised by an adult and it leads to all this disordered behavior. And part of me wonders if our society has become so divisive, so conflicted, and there's so much rancor because of our diet in part, because how it affects our brains and our functioning.

Yeah, I mean it's so powerful to hear that. It wouldn't surprise me at all. I think it's It's not just going to be one thing is it? It's all these multiple inputs coming from all the way around. And that's the whole thing about food, isn't it? It's so reductive to talk about it just in terms of calories and, you know, energy into the body and energy out, you know, as you say, food is information that's so much more than just those calories. And actually, we're doing food a disservice by just talking about it in terms of energy. It is more than that. you know, genetic expression, hormones, as you say with the brain, what it might be doing, absolutely incredible. And, you know, we mentioned emotions before, but again, it goes both ways, doesn't it? You can feel stressed and want to eat more, but actually eating the wrong kinds of food consistently can make you more hungry and cause you to overeat and can cause you to crave more of those foods. So, It kind of it feeds it on both ways. And I sort of feel that the right approach for each person is going to be slightly different. But I think, you know, we can we can absolutely agree that I don't know anybody who won't benefit from eating more real food in their diets. You know, I don't I can't see the downside of doing that.

No. Now let's talk about the other boogeyman in the room around weight, which is exercise. and part of the equation is eat less, exercise more, which implies that you're not thin because you don't exercise enough or you don't move enough. And I think there's some really fundamental flaws with that idea. Not that exercise isn't important, but that in the hierarchy of weight loss, it really is not as important as what you eat, where you eat, when you eat, how you eat, why you eat in determining your metabolism. And so can you talk a little bit about some of the myths about exercise and also what the role of exercise is in metabolism and weight?

Yeah, no for sure. I mean, you're absolutely right. That's one of the biggest myths out there. And it makes sense, doesn't it, that it's just a simple equation that you just sort of add up. And at the end of the day, that didn't determine that you're going to put on weight or put off weight. If only it was that simple. Right. So what is the deal with exercise? So the, there's some new research from Herman Ponce, which has come out in the last few years, and he's been studying the Hadza tribe in Tanzania, and he's been measuring their energy expenditure. And it's super fascinating, Mark, because what he's shown is that these hunter-gatherers are moving a lot more than the average sedentary Westerner, right? They're moving a lot more. But you know how many calories they're burning off? Roughly the same, 2,000 to 3,000 calories a day, which is roughly the same as the average sedentary Westerner burns off, even though they're moving more. So what is going on there? And this is kind of one of those big myths. So we think that if we go for a run, and we burn off 400 calories on our run, let's say, we feel that that number is additive. We just add it on to the number we would have burnt off and we've got 400 extra calories there. But it's simply not true. Our body is a complex system. Your body will compensate if you burn off more calories running, it will reduce how many calories it burns off in other areas. And there's multiple ways it will do that. It will reduce NEATs. non-exercise activated thermogenesis. So, you know, toe tapping and fidgeting, it will reduce that it can change how many calories it burns off in other departments in the body. And the point is that we are this complex system. And I think this is where it gets really misunderstood. Going back to what we said at the start mark, people are not only depriving themselves and restricting themselves with foods, they're putting themselves on punishing exercise regimes. We all know when we see that person really struggling in the gym, you know, who's pounding the treadmill three, four times a week for an hour, wondering why the fat is not coming off without realizing that for some times you're actually stressing out your body even more and raising cortisol, which can actually make the weight loss harder in the first place. But it's not, you know, it's not that moving more is necessarily going to burn off more. And I think that is brand new information for some people. I think that science is really, really fascinating and it really, it reshapes everything we've been told for the last 20-30 years that you've got to move more, you've got to move more. Now, what role does it play? I think exercise is really important. So, can you lose weight without doing any exercise at all? Absolutely. Would I recommend it? Absolutely not. I feel that the reason to move is not to burn off calories, but it's to make yourself feel good. It's to build your self-esteem up. You know, when we're moving regularly, we're showing our body that we're an active, thriving human who's engaging with life. Humans are animals. We're designed to move. So I think movement is very important, but it's about feeling good, not burning off calories. So, like I said before, that tip about the dumbbell by the kitchen. what's that going to do in isolation by the kettle, you know, lifting that several times a day? You know, it's not like the 30-40 minute workout we've been told for years that we have to be doing to losing weight. But what it will do is it changes the signals in your body. It just keeps giving you these little inputs that actually, you know what? I'm alive. I'm engaging with life. I'm an active human who is able to lift a heavy weight or a mediumly heavy weight. and it really boosts self-esteem, which helps you engage in other behaviors in a much better way. And actually, Mark, you know, I've been thinking recently that for many people, weight loss is actually a self-esteem issue. It's about how they feel about themselves. Once they start to love themselves, have compassion to themselves, they no longer want to punish themselves. with highly processed sugary foods. They no longer want to punish themselves by sitting on the sofa all day, watching TV, not getting up and moving. So I kind of feel that compassion part, that self-love is also a part of this equation that we're not speaking about enough. Because when you truly love yourself and value yourself for who you are, you don't want to beat yourself up. You don't want to engage in lots of unhealthy behaviors. So, I think movement has a very important role to play, but it's not the role that we've been taught. You don't need it to lose weight. I just think it helps you boost how you feel.

No, it's true. I've had people who's 100 pounds without changing their exercise. But the other thing is that you cannot exercise your way out of a bad diet. So, if you have one cookie, you have to walk four miles. if you eat one super-sized meal, you have to run four miles a day for a week to burn it off. And if you eat that every day, you have to run a marathon every day just to keep up. So, you can't exercise your way out of a bad diet. That's really important people understand. On the other hand, what you're saying is really important that it is about one, just improving your overall well-being, your mental health, and the side effect if you do certain kinds of exercise like high-intensity interval training and strength training, you will literally increase your metabolic rate so that you burn calories all day long as opposed to, you know, just when you're exercising. So there's, there is a strategy to including it, but you, you know, you can, you can exercise all you want if you're eating poorly. I, I, my weight trainer, the guy who was sort of my trainer in New York, was incredibly fit. He has big muscles, but he had this sort of big layer of fat on him as well. And within, you know, six weeks, he lost 20 pounds just by shifting his his diet. And, this is a guy who worked out hours and hours a day. And, I think even somebody like that who's an extreme level of fitness still can have a lot of body fat if they don't understand how to eat in a way to regulate their biology. Traditional medicine is pretty simple. Eat less, exercise more. That's the solution. Count calories, count your steps. It's just not working. So what do we do differently in functional medicine?

You know, so first of all, we get a really detailed history, right? We find out from that person their timeline. When did weight become more of an issue for them? Was it just this slow progressive increase over the years, or was there a time where they had this big spike in weight? You know, that really impacts how we think about what could be that underlying cause for them, right? If all of a sudden somebody gains weight, then you go, okay, maybe there's something going on with their thyroid. Maybe something shifted there. Right.

Right.

You know, if it's that slow progressive weight gain, then maybe it's a combination of, you know, just getting, you know, the wrong foods and not, you know, not sleeping enough or not exercising enough, right? So, you know, how they gained and when they gained the weight really gives us this information.

Yeah. So everybody's different. It's all, this is what functional medicine is. It's personalized medicine, personalized health. Yep. And we actually dig into your individual imbalances and correct them. And that leads as a side effect to weight loss. I never get people to lose weight. I mean, I never say lose weight. I never say we're putting on a diet. I say, here's the things that are out of balance. Let's get them back in balance. We'll cross our fingers and see what happens. You know, and it's often a miracle what you see.

Yeah.

And then it just comes off. Yeah, and people, you know, there are weird cases of things. Like I remember a case where there was a doctor who came to see me, a woman who had gained a hundred pounds in a few years. And her colleagues were like, oh, you're just eating too much, you know, don't eat so much, get a gastric bypass, this and that. She's like, no, something's wrong. I'm like, well, she showed me her driver's license picture. and she looked like completely different. And I'm like, well, what's going on with this? And I just said, Look, it's probably something weird. So let's check things like her cortisol level. And we checked her cortisol levels off the chart and she had a tumor on her adrenal gland that was causing high levels of cortisol which makes you hungry and fat. And stress makes you fat in the same way. So you could be, I remember this woman who was, and so we had her adrenal gland tumor taken out and she lost 100 pounds like that.

Right, right.

I had another patient I remember years ago was struggling and she had gained 40 pounds and her daughter lived in Israel and she was so stressed because it was during the time of the conflict there and constant bombings and terrorist attacks and she was constantly stressed. And as soon as her daughter came home, she lost 40 pounds.

Right, right, right. Or, you know, I think there's a really interesting connection with the gut and food sensitivities in weight, right? So when we put people on elimination diets, like, you know, somebody does like your 10-day reset or you pull away inflammatory foods and they lose weight so quickly, right? That's a sign that they're eating a food that's causing their body inflammation, right?

Wait, what does inflammation have to do with weight gain?

Oh, well, when there's inflammation, that causes us to hold onto water and that causes weight gain and inflammation also damages the mitochondria and that impacts weight gain.

So it is huge. And it also makes you pre-diabetic. Yes. So you could be eating the same things but if you're stressed, you're actually raising cortisol.

Yep. And if the insulin goes high, then you're gonna gain more weight from the food that you eat.

Yeah. So it's complicated but in functional medicine, we really have a map. to diagnose each person's dysfunction or balance with their thyroid or mercury or cortisol or the gut microbiome or your mitochondria. There are all sorts of things that go wrong that most doctors overlook. And the problem with medicine today is that we sort of blame the victim. Like if you're overweight, it's because you eat too much and you don't have self-control and you're not taking personal responsibility and we blame the victim.

Yep.

And we don't actually have a way for helping these people figure it out. So, you know, I think this is really important people understand that, that we now know a lot about metabolism and weight and all the various factors that go into affecting it and how to fix them. Where we necessarily didn't know a lot before.

Yep.

But now the more and more we're knowing, we can actually figure out how through food and various strategies help people lose weight. So I want to talk to you about a few cases you had that were interesting about how we saw these patients at the Ultra Wellness Center and what exactly you did to help them figure out their issues.

Yeah, yeah, yeah. So the first person that came in was, or one of the women that came in, she was 55 and she was overweight, about 40 pounds overweight, and she had noted that her kids had just gone off to college. It was time for her to start taking care of herself. but she had noted that over the years after her pregnancy, she just slowly started to gain weight and she was exercising and taking care of herself, but those 30-40 pounds just slowly came on over the years. And what we noted with her, we did her waist-to-hip ratio. We saw her waist-to-hip ratio was elevated, indicating that there was insulin resistance. We also checked of fasting insulin, we saw that it was high, also indicating that insulin resistance.

When insulin is high, you can't lose weight because it locks the fat and the fat cells. It slows your metabolism. It makes you hungry and crave carbs. And it makes your body store fat. So you're literally creating a total chaotic sabotage of your body when your insulin levels are high and you're eating all the starch and sugar.

Right, so we had to figure out how do we help drop her insulin levels, right? How do we help drop her insulin levels? Well, you know, you can do that when you shift diet. Because we know that when we eat fat, right, the body doesn't need to make insulin to use that fat. So when you eat carbohydrates, your body makes insulin, you know, and when you eat a lot of the refined processed carbohydrates, your insulin levels spike.

So.

When we shift the diet to one that's a little lower or a lot lower in the refined and processed and more healthy fats, that helps with people with feeling better and not feeling so hungry. It helps prevent those insulin spikes and it helps us not gain as much weight around the belly. Yeah, it's so important to focus on insulin.

Most doctors don't even test your insulin, so you don't even know what it is. Right. But if you check it and it should be less than five, you're good. If it's over 10, it's pretty bad and it can go up to 50, 100 or more and especially after you eat, it can get worse. worse. Right. And I wish we had a little, like, monitor where we could quickly measure insulin for people. Like a continuous glucose monitor or continuous insulin monitor. I think it would be way more interesting. I agree. And I think that, you know, we, we actually know how to fix it. And, you know, people need to realize that without insulin, you can't gain weight.

Right.

If you take a type one diabetic whose pancreas is damaged by an autoimmune disease. Yep. And you look at their symptoms, their weight loss and hunger, they're eating 10,000 calories a day and losing weight. Why? Because without insulin, you can't store the fat. So this is really important for people to understand. It's so powerful and that's why strategies that help fix insulin are so key for weight loss for most people.

Yeah, yeah. And you know, we were so, you know, 20 years ago or so, we were so programmed on that pyramid, right, where we were making sure we were getting enough grains and- oh yeah, 6.

To 11 servings of bread, rice, or pasta a day. That seems like a recipe for disaster.

Yeah, and so it really, it caused a lot of high insulin for people and they're having a harder time with, they're feeling hungry all the time and they're having a harder time with weight loss because of it. So sometimes people get really surprised when we pull away, either pull all away the grains or keep them very minimal. They're like, Really? I thought I was supposed to eat all of these, right? And that can really help with those cravings. And getting more fat. Yeah, and getting more fat.

If you could eat so much fat and not gain weight, because we used to think that fat made you fat. Right, because it has nine calories per gram versus four for carbohydrates or protein. So if you want to cut out the calories, you just cut out the fat. Well, that's what happened. We cut out the fat and had a low-fat craze or low-fat salad dressing and low-fat Snackwell cookies and low-fat muffins and they were all full of starch and sugar. And that was the worst thing that could have happened. So when you eat fat, you don't increase your insulin. You actually speed up your metabolism. There was that study by your friend David Ludwig, Where he basically gave people food, so he knew what they were eating. It was either 60% carbs, 10% fat, or it was 60% fat and 20% carbs. And on the 60% fat, eating exactly the same amount of calories every day, the metabolism increased on the high fat diet. So doing the same level of activity, The people who are the most overweight and insulin resistant, their metabolism increased by 400 calories a day. That's like running over an hour a day without getting off the couch and that would account for the entire obesity epidemic if we could fix that. So this is a really important strategy.

Yeah. And so she then lost her numbers came down beautifully. Her blood pressure was a little high and it came down. Her insulin came down. and she lost about 10 pounds.

She went from 135 to 35.

Right, so she got a little bit stuck and I think that's where we shifted things a little bit. And I think sometimes that's really important is that, you know, sometimes the body gets a little used to a certain plan and you have to change things up. And I think that's where intermittent fasting can be really helpful. And so we put her on a program, it's called a 5:2 program where two days a week, she cut down her calories significantly. You know, it was like 500 to 600 calories on those two days because she was really not eating very much on those two days. And she could pick whatever two days she wanted. And the other five days, she wasn't as strict. And that's when, you know, her body started to kick in and her metabolism improved. I think probably because of the impact on the mitochondria, you know, but it was impressive.

Let's back up and talk about this because, you know, I think there's so much information now online and the media about this whole intermittent fasting thing. Yep. And there's lots of different terms like time restricted eating, you know, intermittent fasting and fasting by making diets and ketogenic diets. And it turns out they all do the same thing. And so, Tell us a little bit about each of these and how they work and why they're so effective.

Right.

So, time-restricted eating just means that you're not eating for specific periods of the day or you are only eating for certain times of the day. So a typical way that somebody will do a time-restricted eating plan is say, okay, I'm only going to eat for eight hours in the day and I'll eat between 11 and 7.

And you fast for 16.

And then you fast for the other 16.

I mean, even just 12 is good. Most people eat all day, eat all up to the time, they go to bed, and then they wake up and they like, you know, eat again.

I think you're absolutely right. I think that is a great place to start with everyone because if we can just get people to not eat after dinner, right, they will, their, their things will improve because we know that the food that we're eating later in the evening, that nighttime eating will cause more of an insulin spike, right? So we know that that's really important to pay attention to. So saying to people, okay, let's try with at least not eating for 12 hours a day. Then you moved to 14 and then to 16, right?

Yep.

And not everybody needs to go longer, but there's good research with the 12 to 13 in terms in terms of helping with longevity, helping decrease risk of cancer. There's some interesting research on breast cancer and not eating for 13 hours at night. So I think that that's something that we can really work with a lot of patients to do and say, okay, let's say at 6:00 to 7:00 at night, that's when you stop and not eat until the next, you know, the next 7:00 a.m. time or whatever that is for them.

Yeah, there's so much research on this now, you know, and they all do similar things, whether you're time-restricted eating, whether you're intermittent fasting, like, you know, fasting one day a week or the 5:2 program, or whether you're, you know, trying a ketogenic diet, which activates the same systems in the body. All of it does the same thing. It enhances your energy production, your mitochondria health, which is really important. It fixes insulin resistance and gets rid of belly fat. It builds muscle. It improves your brain chemistry and your cognitive function. It helps your bone density. and it even helps production of stem cells. It reduces inflammation and it reduces your antioxidant burden. I mean, it reduces your oxidative stress and you get more antioxidants produced. So it's a very powerful way of focusing not on what you're eating or how much you're eating, but when you're eating.

When you're eating.

And that's a very interesting angle that we really haven't focused on. We always focused on how much. and then we now focusing on what, because not all calories are the same, and now we focus on when. Right. And I think that's a really important thing for people to understand that there's a lot of ways to hack weight loss that have to do with the right kind of approach. And if you're not doing it right, you can kind of get in trouble, but you need to know what you're doing. And I think there's a lot that we can share about this, and we'll share at the end about how to actually do this. So, that's a key thing. So what other things. You know, we had this other patient you had that was a male who really struggled. He was overweight, about 40 pounds. So tell us about him.

Yeah, so you know, he came in and he was 55 and he was really struggling with his energy. He was very low energy. He was really frustrated with his sexual function. He noticed he had a low libido. He was having some erectile issues. he had gained these 40 pounds around his belly, but he was really having a hard time with losing them, with losing that weight.

And the higher your belly fat, the lower your testosterone.

Yes, because right, because that belly fat has that aromatase enzyme which takes your testosterone and converts it into estrogen.

Yeah, and then they lose the hair on their body, they get man boobs, pubes, right? They get breasts, you know, it's a real thing.

It's a real thing. And it's a great motivator for men, right? We know that as your waist circumference goes up, so does issues with erectile dysfunction. So, you know, but we need to give them the tools to be able to lose that weight around the belly, right?

So he had all these other issues and you sort of figured out that he had insulin resistance, two that we were talking about?

Yeah, I mean the first thing we did with him was put him on that 10-day reset that you've put together, which really I think is a great jumpstart for people because it can help them say, okay, I'm just gonna, I gotta try this, but I need the tools, I need the map to do it. And it's really motivating because many times, because people were eating inflammatory foods before or they were eating the wrong foods at the wrong time, right? And they do this and they notice a significant improvement in how they feel. And then they're like, okay, I can really shift this. I can make a change. So we did that before any test. And the 10-day reset, you know, is.

Based on what we've been doing in our center for decades, which is an anti-inflammatory, low glycemic, higher fat, phytochemical-rich, fiber-rich diet. It actually helps to reset your whole biology, not just about weight, but any chronic illnesses or symptoms you have is so effective.

Right, because you're pulling away the inflammatory foods, which for a lot of people, those inflammatory foods are triggering a lot of their symptoms.

And you can actually get access to the free program at getpharmacy.com, that's G-E-T-F-A-R-M-A-C-Y.com, and if you want the upgrade on it, you can get with the coaches that help you go through it, with the shakes and the supplements that help enhance the program. So it's all on there. Just go to getpharmacy.com and you can try it because a lot of times you don't really need the doctor. If you can sort of biohack your own biology and figure out what's working, what's not working, and then once you figure out, oh my God, I lost 10 pounds this week and I feel so much better and my joint pain's gone and my headaches are gone and my nose isn't running and my digestion's working and I sleep better. And it's like, well, how did that all happen? It's because your body is so powerfully influenced by food. We always talk about food is medicine. not like medicine. It is medicine. And it has tremendous effects on curing all kinds of illnesses if we actually use it. And that's what this is. It's a very medicinal diet that tastes freaking amazing. So it's not like you're suffering.

Right.

And he felt really motivated. He was really happy. But he actually had a lot of other things going on. So he had lost some weight, but then we also noted, we also you know, through questions, we found out that, okay, he might have some issues with sleep.

Yeah.

You know, he was snoring. His blood pressure was a little high. He had all this weight gain.

Yeah.

So I said, you know what? We really need to get a sleep study on you.

Yeah.

And so when we did the sleep study, we found out that he had sleep apnea.

Yeah. Which is so common and under diagnosed.

Yes.

And sleep apnea, where people snore, stop breathing in the middle of the night even though they don't realize it, right? They're snoring and then they have episodes of apnea where they don't get any oxygen into the body. That in and of itself triggers insulin resistance. So that causes high levels of insulin in the body, which then as we've been talking about, causes us to gain.

Weight around the belly. So wait a minute. So what you're saying is if you don't sleep, you get fat even if you don't change your diet. This is something people need to realize because people think it's, again, it's about what you eat and exercise. And yes, it is, but there are other factors that have to be looked at that most doctors miss.

So often when somebody has sleep apnea or might have the signs of sleep apnea, you know, they think, okay, I'm just gonna lose weight and then it will go away. Right? But so often it's the sleep apnea that's causing the weight gain.

Yeah.

Of course it becomes a vicious cycle. But that sleep apnea causes high levels of inflammation in the body and it causes high levels of insulin. And it just causes us to put on weight.

And it also is one of the biggest causes of high blood pressure. That's not good. Absolutely. I remember this one guy I had, he was like a lawyer, he was in his 50s and he's like, you know, Mark, I have to work at my desk, but I have a standing desk because, and this is before standing desks were popular, because if I sit down, I fall asleep. and I'm like, you fall asleep driving home, you fall asleep watching TV, you snore. He's like, yeah, yeah, yeah, yeah. I'm like, you need to have sleep apnea. Let's get you tested. We got him a CPAP machine.

He lost 50 pounds.

Yep. Just boom like that. Putting on a sleep apnea machine every night. Right, right. Because you're actually getting oxygen into the body, so the body's not at stress anymore. And so the insulin levels come down, the inflammation comes down in the body, and then the weight comes off. I think when people have undiagnosed sleep apnea, when it's not being treated, we can do all these great things in terms of shifting their diet and putting them on an exercise regimen and looking for other issues. But if we don't deal with that, it's almost like I always say to them, it's like you're running against the wind. You're not going to get to your goals. And so we've got to deal with the sleep issues and like you you said it's so common.

And this guy didn't just have sleep issues. He had the insulin issue, he had sleep issue.

His thyroid wasn't right, right? Exactly. We checked his thyroid and he had some elevated TSH, he had some low thyroid and he had some thyroid antibodies that hadn't been discovered before. So then we dealt with all this autoimmune stuff going on and so we took him off of gluten. Well, he was already off it because of the reset but we kept him off of gluten. And so, we were working on every aspect of his health. And that's when he got to his goal weight, right? When we worked on every aspect of his health. And we helped him also get on a diet that he could maintain forever, right? Which is what the goal is.

It's so true. And you know, it's important. We often joke, we say we're holistic doctors because we take care of people with a whole list of problems. And, you know, it's often not one thing, it's many things.

Yes.

And everything's so solid in medicine, so there's a sleep doctor, there's a thyroid doctor, there's a weight doctor. It's like, forget it. In functional medicine, we take a step back and we look at the whole system and we're able to map out. And this is this one guy, another guy who's overweight might have different issues. And so we might have to look at their toxin load or their gut microbiome or their levels of nutritional status that affect their metabolism. So we really have a very sophisticated lens to look through to understand what are all the imbalances and all the systems of the body and how do they affect any different disease. The truth is, you know, we have so many different illnesses that we diagnose in medicine, but they're all connected by very common root causes. You know, just like, you know, you can send a man to space with an incredibly few simple physics laws, right? Very few laws of physics, and they actually can help you do something incredibly complex. The same way the human body has some basic laws of biology and we follow those laws, we can help people get better. It's just learning how to unlock all that. And that's really the beauty of functional medicine. We actually have the ability to personalize our treatments to get people better from things that often they don't get diagnosed or that traditional medicine doesn't have a great approach for. Hey YouTube, if you like this video, you're gonna love the next one. Click to check it out today. Functional medicine is about getting rid of the things that impair health and putting in the things that help the body thrive. And then the body can take over and with its amazing intelligence can repair and heal from all sorts of things. -Oh, totally. Yeah. -And that's what we do.