How to Fix a Broken Metabolism

In this video, I'm going to debunk the calories myth and give you a framework for thinking about how to fix a broken metabolism. But first, I should clarify what I mean by broken metabolism, for your metabolism isn't truly broken. However, it can feel that way for some people when, despite their best efforts at exerting their willpower over their dietary and lifestyle choices, They just can't seem to make progress. Like a bird flying into a strong wind, flapping its wings, expending energy, just to remain stationary. But now imagine if that bird, maybe you or a loved one, turned and the wind were at its back. It would soar! That's what I want for you. And we can get there. Now, I can't promise we will get there in a single video. But this will be a start. But first, we need to unlearn together the idea that calories cause obesity. Because in truth, they don't. Ah! Nutritional heresy! Yes, I did say calories don't cause obesity. And it will be foundational for your change in mindset around metabolism. So listen carefully, really try to internalize what I'm about to say. You see, the word "cause"—calories cause obesity—has very particular implications. It speaks to biology, physiology, and the calorie balance equation—calories in minus calories out equals weight change—simply does not. You can actually have maintenance of the laws of thermodynamics, the calories in minus calories out equals calorie balance equation, that can be maintained if you put calorie balance Downstream of what really matters: hormones, and how your hormones dictate where your body puts energy and how it uses energy. So let's take an example that will resonate with most of you, maybe piss a few of you off. We all know those people who can eat a ton and not gain weight, and those other people who go off their diet for a few days and then self-report that they turned into human manatees. Don't mean to be insulting, that is self-report, people have literally told me that's how they feel. And the literature backs this up. For example, in a landmark overfeeding study performed in the '90s, when they fed people over 1,000 calories beyond their estimated energy needs, there was a tenfold variation in fat gain which was dependent on how these people's individual bodies automatically regulated non-exercise energy expenditure. Yes, calories are part of the story here, but notice how calorie balance weight change is downstream. There's an unconscious physical response that helps hard gainers buffer against overeating better than easy gainers, easy weight gainers. And in some people, calorie increase can even lead to unconscious overcompensation in energy output and weight gain. Weight loss. So eating more calories and weight loss. Bizarre, right? To be clear, this goes far beyond movement. I alluded to non-exercise activity thermogenesis, but there's changes in the microbiome, intracellular adaptations in mitochondrial dynamics, and so much more. The details on these mechanisms aren't that important, but it's important for you to understand there is hardcore physiology behind variations in how different bodies handle energy at different times, and how interventions, which we will speak to later, can influence this physiology to result in better outcomes—result downstream in better calorie balance. But before I get to that, I need to address the most common challenge, which is that, at the end of the day, when calories are "controlled for," diet X doesn't do better than diet Y for weight loss or fat loss in human randomized controlled trials—bringing it back to the human. This sounds compelling, it sounds authoritative, and it sounds like a good counterpoint. But there are hidden nuances to unpack. First, many of the trials that people are referring to are short-term feeding trials that can produce profoundly misleading results since time is not afforded for metabolic adaptations. It's true, in the short term you can force weight gain by eating just an insane amount of calories. But this doesn't actually reflect the physiology that drives or, quote, "causes" obesity in a chronic, real-world setting. Think about it like a sprint versus a marathon. If you start a race and you blast off out of the gate with 110% effort, such that you're spent by 100 meters, well, that technique would work great over 100 meters, but it's a fool's approach to winning a marathon. You need to work with different systems, different modalities, different approaches, different physiologies. Analogies aside, I can provide concrete examples. For one, take a famous 2021 study that was published in Nature Medicine, where people were put on a low-carb or a low-fat diet for 2 weeks each in random order. The original report found that the low-fat diet led to less caloric intake and more weight loss, than the low-carb diet. However, upon reanalysis years later, we found what actually occurred is that there were physiologic adaptations during the low-carb phase that were paying off in the low-fat phase when the low-fat diet came second, and vice versa. Thus, the real driver of energy balance in this case wasn't the diet itself per se, or the caloric density of the diet, but the physiologic adaptations to the diet that were occurring over the longer term. And when this was properly accounted for, the data revealed that the lower-carb diet had the metabolic advantage, i.e., the low-carb diet produced physiologic adaptations that contributed to better, quote, "energy balance downstream." And you can see how that would be profoundly misleading. Now, to practically perform longer trials, so going beyond these 2-week trials, there needs to be done, or they need to be done, in free-living humans out in the world. And you can conduct feeding studies where you provide meals to people to optimize rigor. However, if and when results diverge from the expected calories in, calories out modality mindset, it's all too easy to engage in mental gymnastics and speculation to compensate for the missing calories, explain them away. So instead, What one can do is clamp the quote calorie balance, i.e., clamp weight, and see if there are changes in things like energy input or output, focusing on output. And when this is done, what you see is the body can automatically finagle calorie output to maintain an energy balance, as demonstrated, for example, by increases in total energy expenditure observed when swapping carb calories for fat calories. Again, calories are part of the story, but they're not the primary driver. The calorie balance is a downstream result of other physiologic adaptations. And, like it or not, rodent studies are actually excellent for uncoupling calories from fat gain because you can exert a level of control that you simply can't exert in humans. And the challenge is inevitably, "Oh, but rodents aren't humans." But this challenge falls on its face since the core of the debate has to do with whether caloric intake is the primary upstream cause of obesity, a claim that speaks to biological applications of a law of physics that should apply to all living organisms. So if you can uncouple calories from fat gain in a mouse or a rat, there's every reason to believe that you could do so in a human. Unless one's arguing that physics only applies to humans, and I don't think anybody's arguing that. So all this is to say, the counterclaim that "calorie-controlled trials suggest calories do cause obesity" overlooks 1) upstream behavioral and physiologic drivers of obesity in free-living people, and 2) reveals an implicit ignorance about the practical matters upon which clinical research is conducted. Now, to get to the juice of this video: how to fix a broken metabolism. What I mean by this specifically is how to get to a place where you can eat cued by hunger, without feeling deprived, and through this lifestyle achieve and maintain a healthy weight and body composition. And though it might be very bold to say, I do believe this is achievable for every single person. Here are 4 tips. Now, they might not be entirely novel, but I think you'll find they have a novel spin. Number 1, as much as possible, eliminate processed foods from your diet, including artificial additives like artificial sweeteners, sucralose, aspartame, things like that. At a high level, many of these food additives can disrupt your metabolism, contributing to things like insulin resistance, metabolic dysfunction, the quote broken metabolism over the long term, even if they include zero calories. And to be clear, this has been shown in human randomized controlled trials, as example— as an example, this study from Yale, which showed that when sucralose, an artificial sweetener with zero calories, was consumed as part of a mixed macronutrient intake, it could cause profound insulin resistance and even changes in brain activity. And many of the additives in our food ecosystem can change the microbiome, disrupt normal hormonal processes to alter downstream— alter calorie balance. And it's important to note— this is something really important— the burden of proof is not on the companies that use these additives to prove they're safe in the long term. This means that we introduce many things as a society into our food supply that we don't realize are harmful until many of us have already felt the metabolic burden of their presence. And don't be fooled by the insidious nature of many of the foods that fit into the low-calorie diet food category. Because where forced caloric restriction might result in short-term success, the adaptations that result, especially in the context of eating fake foods with all these hormonal disrupting additives, may very well toggle your metabolism to your disadvantage over the long term. So that was point 1. Point 2 is to reduce your sugar and refined carbohydrate intake. Primarily, I'm talking about added sugars, but really anything that sends your body on a glucose and insulin rollercoaster can be a problem. At a high level, I like to explain this as the phenomenon of hormonal Hunger, where spikes in insulin are driving energy into your fat tissue, yielding a temporary relative energy deficit in the bloodstream signaling to your brain to be hungry as a result of hormonal fluctuations driven by sugar rather than hunger for nutrition. And when your hormonal hunger obscures your true hunger for nutrition, it's impossible, it's actually impossible to eat intuitively, which should be the end goal., but this is impossible with the overlay of a hormonal hunger drive. And beyond that, human randomized trials and meta-analyses do reveal a metabolic advantage of swapping out carb calories for fat calories, where total energy output actually increases on low-carb diets even when clamping calories or weight. This effect can be up to several hundred calories per day, and typically those with the most insulin resistance, i.e., the most broken metabolisms, will have the most benefit from reducing sugar and carbs in their diet, as was shown in a reanalysis of a rather famous randomized controlled trial, DIETFITS. And you can see this paper for more on that. Now, the exact mechanisms of this effect, the metabolic advantage of going lower carb, remain to be elucidated, but it may involve changes in mitochondrial morphology, changes in central nervous system activity, or changes in microbiome structure and function. And on the microbiome, it's also been shown that ketogenic diets can increase your ability to poop out calories. This was a fascinating new finding that I covered recently, and in effect, ketogenic diets can change levels of specific bile acids made by the microbiome, yielding pooping of more calories. And if the calories are in the toilet, well, they're obviously not in your fat cells. That's a joke, of course, but one backed by some biological truth, and if you want the nitty-gritty details on that, see this video. There might be some bathroom jokes, fair warning. So, as a refresher, all this centers on terminology around energy, including calories, but energy balance in these cases is downstream. It's a result of physiologic mechanisms rather than the driver itself. By analogy, if weight control were a car, calories are the tires. They're not the steering wheel. They do matter, but they do not direct. Therefore, I argue that it makes far more sense to focus on the physiologic levers versus focusing on calorie intake, even when, and especially when, the two conflict. Which is possibly why many high-calorie foods like avocados and macadamia nuts are associated with or even in interventional trials cause weight loss. All right, moving on. Point 3, exercise. Exercise including cardio and resistance training. It's really important to exercise, including both cardiovascular and resistance training, but not because of calories per se. Rather, exercise can change the nature of your fat and muscle tissue, sometimes without even fat loss. One recent study has even shown that exercisers have healthier abdominal fat tissue than non-exercisers, even when matched for body fat and body fat percent. And exercise overall changes the release of hormones from your muscles—these are called myokines—and from your fat tissue—these are called adipokines—to yield a healthier hormonal milieu, hormonal ecosystem, that will favor better hunger control, and unconscious energy expenditure in the long term. And here's something else that's really cool. New literature has even shown that intense exercise can boost lactate in the brain, which literally binds to proteins in neurons to reduce anxiety. And now think for a moment, what better choices you could make for yourself, lifestyle and diet choices, if your anxiety and your mental health were improved? So yes, exercise is great in many ways, from muscle to fat to brain and beyond. Finally, my fourth tip: I want you to hormetically stress your body with exercise, food, and fasting. In truth, this is more of a mindset tip, but I want you to think of your metabolic health journey as a forever process of healthily challenging your limits, progressively overloading your body and your metabolism so that you make yourself stronger physically, mentally, and metabolically. A metabolic health journey is in large part about mindset, the internalization that the journey itself can be enjoyable, thrilling, a privilege. So what I really wanted you to get out of this initial Fix a Broken Metabolism video was a mindset shift, if you were in need of one. Because there is no pill that I or anyone else can give you that will magically fix your metabolism and save you. Instead, the important thing is to unlearn what maladaptive myths, or oversimplifications if we're being generous, have led you to spend your efforts in a misguided manner, so that you can recalibrate, redirect your efforts, and commit to a metabolic health journey that can make you and your life and your loved ones' lives by extension that much better, better than you could have possibly imagined. Anyway, with that, sorry, I'm getting sentimental here. Stay curious and I hope you found some value in this unconventional video for my channel.