How We Get Fat

When two great forces fiercely battle each other, what happens to the battlefield upon which they fight?

Right. It gets destroyed.

You are a battlefield. You probably don’t think of yourself this way but that’s what you are nonetheless.

First force is insulin. It is produced in response to food intake. It’s perfectly normal – to a point. See, we are meant to alternate between fed and fasted state. In the terms of the time, insulin level was elevated while we ate that mammoth we recently killed. Then we went out to find another mammoth, and until we found, killed, brought back and cooked it, we stayed in fasted state. That’s oversimplification, of course, but the point is: we did experience both feast and famine, fed and fasted states, that allowed insulin rise and drop.

Then modern life interrupted this natural way of dealing with the historic vagaries of the food supply by making it freely available at all times. It brought two problems with which we are ill-equipped to deal. First is introduction of unnatural foods (highly processed stuff full of sugar and refined carbs) and unhealthy ratio of macronutrients. By the latter I mean a misguided low-fat drive which replaced slowly digested fats with rapidly digested sugars, facilitating higher insulin levels. Insulin response to highly refined carbs is much greater than to proteins and fats.

The second problem is, we eliminated fasted state. By various reasons (of which the food industry’s promotional effort is somewhat to blame) we became conditioned to think that hunger is something to be immediately extinguished or better yet, not allowed to occur at all. Somehow we’ve become accustomed to the idea that we need to eat so often that we furnish our day with frequent meals and snacks in-between to a degree probably never seen in history. Rarely do we go for an hour or two with nothing to chew or sip on. And if, gods of satiety forbid, we do feel a pang of hunger, it amounts to full blown anxiety attack – “I feel peckish, we need to find something to eat ASAP, where is the closest food establishment?” – and when we locate one, we shovel down another enormous portion of fries with gravy and muffin with coffee full of cream and sugar, and pack some donuts to go because who knows when we will get the next chance, maybe more than, perish the thought, two hours from now??

And this is where the second force comes to the scene. Uninterrupted fed state leads to constantly elevated insulin levels. In an attempt to restore the status quo our body responds to the constantly elevated insulin level by increasing insulin resistance. This reaction is not unlike getting used to a constant noise level, so we don’t hear it anymore. But this is not the end of the story. Higher insulin resistance prevents insulin from doing its job – washing out the blood sugar. And so, in turn, the insulin level increases once again to overcome the resistance and keep blood sugar down. And in response, resistance rises once again… Recognize the vicious cycle in the making?

Constantly rising insulin level is not a harmless thing. Insulin commands our body to store fat. While it’s being produced in higher quantities and not allowed to drop, our midlines slowly expand.

These two duke it out behind the curtain for years, unseen and unheard, until the pancreas’ ability to produce ever-increasing quantities of insulin is exhausted. That’s when our blood sugar shoots up and we get diagnosed with pre- or full blown diabetes. Yet the signs of slowly rising insulin resistance manifest themselves long before that if you know where to look for them. If you eat frequently, feel hungry without a snack every couple hours, crave sweets, slowly gain weight (especially around the abdomen) – in all likeliness the two forces are battling behind the scene ravaging the battlefield, which is you.  Odds are, if you experience the signs listed above, you are on your way to heightened insulin resistance and, eventually, diabetes.

Several factors came together to create a perfect storm. Low fat recommendation decreased the intake of slowly digested foods and opened the field for sugars and refined carbs. Those enabled higher insulin response and suppressed satiety hormones – natural defense mechanisms that signal us to stop eating. Ill-advised suggestion to increase frequency of meals by snacks created constantly elevated insulin levels. And we got fat.

Of course, obesity is multifaceted problem; there are more factors warranting its rise. The mechanism described above though is a major reason behind the relentless rise of “diabesity” over the last decades. Term “diabesity,” characterizing close relationship between type 2 diabetes and obesity, was coined by Ethan Sims in 1973. This chart illustrating the usage of the word since then is speaking for itself:

Use of word "diabesity"

There is a silver lining though. As my, and many others, experience confirms, we are not helpless against this assault on our bodies. Next week let’s discuss how we can counteract it. To finish this post, I must thank Dr. Jason Fung for his book The Obesity Code: Unlocking the Secrets of Weight Loss, which has been instrumental in explaining the role of insulin resistance as the underlying cause of obesity. I also plan to do a more detailed review of this book in the near future.

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