this post was submitted on 14 Mar 2025
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Have we accidentally bred some dogs for obesity? (arstechnica.com)
submitted 6 days ago by [email protected] to c/[email protected]
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[–] [email protected] -1 points 6 days ago* (last edited 6 days ago) (6 children)

Let me introduce you to the The Carbohydrate-Insulin Model of Obesity - Beyond “Calories In, Calories Out”: https://doi.org/10.1001/jamainternmed.2018.2933 - Full Paper Here

TLDR: Insulin is the cause of almost all obesity you see. Carbohydrates drive blood sugar, blood sugar drives insulin, insulin drives weight gain. As a good example - T1Ds who don't take their insulin wont gain weight, no matter how much they eat.

[–] [email protected] 4 points 6 days ago (5 children)

T1D who don’t take their insulin won’t gain weight because of vomiting and dying from diabetic ketoacidosis. Sorry, but is is a horrible example and whoever has DM type 1, please take your insulin. People are really dying from DKA and while it is hard to prevent some factors triggering DKA, compliance with insulin is definitely within our control.

Insulin (and to be more precise it’s baseline level and spikes) is one of the obesitygenic factors. But there are much more other factors there too, and reducing such complex multifactorial disease as obesity to insulin only is incorrect.

Otherwise good paper and thank you for adding full article!

[–] [email protected] 0 points 5 days ago (4 children)

Insulin (and to be more precise it’s baseline level and spikes) is one of the obesitygenic factors. But there are much more other factors there too, and reducing such complex multifactorial disease as obesity to insulin only is incorrect.

I'd love to learn about the other factors. Can you illuminate a more correct understanding for me?

[–] [email protected] 2 points 5 days ago (1 children)

Pathophysiology and risk factors are actually a pretty much half of the curriculum for a separate medical specialty. Here are some resources for a different depth levels of this rabbit hole:

Basic level: https://www.cdc.gov/obesity/risk-factors/risk-factors.html

Moderate to deep:

Too deep (mostly for medical professionals) and more expensive: Course of lectures at Columbia university: https://www.ihn.cuimc.columbia.edu/education/continuing-medical-education-cme/columbia-cornell-obesity-medicine

[–] [email protected] 1 points 5 days ago (1 children)

Thank you for the detailed reply.

The CDC link was brief as you indicated.

The CME lectures I can't afford.

I'll grab the handbook and look over it.

[–] [email protected] 2 points 5 days ago (1 children)

You are welcome. I liked the book and it has relatively recent info. Combining it with Obesity Pillars articles, you can get a very good understanding of modern views on pathophysiology of obesity.

[–] [email protected] 1 points 2 days ago* (last edited 2 days ago)

I took a brief look over the handbook, every chapter, and especially the chapters on nutrition and metabolism

I think there are some major gaps that a more updated version of the handbook should cover, such as the previously mentioned carbohydate-insulin model of obesity https://hackertalks.com/post/7617450

If you have time I would highly recommend the ketogenic handbook: the science of therapeutic carbohydrate restriction - https://shop.elsevier.com/books/ketogenic/noakes/978-0-12-821617-0 - it is also available online at the usual places.

While the text isn't focused on obesity it makes a compelling through line between metabolic syndrome, hyperinsulinemia, and the conditions the obesity handbook has associated with obesity.

I did enjoy the opening quote about obesity: To treat obesity, Hippocrates, the “father of medicine,” suggested the following:

[o]bese people and those desiring to lose weight should perform hard work before food. Meals should be taken after exertion and while still panting from fatigue and with no other refreshment before meals except only wine, diluted and slightly cold. Their meals should be prepared with sesame or seasoning and other similar substances and be of a fatty nature as people get thus, satiated with little food. They should, moreover, eat only once a day and take no baths and sleep on a hard bed and walk naked as long as possible. - Precope J. Hippocrates on Diet and Hygiene. 1952.

In this quote we have :

  • Eat fat to lose fat
  • One Meal A Day (Intermittent Fasting / Time restricted Eating)
  • cardio, and walking.
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