Q&A: Becoming a fire fighter

The Question: 

My doctor has advised me to lose weight as she says I’m close to becoming diabetic. I have failed at dieting all my life, so I bought your book and have managed to eat considerably less for the last three months. However, I’m not losing nearly as much weight as I think I should be. Just a few pounds and I am keeping active walking my dogs every day. I really don’t think I can eat any less and starting to feel a bit hopeless about it all. Would appreciate anything you can say on the subject.

My Answer: 

If you search on amazon for books about inflammation you’ll find close to 7,000 results. That’s quite a lot published on this subject. All of this interest is in chronic, low-grade, systemic inflammation; the kind that underlies an enormous range of illnesses, rather than temporary, localised inflammation from a cut or other injury.

Not everyone is susceptible. For example, you’ll see below that wheat can be inflammatory, but it may not affect everyone, and certainly not to the same degree. At one end of the spectrum, there are those with celiac disease who can have a life-threatening reaction to wheat. There are others who, while not celiac, are still very much affected by wheat. One study suggests that as much as 40% of our population could fall into this category, but others say the proportion is much higher than that. (1)

This can get to be more of a problem as we age. There is no single cause; multiple factors build up over time that challenge our immune system until it becomes overwhelmed. The advanced stages of inflammation can become an autoimmune reaction, where the immune system attacks and eventually destroys healthy tissue, whether joint cartilage, the thyroid gland, brain cells or whatever are your weakest genetic links.

How can you know if this plays an important part in your health? If you have changed your eating in the past and felt so much better as a result, it’s likely this was due to lower inflammation. Inflammation contributes to insulin resistance, so not only could this move you towards developing diabetes, but it makes it much more difficult to lose excess fat. Lowering inflammation could be the only thing that will make a difference.

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Comments

  1. Chancery

    “it’s worth pointing out that when an overweight diabetic has gastric surgery, their diabetes resolves within a day or two. This is from eating less; their weight hadn’t changed in such a short space of time.”

    I am absolutely amazed by this. I want to write ‘Are you sure that’s true?’, but assumably you wouldn’t have written it if you didn’t believe it was! I’ve never heard this before and I’ve read a lot on the subject. I see you have a reference for it; I’m going to go read it. Have you heard this anywhere else? – I’d love any links you have, if so.

    • Here are two research papers that discuss this specific outcome. It’s thought that two mechanisms contribute to the resolution of type-2 diabetes in obese patients following bariatric surgery.

      One is simply that they are eating considerably less following surgery.

      The other is that the surgery has had an impact on a range of appetite hormones (peptides) produced in the gut. Those gut hormones contribute to insulin resistance, which, along with creating type-2 diabetes, makes it difficult to lose weight.

      I’d like to add that it is possible to 1. eat less, and 2. create a favourable impact on gut hormone production through the type of food consumed – all without surgery.

      “Bariatric surgery leads to substantial and durable weight reduction. Nearly 30% of patients who undergo bariatric surgery have type 2 diabetes, and for many of them, diabetes resolves after surgery. Glycemic control improves in part because of caloric restriction but also because gut peptide secretion changes.”
      – Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Vetter ML, Cardillo S (2009) Annals of Internal Medicine 150(2): 94-103

      “Current data reinforce the hypothesis that T2D reversion after bariatric surgery may be related to glycemic homeostasis developed by the intestine.”
      – Relationship between gut hormones and glucose homeostasis after bariatric surgery. Sala PC, Torrinhas RS (2014) Diabetology & Metabolic Syndrome 6(1): 87

  2. Joanna

    After reading Jonathan Bailor’s book on the Calorie Myth (thanks to your blog), I cut out all starches and legumes. I was really reluctant to do so at the beginning, but I told myself to just try it out and that I can always stop if it disagrees with me. I have been doing so for almost two weeks now and I am absolutely shocked with how full I feel after a really small meal and how my appetite dropped dramatically. I used to consider myself addicted to food – now I see food as nutrition, not entertainment. I believe that my gut bugs are very happy with this new way of eating and this sudden lack of interest in food I can credit to them 🙂 and perhaps having my insulin leveled out is helping, too. My self-confidence and happiness is sky-rocketing!
    Thank you very, very much Gillian!

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