The following are the highlights of the video. I urge you to watch the video, the link is at the end of this Post.
Dr. Peter Attia says, I’ll never forget that day.
I was a surgical resident at The Johns Hopkins Hospital,taking emergency call. I got paged by the E.R. around 2 in the morning to come and see a woman with a diabetic ulcer on her foot.
The question that was being asked of me was a did she also need an amputation?
I’d love so desperately to believe that I treated that woman on that night with empathy and compassion but I stood in the E.R. and determined that my diabetic patient did indeed need an amputation.
Why did I hold her in such bitter contempt? You see this woman had type 2 diabetes. She was fat.
And we all know that’s from eating too much and not exercising enough, right? I mean, how hard can it be?
As I looked down at her in the bed, I thought to myself, if you just tried caring even a little bit, you wouldn’t be in this situation at this moment with some doctor you’ve never met about to amputate your foot.
Why did I feel justified in judging her? Because I thought I had her all figured out. She ate too much. She got diabetes. Case closed.
I never once questioned the conventional wisdom.
Three years later, I found out how wrong I was.
But this time, I was the patient.
Despite exercising three or four hours every single day, and following the food pyramid to the letter, I’d gained a lot of weight and developed something called metabolic syndrome.
I had become insulin-resistant. You can think of insulin as this master hormone that controls what our body does with the foods we eat, whether we burn it or store it, (fuel partitioning).
Now failure to produce enough insulin is incompatible with life. Insulin resistance is when your cells get increasingly resistant to the effect of insulin trying to do its job.
Once you’re insulin-resistant, you’re on your way to getting diabetes, which is what happens when your pancreas can’t keep up with the resistance and make enough insulin.
Now your blood sugar levels start to rise, which can lead to heart disease, cancer, even Alzheimer’s disease, and amputations.
With that scare, I got busy changing my diet. I lost 40 pounds, weirdly while exercising less. I’m not overweight anymore. I don’t have insulin resistance.
Most researchers believe obesity is the cause of insulin resistance. If you want to treat insulin resistance, you get people to lose weight, right?
But what if we have it backwards? What if obesity is a coping mechanism for a far more sinister problem going on underneath the cell?
Insulin resistance is the reduced capacity of our cells to partition fuel. When we become insulin-resistant, the insulin says to a cell, I want you to burn more energy than the cell considers safe, the cell, in effect, says,
“No thanks, I’d actually rather store this energy.”
And because fat cells are actually missing most of the complex cellular machinery found in other cells, it’s probably the safest place to store it. We become fat.
This is a really subtle distinction. Consider the following analogy: Think of the bruise you get on your shin when you inadvertently bang your leg into the coffee table. Sure, the bruise hurts like hell, and you almost certainly don’t like the discolored look, but the bruise is not the problem.
In fact, it’s the opposite. It’s a healthy response to the trauma, all of those immune cells rushing to the site of the injury to salvage cellular debris and prevent the spread of infection to elsewhere in the body.
Now, imagine we thought bruises were the problem, and we evolved a giant medical establishment and a culture around treating bruises: masking creams, painkillers, etc., all the while ignoring the fact that people are still banging their shins into coffee tables.
How much better would we be if we treated the cause – move the coffee table so people don’t injure themselves – rather than the effect?
Getting the cause and the effect right makes all the difference in the world. Getting it wrong, and the pharmaceutical industry can still do very well for its shareholders but nothing improves for the people with bruised shins. Cause and effect.
We have the cause and effect wrong on obesity and insulin resistance. Maybe we should be asking ourselves, is it possible that insulin resistance causes weight gain and the diseases associated with obesity, at least in most people?
What if being obese is just a metabolic response to something much more threatening, an underlying epidemic?
So what if we’re fighting the wrong war, fighting obesity rather than insulin resistance?
Even worse, what if blaming the obese means we’re blaming the victims?
What if some of our fundamental ideas about obesity are just wrong?
What is a cell is trying to protect itself from when it becomes insulin resistant, the answer probably isn’t too much food. It’s more likely too much glucose: blood sugar.
Now, we know that refined grains and starches elevate your blood sugar in the short run, and there’s even reason to believe that sugar may lead to insulin resistance directly.
It might be our increased intake of refined grains, sugars and starches that’s driving this epidemic of obesity and diabetes, but through insulin resistance.
It is not necessarily through just overeating and under-exercising.
When I lost my 40 pounds a few years ago, I did it simply by restricting those things.
We can’t keep blaming our overweight and diabetic patients like I did.
Most of them actually want to do the right thing, but they have to know what that is, and it’s got to work.
One day people will shed their excess pounds and cure themselves of insulin resistance.
Sometimes I think back to that night in the E.R., I wish I could speak with that woman again.
I’d like to tell her how sorry I am.
You didn’t need my judgment and my contempt. You needed my empathy and compassion.
I hope you can forgive me.
Please watch the moving video: Peter Attia: What if we’re wrong about diabetes?
Next Week the Post will be from 3 Reasons It’s Harder For People With Type 2 Diabetes To Lose Weight
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