Weight Management Part II

By Dr. Ionel Z. Donca, MD, MBA-HCA, FACP, FASN

Principles of Weight Management

Obesity rates remain at historic  highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM).  Explaining obesity as a disorder of energy balance rests on principles of physics without considering biological mechanisms that could promote weight gain.  An alternative theory, the carbohydrate insulin model (CIM), states that increased fat deposition in the body- caused by the  hormonal responses to high carbohydrate diet-leads to a positive energy balance.

The carbohydrate insulin model (CIM)

The CIM of  obesity states that a diet high in carbohydrate leads to fat deposition due to elevation of insulin secretion.  Increased amounts of insulin shift the energy to adipose tissue resulting in fat deposition, leaving less energy available for metabolically active tissues including the brain.  The brain responds with a feeling of hunger and increased appetite to promote energy intake, leading to increased energy intake.  If instead, energy intake is further restricted energy is further conserved through decreased energy expenditure( fatigue and sedentary behavior), decreased thermogenesis and increased muscular efficiency, leading to decreased metabolism.  This could be an explanation for scenarios where calorie restricted diet fails.

The purpose of the two scientific theories is to elucidate the mechanisms of obesity and offer effective ways of treatment.  It should be recognized that, supportive evidence for one model in certain circumstances should not invalidate supportive evidence for the other model in other circumstances, and that the mechanisms of obesity might be explained by elements of both theories.

 Although for different reasons, both models target highly processed carbohydrate diets as major driver of weight gain and obesity, creating common ground for replacing these with minimally processed carbohydrate, healthy fats and protein.

Want to learn more about Weight Management and the carbohydrate insulin model and see how you may be effected by carbohydrates? Schedule a consultation with Great Lakes Care to start your journey to a brighter future.