Since the 1950s, the conventional wisdom has held that we get fat because we eat too much and move too little. Virtually all research on obesity and its related chronic diseases is predicated on this notion. The problem has always been that doing the opposite—eating less and exercising more—fails almost invariably to cure the problem, suggesting the possibility that our underlying hypothesis is simply incorrect. What’s the alternative? Before World War II, European clinicians argued that obesity was caused by a defect in the regulation of fat tissue metabolism. By the 1960s, it was clear that fat accumulation is fundamentally regulated by the hormone insulin, which in turn is secreted primarily in response to the carbohydrates in our diet. So a reasonable hypothesis is that we get fat not because we consume more calories than we expend, but because the carbohydrates that we eat happen to be uniquely fattening. A simple revision to first principles in our underlying assumption about the causes of weight gain will have profound and far-reaching implications.
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