Todd Becker, who writes the blog Getting Stronger, has been critical of both Taubes' carbohydrate insulin hypothesis of obesity as well as Guyenet's food reward hypothesis. He has now come out with his own: the hypothalmic hypothesis:
Where does obesity begin? What drives you to eat too much or expend too little energy, and why has there been such a dramatic increase in obesity since 1980? Some recently popular explanations are the carbohydrate / insulin hypothesis (CIH), singling out the prevalence of carbohydrates in the diet, and the food reward hypothesis (FRH), putting the primary blame on the availability of “hyper-palatable” food.
In this post I will present evidence for new paradigm, which I call the Hypothalamic Hypothesis (HH). I think it provides a better explanation for the facts of obesity than the CIH and FRH theories, and leads to some different advice about how best to lose weight.
Some recent research suggests that obesity starts with specific physical changes to the brain. Appetite is regulated by the hypothalamus, particularly the arcuate nucleus (ARC). It turns out that two very specific changes to the brain cause us to get get hungry, overeat, burn less fat, and gain weight. And these changes to particular brain structures come about as a result of what you eat, eating frequency, and some extent your activity level. The problem of obesity or overweight is often portrayed as a single problem, but it is really two problems, and each type of obesity corresponds to one type of brain alteration. Failure to distinguish these two types of obesity has resulted in much confusion. In part, the confusion comes about because these two types of obesity frequently occur together in the same individual, although one type is usually dominant. If you understand this, and you understand the role your brain plays, you can become more successful at losing excess weight.
I have to really read and process the whole article, but I like it for several reasons. The first and foremost is that, like Todd, I fundamentally agree that the brain is the primary player here, not the body as Taubes argues. Second, his weight loss suggestions are more finessed than those for either CIH or FRH and make more sense to me.
What do you think? Is it a useful addition to the cause of obesity discussion?
Edit: Be sure to check out Stephan Guyenet's response in the comments.
Many thanks, this is an interesting and thought-provoking question. My own reaction:
I had a nasty case of metabolic syndrome which at the moment is healing well with a fairly paleo diet (and less stress/more sleep). I'm afraid I might have skimmed some of the article rather rapidly to jump straight to the bits that have a bearing on my situation!
The idea of insulin-resistance happening in the brain (as well as the liver and periphery) is very interesting. In principle I am sure that an anti-inflammatory diet is important and I avoid trans-fats like the plague.
I am not sure however that this article has the answer to the problem of metabolic syndrome. Along with calorie restriction, moderate carbohydrate restriction (to around 50g/day), together with plenty of natural animal fats, seems to be part of what is helping me to heal. So I am sceptical that fat restriction would be right for me.
I am particularly not sure about the advice that one should avoid eating meat, milk, butter or cheese from grain-fed cows but that olive oil is anti-inflammatory. I manage to get quite a bit of grass-fed meat and all my butter is grass-fed, but I would not wish to stop eating beef or saturated fats like beef dripping (tallow) (even if not grass-fed) and go back to olive oil, which seems to be pro-inflammatory for me.
I think HH is a nice addition to the conversation about what's driving the obesity epidemic. Collectively, we need to know more and while it's challenging to resolve issues between findings and weave a unified theory, many such results are needed in order to find the best/optimal mix of findings and remedies. As an overweight person, I'm more interested in effective remedies than causative factors, but that will change when I reach my goal weight and need to stay there long term.
My personal opinion is that all of these have elements of truth and contain excellent information for us to consider.
Although much improved, I am still an apple-pear. I'm responding well to intermittent fasting, which is compatible with the HH. It's also compatible with major points expressed by J Stanton, Dr. Kruse, Dr. Eades and others and obviously compatible with our favored remedy--the ancestral eating approach.
My continued intake of daily fruit is probably questionable to some or all of the hypotheses. Since I've lost 4 inches off my waist in the last 90 days as part of ongoing weight loss, I assume my intake is reasonable for me but not a blank check to binge on fruit. I'll continue eating limited fruit and I'll definitely continue the IF which seems to have made the difference between struggling and losing steadily.
It's similar to what Dr Jack Kruse ("TheQuilt" as he's known on this site) has been saying for 2 years now: that leptin is a master hormone that controls a lot of different things.
Haven't yet read it, but what immediately comes to mind is the theory behind The HCG Diet, where HCG injections plus VLCD (specifically low fat) are said to induce the hypothalamus to ease up on its conservation of fat and make stored fat available for energy while conserving lean tissue. I look forward to reading Becker, regardless of whether this connection is relevant to his theory.
I just finished it and agree with Beth about the brain is the big player in obesity which Todd laid out very well in this blog. I think that it agrees with my understanding of Dr. Jack's protocols. My take away is that I am leptin sensitive now and need to lower grain based dairy and add high intensity exercise in the fasted state. I think I'll do the Dr. Jack post leptin rx 1-4pm window.
I don't know about the fat percentage. I avoid inflammatory fats but my daily is a high fat diet. I have some experimenting to do.