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Once Again the CDC Gets Obesity Wrong

by | Sep 26, 2016 | Blog Articles, CARB Syndrome - Articles

The Centers for Disease Control and Prevention (CDC) has a trademarked motto that states: “Saving Lives, Protecting People”.  That sounded good to me until I came across their recently published “Adult Obesity Prevalence Maps” informing us about the level of obesity in every state of the union. As with any massive statistical undertaking the first important issue to address is finding out where they got their data.  As it turns out, their obesity data came from telephone interviews using a subset of people from each state. Their definition of obesity was based on height and weight so they could calculate their BMI rather than using the best way to diagnose obesity—actually measuring body composition. If they had actually weighed and measured the height of these folks, at least we would know that their BMI was accurate. Despite its flaws BMI is a better reflection of fatness than weight alone. Instead they called people up and asked them how much they weighed and how tall they were. Thus the BMI figures they used were “fantasy figures” often reflecting a person’s desired weight and height.

White lies and telephone weight surveys
I can imagine how this type of phone conversation might have gone:

CDC:  “Bill, can you tell me how much you weigh and how tall you are today?

Bill:  “I think I weigh around 215 pounds (at least that was true 20 years ago, the last time I remember that I weighed myself). My height is 6” 3” (at least that’s how tall I am wearing high heals and before I lost two inches to osteoporosis.)” I forgot to tell them that I also have some degree of short-term memory loss, especially when it comes to my weight and height!

After the CDC hung up the phone, out of curiosity up I decided to weigh myself and measure my height. “Hmmm—235 pounds, 6 feet even.” I’ll let the CDC know if they ever call back.”

I suspect that people who are not obese are pretty honest about their weight, whereas those who do have obesity might be tempted to juice the figures a bit. People don’t often measure their height so they usually use a figure that they remember from the distant past that doesn’t necessarily reflect reality today. If the CDC did take the time, effort and expense of actually measuring weight, height or ideally the body composition of these folks the obesity rates would have been much higher because it would also include the “thin but obese” (TBO)–those folks with a normal or low BMI who also happen to have excessive body fat. The ratio of fat to muscle will always flush out the truly obese and it is this excessive body fat at any size or weight that carries the feared metabolic risks of obesity, including metabolic syndrome and type 2 diabetes. And data relying on only telephone surveys are always somewhat suspect for accuracy. Even the CDC admits:  The data are based on telephone surveys by state health departments, with assistance from CDC. People self-report their weight and height, which are used to calculate BMI. A number of studies have shown that rates of overweight and obesity are probably higher than shown by the data because people tend to underreport their weight and exaggerate their height.

The CDC’s magic wand
So what’s the big deal? Everyone not living on Mars already knows that we are in the middle of a massive obesity epidemic. Just knowing that we have a problem will do little to fix the problem. What we need are solutions. If you troll throughout the CDC website you will finally come up with their marvelous and original plan for weight loss:

“To lose weight, you must use up more calories than you take in. Since one pound equals 3,500 calories, you need to reduce your caloric intake by 500—1000 calories per day to lose about 1 to 2 pounds per week. Once you’ve achieved a healthy weight, by relying on healthful eating and physical activity most days of the week (about 60—90 minutes, moderate intensity), you are more likely to be successful at keeping the weight off over the long term.”

Eating at the extremes
What happens if you fail to follow their sage advice? We already know that eating at the extremes can lead to significant weight gain or loss. Just look at sumo wrestlers and people with anorexia. Sumo wrestlers manage to gain massive amounts of weight by eating large amounts of stew called chankonabe containing fish, vegetables, meat and tofu. That sounds pretty healthy until you realize that they also consume large amounts of rice and beer and up to 20,000 calories per day. They intentionally become massively obese even though they are in good physical shape because of their high activity level. What happens to these folks after they stop wrestling? Their life expectancy is between 60-65 years of age. That means that if I were a sumo wrester at my age of 68 I would likely be dead rather than being the father of an active two year old, which is my real life. Sumo wrestlers like all obese folks have an increased incidence of diabetes, hypertension and heart disease.

If you go to the other end of the eating spectrum and look at those folks with anorexia, the long-term outlook isn’t much better. Studies have shown that people with eating disorders also have increased mortality compared to normal folks. Thus it is clear that extreme forced over-eating and under-eating are not the way to go when it comes to obesity.

We also know that under-eating can lead to weight loss regardless of what you are eating. A few years ago Professor Mark Haub lost 27 pounds on his “Twinkie Diet” where he consumed 1,800 calories per day consisting mainly of junk food like Twinkies. The experiment lasted a month and in addition to losing weight his cholesterol and body composition also improved. It’s important to realize that the short-term effects of various diets are often markedly different than their long-term effects. We have plenty of Americans who have followed their own “Twinkie” style diet for years and trust me—after years or decades they are far from the role model of optimal health. This “Haub Paradox has recently taken a new twist. I recently exchanged information with Dr. Jason Fung the author of the excellent book “The Obesity Code”. He pointed out that Professor Haub has taken money from Coca Cola and yet he did not disclose this when his so called remarkable “Twinkie Diet” hit the headlines. He name does show up on a list of folks who were supported by Coke. Another diet fantasy hits the dust.

The CDC’s road to an 80% chance of failure
The CDC’s approach sounds reasonable compared to these dietary extremes and following their recommendations will likely lead to some weight loss in the short term, but as a Physician I am interested in long term outcomes. Studies have shown that less than 20% of people who lose weight this way manage to keep the weight off long term. Virtually every diet plan will initially lead to some weight loss but if you are treating obesity you want to lose fat, not lean body mass. I have measured the body composition of my patients over 10,000 times over several decades. I have found that those who reduced their caloric intake by too much immediately started to lose lean body mass and their percent body fat often increased as the lost weight, heading for the TBO title.

When you diet don’t forget about your brain
Studies have also shown that both obese individuals and those with eating disorders have something called “eating dysinhibition” where their brains don’t know whether they are on foot or horseback when it comes to controlling food intake. Those with obesity often binge on processed food loaded with carbohydrates, sugar and bad fats when their body clearly doesn’t need any nutrition. Those with binge eating disorder do the same interspersed with periods of no food intake. Those with anorexia somehow manage to suppress normal hunger drives in a way that is dangerous to their health. When they do eat they usually it is usually the same processed food consumed by those with obesity and binge eating disorder.

A new disease model
All of these disordered eating patterns have one thing in common—their brain doesn’t seem to be working as intended. In my opinion they share one specific type of brain dysfunction, one that is caused by the long-term consumption of highly processed food. I call this form of food-induced brain dysfunction Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. People with normal brain function eat when they are hungry and stop when they are full. Their eating is more or less on autopilot. In people with CARB syndrome their eating patterns become completely divorced from their nutritional needs. They tend to overeat or under-eat and when they do eat they prefer food loaded with sugar, highly refined carbohydrates and bad fats—typical highly processed food.

The solution is not under eating and exercise
In my opinion the healthiest way to lose fat and not lean body mass over the long term without at the same time messing up brain function is to focus on the composition of the food that you are eating. This is also the best way to stay healthy and functional even if your weight isn’t ideal. In my experience a ketogenic diet is one of the best ways to get rid of excessive body fat while staying healthy and maintaining optimal brain function. This type of diet consists of 40-50 percent healthy fats, about 25 percent protein and 25 per carbohydrates mainly from fruits and vegetables. A Paleo diet can have similar benefits as long as you don’t overdue the protein. Both of these diets eliminate highly processed fake food made by our wonderful Food-Industrial Complex. There is also emerging evidence that a fat-fueled brain is a more healthy brain. Thus the goal here is to maintain a healthy body composition and normal brain function and the CDC’s plan of attack addresses neither of these important health goals.

The CDC site also promotes the idea that exercise is a good way to lose weight. Unfortunately this is another fairy tale that is not supported by recent research. In other words you can’t run away from obesity. This is especially true if you are eating a diet mainly consisting of highly processed food. There are many health benefits that come from exercising on a regular basis but apparently long-term weight loss is .not one of them. Exercise has been shown to reduce dangerous visceral fat and it improves brain function so when you exercise forget about the scale because it doesn’t reflect the many health benefits associated with exercise.

I’ve been seeing a lot of clowns lately so there must be a circus in town
So our government is still spewing out useless information when it comes to defining and treating obesity. These are the same clowns that told us to eat low fat diets for decades, throwing logs on the fire of our current epidemic of metabolic problems and obesity. They gave us the disastrous food pyramid followed by the useless “My Plate” campaign. Is there any reason why we should start believing them now? We are now facing a generation of people who grew up with these recommendations and the state of their collective health is nothing to brag about.

In my opinion there are a few simple rules to follow when it comes to eating and staying healthy. They aren’t based on rocket science but they do reflect the best science that we currently have when it comes to diet and health.

  1. Eat real whole foods and avoid fake processed foods. If the food you are eating has a label on it you probably shouldn’t be eating it.
  2. Eat plenty of grass fed animals, fish and seafood. When it comes to fish eat the small ones like sardines that are high in omega 3 fatty acids with low levels of mercury.
  3. Eat a Mediterranean diet loaded with vegetables, nuts, fruits, seafood and full fat dairy products. The Greeks tend to use meat more as a condiment except for special occasions like Easter.
  4. Consume plenty of healthy fats like coconut oil, avocados or avocado oil, olive oil, saturated fat from grass fed animals, butter and omega 3 fatty acids. Also consider adding medium chain triglycerides (MCT 8) to your diet. This type of fat can be used by your body for energy rather than fat storage.
  5. If you have many of the 22 symptoms of CARB syndrome, first focus on fixing your brain before worrying about your weight or size. My web site discusses many ways of doing so: https://carbsyndrome.com/.
  6. Exercise on a regular basis to improve overall health and brain function, not to lose weight. In other words throw the scale out the window and focus on your health rather than your weight.
  7. Have your physician measure your homocysteine level. If it is above 10 you should lower it with a combination of vitamin B12, vitamin B6 and L-methylfolate, a special form of folic acid.
  8. To monitor how things are going I recommend measuring your waist at your belly button. Anything above 31 for females and 35 for males puts you in the high-risk category. When you lose more fat than muscle you will immediately notice that your waist size decreases.

To summarize, if you follow the CDCs recommendations when it comes to obesity, you will have about an 80% chance of long-term failure, you likely will end up with common metabolic diseases like insulin resistance and type 2 diabetes and it’s also likely that your brain will end up in the toilet. If you follow the above eight recommendations I believe you will have an almost 100% chance of success with overall health and brain function worth bragging about. I suspect the clowns would choose option number one but I know that you are wiser than that.

When it comes to a healthy diet, follow the Pros.
A more detailed summary of my dietary recommendations is beyond the scope of this article. For more information I recommend the following resources:

Once you take advantage of the sage advice offered from these folks you will certainly leave the clowns at the CDC in the dust! For more information about the sorry state of affairs at the CDC I suggest that you read these excellent articles from Dr. Mercola:

Acknowledgements:  I would like to thank Larry Hobbs of Fatnews.com for his wonderful feedback and outstanding editorial skills.