After spending a lot of time in the world of low carb and Paleo, I can’t imagine how I missed her. The “her” is an anonymous blogger who calls herself CarbSane. The other day I was preparing to write an Amazon review on Jimmy Moore’s excellent new book “Cholesterol Clarity—What the HDL is Wrong With My Numbers?” The review is still in the works but trust me, I will give the book five stars. I was perusing some of the other reviews when I came across the review written by CarbSane. She not only trashed the book, but also she managed to literally chew Jimmy up and spit him out! She then went on to trash many people who contributed to the book including Gary Taubes, Mark Sisson, Dr. Fred Pescatore, Dr. William Davis and a long list of other people who I respect. She rated the book 2 stars but then went on to say it really deserved a 1 star. Out of 36 reviews there were only three that weren’t 4 or 5 stars so CarbSane’s review really stuck out like a sore thumb.
CarbSane Seems a Little Insane
I decided to do a little research on CarbSane. I visited her web site and read through some of her ranting and rambling blog posts. The pattern was the same—if someone from the low carb or Paleo world pokes their head out of a foxhole, she blasts them with both barrels. The purpose of this blog post isn’t to challenge CarbSane’s positions on diet and health because a long list of people smarter than me has already done so. What caught my attention was CarbSane herself.
I became fascinated with her because I immediately recognized that she fits the pattern of someone with a treatable disease and as a practicing physician with over 35 years of experience, this is what I do. I try to figure out what is wrong with people—in other words I diagnose them and then give them advice on how to fix the problem.
In her blog posts she often refers to the fact that she has an eating disorder and has struggled with her weight. Years ago she had some success with low carb eating but it was only temporary. In the end she became disillusioned by low carb eating and decided to challenge those who still promote this approach. Her opposition to a low carb approach doesn’t bother me in the least, because I actually like to be around people who disagree with me. Science advances when theories and concepts are challenged, not when everyone is in agreement. I even agree with some of her views. What I sense from CarbSane is her passion for attacking others is a reflection of her own ongoing health problems.
Forget About Your Weight and Focus on Your Brain
Like just about everyone else, CarbSane seems to focus on issues like her weight or her eating disorder, yet what I see is a brain that isn’t working as intended. I think she has a classic case of untreated CARB syndrome. Carbohydrate Associated Reversible Brain syndrome or CARB syndrome is a form of reversible brain dysfunction that can gradually occur in people who eat a diet of processed foods. The concept evolved over several decades in an attempt to explain the connection between metabolic problems like insulin resistance, obesity and type II diabetes and common brain disorders. The concept was recently described in a peer-reviewed journal and presented at a conference at Harvard, so it seems to be catching some wind.
As with any other disease, CARB syndrome has typical symptoms that gradually emerge over time in a more or less predictable manner. To date we have identified 22 such brain dysfunction symptoms. After spending a lot of time reading her blog posts and her interactions with others, it is clear to me that CarbSane has some mood issues and at times she even seems a little hypomanic. She also tends to drift into being somewhat obsessive-compulsive, especially when attacking others. She also seems to have poor impulse control, a poor self-image (the eating disorder) and low self-esteem. At times there isn’t a clear transition from one thought to the next, suggesting some focus and concentration issues.
If you read through her comments directed at others, it’s pretty clear she comes up short in the empathy department. She seems to spend a lot of time attacking those who disagree with her. On her web site she states: “I was fatigued from time to time from sleep deprivation as I had raging insomnia”. There go two more off the list—excessive fatigue and insomnia. She also comments: “By restricting carbohydrates you will discover your previously unknown addiction to carbohydrates and start craving them. The longer you do Atkins the fewer carbohydrates you will eventually be able to eat. Eventually even protein will lose it’s physiologically satiating properties and trigger hunger and cravings because a skinless chicken breast might as well be at Little Debbie cake.” I’m not a big fan of Atkins but it sure sounds like CarbSane is familiar with cravings for sweet and starchy foods, the hallmark symptom of CARB syndrome. If you have such cravings your disease is out of control and your brain will push you to store extra fat even as you lose lean body mass from under-eating. If you read through the 22 symptoms of CARB syndrome, it becomes apparent that CarbSane already has most of them.
You might wonder how can I possibly diagnose someone with a disease who I have never personally met? Yes, to some extent I am speculating, but in medicine we often speculate about possible diseases in patients we have never seen when discussing cases with our colleagues in “curb side” consults. CarbSane even does this herself when she speculates that Jimmy Moore has Klinefelter’s syndrome and she doesn’t even have an MD behind her name. Over the years I have successfully treated thousands of patients who fit the CARB syndrome pattern and in my opinion CarbSane clearly falls into this category. After 35 years of clinical experience, my diagnostic skills are very sharp.
Wasted Talent, A Wasted Life
In a sense it’s very sad. She is obviously an intelligent person but she wastes her time obsessing about the weight status of other people like Jimmy Moore. I don’t care about Jimmy’s weight. If his metabolic parameters and brain function are good (no CARB syndrome), then he’s good to go. There is really no such thing as a “weight problem”. Excess body fat itself does not significantly increase morbidity and mortality unless it is coupled with inflammation and bad metabolic markers. Although virtually everyone with CARB syndrome has excessive body fat when you measure body composition, there is no correlation between the amount of excessive fat and the severity of the accompanying brain dysfunction. You can be a thin person with a little extra body fat and severe brain dysfunction—think anorexia, or you could be a large person with a lot of extra fat and only mild brain dysfunction symptoms. In a sense body fat and brain dysfunction move together but don’t correlate in severity.
Thus a large person with a lot of extra fat needs to focus a little more on losing that extra fat to reduce their morbidity and mortality. If their brain dysfunction is only mild, that too will improve as an extra bonus. A thin person with severe brain dysfunction needs to concentrate on fixing their brain in order to improve their quality of life. The good news is that if you focus on improving brain function, excessive body fat will also gradually disappear regardless of your size, weight or BMI.
CarbSane spends a lot of time talking about people who haven’t done well after following low carb or Paelo diets. They continue to have brain dysfunction symptoms or regain weight. In my opinion the reason they fail is because they focus on weight rather than on their underlying disease. CarbSane also believes that when it comes to weight, calories call the shots. I think CarbSane needs to review her science. Obesity is defined as excessive body fat. The most accurate way to access body fat is to measure body composition. I have measured over 18,000 body composition readings on my patients over the years and there are many people with “normal” body weight and BMI who have excessive body fat. Even some thin people have excessive body fat. The majority of these people with excessive body fat also have brain dysfunction symptoms indicating that they have CARB syndrome. So forget about you weight and focus on your symptoms.
Fix Your Brain, No More Insane
The CARB syndrome concept focuses on your brain. If you have CARB syndrome your brain isn’t working properly so your quality of life suffers. You can live to be a hundred years old and you will likely end up spending 100 years making yourself and those around your miserable. Because CARB syndrome is reversible and treatable, it’s tragic when someone like CarbSane lives her life with severe brain dysfunction. I don’t know a thing about her body composition and I really don’t care. If she addresses her brain dysfunction her body composition will automatically improve. CarbSane needs to stop obsessing about her own and other people’s weight and focus on fixing her brain. Her only chance of doing so is for her to understand the nature of her disease.
People with advanced CARB syndrome often lose insight and fail to understand that their brain isn’t working so well. If you read some of CarbSane’s blog posts you will see what I mean. She has several posts that go on and on about Jimmy Moore’s weight and body to an obsessive degree. From what I can tell Jimmy’s metabolic markers are just fine and his brain function seems excellent. CarbSane needs to forget about Jimmy and the other low carbers and focus on her own brain function.
It appears that the three dietary triggers of CARB syndrome are excessive fructose mainly from sugar and HFCS, high glycemic carbohydrates mainly from grains and excessive omega 6 fatty acids from vegetable oils. Any diet that reduces or eliminates this toxic triad will help to reverse CARB syndrome. Low carb, Paleo, ketogenic—take your pick. The reason that these diets have had some success is because they reduce or eliminate processed food. With advanced CARB syndrome dietary changes are often not enough to turn the disease around. People often need targeted supplements like L-glutamine to suppress cravings for sweet and starchy foods, Cinsulin to improve insulin sensitivity and precursor products like CARB-22 to restore neurotransmitters levels. Some patients with advanced CARB syndrome benefit from low dose medications but using them effectively can be tricky.
An Offer You Can’t Refuse
CarbSane, the good news is that there is hope for you. You have a treatable disease and I have a great deal of experience managing complex patients like yourself. In the past you tried various diets in an attempt to lose weight and things stalled out and you didn’t feel good or lose more weight. That’s because you don’t understand the disease that is destroying your health and quality of life. Contact me and I will guide your treatment protocol at no cost. I’ll even throw in a free bottle of CARB-22. I’ll be waiting for your call.