Doctor's Note

You guessed it, the title of the next video is Reversing Diabetes with Food, and then I’ll close out with one of my favorite videos to date: Diabetes Reversal: Is it the Calories or the Food?

Here’s a link to the Diabetes as a Disease of Fat Toxicity video I made reference to. What kind of fat? See Lipotoxicity: How Saturated Fat Raises Blood Sugar.

This is part of my video series diving deep into underlying causes of type 2 diabetes:

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  • Misterimpatient

    I participate in a fellowship of people who are working to achieve (among other things) a health weight. I’ve known many obese men who, when they achieve a healthy weight, their Type 2 diabetes resolves. In fact, it’s common. I also know men for whom the only way they have found to restrict their eating is through surgery. Some of these men are vegan, though not always whole foods vegans. Oreos anyone? For them, surgery has made a big difference (I was going to say huge, but, at this moment in America, huge is off the table).

    • Joan

      I believe surgery can help in extreme cases, however, if old eating patterns aren’t addressed then many of the health issues return. I have seen many people with gastric bypass who never change their eating habits…

      • Misterimpatient

        This is true. It’s quite common for folks that get the surgery to lose a lot of weight and then put much of it back on. Often not all of its and even that small change seems to make a difference. Either that or the change in absorption, even at the higher weight improves Type 2 diabetes. I sure don’t know.

  • HemoDynamic, MD – NF Volunteer

    America continually eats taking breaks only when they have to work, sleep or exercise. This clearly has detrimental effects on the human being.

    • Leonid Kalichkin

      Still waiting for videos on intermittent fasting by Dr. Greger, or at least some evidence that continually eating and eating at night is detrimental.

  • Maureen Okun

    It’s about time we had another cliff hanger.

  • Joe Caner

    Spoiler Alert: Whole Food Plant Based diet to the rescue!

  • Rebecca Cody

    I’ve watched several extremely obese people over the years since my daughter married into a very fat family. Interestingly enough, my son-in-law’s grandparents, who were 30 or 40 years older than me, were not fat at all. Her sister-in-law had gastric bypass, lost much of her extremely excessive weight, as she was well over 400 pounds, but has now gained it all back!!! I have no idea how she could do that, but she did. Her brother-in-law, who was well over 6′ tall, yet weighed probably 500 pounds – can we say larger than life here? – overdosed on pain meds and died in his early 50s. Her husband, well over 300 pounds, hasn’t been diagnosed diabetic as far as I know, but he seems hopeless, as he lost over 100 pounds a few years ago, the promptly regained it. Now my grandkids are obese teenagers. They are all heavy meat eaters who don’t much like veggies. It is sad, but what do you do? If I say anything my daughter is offended.

    • Kal

      Then make sure you say everything at one time, clearly and unemotionally.
      If shes offended, thats her choice. She may just have to watch enough people die before being motivated into action, at that point she can only act if she knows what to do- like if her mother once told her (and does it herself).
      Thats how it went for me, I had to see several people die and care for my father as he slowly died before I got motivated into action. Even then it was difficult because no one had ever told me just what a healthy diet was, not even doctors.

      • Paul

        Or don’t say anything. Many people either have to hit rock bottom before making behavioral changes/attitude adjustments, or they simply aren’t ready for whatever reason. Gastric bypass and post surgical low calorie healthy foods would have solved her weight problem, but clearly there’s more to it for her.

      • Stewart E.

        I struggle with this a great deal. I come from a long line of preachers so I can do a good hell fire and brimstone denunciation of eating dead animal. But this is not a particularly good way to convince people. I think your choice of words, “clearly and unemotionally” is key. people do not like being preached at. However there is a cultural milieu that says, “milk does a body good” “fish is healthy” killing for fun(aka hunting) is fun, you need more protein and etc. The best you can do is counter that somewhat with the clarity and lack of emotion as you said and be part of a countervailing cultural element of health. The more there is out there the more powerful the statement.
        At first you might seem like an isolated crank. To counter this I like to cite the fact that MD Anderson as well a Kaiser Permanente and other major medical institutions recommend a vegan diet. Then I point to the fact that I cured my inflammatory arthritis and dramatically reduced my insulin requirements with a plant based diet. I do try to only bring this up only when asked why I eat the way I do.
        I will keep repeating, “clarity and lack of emotion” and try in spite of myself to remember that I will not change anyone immediately. Thanks for the suggestion.

        • Dr.Jon_NF Volunteer

          Very true Stewart! People do not like being preached at. We health care professionals eventually realize that giving out good information is often not enough. The techniques of “motivational interviewing” are helpful. Basically that means getting patients to say in their own words what their priorities are, and what their roadblocks are, and then carefully steering them to at least make one step closer to where you want them. It’s not easy.

        • Rebecca Cody

          Stewart and Jon, thank you both for your words of wisdom, along with those I responded to earlier. It is hard to know exactly how to handle delicate situations, especially when several people are involved. My son in law does as much cooking as my daughter and my grandson loves to bake. They all love to eat. I think a day may come with various of them as individuals when I can have a positive influence. If not, I can only love them as they are.

          Stewart, while my ancestors weren’t actually preachers (only one cousin), I hear you, because I was brought up in a church that sounds like what you describe. No, preaching isn’t the answer.

          • Thea

            Rebecca: I think that sometimes it is easier for people to hear things from someone other than the person they know. So, how about doing a family showing of Forks Over Knives? You could host a big family party with great food, including a fun dessert that happens to be all plants, and watch the movie. Maybe with popcorn… Tell your family how much it would mean to you if they would watch this movie with you.
            Picking the right first movie is important I think. You have to figure out what will be most likely to motivate. For some people, that first movie of Forks Over Knives which focuses on human health is all that people need. But young people are not often concerned about their health, so focusing on a movie like say Earthlings or another one that shows how much non-human and human animal suffer from the animal food industry might be a better first choice. Or if the family is big into the environment, then start with Cowspiracy.
            Just some ideas for you. In the end, you can’t force anyone to change. You can be a good role model. You can provide good information like giving people a copy of Dr. Greger’s How Not To Die book, but there are no magic words to get people to change if they do not want to. It’s really hard to watch loved ones make a serious mistake, but I think that putting too much pressure on yourself to find that exact right thing to do is not fair to yourself. Be kind to you. It’s not your fault.

    • Paul

      Isn’t it something like the fat cells never disappear, they just sit there empty of fat or filled with water or something? So a formerly 400# person would still have kabillions of fat cells waiting to fill? But yeah, if you eat plant based, you’d be hard pressed to gain 400# even if all you ate was starchy CHO and shoveled it in all day long. :(

      I don’t really consider it my place to lecture friends or family. They’re adults, they can eat what they want. They see how I eat and how thin I am. If they want to ask me, they know I’m open to talking about it. I would no more lecture them about their diet than I would want them lecturing me about mine.

      • Rebecca Cody

        Paul, I agree, and I have seldom said anything at all. I have given my daughter a couple of healthy type cookbooks over the years, but even that seems to sting her. She is overweight, too, but not as much as the rest of her family. Still, as menopause approaches she has suddenly put on another 15 or 20.

        It is my recent understanding that fat cells do actually disappear, just like other cells that age and die (apoptosis is normal cell death), but I also read somewhere many years ago that they don’t go away. I’m hoping they do!

        Like you, I feel it is an adult’s prerogative to choose how to eat, but it kind of breaks my heart to see that lifestyle handed down to my grandchildren. They are smart and I see for them unhealthy, uncomfortable, and shorter lives.

        Interestingly enough, the great grandparents were small. Everybody called Grandpa by the nickname Tiny. He lived in pretty good health to about age 91, and she lived almost as long. I remember going to their 70th wedding anniversary party.

        • Vege-tater

          It may be next to impossible to convince people who aren’t ready to hear it to change their diet, but when kids are involved, bad nutrition that shortens and degrades the quality of their lives is equivalent to child abuse. Sometimes people who won’t improve their own diet can be convinced to do it for their kid’s sake, but who is going to wake them up?

          • Rebecca Cody

            At this point the kids like the bad food and not the veggies, and they’re old enough so the message would fall on deaf ears. Perhaps one day I’ll see a real opportunity, should they become motivated enough, to show them how to become healthy.

            Someone even gave the family a dog that had been trained as a service dog but had to be dropped from the program because he was too interested in food…so they gave him to this food-centric family! Now the poor pooch is another fatty in the household.

          • Vege-tater

            Once they develop preferences it’s hard. When the grandkids come it’s always a balancing act, but they know WHY I eat like I do and have seen the huge differences, so they are awesome for the most part! We each try to be flexible and fair, but they know some things just don’t fly.

          • StephanieM

            It never hurts to try making familiar junk foods in a healthy way. For example, instead of ice cream, making a raw fruit sorbet in the food processor is just as yummy.

          • Rebecca Cody

            I do a brilliant purple one with blueberries, frozen bananas, a little almond or oat milk and sunflower seeds.

            The grandkids don’t live nearby so I don’t feed them too often. I usually go their house, but it’s a good idea and I work the plan when they are here.

          • baggman744

            Child abuse? Wow, that’s a huge can of worms, no pun intended. No, an adult should not smoke in the presence of a child. But give a child a slice of pizza & a soda, and now you’re a child abuser? Sorry, that’s a leap I don’t think our culture is willing to take. There are far too many reasons for obesity, not all of which are yet understood. Its not solely a matter of diet, as there are many, many over weight vegetarians & vegans, and plenty of thin meat eaters.

          • Vege-tater

            Why so defensive? We all give kids treats, I mean the parents who are in denial and can’t say no themselves, so just feed their kids crap all the time. A child has parents for a reason…they are supposed to be the ones who help teach the kids to make good choices and why. Knowingly letting a child hurt themselves when you know better but conveniently ignore it, isn’t a swell option, no matter what it is or what you call it.

          • baggman744

            Your point is well taken, and I agree with you in principle. However, the phrase “child abuse” is objectionable. Child abuse has a fairly well defined and distinct legal definition. “Poor dietary parental choices” is subjective. Why? Because there is no definition of what a “poor diet” is, only opinion. Want to call it irresponsible, ignorant, fine. It certainly is not child abuse.

          • Paul

            There are also class issues to think about. Separating the individual from the social in order to emphasize the individual is capitalist ideology. It has no place in an evidence-based evaluation of the social and political forces involved.

          • Stewart E.

            Sorry baggman744, but I don’t think that flies. The fact that parents might honestly believe that “to spare the rod is to spoil the child” doesn’t mean that it is any less abusive behavior. Deliberately giving a kid food that will raise their odds of more disease than I have time to mention, might be done with love and ignorance but it is still no less abusive. It is not about the morality of eating meat or even the bmi. Where I might differ slightly from Vege-Tater is that I am reluctant to point a moral finger at parents who though having good intentions still ignorantly do the wrong thing.

            However whatever you call it, causing avoidable harm to a child is abusive. Culpability is another matter and that goes to the knowledge we have,our cultural milieu and a whole other tirade.

          • baggman744

            Time to end this thread, because its going in circles. Who determines what “avoidable harm” is with regard to diet? When I grew up, fat, ALL fat was evil. Now, we’ve nearly come 180 degrees to that theory. When does an ice cream cone, a slice of pizza, or a glass of soda become “abusive”? At what point do you measure that? Is it body weight, percentile of body fat, BMI, what? A young girl with “chubby legs”? A young boy with a double chin? Do we cancel all child parties that serve snacks? Or do we bring a scale and only let the “thin” kids eat them, while the “chubby kids” are forced to eat kale? What exactly is “chubby”? And who determines that? The courts? The local police? A doctor? The Federal government? Its abusive and criminal if you force a kid to drink Drano. Is a can of Coke now to be illegal for those under 21 unless they’re under a certain BMI? If you can’t see the so called “slippery slope” here, I can’t help you. By your logic, then we’ll throw a whole set of over reaching standards at parents. Do we call it “abuse” if we let them watch too much TV? Spend too much time playing video games? Run without a helmet? Play tackle football? Are martial arts too dangerous? What the heck, if we’re talking about diet, why not include lifestyle? This, along with my comments above conclude my opinion.

      • Ryan Gajsek

        Just a thought that crossed my mind. Is there any kind of study on those people who’ve had liposuction? I mean if people have the same amount of fat cells in the body whether they are obese or slim and the difference is whether the cells are full or “empty” would a reduction in fat cells through “lipo” make a difference on how much weight would come back?

        • baggman744

          Liposuction only works on subcutaneous fat. That’s actually the lesser with regard to deleterious health effects of excess body fat. Its the internal fat, near and inside of the organs that cause the most harm.

    • Jim Felder

      A person can not change until they are ready to do so. Hopefully your daughter and her family will be ready before they are all so sick that it might not matter. But when they are, they will be lucky to have somebody so close to them to that can help them with the power of example.

      That said, you don’t have to sit there quietly when she or others complain about various ailments caused by their weight. You can just say that you feel really bad that they have chose to have sore feet/knees/hips, or are out of breath all the time, or have high blood pressure or diabetes. Maybe if they can really come to understand that it is indeed their choice to have these conditions and by extension it is completely within their power to reverse it, then perhaps they might find that they are ready to change.

      • Guest

        Very interesting discussion.
        As a retired probation officer with extensive training and experience working with people addicted to alcohol and/or drugs the issues in this thread are sounding very familiar. For example: people in recovery from alcoholism insist that successful interventions such as Alcoholics Anonymous are, “for those who want it, not those who need it.”
        I have watched a loved one die from the standard American diet and am now seeing that tragedy unfold in the lives of other close family and friends.
        To do as they say in Alanon, “Detatch with love”, seems so much more difficult when talking about food, cancer, diabetes, heart disease and stroke. The remonstrations from the sufferers are made more difficult due to the overt complicity of their doctors (one actually gave Mom an Rx directing her to, “Eat Meat”)
        I was able to tell an alcoholic they had 3 choices, death, long-term hospitalization, or recovery. My warnings carried the weight of experience and science.
        But what can families do when the doctor undercuts, contradicts and colludes; when hospital kitchens serve up hamburgers, ice cream and whey protein ‘nutritional supplement’ drinks such as Boost?
        I am daily convinced change will only come through serious litigation.

    • guest

      This brings up the question: is obesity a choice, hereditary condition, or medical condition?

    • Russell

      You don’t need this on your conscience. Tell her because you love her, and don’t want her to die prematurely, you want 30 minutes to be fully heard and then you’ll leave her alone on the issue for all time. And prepare that talk like its your Ph.D. oral dissertation. Then… its fully on her.

      • Rebecca Cody

        Russell, that is probably the road to take. She knows I’ve had a passion for good nutrition for my entire adult life and read about it all the time, that I became a Nutritional Therapy Practitioner (though I never really practiced), and that I’d love to offer help if they would like it. Perhaps one day I will do what you suggest.

        I wish I had come upon whole food plant based years ago when my kids were little. But I don’t know if that would have made a difference. Back when we were eating animal protein we had our own chickens and even a milk cow for a short while. I often grew organic veggies and always cooked from scratch and used whole grains, etc. So the food they ate was always the best I knew to serve at the time.

        After reading the book Whole by T Colin Campbell I now understand even more deeply how all the conflicting diet information in our ever-present media is actually designed to keep people confused so they give up and just eat what tastes good to them, and what is handy in their busy lives. That is an important book I wish everybody would read.

        • Paul

          I don’t know if it’s as organized as “‘let’s keep people confused so they keep eating SOS.” SOS food is addictive enough that even whole food plant based people acknowledge it’s tough to stay away from. I think part of it is an irresponsible media in service to corporate/bourgeois capitalist motives and profits, another part of it is the terrible lack of critical thinking skills on the part of most Americans.

          I’m not a scientist and I’m willing to concede that I leave it to experts to evaluate studies for me. But when every M.D. or Ph.D. coming down the pike is a self-described “expert” and continues to ignore decades of studies and jump on every individual pro-fat or anti-vegetarian study out there completely out of context or historical perspective, the battle is even greater.

          For me personally, I’m a communist, so If we have a socialist revolution, then hopefully somebody like Dr. Greger will be the surgeon general! :)

          • Rebecca Cody

            Paul, you said it, but in your own words, just as Dr Campbell did. He doesn’t see it as a big conspiracy, but as many factors that come together and keep people confused. In fact, here is a little quote from his book that expresses what you’re saying:

            “…independent, intelligent health journalism is rare. Neither professional journals like the American Medical Association (JAMA) nor mainstream media outlets like the Corporation for Public Broadcasting can be relied upon for informed, courageous, and unbiased health coverage…I just want you to understand that the problem isn’t “a few bad apples,” but rather the system in which the media is embedded, and the profit-seeking entities to which the media is beholden.” (page 232 of the book, Whole, by T Colin Campbell with Howard Jacobson, PhD).

            The title of the book, Whole, points to his emphasis on the need for wholeness in the foods we eat as well as how we study disease reversal with food. Many chapters discuss the way that reductionist thinking permeates science, the scientific method, research, reporting, and even the thinking of most people. He acknowledges that we learn a lot from this type of science, but that we must also look at the entirety of how foods work in our bodies. In other words, studying vitamin C isn’t studying an orange, and there is much to be learned from how our bodies respond to the orange. And so much more…

        • Gumbootgoddess

          Oh Rebecca, your life sounds like a parallel to mine as I too fed my family with the best nutritious food known to me. My daughter’s issue is not obesity but heart disease. Her paternal grandfather had twelve siblings, all of them died in their late sixties early seventies. Her father and uncle, while fit, have massive heart issues. I’m sure you see where I’m going with this. I love her dearly, but her education is way more substantial than mine and she seems to believe she has an invincibility gene!!! I just gave her my copy of The China Study to read, and like every other Mom who follows this site I hope she takes it literally to heart. Good luck with your family.

          • Rebecca Cody

            You truly understand. We probably have somewhat healthier genetics in our family, except for the side with all the cancer, but we all know it’s in how those genes express as much as in what they are. Probably more. My son likes to cook and has somewhat better habits than his sister, but he certainly focuses on meat far too much. He lives in Europe, so at least it isn’t quite as bad as ours in this country, and GMOs are not prevalent, but still…

          • VegGuy

            Gumbootgoddess, another good book you may want to give your daughter is “The Whole Heart Solution” by Dr. Joel Kahn (vegan cardiologist). It contains simple straightforward information about preventing and testing for heart disease.

          • Gumbootgoddess

            Thank you for the good advice, I will get the book as you suggest.

    • padutchrunner

      It’s just a very sick culture that we live in. A toxic combination of technology and food profiteering has so far removed us from the necessity of movement and food traditions that we commit suicide, consciously or not, by our poor habits. It’s just a pathetic state for a culture to be in.

  • Craig

    what does more insulin from awakened beta cells, have to do with improving insulin sensitivity, which is the problem in type 2 diabetes?

    • Rebecca Cody

      I think by awakened, he meant the beta cells, or insulin, started working again. If I understand correctly, insulin from the beta cells becomes “insensitive” because organ cells are so packed with fat that sugar cannot be turned into more fat for storage, so it spills into the bloodstream. By losing fat in the organs and around them, the beta cells, which I think were always making insulin, can pack the blood sugar away again. And, of course, with a long-term dietary change which leads to permanent weight normalization, the beta cells and insulin can function normally. If I have this wrong, please, someone correct me!

      • Craig

        Thanks Rebecca, but according to Dr. Fung, a Canadian nephrologist who treats diabetes, and many other sources, the biggest problem is insulin sensitivity. Of course, that improves quickly with fasting, which is Dr. Fung’s primary treatment approach. So comments about beta cell production is rather off the mark. That’s not the relevant problem, though if their is some inadequacy in production, perhaps that improves too. My point is that the comment about beta cell production is misleading. The crux of the issue is insulin sensitivity. Best, Craig.

        • Rebecca Cody

          I guess what I was trying to say is that we become insulin insensitive not because it isn’t there, but because of all the fat packed into the organs. Fat causing diabetes seems to be unheard of to most people.

    • Jim Felder

      Diabetes is caused by more than just insulin sensitivity of your muscle cells. Not only your muscles, but also your liver and pancreas become clogged with fat. Diabetic progression as I understand it is that muscles first develop insulin resistance, but the pancreas can crank out enough insulin to cram glucose into the muscles in the face of resistance and the liver still turns down gluconeogenesis when the blood sugar level is sufficient. But then the liver gets so packed with fat that it stops responding to insulin so the liver keeps putting out glucose even when the blood is already full of sugar. And lastly the pancreas fills with fat and the beta cells succumb and the amount of insulin produced drops and the blood sugar level skyrockets.

      When the foods causing the issues with fat toxicity are removed from the diet, either by simply eating a lot less food (as summarized in this video) or by substituting foods that don’t cause the problem, then the process reverses pretty much in the reverse order with considerable overlap. The beta cells wake up first and so insulin production starts to return to normal levels, but the liver also pretty quickly starts to sense insulin better as do the muscles. So the three major processes that are responsible for full type II diabetes reverse faster than they developed. Dr. McDougall reports that they have to be very careful with diabetics who inject insulin directly or take medication that stimulates the pancreas to make more insulin because the rapid return to more normal insulin production along with better insulin sensitivity in the liver and muscles can cause a dangerous dip in blood sugar.

      • Rebecca Cody

        Jim, thank you for your much more thorough explanation. I wonder how long it is going to take for the world to get the fact that excess fat is such a big part of the problem.

  • Rebecca Cody

    Another comment, more relative to this video: A woman I knew through an online group told us all she was going to have lap band surgery. But her doctor put her on a diet and she lost about 50 pounds before having the surgery. Her diabetes resolved at that point, but she had the surgery anyway. After the surgery she didn’t seem to be losing more weight, though she wanted to lose another 30 pounds. I’ve since lost track as she left the group, but I wonder how she has done since then. Surgery is such an extreme solution, and it isn’t always a solution at all.

    • Misterimpatient

      As a compulsive overeater myself (in recovery for 14 years) I understand the overpowering urge to eat, even when not hungry. It’s not logical but it is very real. For some, the surgery does help control the urges but many still never achieve a healthy weight. I am keeping 125 pounds off myself (I did not need the surgery). I like to tell people I am 55% the man I used to be. I was vegetarian when I lost it. In addition to not eating flesh, I also avoided sugar and refined flours. I’ve found that these are the key to refraining from overeating. I’ve been whole foods plant based now for over 5 years. No complaints.

      • Jim Felder

        Question: So do you still have to overcome the urge to overeat? Or is it that you can now give in to the desire by eating a low calorie density diet that allows large volumes without excessive calories? I have always wondered if the urge to eat when not hungry was more driven by satisfaction of feeling full, and so could be meet by engaging the stretch receptors with low calorie density foods, or the more direct dopamine rewards for eating high calorie density foods.

        • Misterimpatient

          Great question. I weigh and measure my food. I eat over 5 pounds of food a day, and I could eat 10. Normal eaters do not have any idea the quantity of food, even just sweet potatoes, that an overeater can consume. I’ve read that you can just eat all the sweet potatoes you want. Ha! Normal eaters have no idea.

          I do not have that urge every day but I do have it some days. I have my program of recovery that includes my food plan and my meetings and phone calls that help me every day. I’ve kept that weight off now for over 12 years. I prefer it that way. :-)

      • Rebecca Cody

        Mrimpatient, my hat’s off to you! Wow! That’s a huge amount to take off and then keep off. Have you read about Jon Gabriel’s method? He was over 400 pounds, had tried all the diets, but discovered how to stop the emotional eating. He is now helping others. His story is quite inspiring.

        • Misterimpatient

          I haven’t heard of that. I clicked on the link but it doesn’t lead anywhere useful. Just pictures. I’m happy with the solution have though. :-)

        • Rebecca Cody

          Oops! Something wrong there. Just Google Jon Gabriel. He has lots of videos and interesting stories.

    • eatliveprosper

      Unbelievable that the doctor still recommended the surgery. Surgery is not only an extreme solution, it can be a fatal option.

      I have no idea how it is to walk in the shoes of an obese frame but I do understand what it is like to face a serious medical issue. I finally learned how your lifestyle/nutrition choices play a more pivotal and often safer role than the prescription and medical alternatives.

      Sadly, many come to this information after years of misinformation and subsequent abuse to the mind.

    • Craig

      The surgery is stupid. It compromises nutrient digestion and absorption. If a doctor is supposed to provide wise treatment- a silly concept nowadays- he shouldn’t do surgery when the real problem resides, ENTIRELY, with someone’s BRAIN! Appropriate treatment for a savage beast who is out of control, is not surgery, but psychological. After all, the beast must eventually gain control of his appetite after surgery anyway. So the surgery is a temporary measure. And surgery avoids the necessary confrontation with the real problem.

      • Vege-tater

        Kind of like diet pills and fad diets…lose the pounds…even if you lose your life. I always thought the idea of losing weight was to improve your health, not risk it further. I get that people feel stuck in that rut when they have no clue what will work, which is why getting that WFPB message out there is so critical. Been there.

    • Rebecca, you make an excellent point. I met a woman last week who had wt loss surgery 8 years ago. At the time, she was making tremendous progress with changing her diet prior to surgery, losing over 60 pounds. At that point, she was warned that as she was nearly out of the BMI range to qualify for surgery, she needed to decide if she was going to have it or not. She was so afraid that the door would close forever on her option to have surgery she had it! Seems like such a risky choice considering her success!

  • Foodie73

    You forgot or failed in this video to mention that with some types of theses surgeies the hormone grehlin is removed or lowered so much so that you don’t have the appetite to eat hence not wanting the food in the first place.

    • Jim Felder

      I think the point was that the effect of calorie reduction on reversing insulin resistance and hence diabetes was that it didn’t matter how you reduced the calories. So whether you don’t eat and feel like you are starving to death or don’t eat because your grehlin levels are low, the common denominator is that you don’t eat.

      And, spoiler alert, the same effect can be achieved without reducing calories by changing rather than reducing the food you eat. So absolutely no need to have 90% of stomach stapled off or to go on a starvation diet that leaves you “hangry” all the time.

    • Paul

      Also don’t you get accustomed to these super low caloric diets because the stretch receptors shrink? There’s a blog written by a guy who had gastric bypass (or one of the weight loss procedures) and he writes about eating 8 bites 3x a day, which is the amount of food he had to get used to eating. His blog went on for a few years at least, and he was a gourmet cook often posting recipes.

  • Mick

    OMG, dr G., you’re making me hate the word “next”… I can’t wait to see the next part…

  • BrianBenkle

    I find this fallacious. I had the surgery. My A1C has been normal.

    • David

      Hi Brian,
      Dr. Greger says in the video that the surgery can work (albeit with significant risks). I think his main point is that one can potentially get the same (if not better) results without surgery and without the associated risks.

    • Vege-tater

      He didn’t say it wouldn’t work, he said there are safer, healthier ways to accomplish it.

      • Rhombopterix

        Hi Charzie, this is off topic here but ummmm Julie said you ferment your own food. do you think you’d like to email me about a plan? my neighbor just offered us a ton of beets…

    • 2tsaybow

      Hi Brian, I’m glad to hear that your surgery helped you. Changing to a whole food plant based diet helped me reduce my weight and normalize my blood sugar. Have you been consuming a whole food plant based diet, or have you investigated this type of diet? I know that your choice to have surgery has been successful for you, but there are lifetime consequences from eating animal products that go beyond obesity and diabetes. Thin people are still having heart attacks.

      Also, it’s always worth considering the costs to our planet and climate. We kill over one billion animals a week in order to survive on our planet and it is completely unnecessary.

      Here are some websites for you to look at:

      Here is my favorite video on this website. Watching it really changed my life. Until I watched it, I hadn’t a clue:

      • Paul

        “We kill over one billion animals a week in order to survive on our planet and it is completely unnecessary.”

        That’s horrifying. Meanwhile, everybody is throwing their cans and bottles and papers in the recycling bin and not for a moment giving a thought to their food consumption. The animal oppression and exploitation industry spews out more GHGs into the atmosphere than any other industrial process on the planet. Animal oppression/exploitation is responsible for a staggering 51% of GHGs every year into the atmosphere.

        The U.S. is now prosecuting animal rights activists as “terrorists.” I don’t know about anybody else, but I simply can’t support an industry that is in bed with the bourgeois government to the extent that they can get laws changed to ruin the lives of AR activists, who only care about the lives of animals and oppose their exploitation.

  • NFpayoung

    Until dieting brings the same financial return that surgery brings it will never carry the “weight” that surgery carries in mainstream medicine. (Just my opinion)

    • Misterimpatient

      Dieting is a multi-billion dollar business so the financial return is HUGE. It’s also useless to those who end up needing the surgery. If they could diet and lose weight, they would.

      • Clint

        Not remotely as big an industry as surgery.

        • Misterimpatient

          I’d be surprised to learn that weight loss surgery total “sales” were greater than the rest of the weight loss industry.

          • Paul

            Right. Bari surgery is a sub-specialty of general surgery. I think the bari surgeons might be lowering the bar, so to speak, and operating on patients who are not morbidly obese, but the majority of patients still need insurance approval for the surgery no matter what they weigh. It would surprise me if the majority of amerikkkans are paying out of pocket, and that limits the number of surgeries as well.

  • vlp

    Quite the image with the sugar cubes!! Wow.

  • BB2

    Doc, what do you think of this notion being investigated that metformin may have longevity benefits (not necessarily just for diabetics)? Sounds kind of dissonant to me, for some reason…

    • David Sprouse MS PA-C (NF Mod)

      Hi BB2,
      I share your interest in metformin, which may have overlapping mechanisms with caloric restriction in enhancing longevity. However, certain natural compounds in food (curcumin in turmeric, for instance) may share some of metformin’s beneficial effects on longevity, at least in theory, through mechanisms like activation of AMP kinase. Also, this: :)

      • BB2

        Thanks David, quite interesting.

        By the way, have you had a chance to access the full article of this PubMed abstract? I wonder what they define as a low-carbohydrate diet? Maybe they are referring to a diet that does not contain foods that excite insulin secretion too much. I wish scientists stopped using terminology like this though, it can be confusing…

        • David Sprouse MS PA-C NF Mod

          No problem! From the full text article, the low carb diet was 16.5% kcal carbohydrate, 55.2% kcal protein and 28.3% fat

  • Matthew Smith

    Diabetes is nearly identical to beriberi disease. Diabetics should consider supplementing with Thiamine, B1. The progression of diabetes is ended with Thiamine, or B1 supplementation.
    Curr Diabetes Rev. 2005 Aug;1(3):287-98.
    The potential role of thiamine (vitamin B1) in diabetic complications.
    Thornalley PJ1.

  • (New NF volunteer): This is a test.

    • JMA

      Hi Jonathan!

  • Jacob

    I understand that achieving a normal healthy weight resolved many cases of diabetes, but what about people who already have a healthy weight and yet are diabetic?

    • VegGuy

      Yes, I have been wondering the same thing. Inflammation may play a role as inflammation leads to insulin resistance. Also one may be mistakenly diagnosed with T2 when they really have one of the other forms of diabetes that are more uncommon.

    • Paul

      WFPB should take care of the problem? I’ve read some accounts on McDougall’s forum of people still not able to eat stuff like white potatoes without spikes but micromanaging may not be necessary until one is completely WPFB.

  • Rodrigo Cardoso

    Legendado em Português / subtitled in Portuguese:

  • justme

    No need for the next !! I’ve since starting to listen to the good Dr. have taken a majority of meat and meat by products (not realizing fish is also meat) out of my diet and my T1 numbers are become better than the previous 28 yrs. as is my weight loss, without the diet, just wished I found this site earlier !! Thanks Dr. Greger, your team, and people who’s comments are also helpful.

    • Stewart

      Hey justme, it’s better late than never. Just curious what do your numbers look like? I also am T1 for 40 years now and was pretty well controled before but I now just use 20-25% less insulin to accomplish the same thing. I’m generally able to keep my A1c in the low 6 range.

    • Wade Patton

      Weight loss without calorie counting with automatically improved health as well?

      Ain’t it grand!!!

      So sad to watch our friends and family and our whole society continue their largely self-inflicted suffering. Frustrating even. Wish we had 10,000 Dr. G’s to help spread the word faster.

      Nobody listens to me.

      • Paul

        I’ll listen. :)

    • Congratulations to you justme!!! You are inspirational!

  • Heidi Kaufman

    I am a Certified Diabetes Educator and nutritionist. I also teach patients who undergo gastric surgeries. Most of my patients have diabetes. There are many nutritional roads to reversal of diabetes. The reason why the gastric surgery is so successful is because the patient can tolerate such a low calorie intake after surgery. It takes away the hunger making it possible for them to be on 600 calories a day. The problem comes when people start to eat more often, getting in too many total calories in a day. Most people lose the majority of their weight in the first 3 months and then that slows down as it does with all weight loss regimen’s as the body adapts to the reduction in calories. At around 12 months people are at risk for gaining the weight back as they start to liberalize the diet more and some stop having the dumping syndrome when they eat sugar. The Rou-N-Y is expecially effective because of the risk for dumping syndrome which keeps them from eating sugar rich foods. You experience that once and you never want to have that happen again.
    Most of my patients do not get the surgery but reverse diabetes by reducing their intake of starchy carbs, fats and animal protein and increasing their intake of low carb veggies and lower carb fruit. Everyone is different and what they are willing to give up or change is different but most will see a very significant drop in the sugars and A1c from even modest changes in the ratio of high carb to low carb veggies. I have also had vegetarians diabetics who had to reduce their intake of high starch foods and fruits. Vegetarianism by itself was not enough in their case.

  • Ronald Green
  • Vege-tater

    Okay not sure where is the best place to ask, but I am so mad I have to! Having gotten rid of diabetes by switching up my diet to WFPB and getting rid of added fats, I KNOW for a fact Mark Hyman is dangerous and is spreading yet more “healthy fat” propaganda and of course books and supplements! This is his proof of premise… …some one PLEASE comment so I know how to debunk this garbage publicly?

    • Thea

      Vege-tater: I was hoping someone would jump in with some technical information. I’m not the best person to evaluate studies. But I agree with you that Mark is doing the world and lots of people a huge disservice and it is enough to make anyone fighting mad. I do think that between NuritionFacts, Plant Positive, and some other sites out there, Mark’s fat program is well debunked. The hard part is finding someone who can synthesize all the information into a concise enough rebuttal for the various situations one might be able to comment on. Hopefully someone will step up…

      • Vege-tater

        Thank you Thea. I have read enough and learned through first hand experience what generally works for humans and what doesn’t, I just don’t have the capacity to catalog the info in a way that lets me rebut it when necessary. (I could call it senility like my kids did and do, but it is just not my strong point, I’m better at assimilating information than I am at spitting it back! lol) It just really grieves me that the ones who ARE so skilled at cataloguing what is very often BOGUS information seem to also be the ones with the most “charisma” and influence because they sound so knowing! Makes me think of snake charmers and snake OIL salesman! (Poor snakes, I insulted them but I did make a punny!)

        I thought that as people age they are supposed to mellow out, but after waking up to the way we are being manipulated on so many fronts, this kind of stuff inflames me because it proliferates and prolongs needless pain and suffering among the ones who need the truth, now! Mark is the antithesis of Dr Greger and others whose first concern is the health of people, and whose last concern is their own bottom line! Yet he, and others like him, are the ones who get adulated, and the good ones get criticized of having the infamous “vegan agenda” or whatever, because it isn’t what people want to hear! Whoever coined the term “sheeple” was sure ahead of the flock! (Groan) I should shut the flock up and step down off my bandwagon! lol

        Speaking of Plant Positive, his vast knowledge and the mystery of his anonymity has always made me curious. I hate mysteries, guess I’ve dealt with too many needless ones! The other day I was listening to a diabetes perspectives summit organized by John Vargas Eddy, (awesome by the way, with our own Dr G being a speaker!)
        The guy’s unique voice and speech mannerisms remind me a lot of Plant Positive, and made me even more curious!

  • Graham

    I have a good friend with cystic fibrosis and diabetes (type 1). What would you suggest as the optimal diet for someone with that condition, would it be essentially the same as for general health (a whole-food plant-based diet)?

    • EvidenceBasedNutrition

      Thanks for the question, Graham.
      Eating a whole-foods plant based diet will promote health in the case of Cystic Fibrosis. All of the same principles apply and a diet that supports general health will support a person who has CF. With that said, a person with CF will have to consider more than the average person to ensure proper nutrition and weight. Here is some additional information from Medline on nutritional considerations in CF

    • Thea

      Graham: Here’s a something to consider: A diet can not cure T1 diabetes, but several people with T1 diabetes have reported on this site that following a *low fat,* whole food plant based diet has allowed them to lower their insulin needs. That’s a plus. Also, as you point out, if general health diet would at least prevent your friend from having to deal with any other health complications. Your friend’s life is complicated enough!
      So, my thought would be: Why not give it a shot? It seems unlikely to me that a healthy diet would hurt. The important thing would be for your friend to work closely with a doctor. Insulin needs can change quickly for a person with T2 diabetes. If a similar change happened with your T1 friend, then I would think that she/he would need a doctor’s help to adjust medications in real time/quickly as needed.
      If your friend tries it, let us know what happens.