Why You’re Fat and Sick
If you are reading this, you likely have something in common with your humble author: You are a fat ass. That seems harsh, but the reality is harsh. As I will describe in some detail in this book, being a fat ass is part of a more significant problem (for most of us) that is deadly dangerous. You may look hideous at the beach, but that’s the least of your worries. We true fat asses have a lot going on beneath the surface, and none of it is good. Even if you just want to be pretty, you have to fix all the other stuff. It’s all connected, and you can’t separate the issues, despite what an incompetent doctor may have told you. I’m a humanitarian at heart, and I’d prefer you think I’m an asshole rather than be dead and not think at all. The good news is that while you may be a fat ass, it isn’t your fault, and, with some work, you can fix it.
I don’t advocate a twelve-step program, but I have to insist that if you are a fat ass, you admit the problem to yourself and resolve to do something about it. The odds are, you’ve already made this first important step. If you put in a good-faith effort to lose weight and feel great in the past, then the fault isn’t yours. The problem is that you have fallen prey to a vast conspiracy to keep you fat and sick. If you’ve tried hard and just given up because nothing seems to work, this little book is for you.
Please note that this book is trying to treat a very complex topic in plain English. I’ve resorted to analogies and gross oversimplifications throughout. That’s part of my promise that I’ll try hard not to get too sciency with all of this. Again, if you want thorough, completely accurate scientific information, I refer you to your doctor and the peer-reviewed scientific literature. I’ve provided relevant links throughout. I’ve also added links to scientific papers, books, and media content on my website:
https://www.docmckee.com/fat-and-sick/
A note to nerds: I’ve used the basic citation system of the APA in this book. So if you see something in parentheses with a name and a date, that means you can go to the reference section at the end of the book, scroll down the list of names and find the article or text where the information came from. For example, if you see “(McKee, 2022)”, that means scroll down the list of references until you find something written by someone named McKee and published in the year 2022. I’ve linked the source directly if the information comes from a webpage, video, or other internet information resources.
Who The Hell Is This Guy?
In the internet age, bullshit is rampant, and you must vet your information sources. Before you trust a reference, it’s an excellent idea to know who the person is and their qualifications. I’m not a medical doctor, nutritionist, or dietitian, and I don’t have a license in any medical field of practice. I’m not qualified to give professional advice, so consider this a thought-provoking conversation about some stuff I’ve learned. I hold a Ph.D., but not in any field related to fixing America’s fat ass problem. Part of my professional duties are teaching research methods and statistical methods, so I do have a good understanding of what good research is and how to call bullshit when I see it. Also, I am pretty good at calling bullshit on conjecture masquerading as science.
Case studies are terrible science, but my journey is my reason for writing this book. Over six months beginning in January 2022, I have lost 70 points and lowered my BMI, blood glucose and A1C, and blood pressure. That’s just the stuff I can track at home. I feel better, have more energy, better mental clarity, and less muscle and joint pain. If you are lazy and don’t want to read the whole book, I’ll go ahead and tell you my secret: If you wage war on fat, you will fail. The real battle is against insulin resistance.
For you lazy souls that don’t want to read on, I’ll tell you what has worked for me. I can’t say it will work for everyone because there are loads of differences between people and their degree of metabolic disease. Genetics plays a role. Age plays a role. Gender plays a role. Personal tastes and motivations play a considerable role. Maybe the alignment of the planets plays a role.
I had great results using a two-stage process. The first is alternate-day fasting. You simply don’t eat every other day. (I don’t recommend jumping right into this!). The other piece of the puzzle is being on a ketogenic diet the days you eat. I am agnostic on how to accomplish this; the key is to stay under 20 grams of carbs per day. I must confess that I do cheat, and charting my numbers tells me that this cheating has slowed my progress. I ate like a pig at Christmas and went ahead and celebrated birthdays, mother’s day, and so forth. If you keep the cake and beer days down to once a month, you’ll still see progress (at least I did). If you want to know the why and how of doing this, keep reading.
Basic Vocabulary
I said I wouldn’t get too sciency with this book, but you have to know some of the words doctors and nutritionists use to talk about this stuff. Below are some really important ones and my (crappy, unscientific) definitions.
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- Carbohydrate: A complex form of sugar that the body quickly breaks down into the simple sugar glucose. The More “complex” a carbohydrate is, the longer it takes for the body to convert to sugar. Also known as “carbs.” This is the stuff that makes you fat.
- Fiber (Dietary): Dietary fiber, also known as roughage, includes the parts of plant foods your body can’t digest or absorb. Soluble fiber is a type of fiber that dissolves in water to form a gel-like material. It can help lower blood cholesterol and glucose levels. Insoluble fiber is a type of fiber that promotes the movement of material through your digestive system.
- Hormone: A hormone is a chemical that one part of the body sends to tell another part of the body what to do. We will talk a lot about the hormone insulin in this book.
- Insulin: Insulin is a critically important hormone that regulates the glucose level in your blood, which keeps you from falling over dead. It also tells your body to get fat and sick when you have too much of it.
- Insulin Resistance: Insulin resistance is a medical condition where you have eaten way too much fructose over a long time, making you fat and sick. To restore the desirable, opposite state of insulin sensitivity, you must quit eating sugar and carbs that turn into sugar.
- Metabolism: Chemical processes within your body that maintain life; our chief concern is the burning and storage of energy, and how messing this up makes you fat and sick.
- Metabolic: Relating to metabolism (see above).
- Metabolic Syndrome: A cluster of conditions including high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels; primarily caused by insulin resistance. The syndrome increases a person’s risk of becoming sick and dead. If you are a fat ass American, you probably have this.
- Satiety. A fancy word for satisfied or feeling full so that you stop eating. Successful weight loss programs only work when you feel full and satisfied; brute force by willpower will ultimately fail.
- Sugar: Any of the class of soluble, crystalline, typically sweet-tasting carbohydrates found in living tissues. They are not all equal; fructose is a poison and should be avoided.
- Glucose: A simple sugar that is an important energy source in living organisms and a component of carbohydrates. All digestible carbs turn to glucose before entering your bloodstream.
- Fructose: A dangerous poison that causes humans to become fat and sick in all but the smallest doses. It is added to everything with a bar code by the food industry because it is addictive and cheap.
- Standard American Diet (SAD): The high fructose diet eaten by most Americans (and recently the world); makes you fat and sick.
- Sucrose: Also known as table sugar, sucrose is a disaccharide composed of glucose and fructose. See fructose above for why you shouldn’t eat this stuff.
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Why Do They Lie?
Americans (along with the rest of the Western world) are generally fat and sick. According to the CDC (2020), 2018 data suggests that among the US population overall, “34.2 million people of all ages—or 10.5% of the US population—had diabetes.” Further, “34.5% of all US adults had prediabetes, based on their fasting glucose or A1C level.” Some quick math tells us that nearly half of all Americans (including children!) are metabolically ill. The problem is still getting worse. Recently, it was reported that more Americans now fall into the “obese” category than fall into the merely “overweight” category (Yang & Colditz, 2015).
One possible explanation is that half of all Americans are somewhat suicidal and don’t listen to the sage advice of their doctors and the government. The more plausible explanation is that the conventional wisdom about how we should eat is a complete load of bullshit. The preponderance of the evidence suggests that the public has been lied to about this. Why would those we trust lie to us? It depends on who we are talking about.
Big Food. The reason the big food companies lie to you about a healthy diet is the easiest to understand. For them to get rich, you have to buy their stuff. Their stuff is made in factories, as cheaply as possible, is as addictive as possible, and their advertisements convince you it is both the tastiest and healthiest stuff you can eat. The more you eat, the more money they rake in. It may say “healthy” on the box in hundreds of different ways, but at the end of the day, food companies want you to be a fat ass.
I promised not to go off on too much of a conspiracy theory tangent in this book, but the conspiracy is real when it comes to Big Food. If you find this interesting, I highly recommend Dr. Robert Lusting’s book Metabolical. Metabolical is half science and half crime expose. Lustig tells a tale that reminds you of the shady shit the tobacco industry did before the world called bullshit on that. He reveals that the tobacco industry’s tactics to convince us that smoking was safe were stolen from the sugar industry. They absolutely knew that sugar makes people fat and sick, and they did a lot of shady shit to bury the truth. He also reveals that the “scientists” that published the important papers exonerating sugar and pointing to saturated fat as the smoking gun were on the sugar industry’s payroll. The fee for complicity in genocide? Around $50,000 in today’s dollars.
Big Pharma. Large pharmaceutical companies make money selling pills and injections. They are drug dealers, so shady shit comes with the territory. They are no more ethical than your weed guy (if you happen to have one). They benefit most if you get really sick and stay that way for a really long time. They are much like viruses in that respect. The single most significant source of shareholder profits in these companies is the treatment of chronic diseases like high blood pressure, high cholesterol, and diabetes. For obvious reasons, they absolutely don’t want you to figure out that all of these things have the exact cause (and same solution) as you being a fat ass.
Doctors. Doctors, nutritionists, and other healthcare providers are the most complicated to figure out. Most of these folks want to help, but they are not prepared to deal with a fat ass. The biggest problem is the nature of the profession. Doctors (in the West) are trained to treat diseases and not how to prevent them. How not to get sick isn’t something that they study in any detail, and they spent maybe a day on how to eat in medical school. They are also unduly influenced by Big Pharma.
The smokin’ hot drug rep convinces them that you really need their pill to be healthy and shows them some impressive study results to prove the point. Very few doctors are well-versed in probability and statistics, so they don’t really know how to call bullshit on those clinical studies when they are poorly done. If you want a doctor who understands how to deal with a fat ass, you have to find one who has studied the matter independent of medical school and doesn’t listen to drug reps and the United States Government.
Doctors also suffer from a fear of being sued for malpractice. They rely heavily on professional associations and the government to determine the best ways to treat every possible condition. They are very reluctant to depart from what is often called “best practices” of the “standard of care.” No doctor ever wants to explain to a jury why they didn’t follow the “best practice,” even when doing that is stupid and killing people. These best practices are often touted as “evidence-based best practices.”
Evidence-based is supposed to suggest that scientific studies have been done to demonstrate the success of the particular treatment. Very often, there is no evidence. Often, the best practices are just the consensus among a bunch of old guys in long white coats. Doctors should demand to see (and, of course, read) the peer-reviewed scientific research, but they don’t. Many medical “best practices” are really “just so” stories. Medical schools are infamous for beating the science out of young would-be doctors. Patients are treated with prescription pads, so forget all that nutrition nonsense.
In our society, doctors are very well respected. Our parents wanted us to grow up to be doctors and lawyers because those professions are well respected and well-compensated. Lawyering may have lost its luster, but not so with doctors. That respect for anyone with “Dr.” in front of their name is even more pronounced in other cultures worldwide. This presents a massive problem for the fat asses because so many doctors have so many different opinions about what is the proper human diet. I grant you that most doctors are intelligent people. Just getting into medical school means you are pretty damn smart and willing to work very hard.
However, we must remember that doctors are people, and they grew up in the same society as the rest of us. They have a great deal of respect for their elder colleagues. If the guy that trained me says something is so, who am I to question it? Once a stupid idea takes hold in the medical profession, it takes at least a generation to get rid of it. Modern ideas about what and how we should eat are stupid and have made the world fat and sick. If you wait for the medical profession to fix this, you will probably die while you wait.
Another problem that plagues Western doctors is that they’ve generally never had the experience of seeing a patient get well. Got hypertension? They’ll tell you it is a chronic condition that has to be managed. It doesn’t go away. Got type II diabetes? They will give you insulin, almost guaranteeing you’ll never cure your diabetes. In the world of treatment by the prescription pad, people with the diseases of metabolic syndrome don’t get better. The idea is to manage the symptoms and stretch the patient’s life into a relatively long, miserable one. Such doctors are not trying to help people get well; they are merely trying to help people manage the consequences of their dietary excesses.
This book isn’t about conspiracy theories. It is a call to bring common sense back into the world of eating. My dad always said, “if it ain’t broke, don’t fix it.” I encourage you to examine what eating practices have withstood the test of time. If you were alive in the 1970s, recall what eating was like. Most likely, you ate meals that were cooked at home. Snacks didn’t really exist. Sure, you may have had some popcorn at the movie theater, but you didn’t eat six meals a day as we do now. Why do I bring this up? Because in the 1970s, there was very little obesity in the United States. Sure, there were some fat asses, but they were the exception and not the rule.
What changed? In 1977 the Dietary Guidelines for Americans came out, and they said we needed to quit eating fat. You are left with protein and carbs if you eliminate that whole category of macronutrients. For several reasons, Americans decided to load up on carbs. Not only carbs, but sugary carbs without any fiber to slow down the insulin spikes. Suppose we graph the fat consumption of Americans along with obesity. In that case, we find a shocking fact: the less fat we ate, the fatter our asses got. This sad state of affairs has since played out around the world, except in places that are too poor to afford our super-processed sugar diet. “Eat less fat” was interpreted by the food industry and the world as a demand to “eat more refined carbohydrates.”
That damn food pyramid you learned in elementary school is the ultimate example of this bad science. It says you should eat eight or so servings of pure carbs daily. Eating eight pieces of bread daily will do nothing for your fat ass problem. Calling it a low-fat muffin and marketing it as healthy doesn’t change the fact.
Fat, it seems, doesn’t really make you fat. That’s an excellent slogan for selling sugar, but the data tells a different story. If you want to be a real, bona fide fat ass, eat a lot of sugar. Another big problem with ultra-processed carbs is that they are already pulverized and essentially predigested. They move in and out of the gut very quickly. If you eat steak and eggs for breakfast, you may forget to eat lunch. If you eat that low-fat muffin at 8:00 AM, you will likely be hungry again by 10:00 AM. Real food is satisfying. Processed junk, no matter how labeled, does not satisfy you, and you will probably eat way too much of it.
The content is out there if you want to go down YouTube rabbit holes on food and nutrition conspiracies. The bottom line is that almost everything most Americans think is healthy is really a slow, cruel death sentence. We must revise our conceptions of what we should eat and when we should eat it if we want to be healthy.
The Basics of Food Metabolism
I know I promised not to get too sciency, but there are some basic things about food and nutrition you must know for this little book to make any sense. You may have noticed that you must eat if you want to live very long. Always remember that the human body is a brilliantly designed biochemical machine. Like all machines, you must maintain and supply it with energy. Thousands upon thousands of complex chemical processes are going on all the time to keep the human machine running correctly. This means the body needs lots and many different chemicals to run correctly. In this little book, we will focus (mainly) on a few things that the body uses for energy.
Thinks that the body needs in small amounts, such as vitamins and minerals, can be called micronutrients (micro means small). Things that we need a bunch of are known as macronutrients (macro means big). We may eat and drink thousands of different foods. Still, they all are made up of lots of different micronutrients, but only three primary macronutrients. The macronutrients are fats, sugars, and proteins. All carbohydrates are more complex forms of sugars that the body ultimately breaks down into simple sugars (if it can). A chemist will tell you that fiber is a carbohydrate. Still, the body can’t break it down into simple sugar, so it doesn’t impact your metabolism directly.
There may be hundreds of chemical steps to break down what you eat, but in the end, you wind up with fats, glucose (the simplest sugar), and proteins in your blood. Once in your bloodstream, they can be transported to your body’s cells for growth and energy. Your individual muscle cells don’t know or care if you got glucose from a candy bar or a piece of bread or a potato. All of it turns into glucose by the end of digestion. How long it takes the digestive system to break those carbs down into simple sugars is very important because it determines the glucose concentration in your blood.
Sustained high blood glucose levels (also known as diabetes) are very dangerous. The body will struggle to keep those levels low. If you overwhelm the body’s ability to do so by pumping in too much glucose over a long time, you will get very sick and die. It is critical to understand that while we call this a sugar problem, sugars are merely the simplest form of carbohydrates. Any carbs you eat (bread, pasta, rice, potatoes, etc.) will turn to glucose in your gut and then be fed into your bloodstream.
Over the last twenty or so years, conventional wisdom tells us that carbs are energy. The human machine needs energy, right? This tragic fallacy ignores a fundamental design feature of the human body: Human bodies are designed to be dual-fuel machines. We can and should burn fat for energy. If you are metabolically healthy, carb-rich foods are okay if you give the body time to recover after loading up on them. Loading up on simple sugars is poison, and nobody should do that. If you are a fat ass, you are most likely metabolically ill. You need to tightly control all carbs to restore your body to proper working condition.
What To Do
The real path to becoming healthy is to change your lifestyle. Commitments to lifestyle changes are much more durable than short-term goals. You don’t just have to eat some special things for a few months; you have to entirely change how you think about food. That will take a lot of effort, and you will have to shoulder most of the burden of getting this done. Your doctor can advise, help you assess your health, and so forth. Your doctor will not help you learn what to eat, how to eat it, and when. You’ve got to figure that out mostly on your own.
When you have hard days, and you want to give up and buy a case of beer and a large pizza, you need to know what motivates you to want to get healthy. Wanting to be sexy to pick up dates at the bar usually won’t cut it. What deeply motivates you not only to have a long lifespan but also to have an extended health span? Ideally, you want to live a long life and die peacefully in your sleep after you’ve spent a long day doing what you love to do. What you did that hypothetical day is what can really motivate you to stay the course.
Maybe you want to play catch with the grandkids. Perhaps you want to build that cabin down by the lake with your son. Maybe you want to blow that 401(k) seeing the world, and you need to be healthy to enjoy your international travels. What constitutes an epic life changes from person to person, but you need to understand why you want to love a long and healthy life. Maybe, like many of us fat asses, you’re just really sick and tired of being sick and tired. Fat girls on Instagram can rail against fat-shaming all they want, but every fat ass knows deep down that it’s miserable to be fat and sick.
Once you have identified the why of getting healthy, the next step is to decide how. As I will argue in several different places in this book, a blueprint to a healthy life is a very personalized experience. You have to account for cultural, environmental, family, genetic, and health factors. There are way too many variables for a one size fits all approach to this. As you begin this book, I encourage you to start a notebook (yeah, yeah, of course, the professor wants you to take notes).
Write down questions you have, essential points you want to remember, and articles and books you want to read next. I also suggest you move to the last few pages of your notebook and write down action plan items under major headings. You may want to start with Diet, Sleep, and Exercise. You must wind up with a list of things that you actually do—action verbs. It is excellent to begin with the end in mind, but you’ll never get there without taking the appropriate actions to move you along the path.
I also suggest you track your progress. I advise making a grid in your notebook or creating a spreadsheet. Every day, check your blood sugar first thing and write that down. If you have identified that you are a prediabetic or a full-blown diabetic, then make more observations and record those. Check your blood pressure at least twice per day and record that. I document my weight daily and how much I’ve lost in total. I use a handy app that records my current weight, calculates my BMI, and graphs my progress. There will be ups and downs with any “get healthy” plan, and seeing that downward-sloping trendline makes me feel better on a bad day.
Figure out a way to record how much exercise you got. Start walking every day, for example. You can get a pedometer app that will track your steps, estimate the calories you’ve burnt from walking, and so forth. Getting healthy is a slow process; having a record will prove that your program is actually working. If you see after a few weeks the numbers are not moving, then you know to make changes. This record can also be shared with your doctor to make better medication decisions. Those on a keto diet may want to measure and record ketone levels. Dr. David Perlmutter makes a compelling argument that you want to measure and record your uric acid levels. You can measure all of these things at home. Your blood levels of cholesterol and nutrients like vitamin D are more complicated, and you’ll need to work with your doctor to track these.
Also, track your behavioral goals. I have a diet column in my notebook. I use K for a ketogenic diet day, F for fasting, and C for a cheat day where I had carbs. If you are doing intermittent fasting, you could use number codes like 16:8 or 14:10. If that doesn’t make sense, don’t worry. I’ll explain these ideas in more detail in the coming chapters. Remember that a good goal has to be specific and measurable. If you are trying to record how you did, that is an excellent way to ensure your goals are good.
“Exercise more” is a nice thought, but it’s not a good goal. “Walk my dog 30 minutes per day” is a good goal. It is realistic (you can do it), and you can measure it (you did or did not walk that 30 minutes). You could set the goal in minutes, distance, calories burned, etc. As long as you have data to keep yourself accountable, then you’ll be fine. Suppose you can’t figure out how to measure your progress. In that case, you are probably focusing on the end result rather than the behaviors that get you there.
You will also want to learn as much as possible about health and nutrition. I’ll make the case repeatedly that your health is your responsibility. Your “healthcare provider” is just a consultant you see infrequently. The details and the daily grind of getting healthy and staying that way are all on you. Subscribe to the youtube channels of book authors you trust. Get their books and make a plan to actually read them.
References
I’ve added a complete reference page to my book on this site. I’ve also included “further reading” articles in books on this site, organized by the book chapter headings. Book links to Amazon are affiliate links, and if you happen to buy something via one of those links, I get a small kickback from Amazon to help keep this site up and running. Thank you for your support!
Dr. Robert Lustig is a well-respected medical doctor, YouTube sensation, and prolific author. In the video linked below, Dr. Lustig (UCSF Division of Pediatric Endocrinology) updates his very popular video “Sugar: The Bitter Truth.” He argues that sugar and processed foods are driving the obesity epidemic, which in turn affects our endocrine system.
If you really want to dig deep into how bad sugar is, and how evil the sugar industry is, check out the book linked below.
If you are interested in a colorful medical doctor that isn’t scared to call bullshit on his own profession, Big Food, Big Pharma, and Big Healthcare, look no further than Dr. Ken Berry. Dr. Berry is a prolific writer and YouTube inspiration. His no-bullshit approach to telling it like it is was a major influence in my writing of this book! Check out his short “Lies Doctors Tell Diabetics” video below. If you like that sort of in-your-face truth, then be sure to subscribe to his YouTube channel. He posts new videos frequently.
If you want a deep dive into what lies doctors tell people and why check out Dr. Berry’s book below.
Last Modified: 07/19/2022