Why You’re Fat and Sick
As the title suggests, this book assumes that you are a fat ass and that you are so because you are metabolically ill from years of eating the Standard American Diet (SAD). Most of the material herein suggests things that may benefit people who desperately need to reverse metabolic syndrome. If you are generally healthy and are seeking other benefits, then peruse the resources discussed herein (and check out the reference page at the end of the book).
The common thread that binds all of my ideas about food is managing carbs to manage insulin. Suppose you can drop your insulin over time. In that case, your fat ass will shrink, your blood pressure will go down, your gout will go away, and you will likely see a lessening of the symptoms of inflammatory diseases. The critical aspects of this book can be summarized as follows:
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- Eat only whole, natural foods. Get rid of the processed stuff completely.
- Get rid of all processed sugar and most of the natural sugar.
- Remove all grains, beans, and legumes.
- Remove all vegetable seed oils.
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Many diet strategies in this book have been derided as “fad” diets. The processed food-based Standard American Diet is the fad. This stuff wasn’t designed to make you healthy and doesn’t exist in nature. Your body wasn’t designed to process it, making you fat and sick. Eating meat and plants is something humans have been doing for as long as there have been humans. Your body knows exactly what to do with these whole, unprocessed foods. We must exclude fake fats and highly processed carbohydrates (especially sugar) from our diets if we want to be well. The ratio of meat to vegetables is essentially a matter of personal preference. How much broccoli to have with how much meat isn’t a hill I’m willing to die on.
Cheap industrial sugars and industrial seed oils are essential to the profits of big food, but they are not at all essential to the human diet.
Eat Meat
If you decide to be a vegan or vegetarian for religious reasons, nothing I can say will sway you. If you avoid meat because you think your arteries will clog up immediately after eating some, then perhaps you should relax your stance. Much of what has been said about the evils of saturated fat was manufactured by Ansel Keys and his progeny, and it doesn’t stand up to strict scientific scrutiny. The conventional wisdom is that saturated fat is the cause of heart disease. I argue that fructose is a much more powerful predictor of heart disease and the other disorders that make up metabolic syndrome.
Note that coconut oil is about 95% saturated fat, while beef is something like 40%. If saturated fat is evil, then lots of vegan-friendly oils shouldn’t escape whipping.
Skip the Middle Isles
Most grocery stores have fresh produce, dairy, and meats on the outside edge of the building, and packaged goods are in the middle aisles. One sage piece of advice is to skip the center isles. Avoid prepackaged, processed foods. As several YouTube personalities are fond of saying, “If it has a bar code, don’t eat it.”
Hidden Sources of Sugar
Marketing masters have convinced us that fruit justice is very healthy stuff. That argument can be made for whole fruit, but when you squeeze all the juice out of the fruit, all of the fiber is removed and becomes essentially colored sugar water. This is a naturalistic fallacy. Just because something comes from a smashed fruit doesn’t make it healthy. Remember that fructose is “energy,” and fruit juices are pretty much nothing else. This is just one example of sugar hiding out in plain sight, wearing “healthy” clothing. A whole book could be written on this one warning.
Sugar and Food Labels
A lot of people are now learning that sugar is bad for you. Fructose is deadly, and table sugar is about half fructose. Logic tells us that we must avoid “sugar” or “high fructose corn syrup.” Federal law requires that processed foods list the ingredients, but Big Food has come up with some clever ways to hide the fact that they are adding tons of sugar to your “healthy” foods. This is critically important.
The American Heart Association (AHA) recommends no more than 9 teaspoons (38 grams) of added sugar per day for men and 6 teaspoons (25 grams) per day for women. The AHA limits for children vary depending on age and caloric needs but range between 3-6 teaspoons (12 – 25 grams) per day. That is likely way too much for anybody, given the state of the science. Still, if you are already fat and sick, this amount will keep you fat and sick and likely make you fatter and sicker. Below is a partial list of stuff you may find sugar called on food labels:
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- Agave nectar
- Barbados sugar
- Barley malt & Barley malt syrup
- Beet sugar
- Brown sugar
- Buttered syrup
- Cane juice, dehydrated cane juice, evaporated cane juice, cane sugar, & cane juice crystals
- Cane sugar
- Caramel
- Carob syrup
- Castor sugar
- Coconut palm sugar and coconut sugar
- Confectioner’s sugar
- Corn sweetener, corn syrup, HFCS (High-Fructose Corn Syrup), and corn syrup solids
- Date sugar
- Demerara sugar
- Dextrin
- Dextrose
- Free-flowing brown sugars
- Fructose
- Fruit juice, fruit juice concentrate, grape juice
- Glucose, Glucose solids
- Golden sugar & golden syrup
- Honey
- Icing sugar
- Invert sugar
- Malt syrup
- Maltodextrin
- Maltol
- Maltose
- Mannose
- Maple syrup
- Molasses
- Muscovado
- Palm sugar
- Panocha
- Powdered sugar
- Raw sugar
- Refiner’s syrup
- Rice syrup
- Saccharose
- Sorghum Syrup
- Sucrose
- Sweet Sorghum
- Syrup
- Treacle
- Turbinado sugar
- Yellow sugar
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Seek Out Dietary Fiber
When the mass-produced food pandemic happened, and fat was removed, industrial food producers also removed all of the fiber from foods. Prior to this, Americans consumed around 200 grams of fiber per day. Today, it’s just over 10 grams. Fast food is fiberless food. Fiber takes too long to cook, and it doesn’t freeze well. It doesn’t fit into our modern convenience for cheap demands.
Sick Versus Well Diets
Many people will balk at the idea of intermittently fasting forever or staying on a ketogenic diet forever. Either option in a strict form is probably a recipe for madness. The thing to realize is that you spent 15 to 20 years or more making yourself metabolically ill, and it will take time to reverse the process. Once you are healthy and all of your health markers are in a good range, you perhaps can relax a little. You can’t, however, ever go back on the standard American diet. You can carb load on feast days because feasts are okay if you balance them with later fasts. Most of us already subscribe to this logic; that’s why we eat like hogs on Christmas and make New Year’s resolutions to deal with the aftermath.
Other Factors
All diseases associated with metabolic syndrome are essentially hormonal in nature, and the most important among these is insulin. Insulin must be controlled if you are to beat this thing. It is essential to understand that other things besides diet mediate these hormones. Some common culprits of being fat and sick outside of diet are mentioned below.
Sleep
It may sound inconsequential, but sleep is critical to metabolic health and weight loss. Experts tell us we need between 7 and 8 hours of sleep per night. Get less than 7, and it causes problems. Get more than 8, and it causes problems. For optimal health, you need to hit the sweet spot. In a review of the literature on the relationship between sleep and insulin resistance, Van Cauter (2011) noted that “In recent years, evidence has accumulated to support a role for sleep disturbances, including insufficient sleep, poor sleep quality and insomnia, and obstructive sleep apnoea, as independent risk factors for the development and exacerbation of insulin resistance.” In laboratory studies of healthy young adults submitted to recurrent partial sleep restriction, marked alterations in glucose metabolism, including decreased glucose tolerance and insulin sensitivity, have been demonstrated.
Exercise
If you’ve ever spent an hour on an exercise bike or a treadmill, you probably were disappointed in how many calories you didn’t burn. Physical exercise isn’t nearly as effective as merely staying alive as a way to burn calories. You’d have to pedal your fat ass nearly to death to burn the same calories as your basal metabolism daily. The real benefits of physical exercise aren’t derived from merely burning calories but from modifying how your metabolism operates.
Venkatasamy et al. (2013) found that exercise is important in increasing insulin sensitivity. They found that physical activity tremendously benefits the diabetic population, stating that exercise “is an irreplaceable part of the overall strategy against diabetes.” There are multiple mechanisms through which physical exercise has the potential to reduce obesity, reduce inflammation, up-regulate mechanisms governing the anti-oxidant generation, and drastically increase cellular sensitivity to insulin. Exercise, both strength training and aerobic exercise are very good for heart health. Especially if you are older and want to maintain your quality of life, resistance training is an excellent way to maintain and develop muscle density. Also, muscle mass is related to your basal metabolic rate.
So the bottom line is that you need to exercise, but not for weight loss via “burning calories.” It sucks for that. It does an excellent job of helping maintain and improve cardiovascular health. It can lower blood pressure (seriously, it’s massive compared to pills) and help regulate blood sugar.
Sleep Apnea
Sleep apnea is the most insidious condition that most people have never heard of. In obese people, fat deposits in the upper respiratory tract narrow the airway; there is a decrease in muscle activity in this region, ultimately resulting in sleep apnea.
Peppard et al. (2000) found that being a fat ass is a significant driver of sleep apnea. These researchers found a relationship between weight gain and increased sleep apnea severity. In people who initially had mild or no sleep apnea, they found weight gain predicted the development of moderate-to-severe sleep apnea. Weight loss was associated with reduced sleep apnea severity and the likelihood of developing it. Several experimental and statistical controls were in place; the findings were independent of many potential confounding factors, such as age, baseline body habitus measures, and change in smoking habits. Modern CPAP machines can vary pressure according to need, and that data is recorded on the device and can be viewed via a phone app. Your humble author has noted a 50% reduction in average CPAP pressure over six months. [1/1/2016 update: I no longer use CPAP]
One of the most common yet underdiagnosed sleep conditions, especially among the fat asses, is sleep apnea. If you are fat and snore a lot, get off your fat ass, go to your doctor, and request a sleep study. If you have the condition (which most people with a BMI over 40 do), then a CPAP machine can save your life. It is horribly annoying and uncomfortable. It is expensive. But it’s better than dying young. Get the study and comply with your Doctor’s orders on this.
Social Support
If you are a member of a religion that doesn’t eat certain foods during lent, you have a solid social push to comply. Humans have been controlling what they eat and when they eat it for thousands of years as part of a group. We know that support groups are a powerful tool to change behavior, even when those behaviors rise to the level of addiction. The group really doesn’t matter if it is meaningful to you. It can be a religious fast conducted by millions of people at once, or it can be a group of guys at the office who decide to try Wednesday fasting after Tuesday. Families and other groups living together, even couples, can be great for social support. It usually isn’t that hard to get people to join you in an effort to lose weight, reduce blood sugar, and the other health benefits of changing your diet.
Stupid Things That Fail
Many Small Meals. For a while, “Experts” told us that eating four or more “small” meals during the day was a good idea to reduce overall calories for the day. This advice made people trying it feel like crap and look like crap. The reason should be easy to guess at this point. The frequent eating kept insulin levels high, so no fat stores could be accessed by the body. The reduced calories didn’t provide enough glucose to run on, so these poor souls are in an energy deficit, have no energy, and feel like crap.
Snacks to Control Hunger. One of the best things you can do for your metabolic health is never to have snacks. Three meals per day is probably pushing it for most people. The extra snacks between meals mean insulin levels never drop, and fat stores can never be accessed. So even if the snacker is eating “healthy” snacks with reduced calories for the day, it doesn’t do any good because no fat can be burned.
Willpower is key. If you take calories out of someone’s diet long enough, they will get lean. Keep it up, and they will die. In the calorie-rich world we live in, the vast majority of people will break down and eat long before any of that happens. If you are hungry all the time, you will eventually eat. If you go back to eating the crap that made you fat and sick in the first place, you will get fat and sick again. This is what happens 99% of the time on “calorie reduction” diets. They simply don’t work, and it doesn’t matter how much willpower you have. It isn’t the number of calories that matters in the long run; it is what your body does with the calories it gets.
Hopefully, you now understand that the “thermodynamic” model of human nutrition is a complete load of bullshit. When you take in calories, your body has two basic choices: It can burn the calories to increase your metabolic rate and activity level or store them as fat. Which it does is largely due to the hormones created to deal with what you eat. If you have the wrong hormonal environment, cutting 100 calories may well result in your body deciding to burn 100 fewer calories. It doesn’t mean that you will burn fat. Since your basal metabolism is dynamic, it isn’t a closed system, and physics fails to explain what is happening.
Eat Less. This “just so” advice comes from the thermodynamic model of human metabolism. I keep beating that dead horse because it is a zombie: it is so ingrained into the American psyche that it refuses to die. It is true that the number of calories you take in matters, but only if you can successfully burn the food you have stored as fat. The traditional “eat less” diet is high carb and low fat, which can’t possibly work in the long run. You may burn 2,500 calories daily, but go on a calorie-reduction diet, and that number will diminish.
When your body doesn’t have fuel it can burn, it lowers fuel consumption. You get cold and sluggish but don’t burn much body fat. Cutting 500 calories per day from your diet can work, but only if you change your body’s hormonal system to burn fat first. Thermodynamic math says that if you cut 500 calories daily from your diet, you will lose a pound of fat each week. That is simply false and explains why most diets ultimately fail.
Food Index
The glycemic index (GI) measures the blood glucose-raising potential of the carbohydrate content of a food compared to a reference food (generally pure glucose).
There are many other potential ways to put a list together of what you should eat and what you should not eat, given the goal of reducing carbs to less than 20 grams per day. One big difference in the “keto community” is the distinction between total carbs and net carbs. One school of thought is that you can subtract carbs from dietary fiber since those are not digested. The other way to view the issue is to limit your total carbs, which makes the calculations easier (which is important to comply with the diet).
If you are new to the low-carb lifestyle, the easiest thing to do is keep it simple. You will be quickly overwhelmed if you follow keto influencers on the Internet. My suggestion is to simply choose foods from the lists below and only add items when you are absolutely sure of what you are doing. Eating this diet doesn’t need to be complicated, and it doesn’t need to be expensive.
Meat, Fish, and Fowl
The big limit on meat is avoiding processed meats with added ingredients. Deli meats are notorious for additives, which often involve sugar. Sausages are also common culprits for added sugar. Most keto advocates say don’t worry about the fat. Some folks take the middle ground and rail against saturated fat, which includes animal fat. You’ll have to decide how much faith you want to give the idea that saturated fats in your diet lead to high cholesterol and weigh that risk against your personal tastes in low-carb foods. The following are generally acceptable to eat (from a strictly ketogenic perspective) until you are no longer hungry (Don’t eat just to eat):
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- Beef. Steak cuts, roasts, or ground beef are both acceptable.
- Pork. Any pork is acceptable, as long as it isn’t glazed or otherwise sweetened. BBQ sauce is almost always a bad idea.
- To the delight of many, bacon is fine.
- Veal and other meat are fine.
- Chicken
- Turkey
- Duck and other fowl
- Fish
- Seafood
- Eggs (the whole thing is fine)
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Most keto diets suggest that meats are “unlimited.” I disagree with this for the fat ass. I recommend keeping your selections from the above list down to 16 ounces per meal or less. Meat is very filling, and you will be fine if you stop eating when you are full. If you eat five pounds of bacon twice daily, you won’t likely lose any weight.
What about fake meat? Starting in about 2019, Impossible and Beyond Meat started rolling out phony meat on a massive scale. This is not a low-cholesterol solution to avoiding meat. The only reason to eat this stuff is if you don’t want to eat animals. These products went through a lot of trouble to look and taste like meat, and they did so mainly by matching the constituents of meat, albeit derived from plant sources. You get saturated fat from coconut oil rather than animal fat. Get the idea that veggies are a defacto healthy idea out of your head. If you ultra-process anything, it ceases to be healthy by default. Artificial components in artificial combinations are always a big red flag. Don’t let labeling sway your judgment. If you like meat, then eat meat. The fake stuff has no evidence of improving health outcomes. I’m not saying that these particular products are harmful per se. I mean, we just don’t know yet. There is no good data to make the call either way.
Green Leaves
Try to get at least two cups (uncooked volume) of some kind of leafy greens daily.
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- Any kind is acceptable.
- Any kind is acceptable.
- Arugula
- Bok choy
- Chard
- Chives
- Endive
- Greens (mustard, collard, turnip, etc.)
- Parsley
- Spinach
- Watercress
- Radishes
- Scallions
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Note that you must be very careful with dressing. Most prepared ranch-style dressings will have added sugar. Making your own out of olive oil and vinegar is your best bet.
Vegetables
Vegetables, by nature, contain lots of fiber and other carbs. You can’t eat these in massive quantities. Limit the following foods to 1 cup daily (raw volume).
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- Artichokes
- Asparagus
- Broccoli
- Brussels
- Sprouts
- Cauliflower
- Celery
- Cucumber
- Eggplant
- Green beans
- Leeks
- Mushrooms
- Okra
- Onions
- Pepper
- Pumpkin
- Shallots
- Snow peas
- Tomatoes
- Rhubarb
- Zucchini
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Foods to Limit
Cheese. Many keto fans love the idea that cheese is finally something you can eat again. You shouldn’t go nuts and eat pounds per day. Keep your cheese consumption below 4 ounces daily, and check the labeling for carbs. They should be less than 1 gram of total carbs per serving, which takes processed cheese out of the equation.
Cream. Heavy or sour cream is fine, but keep it under 4 tablespoons daily.
Mayonnaise. Be sure to check the carbs. I’ve found Duke’s to be delicious and low carb. Choose up to 4 tablespoons per day, but be sure to count what you put into dressings.
Olives. Eat up to six per day as a snack or on a salad.
Avocado. Up to half an avocado per day is fine.
Lemon/Lime Juice. Limit this to 4 teaspoons per day.
Soy Sauce. Up to 4 tablespoons per day. Check labels for carbs. Note that teriyaki sauce is always sweetened and isn’t the same thing. Look for Filipino pork adobo recipes for a change of pace.
Dill Pickles. Choose up to two servings per day. Check labels for added sugar.
Snacks. Look for zero-carb snacks. Chicharrones and meats are all fine.
Carbohydrates
The whole point of this diet is to eliminate sugar and starches that turn into sugar. There are a fantastic amount of hidden carbs and sugars out there. The easy plan is to eat only the things listed above and add items only when you are sure they fit within the parameters. Ignore all the “healthy” complex carbs you have likely heard about. They are still full of carbs. Here are some familiar sources of sugar that you should absolutely avoid:
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- white sugar
- brown sugar
- honey
- maple syrup
- molasses
- corn syrup
- beer
- milk
- flavored yogurts
- fruit juice
- fruit
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Also, remember that carbs quickly turn to glucose in your gut. You must avoid them.
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- grains (Yes, even “whole” grains)
- rice
- cereals
- flour
- cornstarch
- bread
- pasta
- muffins
- bagels
- crackers
- “starchy” vegetables (beans, carrots, parsnips, corn, peas, potatoes, French fries, potato chips)
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Fats and Oils
Fats are part of the ketogenic way of eating; you don’t have to avoid them. However, since you are a fat ass, you don’t need to seek them out. The idea of going into ketosis is to start burning fat, but it’s the fat on your ass that you want to burn, not your deep-fried blubber nuggets. Don’t attempt to eat a low-fat diet, but don’t add on unnecessary fats just to “hit your macros.” That idea may work for elite athletes trying to train in a fasted state, but fat folk still need to be in a calorie deficit. I’m not suggesting that you count calories. As I’ve already argued, that’s foolish and doesn’t work. The idea is to eat until you are full, then stop.
Avoid trans fats like the plague (they are mostly illegal now anyway), and I add seed oils (which are falsely called “vegetable oils”) to this list. Stick to real butter, olive oil, and coconut oil. What oils are good and which ones are bad is a matter of much debate. I suggest digging deeper into this critical topic.
Beverages and Sweeteners
When we look at the metabolic disease pandemic sweeping the world, we see that it strongly correlates with the rise of sugary beverages. We think of diets as all about eating, but beverages matter. The best choice is to drink water. Black coffee is okay, as is unsweetened tea.
References and Further Reading
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!
Fasting
For a complete “ultimate guide” to fasting, you need to look no further than Dr. Fung’s best-selling book:
Sleep Apnea
Sleep apnea is often dismissed as “just snoring.” The video below explains why this problem (very common in fat asses) is so dangerous and deadly. You can’t fix your metabolism without treating this, and it may go away once you do!
Last Modified: 01/06/2023