I am referring to your Intake Balance Mechanism. You’ve never heard of an Intake Balance Mechanism? That’s not surprising since I just made it up.
I love inventing new words for the ins and outs of weight loss! It turns out that the story of fat and its fellow-travelers (high blood pressure, elevated lipids, high blood sugar, increased inflammation, a tendency to blood clotting, etc.) is so complicated that it needs some clearer methods of explanation. I am constantly struggling for ways to boil down my pet theories about weight gain. The appearance of IBM is just my latest effort.
As those of you who follow this blog know, I don’t believe in the reasoning that says a calorie is a calorie. Neither do I believe in many of the accepted theories about how we gain weight. I am now entering my 10th year in specialty practice and I’ve had five additional years working with obese patients. That’s a whole lot of overweight to observe. As the year 2008 comes to a close, I’ve been thinking about where I stand on the question of how we become too fat. This is my current theory: People who never become overweight eat at will and exercise when they feel like it – maybe not at all. Like other Americans, they overeat quite a bit at times. They may even overeat frequently. They don’t keep track of the types of food they eat or of the quantity. Yet, at the end of a year—which includes the consumption of approximately 1 million calories—they still weigh the same as they did on January 1st. If they eat hugely at any given meal, no one will think they are gluttonous. If they never get off the couch, no one will fault them for their slothful ways. Why not? Simply because their bodies don’t accumulate fat. Until I was about 40 years old I used to be one of these people and believe me, I never gave the slightest thought to my eating habits.
NOWs (Never Over Weight people) have an efficient Intake Balance Mechanism (IBM). This mechanism is a complex of body reactions that responds to the ups and downs of eating. If someone eats more, the IBM gets rid of it. If he stops eating, the IBM makes the appropriate adjustments. It’s an auto-pilot for maintaining weight within a small range. Why believe in such a controller? Simply because every function of the body is controlled in a similar way by just such mechanisms. The body’s desire to correct slight imbalances is called homeostasis and manifests itself in balance mechanisms that regulate all of the body’s functions to keep them within tight ranges.
To my way of thinking, POWs (Previously OverWeight people) have developed a malfunction in their IBM. When they eat, their bodies do not respond by getting rid of appropriate amounts of calories or by making the right adjustments. This malfunction means that they store fat inappropriately. No matter how much they exercise, no matter how moderately they eat, they tend to store excess weight.
So why should such an IBM malfunction occur. My hypothesis is that there are two potential explanations. The first is just what you might expect – extreme overeating. Any of the body’s balance mechanisms can be overwhelmed by extreme circumstances. Pour potassium into the bloodstream and toxic levels will eventually accumulate. Pour huge amounts of calories into your body,and you will eventually overpower the IBM. But unlike most doctors, I don’t believe that calorie overconsumption is the most common reason for gaining weight. I hypothesize that the second cause for IBM failure, and the one that I believe is vastly more common, is contact with harmful elements in the SAD (Standard American Diet). These dietary components cause IBM breakdown in susceptible individuals. Most of us are susceptible, but some IBMs are more sensitive than others.
What are these dastardly elements? There may be many. Our study of diet is still young and we are constantly discovering new categories and subcategories of nutrients. However, we do know about one very major player: the huge load of starches and sugars in the SAD. Starches (from grain and its products, and from starchy tubers like potatoes) turn into glucose in the bloodstream. Glucose begets insulin and insulin stores fat. The IBM is disrupted when years of asking the body to make insulin repeatedly causes insulin resistance, a condition in which glucose can no longer be sent to the muscles for burning, but is diverted directly into fat storage. Since the body can’t burn calories appropriately, it can no longer balance itself.
There is much about diet that we don’t know. So let’s look at what we do know. Originally, we didn’t eat starches and sugars in any significant amount. Populations that eat a diet which is close to what we humans originally consumed do not suffer from the diseases of modern civilization (heart disease, autoimmune problems, obesity and others). They have functioning balance mechanisms of all types. This is the basis for my advocacy of a “Primarian” diet.
The question remains as to whether weight loss can restore the IBM to its normal function. Purely on the basis of observing maintainers, I believe that it can. This means that so long as a maintainer chooses foods that don’t restart the problem, he or she should be able to eat within a reasonably broad range of large or small meals without regaining weight. The catch, though, is that the types and amounts of foods that disrupt the IBM seem to vary greatly from person to person. I have some patients who can strip down to a primary diet and then add back a fair amount of whole grains, even some sweets, while remaining stable. On the other hand, many POWs (including me – a smaller POW) cannot tolerate very many S Foods at all without starting the regain cycle.
For this reason, I suggest that new maintainers take their diet back to basic Primarian choices to start out (lean meats, lean poultry, fish, seafood, fruits, non-starchy vegetables, nuts, roots, eggs and low fat dairy). Once they feel in balance, they can add back some starch and sugar elements with caution and while watching the scale. The majority of their food choices, though, should remain primary.
If we believe that people gain weight because they eat too much and exercise too little, our only choice is to believe that overweight people have bad judgment, lack willpower, and are lazy. No naturally thin person on the planet is judged this way even if they overindulge or spend days on end playing video games. Overweight people are not the only ones who eat more than they should or watch TV rather than hit the treadmill.
The people I’ve worked with over the years have almost unanimously wrestled with guilty feelings. They suffered because they thought that they could have controlled their problem if only they had eaten less and exercised more. But if my theory is correct, neither of these interventions would have gotten their intake balance working again. The minute they began to consume the modern diet (at some level particular to themselves), the problem would have reasserted itself. I wonder if the successful maintainers out there can confirm this assumption? I’d love to get your feedback about foods that seem to cause a problem versus foods that can be eaten pretty much at will. I also would be interested to know if you feel that you fall into the category of someone who previously overate to a significant degree (more than most NOWs), or someone who just stored fat very easily. As always, thanks for your input, intelligent feedback, and provocative thoughts.