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Insulin and Obesity
The structure of scientific revolutions has been rattling in my head. I am hardly alone. Over the last forever long, turns out since at least the 1940s, we have been using energy balance as our model of obesity. It makes intuitive sense since energy (or matter for that matter) cannot be made or destroyed, it can only be transformed. This works whether you are talking of the heat of the sun, where fusion leads to energy, the energy that keeps us alive, or cell biology.
However, it’s the transformed part that people are having trouble with.
The other day I came across this excellent essay in Stat News by one of the leading reporters in the field. Let me quote from the leading paragraphs, and I recommend you go read it next
For nearly a century, obesity research has been predicated on the belief that the cause of the disorder “is an energy imbalance between calories consumed and calories expended,” to quote the World Health Organization. By this ubiquitous thinking, obesity is an energy balance disorder: People get fat because they take in more calories than they expend. They stay lean when they don’t.
This is the central dogma of obesity science. Virtually all obesity research is interpreted in the context of this balance principle; all related public health discussions, not just on obesity but on all the common chronic diseases that…