#59 - Jason Fung, M.D.: Fasting as a potent antidote to obesity, insulin resistance, type 2 diabetes, and the many symptoms of metabolic illness

27 snips

Jun 24, 2019

Dr. Jason Fung, a nephrologist and best-selling author, dives deep into the transformative power of fasting in combating obesity and diabetes. He challenges conventional diabetes treatments, arguing that hyperinsulinemia, not insulin resistance, underlies metabolic issues. The conversation shifts to the complexities of evidence-based medicine, paralleling its challenges with theoretical physics. Dr. Fung also explores the nuances of dietary strategies like intermittent fasting and how they can effectively target the root of metabolic dysfunction.

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INSIGHT

Physics vs. Medicine

In physics, theories must align with experimental evidence to be valid, unlike in medicine where disproven theories persist.
Insulin resistance, a key concept in nephrology, is often misunderstood, leading to ineffective treatments.

INSIGHT

Anomalies and Evidence

Physics advances rapidly by focusing on anomalies and developing new theories, unlike medicine's slow, consensus-driven approach.
Evidence-based medicine, while valuable, can hinder progress by prioritizing consensus over potentially groundbreaking theories.

INSIGHT

Insulin Resistance Paradigm Shift

The conventional "lock and key" paradigm of insulin resistance, focusing on glucose, fails to explain several observed phenomena.
The "overflow" paradigm, where cells are already full of glucose, better explains these paradoxes.

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In this episode, Jason Fung, nephrologist and best-selling author, shares his experiences utilizing an individualized approach to fasting to successfully treat thousands of overweight, metabolically ill, and diabetic patients, and why being a doctor who specializes in kidney disease gives him a unique insight into early indications of metabolic disease. We also have a great discussion on insulin resistance where Jason makes the case that we should actually think of hyperinsulinemia as the underlying problem. We also discuss the difference between time-restricted feeding, intermittent fasting, and dietary restriction (e.g., low-carb) and how they can be used to attack the root cause of T2D, metabolic syndrome, and obesity. We also have a fascinating discussion about the limitations of evidence-based medicine which leads to a conversation where we compare and contrast the scientific disciplines of medicine and biology to theoretical physics. We discuss:

Comparing scientific disciplines: Medicine and biology versus physics [7:25];
The limitations of evidence-based medicine [12:30];
Early signs of metabolic disease: How specializing kidney disease gives Jason a unique insight into early indications of illness [20:50]
Insulin resistance, hyperinsulinemia, and the overflow paradigm [29:30];
Why the common treatments for type 2 diabetes seem to make things worse [42:30];
How hyperinsulinemia (not insulin resistance) drives metabolic syndrome [53:15];
Insulin and weight gain, and using fasting to empty the cells of glucose [59:30];
The two step process of developing type 2 diabetes and how they are both manifestations of hyperinsulinemia [1:03:15];
NAFLD and hyperinsulinemia: A vicious cycle [1:08:30];
Are the features and symptoms of diabetes actually protective? [1:12:15];
Is obesity causing insulin resistance or is it the other way around? [1:17:30];
What role does inflammation play in obesity? [1:21:45];
CVD and cancer: Diseases of too much growth? [1:27:30];
How to reduce proliferation with rapamycin, nutrition, exercise, fasting, and manipulating hormones [1:32:45];
Getting patients to fast: How Jason and Peter utilize fasting in their practice, and how their approach differs [1:40:15];
Comparing bariatric surgery to fasting as a treatment for type 2 diabetes [1:48:00];
Why people think that fasting is bad for you [1:55:15];
Time-restricted feeding and intermittent fasting: Defining terms, and how Jason applies them in his practice [1:58:30];
A fasting case study: A diabetic patient with a non-healing foot ulcer [2:04:00];
Keys to a successful fast [2:12:45];
Muscle loss during fasting, and why Jason isn’t worried [2:24:45];
Will fasting help a healthy person live longer? [2:31:30];
Does fasting cause gallstones? [2:38:45]; and
More.

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