Stephan Guyenet On Diet, Obesity Models, and Obesity Drugs

Stephan Guyenet completed a PhD in neuroscience, then went on to study the neuroscience of obesity and eating behavior as a postdoc. He’s also been involved with Givewell and Open philanthropy projects. In 2017, he wrote the book the Hungry Brain.

We discuss two competing obesity models: one based around  a model of energy balance with the brain as one of the main central controllers.

And one model which  s based more around an insulin - carbohydrate pathway. The carbohydrate - insulin model emphasizes the role of insulin from glycemic load inputs.

While not necessarily mutually exclusive, Stephan explains how the brain centric energy balance model can explain some data, in his view, that the carb-insulin model does not. Stephan notes much individual variability and how the naming “energy-balance” is perhaps not the best type of name for the model.

We discuss the challenge of processed foods, which tend to be easy to eat and tasty foods. Stephan notes that the combination of fat + carb (eg in chocolate!) is very appetising. We chat about the role of genetics, and satiety.

We chat about two classes of  obesity drugs, one rimonabant (using cannabinoid receptor pathways)  which has been withdrawn; and the other being GLP-1s. We talk about the possible role of inflammation and some intriguing data on Alzheimer’s. I ask about his view on intermittent fasting, also on the microbiome.

I talk about my challenges with exercise and we discuss how some people probably are not wired to enjoy intensity training whereas some others are.

We talk about effective altruism and what he has learnt from his work at Givewell.

We play over-rated | under rated on:

• Climate Change
• Nuclear War
• Rogue AI risk
• Giving away more wealth
• Animal welfare
• Diversity of thought

We chat about making cider, growing your own food and cycling in Seattle.

Stephan ends with his general diet advice. 

Links to academic papers and video available here.