#59 - Jason Fung, M.D.: Fasting as a potent antidote to obesity, insulin resistance, type 2 diabetes, and the many symptoms of metabolic illness
The Peter Attia Drive - A podcast by Peter Attia, MD - Mondays
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. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.