3 Levers

Peter Attia is a very smart, very nerdy physician that is obsessed with finding ways to improve lifespan (how LONG we live) as well as healthspan (how WELL we live).  He hosts a weekly podcast and always has really interesting topics and guests.  He isn’t focused solely on weight loss, as obviously, losing weight isn’t the only way to better health and longevity, but it is definitely something that he talks about and touches upon.  The other day, he was talking about the various levers that we use to achieve weight loss and I thought I would share it with you here. It’s a really good way of explaining what we do in our clinic all day!  

The way Dr. Attia describes it, there are three levers that we can pull when it comes to nutrition.

  1. HOW MUCH we eat
  2. WHAT we eat
  3. WHEN we eat

If we aren’t pulling any of the levers, we are typically in a nutritional metabolic free-fall.  We have to be pulling at least one of them all the time if we want to be remotely healthy.  Most of us need to be pulling two of them and for some of us (especially those trying to lose weight and reverse chronic disease), we often have to pull all three of them.

The problem is that most of the time, we approach weight loss by pulling the HOW MUCH lever.  This makes sense – it’s definitely the most logical (and often the easiest) lever to pull.  Although this works briefly when pulled by itself, it rarely works long-term.  It usually results in weight loss for several months followed by weight regain in the following months (usually with a little extra weight regain – as though the body is preparing for another HOW MUCH insult by hoarding a little more just in case).

I always tell patients at the onset of treatment that we aren’t going to tell them to eat less.  We aren’t going to repeat the same old dogma of “eat less and move more” that is so often at the center of the discussion of weight loss.  Everyone has tried it before coming through our doors – and if it had worked, they wouldn’t be there!  

In our clinic, the lever we pull first is WHAT we eat.  This lever is a little more complicated and difficult to pull for most of us, but it’s much more effective long-term.  And – more importantly – once that lever is pulled, it’s pretty darn easy to pull the other two levers.  Once people are eating the right foods, they almost always instinctively eat less than they used to.  If that isn’t enough, we can play with the WHEN lever and do some version of intermittent fasting.  

There does seem to be a small percentage of people that seem to be immune to the health effects of the standard American diet (SAD) – meaning they can eat whatever they want and not get things like excess weight, diabetes, high cholesterol, etc.  They don’t have to turn any levers.  My guess is that it’s about 5-10% of the population.  The rest of us aren’t so lucky.  The rest of us have to turn one or more levers.  Some of us have to start turning them in childhood, others get a cushion and don’t have to start until our 30’s or 40’s. Regardless, most of us need to turn at least one of them if we want to be healthy and two or three if we want to reverse excess weight and/or chronic disease.  

I tell my patients all the time that you can fix something until you understand it.  Hopefully, understanding the levers and the way we pull them will help some of you on your journey!  

As always, if you have any questions, you know where to find me

Courtney Younglove, M.D.

ATTENTION LAWRENCE PATIENTS: 18th Street is closed at Wakarusa until further notice due to construction. You can access our parking lot via Research Parkway and Research Park Drive. Expect traffic delays and make sure to give yourself plenty of time to get to our office.
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