A “Simple” Solution for Diabetes and Obesity

Writing in the Guardian, Jon Ungoed-Thomas tells us he’s stumbled upon a simple solution for diabetes and obesity. A low-carb diet will cure them both! In an observational study of patients in a general practice who volunteered to religiously follow a low-carb diet, they found that patients could lose weight and put diabetes in remission. It worked for a few years in about half of the patients who signed up for it. GP David Unwin was first author on this study.

Professor Roy Taylor says this study describes the “magic ingredients” for success – structured support and regular GP checkups. He was the senior author and also a lead investigator for the DiRECT program to study diabetes remission through restrictive diets.

Easy Peasy

Taylor is a true believer. In a recent paper for the British Journal of Diabetes, he explains:

“There is a simple bottom line: if a person has T2DM, they have become too heavy for their own body – nothing to do with the population science concept of obesity. The solution is at hand.”

Simon Tobin, also an author on the observational study, is a keen runner who follows a low-carb lifestyle. Another zealous fan of this approach, he says he knows why everyone doesn’t latch onto it:

“Many of our patients have been low carb for six, eight or 10 years, so it is completely sustainable. If you had a drug that did half of what we have done with the low-carb approach, it would be worth an absolute fortune. No one is shouting about it because it is not a drug that’s making a profit for a big pharmaceutical company.”

So What’s the Problem?

Unwin says that money might indeed be part of the problem:

“We need proper remuneration and incentives that value lifestyle alternatives against long-term medication. We spend about £68,000 a year less than is average for the area on medication. I would only need half of those savings to fund further services, but there is no incentive for GP practices to do this work.”

For sure, to get good results for patients with diabetes and obesity, it takes time for skilled providers to provide the care these people need. Health systems in the U.S. and the U.K. don’t typically provide this.

But there’s more to it than that. Yes, some people get good long-term results from following a very strict dietary regimen. But most do not. Other tools, like surgery and advanced medicines for obesity, deliver much better outcomes for many more people.

Deception and Bias

Health systems are reluctant to pay for any of this – including the remuneration Unwin says is necessary. That’s because of the bias that this is a problem stemming from bad behaviors. Pretending that diets offer a magic solution only perpetuates that bias.

Delivering better outcomes for obesity and diabetes is totally doable, but not “simple.” Describing it as simple and evangelizing for a diet as a “cure” is simply deceptive.

Click here for the article by Ungoed-Thomas in the Guardian, here for the paper by Unwin et al, and here for Taylor’s description of how simple it all is.

Egrets from Quick Lessons in Simplified Drawing, painting by Katsushika Hokusai / Wikipedia

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April 10, 2023