The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

Research output: Contribution to journalJournal articleResearchpeer-review

  • David S Ludwig
  • Louis J Aronne
  • Astrup, Arne
  • Rafael de Cabo
  • Lewis C Cantley
  • Mark I Friedman
  • Steven B Heymsfield
  • James D Johnson
  • Janet C King
  • Ronald M Krauss
  • Daniel E Lieberman
  • Gary Taubes
  • Jeff S Volek
  • Eric C Westman
  • Walter C Willett
  • William S Yancy
  • Cara B Ebbeling

According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body-resulting from the hormonal responses to a high-glycemic-load diet-drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models, which have substantially different implications for obesity management, and to generate new models that best encompass the evidence.

Original languageEnglish
JournalAmerican Journal of Clinical Nutrition
Publication statusE-pub ahead of print - 13 Sep 2021

Bibliographical note

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

    Research areas

  • Faculty of Science - Obesity, Weight loss, Dietary carbohydrate, Energy balance, Macronutrients, Endocrinology, Insulin, Glucagon, Incretins, Scholarly discourse

ID: 279686631