Ben Bikman on GLP-1 agonists (the weight loss drugs you take by injection)

(Bob M) #1

Was listening to this podcast:

https://pocketcasts.com/podcasts/aad5e480-b559-013b-f3d1-0acc26574db2/51fa48c2-5842-4f2c-9bcc-6fb2e3ba800d

By Ben Bikman, on the metabolic mind podcast. (I tried to find a different link, but I had a hard time doing so; this is to my player).

In the discussion, Dr. Bikman cites to this study:

They compared the GLP-1 output for carb meals for obese and non-obese people, and found that the output is less for the obese. What this means in practice (according to Dr. Bikman) is that lean people eat a high carb meal and their hunger goes down, while obese people don’t get full and maybe even get hungry.

For high fat meals, there wasn’t a difference.

I’m basically convinced that things like this - low GLP-1 output - are causal for gaining weight and obesity. That is, people who gain weight, particularly eating carbs, do so because they don’t produce enough hormones (including GLP-1) or other “I’m full” signals in response to eating.

I wonder if this extends to low carb eating, too. For instance, if I eat a low carb meal, I get hungry, and this occurs even if I’m not hungry - at all - before the meal. I postulate that this is one reason some people get to lower weights while keto/low carb, while others don’t: the people who do get to lower weights don’t have a broken feedback system and instead their system is better at telling them they are full, whereas people like me, who don’t get to their lowest weight while an adult and continue to be heavy, have something broken in that system.

(Pete A) #2

Continue to be heavy?

#3

I’m about the same way, Even when I’m not using a GLP-1, when I started the TKD/CKD I noticed a bowl of oatmeal preworkout and I wouldn’t even think of food for hours, but on lighter days when I’d have a normal low carb breakfast my hunger was out of control. The high fat never did anything for my hunger either, only tons of protein would do that.

(Peter - Don't Fear the Fat ) #4

This whole hormone thing is interesting to me personally … my reason for getting fat was that I never felt full. I still don’t know when to stop eating, this ususally means I’m chasing that full feeling, like an addict chasing a high … you never quite get high enough. This of course means I over eat, often by silly amounts.
Low carb or Carnivore certainly helps me keep more healthy but eating until your ill is not ideal … Perhaps I don’t make the right hormones!
Bit off topic but interesting to me.

(Mark Rhodes) #5

I am never satiated. I can eat high amounts of fat or high amounts of protein. I find I need to go through a month of eating higher carbs 50-100> to get my hunger. The first 4 years or so this was not the case, but sometime during the 5th year… I always thought it had something to do with fat cell turnover. Adipose tissue turns over at a rate of 10% annually which in theory means by the 5th year you are healthier in storage and accessing adipose than before. But I also have very little fat left. Some tummy tube. I also thought with the 12 hours a week I spend lifting weights, I just couldn’t keep that fueled with fat oxidation alone. My blood glucose was 99 this morning and BHB was 0.6. Definitely still in ketosis.

#6

I believe it’s quite complex. I do have okay hunger/satiation signs - if my diet and meals are right. Some people seem to get satiated easily just by “some food”, many of us need more than that. And keto isn’t always enough. Even carnivore isn’t always enough. I personally need to focus on leaner protein, avoid eating too early and everything falls into place. Small meals make me hungry too, some people are like that. I almost always need bigger, protein rich meals. But perfect satiation isn’t my goal right after a meal, I often stop and it will arrive later, I feel when it has a good chance.

So it’s just personal rules in some cases.
But we know there are people without hunger or who has very serious problems with reaching satiation so that is a thing too.
And I don’t know how anyone can get satiated by a little carby thing, I keep being baffled when reading about eating an apple when hungry… It’s everywhere. In some era in some countries it was a THING, telling kids to eat an apple from the tree when hungry, apparently. It probably didn’t work for everyone but it’s a small miracle in my eyes even if it worked sometimes… And people do eat a very plain (I mean mostly bread), small sandwich for lunch. I would STARVE so pitifully afterwards… But we are all different. My SO get satiated very well and super long by a very carby meal too but at least it’s big! Like 1kg oatmeal. Too low-cal and low-protein for me personally but I can understand it works for someone who find carbs satiating and need somewhat smaller meals.

Carbs mess with some of us, that’s quite a common thing, we know that on this forum but there are other factors and we should figure out what works for us.
And if one is unfortunate enough to have their satiation signals broken, hopefully they can eat according to a good plan. I am very glad I don’t have that, good feedback is precious and convenient.

(Central Florida Bob ) #7

I have a feeling that what’s going on bridges this podcast and another one, also from Metabolic Mind, on the different kinds of blood sugar spikers in a population. That one started showing up before Dr. Bikman’s.

The availability of data from larger segments of the population are showing more differences in the responses on their CGMs.

Spikers
Spikers.jpg1304Ă—876 254 KB

We see and talk about the differences in the way we respond to various carbs and combinations, and while it seems the majority can find some ways to eat that don’t ruin their health, and low carb or keto as broad statements are valuable, it’s really more involved. The graph shows how the different groups responded to all the same foods. They groups are named for the food that gave them the highest blood glucose. Note that the groups respond to other foods differently.

From the video:

In this episode of the Metabolic Mind podcast, Baszucki Group Neuroscience Program Officer Dr. Cristina Nigro joins Dr. Bret Scher to break down the study “Individual variations in glycemic responses to carbohydrates and underlying metabolic physiology.” This research used continuous glucose monitors (CGMs) to track how different individuals respond to carbohydrate-rich foods, and the results are eye-opening.

As they say, “Did you know that your blood sugar spikes differ from everyone else’s? Even with the same food!” I think Dr. Bikman would say, “Did you know that your GLP-1 responses differ from everyone else’s? Even with the same food!”

(Edith) #8

There was an interesting discussion between Dr. Layne Norton and Dr. Richard Johnson on the Metabolic Link.

According to Dr. Johnson, fructose is the main culprit of metabolic disfunction. In experiments where participants were given a fructose drink, the subjects at first decreased the intake of other food to account for the added calories from the drink, but within about two weeks, their hormones changed. For example, leptin output decreased so that the subjects had less satiety signals and they started eating more calories. (This may have been mouse study.)

He also gave an example of bears getting ready for hibernation. For most of their non-hibernating season they maintain their weight. Once they start eating fruit as they prepare for hibernation, their satiety signals get turned off and they start gorging themselves. They develop fatty liver and insulin resistance. But for them, because of hibernation, the insulin resistance and fatty liver goes away until the next cycle.

There was a lot of other compelling evidence he provided in the debate that fructose is the driver for metabolic disfunction. GLP-1 was not mentioned in the discussion, but if fructose messes with leptin levels, maybe it messes with GLP-1 output as well?

For my own musings, I wonder if the fact that we no longer eat seasonally and have fructose at our disposal year round via fruits and anything containing high fructose corn syrup, if we are constantly in a state of preparing for hibernation, aka winter.

There was much more to unpack in this episode then I mentioned here. Like I said, it was very interesting.