Dr. Anthony Chaffee welcomes Dr. Eric Westman, a professor at Duke University specializing in internal medicine and obesity medicine, to discuss the misconceptions surrounding diabetes and the impact of a low-carbohydrate diet on health. Dr. Westman shares his journey into ketogenic diets, which began when he observed remarkable weight loss in two of his patients using the Atkins diet. His research and clinical practice since the early 2000s have demonstrated that a well-structured low-carb diet can effectively reverse type 2 diabetes without medication. He emphasizes that many endocrinologists and diabetologists still rely on insulin and high-carb diets, despite overwhelming evidence that a ketogenic approach is superior.
Dr. Westman explains that ketogenic and carnivore diets improve numerous conditions beyond diabetes, including obesity, heartburn, irritable bowel syndrome, polycystic ovary syndrome (PCOS), arthritis, and more. He describes how traditional medical teachings often dismiss dietary interventions, focusing instead on pharmaceuticals. He highlights studies proving that restricting carbohydrates drastically improves glucose control, with some patients even able to discontinue insulin altogether. He shares an anecdote about a patient who was initially diagnosed with type 1 diabetes but, after adopting a strict ketogenic diet, regained insulin production—suggesting that some cases of early-stage type 1 diabetes might be reversible.
The discussion then shifts to weight loss medications and bariatric surgeries, which are increasingly popular but often prescribed without proper dietary guidance. Dr. Westman criticizes the overuse of GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy), noting that while they can be effective, they frequently cause side effects and do not teach patients sustainable eating habits. He warns about the muscle loss associated with rapid weight loss from these drugs and stresses that a well-formulated low-carb diet can achieve similar or better results without adverse effects. He also critiques the influence of pharmaceutical companies on medical education, stating that many doctors are now trained primarily to prescribe medications rather than address root causes through diet and lifestyle changes.
Addressing the common concern of elevated cholesterol levels on a ketogenic diet, Dr. Westman reassures that LDL cholesterol alone is not a valid predictor of heart disease. Instead, he advises focusing on triglyceride-to-HDL ratios and direct measurements of arterial health through coronary artery calcium (CAC) scans or carotid ultrasounds. He argues that statins are often overprescribed based on outdated cholesterol models and that a low-carb lifestyle generally improves metabolic health, reducing overall cardiovascular risk. He encourages patients to educate themselves and challenge outdated medical perspectives when discussing cholesterol with their doctors.
In conclusion, Dr. Westman and Dr. Chaffee discuss the broader implications of ketogenic diets in medicine, noting that the medical field is slowly recognizing the benefits of low-carb nutrition. They stress the need for more research and education to help shift mainstream medical practice away from pharmaceutical dependence and toward dietary interventions. Dr. Westman invites viewers to a free live seminar on February 10th about using low-carb diets to reverse type 2 diabetes, hoping to reach more people and challenge misconceptions about diabetes treatment. The episode ends with a call for more advocacy in the medical community to adopt evidence-based nutritional strategies.