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I've been looking into popular literature about weight loss, and, in particular, the talks, interviews, and books by Dr. Jason Fung and Peter Attia.

A lot of it is centred around the Carbohydrate-Insulin hypothesis. I then tried to find the sources that underpin all the talk, but it looks like even now in 2024 there are still no high-quality studies on humans with large groups of subjects and control groups that prove the hypothesis. A lot of what I can find are reviews of studies which themselves are not many and not large scale.

I found that Peter Attia's foundation, NuSI, collapsed before producing meaningful results and that the collapse was to a great extent caused by disagreements among the scientists conducting the studies. All very disappointing.

Am I right to think that most of the talk around the Carbohydrate-Insulin model remains unproven?

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    I can see several recent (good quality journal) reviews on this topic - please tell us what you have found from them?
    – bob1
    Commented May 11 at 0:54
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    According to this guy it goes beyond a lack of evidence. He says the hypothesis has been outright falsified by multiple studies. I'm not agreeing or disagreeing, just pointing out that there must be some studies out there you haven't found.
    – Carey Gregory ♦
    Commented May 11 at 16:35
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    I believe the correct answer to your question, "Am I right to think that there is no high-quality evidence to prove the Carbohydrate-Insulin hypothesis?", is maybe. However, you'll never find out by reading one source. You need to look for good studies, and that can be difficult to evaluate. This site doesn't ask you to solve your question, but we do ask that you show us an attempt to do so (as shown in the first comment) so we know what you know.
    – anongoodnurse
    Commented May 11 at 23:05
  • I suppose it depends on what you think constitutes "high-quality evidence". I also suspect that as with many complex systems the devil is in the detail and its more complicated than we think (perhaps the Carbohydrate-Insulin hypothesis is only true under certain conditions etc). That said there is some evidence: pubmed.ncbi.nlm.nih.gov/12761364 pubmed.ncbi.nlm.nih.gov/17341711 pubmed.ncbi.nlm.nih.gov/12761365
    – Slarty
    Commented May 14 at 16:15
  • Joke: "You want to lose your pounds easily? Go to London Stock exchange". But, seriously, what difference would it make on reality if there a articles on that subject or not?
    – Gyro Gearloose
    Commented May 18 at 18:33

2 Answers 2

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You're right. The Carbohydrate-Insulin Hypothesis (CIH) lacks strong, conclusive evidence.

  1. Mixed Evidence: Some studies support CIH, but many are small and short-term.
  2. Few Large RCTs: High-quality, large-scale trials specifically testing CIH are scarce.
  3. NuSI's Issues: The Nutrition Science Initiative (NuSI) didn't produce conclusive results due to internal conflicts.
  4. Scientific Consensus: Obesity is complex, influenced by many factors, not just carbs and insulin.

There's no solid proof that CIH is the main cause of obesity. Most evidence points to overall calorie intake and energy balance as key factors, with individual differences in how people respond to diets.

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  • Calorie balance tells us how someone fattens but nothing about why. Everyone knows that energy is conserved. The same is true of mass, if we measured the total mass intake and expenditure of a fattening person we could conclude that the fattening person was suffered from excess mass intake. But that's not the real question any more than excess calories are.
    – Slarty
    Commented Jun 17 at 22:06
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I suppose it depends on what you think constitutes "high-quality evidence". I also suspect that as with many complex systems the devil is in the detail and its more complicated than we think (perhaps the Carbohydrate-Insulin hypothesis is only true under certain conditions etc).That said there is some evidence:

pubmed.ncbi.nlm.nih.gov/12761364

pubmed.ncbi.nlm.nih.gov/17341711

pubmed.ncbi.nlm.nih.gov/12761365

There may also be counter evidence, which is really evidence of the idea that the devil is in the detail. "We" still do not fully understand these issues.

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  • Thanks for sharing those studies! While CIH may hold in specific cases, evidence is mixed. Large-scale RCTs are still lacking. Experts generally view obesity as multifactorial, with calorie balance and individual differences playing key roles. NuSI's inconclusive results underscore this complexity.
    – lu1s
    Commented Jun 14 at 21:13
  • It certainly is very complex with many moving parts. Calorie balance obviously has a major effect, but tells us nothing about why people fatten. It is exactly the same as mass balance, we know that both energy and mass are conserved. Asking why a person got fat and being told it is because they ate more calories than they expended is exactly analogous to asking why lots of people are gathering in a village hall and being told that it's because more people entered the hall than left it.
    – Slarty
    Commented Jun 17 at 21:58

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