The Case for a Low-Carb Diet Is Stronger Than Ever

A new, major study supports the “Carbohydrate Insulin Model” of obesity

Dr. David Ludwig
Published in
9 min readNov 14, 2018


Illustration: PollyW/Getty

The Problem

Most people have trouble staying on a weight-loss program.
Of those who stay on a program, most don’t lose much weight.
Of those who do lose weight, most regain it in 1 or 2 years.

These observations, first made in the 1950s, remain true today.

It’s now time to question every assumption.

The conventional approach to obesity considers weight control as a matter of accounting — too many calories into the body, not enough calories out. The solution: count calories, eat less and move more. As long as you have a negative “energy balance,” you’ll eventually solve the problem.

Sounds simple. The problem is, calorie restriction is devilishly difficult for most people to sustain over the long term, because the body fights back when it’s deprived of calories. Decades of research shows that, as people lose weight, their hunger inevitably increases and their metabolism slows down.

The more weight you lose, the harder it is to burn off those extra calories, even as hunger and cravings for extra calories keep rising. This isn’t a matter of will power. In the battle between mind and metabolism, metabolism wins. According to nationally-representative data, fewer than 1 in 5 people with overweight or obesity have ever lost just 10% of their weight, for just 1 year.

We each have a sort of set-point, a weight that our body seems to want to remain — it’s lighter for some people, heavier for others, and determined in part by our genes. Some people can eat whatever they want and stay thin. Others seem to gain a few pounds by simply walking past a bakery. For both groups, attempts to either lose or gain significant amounts of weight run into biological resistance.

But if our biology controls body weight, why does the average person in the US weigh 25 or 30 pounds more today than 40 years ago? Our genes haven’t changed. What’s pushing our body weight set-point up, year after year? The conventional “energy balance” view of obesity offers no compelling explanation.



Dr. David Ludwig

Physician, Nutrition Researcher, and Public Health Advocate. #1 NY Times bestselling author ofALWAYS HUNGRY? and ALWAYS DELICIOUS