#1 Way To Lose Weight & Fix Disease [EAT THIS] Dr. Westman

I have a patient who only ate at McDonald's and he 

lost a 100 pounds just eating at McDonald's. Wait, what did he eat at McDonald's? Double 

cheeseburgers, no bellon, no fries, and no sugar in the drinks. This is all I do. I 

help people lose weight, and I've helped people lose hundreds of pounds on diet change alone. Dr. 

Eric Westman is a pioneer in obesity medicine who has helped thousands lose weight naturally. He 

returns to expose the truth about healthy foods and breaks down the biggest myths surrounding diet 

and long-term health. Nutrition really is the key. By changing the food, I can take someone off 12 

medicines. Heartburn goes away. The irritable bowel syndrome goes away. If you put people onto a 

research board and just feed them as much as they want of low carb foods, they all lose weight and 

they all have diabetes reversal. You don't have to count calories. So, do you need fiber for a good 

microbiome? No. And if anything, the carnivore keto calms the gut microbiome. I can find papers 

that show by giving more fiber, it made things worse. I'll say, "Look, do you want this to work 

the first time every time 100% then stay under 20 total grams of carbs per day?" Well, this is 

like the cheapest weight loss approach ever. Dr. Westman, you're a doctor that specializes in 

obesity medicine. That means that you have helped over 60,000 people lose weight and keep it off. 

So, you know what works, but you also know what doesn't work. So, my first question for you, how 

many people do you think fail at losing weight? Oh, well, uh, depends what they try, right? 

depends who coaches them or or depends what resources they use. In a clinic like mine, this 

is all I do. I help people lose weight. So, my effectiveness has to be pretty good or or I don't 

have a job. So, in a uh clinical practice, um a lot of people come to me knowing they want to lose 

weight and they've tried lots of different things. Some people end up in my office, the other doctor 

sent them and they have no idea why they're there. So the motivation I think is a good uh beginning 

place so that people who are highly motivated and they get a proper instruction whether it be diet, 

pills, shots, surgeries, they'll do 100% they can do it. They won't fail. So, out of all those that 

you just said, diets, pills, injections, what do you think is the most effective for somebody to do 

to actually lose weight? Well, there in a clinic like mine, so I I work at Duke University 

in Durham, North Carolina. I've been here for 35 years. The most effective thing we think is 

matched to the individual. So if someone has tried all of the diets on earth, I still say you haven't 

tried the diet with me. So So there there's a bit of an art to teaching people what's available and 

then matching people to what you think is best, but then following them up to make sure that there 

isn't some mistake or or misstep. Uh, I once had someone in my clinic, I've been doing this for 

over 20 years, who didn't really understand that there was sugar in sweet tea, which is so common 

in the US, in the south. If you ask someone that they drink tea, it means sweet tea, means a ton 

of sugar in it. So, in teaching this individual, it didn't click or make sense to her that sweet 

tea had sugar in it because she actually came back and it wasn't losing weight. And and I said, 

"Well, you can't have sweet tea." And she said, "You never said I couldn't have sweet tea." 

I said, "Well, you couldn't have sugar in the drinks." So, this is one reason why the followup 

with any program, again, diet is what I start with. That's what we did our research on. and and 

uh but sometimes I use pills and injections or shots. Uh some people come to me already having 

had weight loss surgery. So in a practice where people sit in front of, you know, sit next to me 

and and they come back if it's working or not, you have to have flexibility in what you do. And 

and that's sort of my perspective where where I come from. Absolutely. So, in your clinic, 

if somebody's coming to you, how many of your patients do you think have lost weight? How much 

weight, I should rephrase this, how much weight could somebody lose if they follow your method, 

the natural way, using diet? Pretty much any successful program where people will either 

come back based on insurance payments, which is the system I'm in, or they come back and pay 

out of pocket. You have to have results and the results have to be fairly quick otherwise people 

won't come back. So a good weight loss program and what I see even with diet instruction alone gives 

about one to two pounds of weight loss per week. And so that's four to eight per month. That's 

50 to 100 pounds of weight loss per year. 1 to two pounds per week multiplied out for the year. 

And I've helped people lose hundreds of pounds on diet change alone. Now, if you add in pills and 

injections or shots or even weight loss surgery, it can be so fast that you start getting into 

the muscle mass loss, the the you know, the worry about the the cyclopenia and all of that. So, we 

we teach people all the different possibilities of how to do it. And most people will at least try a 

diet change like the keto or carnivore diet that I teach because they don't most people don't want 

the side effects of of the shots and the pills. And most people don't want the permanent change 

of their intestines of the stomach mainly. But uh so 1 to two pounds per week is a a healthy rate 

of weight loss and that's what I typically see. But you know I guess my main message is diet 

is so important and being a doctor who talks about diet. You think think for a moment has your 

doctor asked you about your diet? You know what do you really eat? And so when a a resident physician 

comes in and I I train them, you know, have a half day generally, I'll say, "Look, just give people a 

sheet of paper. It says breakfast, lunch, dinner. Have them fill it in before you go into the room. 

How much time did that take to assess their their dietary intake?" You know, a millisecond. So um 

I think uh being in the university setting with trainees and and you know I'm trying to educate 

and that's a whole another fortress that needs to be climbed to change medical education. Although 

many of the skeptics or or realists say that that's just it's too entrenched in medication 

care for for doctors and you'll always want to be outside that. I'm not I'm not convinced. I I 

think there's still a role for teaching nutrition in medical schools and in osteopathic schools and 

and even teaching the the nutrition organizations about this because nutrition really is the key. So 

I I by changing the food I can take someone off 12 medicines. It might take a year in deprescribing 

it. the medicines for diabetes that they told they would have forever, the medicines for high 

blood pressure, the medicines for arthritis, the medicines for heartburn and irritable 

bowel syndrome and and you know the number goes on and on and uh so that that's the exciting 

frontier for me is pushing this knowledge into the medical realm. Uh and yet when you asked what am 

I really excited about, it's the new researchers coming to this without any baggage. So they 

didn't grow up, you know, being forced. No, I love Captain Crunch and Froot Loops, you know, 

it's addictive, right? But they didn't grow up with that. And so the new scientists, they're even 

changing the language about what what's going on. And I so I look to the these many of them eat a 

carnivore type of diet. Uh but uh the new science I and new scientists coming at this just they're 

super smart there. uh remember my background is I went to other doctors who had figured it out and I 

just published papers on it and uh and kind of as a a place I I'm saying well you know I need to 

prove to add add something to what I teach and then I'll start saying what I teach can be helped 

by you know adding oils or or you know creatine or something I I don't push all that stuff 

changing the diet is so important and so effective for reversing things. Now the question is maybe 

it's the healthiest diet ever and that's what the new scientists are studying. It's it's um so I'm 

really excited looking forward to getting back to the research world if I can. But I'm watching now 

with eyes wide open uh new science that says being in ketosis. Oh wait, ketosis means the abnormal 

condition of the new term u ketomia meaning eu normal keto ketones in the blood. Uetmia means 

it's normal to have ketones in the blood. And we're seeing that now in the medical literature 

as a new term to get away from ketosis. Osis mean like hattosis means abnormal condition of you know 

ketoacidosis. Yeah. So I think having a new term is so it's brilliant and and well you know we've 

chatted about it in the informally for a long time to have it now in a publication peer-reviewed 

publication that is now looking at people who are already in Q ketomia for years meaning maybe it's 

normal maybe it's even better to be in ketosis th this is this is pioneering and to me mindblowing 

research that's going on right now and it's great. I think I want to touch more about you ketomia. So 

this long-term being in long-term ketosis. There's so many questions around that especially when 

people do carnival keto and they feel like if I never touch a carb, is that okay? I want to first 

talk about the never fail approach to weight loss and then we can get back to that one so that 

people can have the steps do this, do this, do this to lose weight to get your results. So the 

first step would obviously be the carbohydrates. So do carbohydrates stop weight loss? They can. 

So here's the the nuance is not in everyone. And so but if you want to take that risk, uh so the 

never fail approach, if you want it to work 100% of the time, yeah, just don't have carbs, don't 

have carbohydrates. That's going to be your best never fail approach. However, some people can 

have based on their metabolic background can have some carbohydrates and maintain weight or 

even even lose weight. You know, now the balance, remember the rice diet, the and the ultra low carb 

Atkins diet. Um, or you might call Atkins Ornish, if you want to put names, the people, you know, 

that diets often become larger than life because they get wrapped up in somebody, a person, you 

know, a promoter. um that um the ultra low fat diet somehow you have had you have to keep the 

calories in check the amount you eat in check and a lot of people well the people who end up 

in my clinic are the ones who can't do that so there are some people who they and they there 

they mercilessly have no empathy for those who can't control it right they just say ah just eat 

less you know what's the matter with you you have no willpower and all. No, it's a different 

hormonal system. And and so for those people who can't moderate the carbs, just cut them 

out. Like that study in 2005, Gunter Bowden, Annals of Internal Medicine, you put everyone on a 

research ward where they only have foods that have no carbs. They all well within the 25 30 people in 

the study. So I guess all of humanity there might be some people for whom it doesn't work. But they 

didn't select out, self- select people who were going to have great results. But yeah, keep the 

carbs really low. And yet there are some people who still overconume for the weight loss side 

of things when they don't eat carbs, which is another sort of fascinating subset of people. And 

which hormone it is, I don't think we know yet. Is it the the ghrelin leptin kind of insulin 

kind of the classic ones? Is it the GIP GLP1? Is it one of the incretins? And but if you do low 

carb, keto, carnivore and and all of these things are working together and you're not hungry, most 

people it's a no fail weight loss approach. Yeah. Even diabetes reversal approach. So do you like 

to think of total carbs or net carbs and what's the difference? Yeah. So total carbs always unless 

you can tolerate carbs and then net carbs becomes useful for those who don't need metabolically to 

restrict to the a keto level. So in fact I've been on an author on different books through the years. 

You can kind of see as we've published the the thinking um I've gone from one extreme now to kind 

of a one you know three different levels of carbs in in my latest book. Net carbs is a problem when 

you're trying to reverse diabetes or lose weight and you and you a lot of weight to lose. Don't 

use net carbs if you're trying to lose weight or reverse diabetes. Use total carbs. The reason 

for that is net carbs just means more carbs. So you're deducting the fibers, sugar, alcohols. The 

theory is the the theory is that these don't raise the blood sugar. They don't get absorbed. But in 

the practical reality, it means more carbs and some people do absorb fiber carbs. Of course, you 

can check on a continuous glucose monitor to see if you have that sort of increase or or just don't 

have them. And that's my approach is I I don't ask people to monitor this. Most of my patients don't 

want to do that or they don't have the money, the resource, the the the the mind to figure out 

the biohacking side of things. So I always use total carbs in my clinic and in our latest in my 

latest book and your carb confusion, I stressed using total carbs, not net. And that may be the 

only change someone needs to make for it to work. Some people come to this, they don't really need 

metabolically the keto level of carb restriction. Net carbs can work. I think of it as kind of like 

over-the-counter medicine. If you have a pain, you go get a medicine from the drugstore, pharmacy, it 

can help. But if you want prescription strength, pain relief from a doctor, that's the total carbs. 

The it's stronger. So I call it prescript So I call it prescription strength keto or prescription 

strength low carb. If you use total carbs and you stay under 20 to 30 per day and I say 20 to 

30, I was taught 20 and I and I have kind of the strictest approach in terms of grams of carbs 

per day. The Verta Health company chose 30 grams for their their approach. Of course, they have uh 

ketone monitoring sent out and they have Bluetooth scales and they they have a doctor in the app to 

help you. I don't use any of that high-te stuff. So, maybe the 30 works with all of that or 30 

total per day might work for you. Uh again, the your language is the no fail diet. I I'll 

say, "Look, do you want this to work the first time every time 100%." Well, yeah, of course. Then 

stay under 20 total grams of carbs per day. Don't deduct the fiber or the sugar alcohols. Now, as 

Dr. Westman mentions, the easy way to lose weight is to simply drop the carbohydrates. And for many, 

it can be simply going low carb. And for others, it can be keto or carnivore. And the main thing 

you want to do is to simply drop your insulin levels. Now, as you do this, dropping your 

carbs, you might experience some side effects like headache, nausea, and fatigue. Now, all this 

is very normal, especially at the beginning. So, a really easy way to fix this is to do the salt 

trick. Simply add some high quality salt to your meals and also add it to your water. But if 

you still feel those symptoms, you might want to get a high quality electrolyte, one that 

has sodium, potassium, and magnesium because this is so important for your brain and how your 

brain functions and also your body. And that's why I'm so excited to have Element as a sponsor of 

today's episode. Now, I like to use a high quality supplement like Element because it has scienceback 

mix of sodium, potassium, and magnesium without anything artificial and no preservatives. And I 

personally like to use the raw unflavored option. It's a teal color and it has a real nice salty 

taste. I use that every morning in my coffee and I also put it in my water. And right now 

Elmer is offering this free sample pack on every order. So you're going to get eight single 

servings of element to try for free. So if you want this just head to drinkelement.com/theprimal 

podcast. So what do you think is the worst food healthy food that people are putting in their 

weight loss regime that you think just stalls the weight loss? Think of it in general terms 

and then in the kind of low carb keto world, right? So I it seems to me in my area the there's 

confusion and the thought that fruit is healthy and you have to have fruit every day and and and 

it tastes so good and you have juice and all this. So in in any type of diet, I think fruit is the 

the thing that the sugar in the fruit is still in there even when someone's trying to lose weight 

on a healthy program. The rice diet years ago was a limited amount of rice, fruit, and fish. So 

the calorically limited. So if someone's just trying to lose weight and they're still having 

fruit, that makes it very difficult or or or drinking fruit, you know. Um, now in the low carb 

keto world, they probably should have gotten that message early on and but yet a lot of programs 

teach berries. And to me, berries are just little fruits. And so on a keto kind of program, you 

might have gotten the message that, yeah, I can't have a banana, but I'm still having blueberries. 

And to me, it's total carbs, whether it's bananas or blueberries or so. That's kind of the uh it's 

those it's that darn fruit that's so tasty too, you know. Well, so I go to fruit flavored things 

as a substitute. And that's again that meeting people where they are. Uh if you say, "Oh, no, 

you can't ever have a beer or a glass of wine," a lot of people will gravitate away. If you say you 

can't have any fruit, well, they're little pieces of fruit that are added to yogurt servings in some 

stores and and those because it's total carbs, not forbidden, you know, there. So, you have to 

just limit the amount of it. But I would I would say still in the general world and even in the 

keto context, it's fruit and berries or is it nuts? So I'm going to add in most commonly people 

well so I I had the ability of being in my clinic watching people treating them but then I also 

went around the country in the US for a year where I had mornings with people who would get 

together and talk about low carb. This is precoid era co times. So, I'd have several hundred 

people in the in the same room and I would ask, "How many of you have trouble with nuts?" Like, 

at first you couldn't stop eating them and hands would go up. I would say 50% of people who were 

interested. These are motivated people. They came out on a Saturday morning, often in the middle 

of the winter to come talk to us about diets, you know, and and I brought in experts from their 

particular area. uh one of the um memorable ones what we were in Tennessee and uh now the popular 

Ken Barry was there at our it was we called it an adapt conference but um that's where I I first 

met him and so but nuts are a problem too. So, let's say you're watching this, you're having 

trouble. So and so on and internet keto says you can have some berries, you can have some nuts 

and you can have net carbs. You might just try shifting down count total carbs and then no nuts 

at first, no berries at first and that might be what you need to get things rolling, get things 

moving. Do you know that is so true? Do you know I have a carnival keto group and then they'll say 

that they're carnivore but I say exactly what are you eating? Oh, sometimes I have some nuts and 

some fruits because every now and then, but you'll be surprised. And also dairy, which we'll 

get to how many times it stalls the weight loss and I just say take that out. Eat the fatty meat 

and it's so surprising every time the weight just comes off. Um, so that's the carbohydrates. I also 

want to ask, do you think you need to eat fiber to lose weight? No, there's no evidence. So, do you 

need fiber for a good microbiome? No. Oh, what is a good microbiome? So, this is a fascinating area 

because what doctors test? Carb eaters. Oh, right. Yeah, they're all carb. And and the microbiome 

that people say is the good one is from people who eat carbs. And so, if you want to replicate the 

microbiome of someone who eats carbs, then yeah, you got to eat fiber because they're eating fiber 

and that changes your microbiome. This I've been thinking about this for a long time, you know, 

over 20 years where the first people I put on a low carb diet had an elevated blood ketone level. 

We called it ketosis. And 20 years later now, it's been called u ketonemia in in a research paper by 

Isabella Cooper in in London. So if you look at the microbiome of carb eaters, I mean it's like a 

jungle and I saw a world expert talk about a world expert of the microbiome show a slide of and it 

was the Amazon rainforest and he said, you know, this is the beautiful microbiome of a normal 

human. Well, car beater human. My my quotes, you know, he didn't say it. And then click, 

he showed a slide of a desert and and said, "And this is the barren microbiome of someone who 

doesn't eat carbs." And I'm thinking, you know, I'm really not a skeptic and and you I'm not an 

early adopter. I just want some data other than um what seems right or seems appropriate for the 

time. So I'm looking at the Amazon rainforest. There are things that can kill you there. I mean, 

they're, you know, snakes and and, you know, piranhas, things like that. And then I look at the 

desert and that's that's so calm that that I mean, that's where I go where resorts are and 

you chill out and you de-stress. So yeah, you can change your gut microbiome by changing 

the food and and if anything, the carnivore keto calms the gut microbiome and turns it into this 

resort type of of of desert where it's serene and I mean that seeing people every day in the clinic 

100% almost you know so maybe 95% of people will have a reduction in anything that's giving them 

trouble in their gut. So, heartburn goes away. Uh the gurgles that that you know and even pain 

that some doctors are treating with pills called the irritable bowel syndrome goes away. And 

so, you don't need fiber to have a healthy microbiome. But it's a different microbiome. and 

and until studies until you can pause and do some studies to go forward and say look these people 

had a totally different gut microbiome and they did fine or or they did even better. That's that's 

what I certainly gonna have fewer symptoms in the GI tract u if you change the um change the food. 

In fact, I can find papers that show by giving more fiber, it made things worse, and by taking 

away fiber, people had better bowel movements, better regularity. It's the exact opposite of the 

companies that are pushing fiber now. And and it's not just the fiber makers. It's it's foods that 

have fiber in it that's being used as a well, you got to have fruit for your fiber. And you 

know, no. No, I don't think you do. And and yet, do I have randomized trials of this microbiome 

versus that microbiome? No. No, I don't. Would I want to study that? Sure. And and we're just 

getting to the point where the powers that be are kind of curious about, well, maybe we don't 

just squaltch this low carb keto thing that now is in our national dietary guideline. Maybe we 

should study it. And that's I hope that's what happens. So, I mean, right now, you can send your 

microbiome off for analysis. I have patients who who send their genetics off the the companies that 

do their genes and and u and the expert opinion of what to do based on those things is going to be 

the old paradigm of you know you need to eat more fiber to get that microbiome of the quote normal 

carb eatating person well who's also on pills for heartburn and irritable ball syndrome. So that's 

the the irony of it all is that the normal range of what people have is not necessarily the optimal 

range. There is a reason why I asked that because if someone wants to do the never fail approach, 

take away the carbohydrates or even just do 20 grams, somebody might think, well, I need fiber. 

And that's why I just want people to understand that you don't really need that fiber for good gut 

health, weight loss, and just a health overall. So let's move on to what to eat. So if you were 

to give somebody a list of foods, eat every day as much as you want. What would be those foods? Well, 

so the approach I use in the clinic, you know, almost 100%. But and that's what people want and 

let's say they they're willing to try a dietary approach. The only diet really scientifically 

that can work without calorie restriction, without like explicit use an app and all this is 

the keto carnivore diet. And so I'll explain I mean do you want a system that's simple that cuts 

the hunger out in a day that that has been studied like a drug and you know most of people will say 

sure that and then I'll say you know can I make it easy for you? Yeah that that'd be fun. So, I teach 

people the keto 20 gram or less for the day by leading with protein. You can have all the meat, 

poultry, fish, and shellfish, and eggs that you want until you're comfortably full. And and you 

don't have to eat three meals a day. And and so, you know, I have a handout and then I have a 

video of me going over the handout that goes into the details of, well, but I thought I had to eat 

three meals a day. you know, breakfast is the most important. No, no. So, in the video, I go over 

some of the kind of common things that people come to with. But so, when you just eat protein, you 

don't turn off your body's fat burning. In fact, it it it elicits fat burning from within. So, uh 

remember, if you don't eat anything for a day or two, you start burning your body fat. We we store 

energy on our bodies as fat. And so when you take the carbohydrates away and just eat protein, your 

body fat starts to burn automatically. And that's why this is known as a weight loss approach. But 

it's really just a fat burning approach because it can fix so many other things. But I used that in 

my clinic once. It's not a weight loss approach. It's a fat burning approach. And one of the people 

said, "Well, I'm leaving then because I want to lose weight." And you know, no, that wasn't my 

point. So I mean this is also the tough part about teaching through the internet and and learning uh 

about the individual and the nuance you know the woman who drank sweet tea not knowing sugar was 

in it. So the followup for all these things but um meat, poultry, fish and shellfish and eggs gives 

you what you're made of which is you're made of protein. And then you have to understand that you 

can run your body energy-wise with sugar, carbs or fat. And so what we really need to do is take away 

the the fear of burning fat and eating fat and and uh it's just a fuel and it's your choice. and 

and and if you don't eat carbs, the sugars and starches, your body knows to look around and 

start burning its own fat. You don't even have to tell it. And that's where the hunger goes down 

automatically. So, I never tell people to eat less. I tell eat till you're comfortably full. 

And yet, just about everyone eats less because they start automatically burning their fat from 

within. And it it's brilliant. It's actually Gary Tabs has uh tried to teach people this through 

the years and and the there's so much confusion about no you don't have to tell people on a low 

carb keto carnivore diet to eat less. It happens automatically because they start burning fat and 

then because that fat burning cuts the hunger out. You eat less or or you might say you you normalize 

the dietary intake. So, it starts with fat burning and the eating less. And I know I have some people 

who even in the first visit, well, I don't have to count anything. Well, you need to count the the 

dairy, the food, the the vegetables on my list. That's not just the proteins that I teach, but you 

don't have to count calories. You don't you don't have to use an app. And so some people think 

keto means using an app and and taking certain supplements, things like that, watching macros. 

No, it doesn't have to be that complicated. And so even carnivore has a simplicity to it that some 

people like. You know, I don't have to worry about what to eat. I defrost the meat the night before, 

eat it the next day. That's pretty easy. So, so if you have plenty of other things to do with 

your life and you want to, you know, eat great meat every day, some people find that liberating 

rather than restricting. But so going on my list, the sheet, the sheet that actually Dr. Atkins came 

up with through his 30 years and we just studied it, published papers on it, there's a little bit 

of vegetables, uh, two cups of leafy greens, and I explained that a cup was roughly the size of your 

fist. you can go home and compare. So, you don't have to walk around with a measuring cup. You just 

measure your fists. Um, two cups of leafy greens, one cup of a non-starchy vegetable, asparagus, 

broccoli, cauliflower, it's on that list. And then a limited amount of dairy. And this is kind 

of the interesting I don't quite know. Remember, I I inherited this list without knowing how great 

it was and did studies on it. But cream, cheese, oils. So cheese is in this box where there's a 

limit. It's separate from the unlimited uh meat, poultry, fish, and shellfish and eggs. 

And often that's what trips people up. Oh, they say you can have all the cheese you want 

and not if you're trying to lose weight, reverse diabetes. So So there's a special box here. Even 

cream and half and half can be over consumed. Uh, if you're trying to lose weight off your body, 

you want to minimize the fat. I don't recommend, you know, pounding a half a stick of butter. 

Uh, fat when you're trying to lose fat off your body. It might work when you're at your goal and 

you're using that as your energy source, you know, but until you get there, I think limiting the 

dairy for for me is a matter of limiting the energy in there. Are some people sensitive to 

dairy? Yeah, I think so. But to me, that's a kind it's not an allergy issue. To me, it's more 

of a energy uh quantity issue when it comes to dairy. But so when people say I I was doing keto 

and then I got rid of the dairy and it started working, I don't automatically think um allergy 

sensitivity. I think caloric restriction happened and maybe that's why it started working. But a lot 

of this is uh testable. Imagine if we could take uh in research uh paradigms with careful control 

adding dairy for some people and not and and seeing uh in the meantime we go by trial and error 

of what happens in that individual. And so if you're watching this, you might you might not have 

to do all of these restrictions or or you might have to. It's really until we get a blood test or 

a better sense of how to predict or or recommend. It's really trial and error for these changes. 

Perfect. Well, that was a very easy list of people of what to eat. So fatty meat, seafood, eggs. Um 

be careful of the dairy and that's limited. So I think in the Atkins it's like 3 or 4 ounces a day 

of dairy of like cheese which you should measure that. So for people in Australia it's like 100 

grams or so. So it's not that much. And then also heavy cream you can have but only a little bit. 

It should be measured. And then if you can't lose weight take that out and I'm sure people are going 

to lose weight. And then also I want to mention that avocado is in there. I think it's half an 

avocado that you can have. That's the quantity per day. So it's really easy. If everyone did 

this, they'd like lose hundreds of pounds without calorie wi without counting calories. Point 

number three is, do you have to do fasting? Many people say that I want to do like OMAD or prolong 

fasting. Is that necessary for weight loss? No, it's not necessary, but it it can be used or 

consistent. Uh, so the method I was taught, remember, it predates internet keto. It predates 

paleo primal the clean eating kinds of treatments or approaches. Um the approach I was taught that 

you should eat when you feel the urge. I mean and then understanding that a gurgly stomach is not 

really hunger. So you eat when you're hungry. Some people might eat multiple times a day and 

still lose weight and reverse diabetes, fix the metabolic problem. Some people gravitate naturally 

toward a one or two meal a day approach and call it fasting. So I I think this is uh open for 

research in terms of again how to recommend it, how to utilize it best. the researchers funded by 

the the governmental agencies, they are studying intermittent fasting and carb eating at the same 

time and they don't get very good results. So, in the context of a low carb keto diet, if you're not 

hungry and you eat one meal a day, call it OMAD, call it intermittent fasting, you know, it's 

all the rage, but if you ask someone to fast and it's not comfortable for them, they're they're 

hungry and they're kind of white knuckling through the day. I don't think that's the right approach. 

Again, matching people to what works for them. Um, yes, there is some really interesting research on 

the early preclinical research, I would call it, on fasting and autophagy and mphagy. The idea that 

your body cleans house when you're not eating, you know, for 12 hours. But, you know, what that 

ignores in the um kind of physiological world is that you're absorbing food even during that 

time. you're just absorbing it further down the intestinal tract. So, you're really not 

stopping all inputs to your So, if you f you eat one meal a day, you're you're not putting food 

in your mouth all day long, but your body is still absorbing food from your intestines. So, it's 

not like it t it allows your body to just start cleaning house because there nothing coming in the 

intestinal tract. So that that's kind of a a flaw a fly in the ointment of the oh you must fast and 

all this you know total fasting for three days a week a month is used by some practitioners within 

the medical setting within the medical world but I wouldn't do that on your own without the medical 

monitoring especially if you're on medications even even doing keto or carnivore and you're on 

all sorts of diabetes blood pressure medicine. You need to do this with monitoring on your own 

if you're a health professional or with a doctor or or a practitioner who understands this because 

this is medically significant sort of change that we see which is it's great for a doctor but 

it can be kind of overwhelming and too strong uh for for other people. Um but uh fasting is not 

necessary. Uh, does it add incremental benefit to a keto carnivore diet? Maybe. Uh, I would like to. 

So, the problem we have is the measures of, well, you're going to live longer. Well, okay, we're 

going to have to do a long study to prove that, right? But I would love to do that study. Let's 

sort people into different groups and start over the next 10, 20, 30, 40 years. See who lives 

longest. Um now in the animal models uh the you know rats in one study live longer if they didn't 

eat carbs uh 10% or something and and you know but that's not good enough. I don't so I don't rely 

on that information to to teach my patients at a clinical level. I find it interesting and and 

it's great that it's being done but we need human studies with good biomarkers or or even outcome. 

uh uh you know the atherosclerosis the coronary calcium score is a um I think people think of 

that as an aging phenomenon and so you could use a follow people with um very interesting measures 

that won't take 50 years you know this cohort well I was born in 1960 don't don't think I'll live 

another 50 years but you could take people at various stages and ran randomize them and see. Uh 

it it actually doesn't take all that many people to do the research as some people say because the 

effects are so big in in this dietary change. We we did a study in type two diabetes and we only 

have 50 people and it showed differences between the diets over six months. So uh that would be 

fascinating to see comparing fasting with with or you know so low carb, keto, carnivore with 

or without fasting and compare people ideally randomize people. Um I you know I I watch people 

do their own studies the end of one you know I did this for a week and and then another week and 

it's interesting it but I don't think tells you what we want to know for the long long term. Now 

as Dr. Westman mentions carbohydrate is the main thing to focus on if you want to lose weight. 

But if you also want to focus on your health, including fixing disease like insulin resistance 

and diabetes, we also need to have a look at our environment. Go have a look at your soap, 

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checkout. There's also a link in the description. Well, I think it's good that people can do 

this entry level and not think about fasting, but think about when they're hungry. It's 

very good. So, let's get back to that new science of you ketoonomia. So, long-term ketosis, 

because you know why this this answers a question of people ask if I never eat carbohydrates, am 

I going to get into this? I think it's called, is it pathological insulin resistance or is it 

physiological insulin resistance? Which one is it? where your body goes into an insulin resistant 

state because you haven't eaten carbohydrates. So does that answer it? Like is there such a thing? 

Right. So there is no essential carbohydrate meaning you have to eat the food because we don't 

make it. There are essential amino acids meaning we we don't make these amino acids for for 

our protein uh our body structure. And then there are essential fatty acids where yeah, you 

you do really have to eat fat. Not a whole lot, but if you don't, you get a syndrome of essential 

fatty acid deficiency. If you don't have protein, you get protein deficiency, amino acid deficiency. 

And then if you have calorie restriction so bad that you get calorie malnutrition. I'm confident 

to say that if you have proteins and fats in in a relatively healthy way, you don't ever need to eat 

carbohydrate. And carbohydrate doesn't Another way to say it, carbohydrate doesn't carry anything or 

convey anything that's not in the other foods. You can just look at other animals that only eat 

other animals and they're not having bananas and and orange juice and all that. So have no 

fear that you you can't live and thrive without carbohydrates. So that includes fiber. Fiber 

is not an essential nutrient. That said, is it better? Is it optimal? Well, I don't know. In in 

the long term, those studies aren't done. But it's not like we're saying go uh go do this forever 

and we'll never never look. You know, you can in a doctor's office, we measure things. So, we we 

are monitoring along the way and to see if things are changing in a favorable way or not. Uh so, 

you don't really ever have to eat carbohydrates that supports the variant of carnivore, which 

I see as a variant of a low carb keto diet. Whether you're in ketosis, excuse me, whether your 

ketone level is up to a level called u ketomia, meaning it's healthy, it's normal to be there. Uh 

that is science that's emerging. A lot of people with their own information. Would love to see 

one day one of these ketone monitor companies just data dump, you know, what levels are people 

in their blood and urine and breath. All of these are available now. That said, I I don't sign off 

saying it's better to be in ketosis because I don't think we have that long-term information, 

but there are certainly a lot of people who are adopting this. It's a grassroots change. And if we 

could assemble that information and include, you know, biologic measures, I think that would be be 

great. Uh so I don't fear or I'm not worried about people being in ketosis only. I mean, the one 

time I do is if they're taking a medication that might make things worse. And so, if you're taking 

medicines, just be sure that someone trained can scan them. the one that makes you urinate sugar 

uh uh called the SGLT2 inhibitors, not the GLP1s, not the weight loss shots, but the these 

medicines are being used for heart failure. And uh they can cause ketoactosis, not ukidonmia, not 

ketosis, but actually keto acidosis. And you can uh it can be lethal or life-threatening if you're 

on a medicine and doing a keto diet together. In fact, these medicines can cause keto acidosis even 

when you're eating carbs. They're that strong. So, uh often I I'm fighting the the really strong 

medicines that doctors are prescribing today or or or not fighting but explaining that that's not the 

only way to go about things. And here's uh another way. I don't personally measure my ketones, which 

might surprise you. Um I do informal. In fact, someone came into me once and said, "You're doing 

lazy dirty keto as a as what I teach." And I said, "What's that?" and and so I'm teaching, you 

know, kind of an a flexible approach and all this without you don't have to get grass-fed beef 

and and all the and and I was looked down upon by someone who came in thinking that, you know, the 

only door into this area was through the super clean eating and and you know, you have to change 

the world's food environment with every dollar that you spend. Well, you can do it that way, 

but but if you're meeting people where they are, I I have a patient who only ate at McDonald's, you 

know, or any you say any fast food establishment and in our area. And he, you know, had no money 

to buy fancy things. And he lost a 100 pounds just eating at McDonald's. And wait, what did he 

eat at McDonald's? The burgers, the burger patties with the cheese. So, double cheeseburgers, no 

bun, no fries, and no sugar in the drinks. Well, this is like the cheapest weight loss approach 

ever. Well, it doesn't have to be expensive, does it? Now, I would love to study that. Compare 

before making a proclamation that everyone should do this. Compare it to a, you know, what 

you would think is the cleanest, fanciest, expensive keto approach. study these two together 

and see if there's any clinically meaningful or clinically relevant difference. So in his case, 

the the benefit he got from the fat loss off his body was enormous. You know, did he have some 

other minor little thing because it wasn't the best food on earth? Well, you know, compare that 

to other people in my clinic who don't make any change at all and they're still eating carbs. 

So often I have to choose the the something that will work and and and relax the super clean 

eating expensive food thing because that's just the the the world I'm in. It's insurance pay. I 

have people on Medicaid or even I get referrals from a clinic where they're basically too poor to 

get Medicaid. Medicaid actually you have to apply and and it takes a year in our area at least it 

used to to get it. So, if you're uh trying to do the best food on earth, great. You know, try 

the uh what uh the there some books that came out that were just kind of like, can you really 

do this very long in in my mind, you know, and um then having that person say, you're teaching 

lazy, dirty keto, like it was something bad. Well, some people in their minds think, "Well, if 

I'm not eating this, I might as well just have the hamburger with the bun, right? If it's not super 

clean." And no, no. So, when you're out and about, you you can just eat the burger patty. Even at 

airports, at uh traveling in gas stations, you you get the and this might really surprise especially 

doctors if they're watching is I recommend pork rinds for people or chichon chichones. It 

it well and to a carnivore it makes sense, right? But to someone who, you know, is taught 

that pork is bad and and uh and that oh my god, you're eating the skin of the pig. uh um they 

have no carbs and so they are like a placeholder instead of a cracker or that's kind of one of 

my secrets that I actually recommend that people will eat pork rind or chicken rind. You can 

get those in a bag. Uh now I don't personally eat them. Uh and that introduces the other thing 

about being the practitioner is it doesn't have to be something I like right it it's something 

within your background your you know okay you don't eat pork but you don't have to have those 

or and then you know I grew up in uh in an area of the US but I know there are a lot of parts of 

the world where the beer or wine consumption was just part of daily life and And I still consume 

uh alcohol. And a lot of people will, oh my god, I can't believe you do that. Well, now my personal 

life, remember, I didn't come at this with a 200lb personal weight loss journey. I started watching 

two of my patients do this and I started eating this way or, you know, 95% of the time because 

I just saw that it was healthy and I gravitated toward these foods. But so with my metabolism, I 

don't have to be super strict like some people. But then if you're trying to be in ketosis all 

day long, you know, don't do what I do because I don't measure my own ketones to know. There are 

other influencers who who will look at you and do their ketone monitor in front of you and show it. 

Well, that's not my style. And until there's more solid research saying that that's incrementally 

beneficial beyond what I teach, I'm not going to teach that. But it's okay if you do. Uh but for 

a lot of people, it's just too complicated. They they don't want to be pricking their fingers 

or or getting a continuous glucose monitor. Um uh but those are available. And if someone in my 

clinic is doing that, I I don't really I don't tell them not to. I I'll use that information 

and learn from it, but I don't recommend that people have to do that for it to work. So So 

what I teach was here, remember looping back, uh was being used in the late 1990s and it was 

before any of these biohacking sorts of things were available. Now, the criticism of that is all 

of these things might make it easier or better or healthier. Uh there's one study where the doctor 

just handed out a continuous glucose monitor to people and said, "Eat things that keep your blood 

sugar down." Well, guess what? They started eating meat. And and so they cut out cut out carbs on 

their own because they were given an end point to follow the blood sugars. Uh, so they certainly 

can be motivational and helpful, but they're not necessary. I guess it's kind of in that fasting 

category. It it can be useful and health helpful, but it's not necessary. So, question for you. 

The McDonald's story was good. I think it just highlights the idea that, oh my god, you can 

eat out and have a life and just eat meat and cheese and it kind of works. So along with that 

frame of thought, can someone have Coke Zero, Diet Coke, Stevia, and still lose weight? Yes, 

absolutely. I've seen it over and over and over. That's another place where I kind of the practical 

reality. How do I get someone off sugar? You tell them not to have it. It doesn't work for some 

people. So, you transition them to sugar-free things. So I think those non-sugar sweeteners 

at least for a short period of time I think are harmless or or as uh less harmful than sugar. You 

know we we don't measure blood stevia or you know blood sucralose levels. We measure blood sugar. 

Now you could argue well one day we'll find out that the stevia level correlates. No, I don't 

think so. Um but um the uh practical reality of getting someone who's a sugar addict off of sugar, 

some people need uh so in the medical world, we have something called harm reduction 

or even just giving people a drug to get them off a drug. It's less harmful. And then the 

idea is you taper people off that other drug. So uh so back to the food, if someone's on sugar, 

we get them to sugarfree. most of the time over time people just it kind of fades away and the 

the quote need for sweet isn't there. Uh so in the short run I find those things to be very 

helpful and yes can consistent with weight loss. Now where what stage you're in can matter. 

So now I know this makes a little complicated I guess when you're starting out you can do things. 

So the first year I might have someone have sugar alcohols and and stevia and the even just any 

sweetener that's not sugar. They're down 100 pounds. So I mean this this is pretty substantial. 

But the next year they have another 100 pounds to go. That's where we start talking about the 

amount of food, the sugar substitutes, the the um I never really mentioned seed oils as kind of 

a new thing because if you teach someone this, they're not going to be getting many seed 

oils. You don't have really have to say it. Implicit is it in it is that they're reducing the 

amount. Seed oil, we don't measure seed oils in the blood. Doesn't correlate with long-term uh 

outcomes. Uh but that kind of if I say I'm not worried about seed oils now. Now now I'm not even 

in the keto community. So if I do worry about it, we we're reducing them in the foods that we ask 

people to eat. And every now and then or even in that one man's case, he could be at McDonald's and 

and still um you're you can be a fat burner and eat at McDonald's. Now, could you argue that your 

internal metabolism isn't running as efficient as it could? You could make that argument, I suppose, 

but at least it's better than the way it was before. and and most people, okay, some people 

do just state at Diet Coke or Coke Zero or or Pepsi 1 or what's fascinating is that companies 

have now come out with drinks that flavor match just a little better than before. And I, you 

know, I wonder, you know, if you're, let's say, you're a company making money off Coca-Cola or 

Pepsi, you don't want to give people a sugar-free version. Well, the sugar industry doesn't want you 

to have a sugar version, sugar-free version. So, the Diet Coke and Coke never didn't really match 

the flavor. You know, people go to Diet Coke. Oh, it's just not any good. But now there are these 

other flavor matching that makes it easier for people to transition to sugar-free. I don't think 

the sugar industry is might be happy about that, but at least CocaCola is still um profiting or 

making money from the Coke Zero or or the flavor or Pepsi Pepsi one. Uh so that was interesting 

to see that change uh happened over time. It makes it easier to switch people off the sugary 

drink to the non-sugar flavor matched soda that are they harmful in the long run. I don't know 

of any benefit of those drinks. So if you're now at a spot where you're in charge of what you're 

eating, the the food noise is gone and all that, don't have that stuff. I mean, I I I even, 

you know, I'm not pushing those things at at so at the beginning, I think they're fine and 

and even necessary sometimes at at, you know, at the end game, I don't think those additives in 

in Coca-Cola and Pepsi and other drinks are good for you or or healthy. There's no evidence for 

that other than the immediate pleasure or habit or something. Okay, last question. When it comes to 

weight loss, where does the insulin fit in? Are we just trying to drop the insulin if it's elevated? 

Is that a big thing when it comes to losing weight? Yeah, I think that might be just the main 

thing. Yeah. So any dietary approach that lowers the insulin level will lower the signal toward 

fat storage, allow for fat burning to happen, lipolysis was it called. So there was even a study 

done where they gave a pill that lowered insulin levels and children lost weight. So not even 

changing the diet if you just went in with a pill that lowered the insulin level. So I think that's 

one of many levers that could be changed. Uh and uh I think the main effect of a low carb or or 

lowal kind of diet is insulin reduction. The problem is you can't measure it very easily. Some 

doctors won't even measure it for you even if you tell them I'll pay for it. Well, now there are 

companies where you can go and get them ordered if you really want it, but uh I don't typically 

measure insulin levels in the clinic because I know it's going to get better. You know, 

if someone needs that as a motivating tool, uh uh now insulin, I guess I I didn't answer a 

question from before where what about you've been on carnivore or keto and does insulin resistance 

come back? you know, does the um idea that the blood glucose is up and it's not normal, does that 

mean you have insulin resistance? I don't think so. And it's important to realize that someone 

who has had insulin levels go up over time, it's called insulin resistance and then type 2 

diabetes with elevated blood glucose. That's what diabetes is. So what we're seeing is some people 

have that elevated blood glucose but their insulin level is super low and so you're not be you're 

not getting the intracellular glycation because you're not eating the carbohydrates. Now, this 

puts me, you know, into a So, I have a a paper I'm working on where I'm trying to send it around 

for colleagues to help where di the diagnosis of diabetes or insulin resistance can't be just from 

the blood sugar itself. And that's what I hear on the internet chatter is that, oh, your blood sugar 

went up, that means you have insulin resistance. No, no. It just means you're not using the the 

glucose as much or you're allowing the glucose to be where it needs to be in the blood. So the 

glucose requiring cells, the red blood cells, the white blood cells are all in the blood. So 

it might actually be better to have a little bit of a blood glucose elevation without the insulin 

elevation in the long run. And I know that's going to, you know, don't go to your doctor and say, 

"Dr. Westman said that yet." I want to be like Dr. Finny where, you know, everything I say has 

been in a research paper, but it's close to that. And there are enough people who come to me worried 

about their blood glucose just being a little bit elevated. Well, it's not normal. Well, but your 

insulin level is so much lower. You're not getting the same uh problem. So, I don't believe in that 

physiologic or pathologic insulin resistance on a carnivore or keto diet. I I think it's a 

different beast. It's a it's a not path path, not bad for you, not harmful. Okay, last last 

question. So, I had my fasting insulin tested. It's 2.9, so that's good. Um, my husband had his 

one done. He's not carnivore, but it was seven. Do you have any concerns if somebody is in their 40s 

or 50s, relatively healthy, but their insulin is like seven, eight, like under 10? Under 10 to me 

is great. Although that might be Yeah, that might be because I see a lot of people whose are still 

are very high, right? It's the context. um I don't think we know with great precision if that will be 

clinically relevant clinically different. So I I'm I would be happy with that and and it's not just 

the insulin level it's the carb throughput and that so if you if you've cut out all these carbs 

um and you're you're not eating them you're not burning them. So basically, we burn what we eat 

and carbs create uh they're they're not a great fuel. They they're just they're messy. So, and 

that's the part that leads to the blood sugar, diabetes, the metabolic syndrome problems that 

can occur, even gout, things like that. It's the carb consumption and the carb metabolism that 

is creating that problem. So, you know, so I think your husband's fine. as long as he's not so 

eating the carbs. I so I don't know. I mean, that would be a study where we take people with insulin 

levels of seven and we do an man manipulation to get it down to two and follow them over time with 

some clinically relevant endpoint. I I I don't know that that's that wouldn't be the highest 

study for me to do. I think that's a good sign. Well, at least people know under 10 is good. I I 

think that sometimes when you do these labs like you have these uh like competition who's got the 

lowest love, who's got the lowest or highest HDL, but under 10 fasting insulin is really good. 

I've heard some people even have like 30, 40, 50 fasting insulin, so we want to get it under 

10. Dr. Westman, you've been amazing. I've asked so many questions, but I think if people follow 

the never fail approach, everyone's going to lose weight. The thing is consistency. I'm going to 

leave all your links in the description, but thank you so much for your time. Well, it's been great 

talking to you. Keep up the great work. Really appreciate it. I hope you love this episode. Check 

out this one with Dr. Eric Berg. Everything about how to lose weight and how to get rid of visceral 

fat with his best 61 tips. See you next week.