I don’t understand why people are so bothered by the fact that metabolic disease can be treated by medicines. It’s not that lifestyle solutions can’t work; they can! It’s that they don’t work for a very large number of people…
We should celebrate that more people have solutions that can work for them. Not doing so is the height of arrogance
It also seems relatively uncontroversial to acknowledge that medicines are a life-saving solution for those with hypertension who cannot control their blood pressure with lifestyle alone
Well this sure has generated a lot of enthusiasm. Just happy everyone’s got it all figured out…

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More from @ethanjweiss

May 20, 2022
Anyone else finding it increasingly difficult to tweet anything that does not feel like it is a massive cry for attention?
I am overwhelmed by my own self-consciousness here and honestly it is a new phenomenon
I find myself writing and deleting tweets almost 100% of the time
Read 5 tweets
Apr 17, 2022
Here’s a question for @nicknorwitz & @realDaveFeldman: if I understand, your model hypothesizes that increased ApoB in lean/athletic people on low carbohydrate or ketogenic diets does not result from either 1) saturated fat or 2) genetic variation, but rather from CHO restriction
So in the spirit of n=1 case studies, I have one for you. 52 year old male cardiologist BMI 21, exercises 6 days a week, on low SFA ketogenic diet for 4+ years with ApoB ~80 mg/dl
So how do you explain this? Is it genetics? Is it environment? If so, what else besides carbs is it? Fiber?
Read 5 tweets
Jan 30, 2022
Lotta red
Anyone else hearing the “Beat LA” as loudly and clearly as I am?
Wow
Read 7 tweets
Jan 29, 2022
It's been a while since I've bragged on Ruthie so if you're not into that kind of thing just mute me.

Meanwhile, during the pandemic, since basketball was a challenge, she took up crew. She got waaaay into it and very nearly quit basketball as a result
But she ultimately decided to play for her high school, where she's now a 9th grader. The girls' varsity basketball team is definitely in a rebuilding phase. They have really struggled, but they've also worked hard, and they do keep getting better (which is all you can ask)
The silver lining of on being on a not very good team as a legally blind freshman who had not played in a real game in 2 years is that she is getting to play a lot, and with that time on the court, she has also gotten better. She has also rediscovered her competitive "spirit"
Read 5 tweets
Oct 5, 2021
If I understand correctly, one of the core tenets of the CIM is that fat gets trapped inside fat cells which leads to "internal starvation" and this causes overeating & obesity (and associated metabolic disease(s))
One of the things that has bothered me for a long time is that metabolic disease is actually associated with *inadequate* fat storage in fat cells. diabetes.diabetesjournals.org/content/51/9/2…
There is a well-known system which is engineered to regulate fat storage mostly through the activity of lipoprotein lipase (LPL) which is highly regulated by insulin and a set of proteins that serve to shunt fat to where it is needed depending on the physiological situation
Read 9 tweets

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