Is the Carbohydrate-Insulin Model of obesity over?

Introduction

Obesity is ultimately the result of excessive body fat accumulation. Given the explosion of obesity rates around the globe, understanding how people become obese has been the center of much scientific investigation. The consensus model that informs most attempts to prevent and treat obesity has to do with energy balance and the mismatch between caloric intake and expenditure [1]. As such, the overconsumption of highly palatable foods coupled with reduced physical activity (termed the ‘obesogenic environment’) leads to increased adiposity and poor health. Despite the wide acceptance of this model (often termed calories in, calories out or CICO), in recent years, a new model of obesity has taken the nutrition research field by storm. This model also aims to explain the obesity epidemic given the lack of successful dietary preventatives and treatments for obesity based on the conventional model. The new model is termed the carbohydrate-insulin model (CIM) of obesity [2]. It posits that dietary carbohydrate, not energy balance, is the primary culprit. The guilt lay in carbohydrate’s ability to robustly increase insulin levels, thereby promoting fat storage and accumulation. This scenario, in turn, promotes increased dietary intake and further weight gain (see image comparing the models below).  

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