Notes from the Obesity Conference in Phila. Jun 22-24

I just attended an obesity treatment conference that was held right here in Philly at the Hilton, Penn's Landing. What a bargain! No airline ticket!  No hotel room! I just rolled out of bed and shot down the schuylkill to listen to some of the world's biggest names in nutrition.  Honestly, I went to hear just two guys Robert Lustig, MD and Jeff Volek, PhD . Lustig the pediatric Neuro-endocrinologist who has made sugar today's giant dietary villain. If you haven't heard his most famous seminar entitled, Sugar the Bitter Truth on the topic, I urge you to do so.   Of course, he spoke about the evils of fructose; his signature topic. He also had interesting thoughts on differentiating the possible causes of obesity based on their response to insulin secretion. Insulin hyper-secretors and insulin resistant patients need to be treated differently. (at least in kids)  Low carb diet works best for hyper-secretors and metformin is for the resistant. He does a 15 minute insulin/glucose test. This sounds a whole lot more feasible in the real work than the 3 hour Kraft assay. Additionally, Lustig basically shot down another conference speaker whose topic was mindful eating. He quoted recent studies that found it is ineffective for obesity treatment,
 Dr Jeff Volek also gave his famous talk The Art and Science of Low Carbohydrate Living. 
 He is one of the guys who has made huge contributions to the understanding of the biochemistry and physiology of ketogenic diets. He reports that Beta-hydroxybutyrate, the major blood ketone, can fuel the brain even when blood sugar is extremely low. It also activates genes that promote anti-aging effects and promotes antioxidant activity. This possibly is a reason why low carb diets are thought to be cancer-preventing.

Some attendees were observed wolfing down handfuls of the meal replacement bars samples that the salespeople in the lobby were giving away. I'm pretty sure that's not how they're intended to be used... 
I don't prescribe meal replacements because:
Meal replacements are not real food. They're made from the same stuff all all processed food. That's grains, isolates, artificial sweeteners and industrial seed oils.
They are calorie restricted. Once you've eaten your allotted calories, you're done and probably still hungry. They are too high in protein to suppress insulin so once the program is complete weight regain is the norm. Then there is the question of how to transition from meal replacement food to real food or non-replacement food. If all you know how to do is to tear open packages of bars, shakes or TV dinners then you will be ill prepared to eating normally for the rest of your life.
Meal replacements are mostly about increased revenue for the company who makes them and the people who prescribe them but not for long term weight loss.
Dr. Lazarus gave a lecture on weight loss meds. These are possibly useful for people who struggle to hit targets.