How can we stay in good shape, asks Prof Grant Schofield. Or, if you’ve put on a few kilos, how to get back to your fighting prime? For most of us, that’s a daily struggle.

Dr Peter Attia has an interesting framework around this, which I think is a great way of thinking about the tools that we have at our disposal and the biology of those tools. Dr Attia talks about pulling the three levers of weight loss. The first lever – always; the second lever – often; and all three levers – sometimes.

So, what does he mean by the levers? What are they? Well, in the following order, the levers are:

  • Lever 1: What we eat

The type of food that we put in our mouth affects our biology deeply. Refined and processed carbohydrates, sugar and alcohol adversely affect our insulin, our glucagon, probably our leptin – all hormones involved in energy, metabolism and satiety.

Ultra-processed food is the opposite of food that is low in human interference. The sort of food we should be eating is the stuff that’s been running around and growing in nature recently. Then, if there’s carbohydrate in that food, it’s in cells. As soon as you start to process that food, it becomes acellular carbohydrates. They go into the upper small intestine – a whole different route into the body. The problem with that is it bangs up your blood sugars. It bangs up the hormone insulin, and it also bangs up the hormone glucagon. Glucagon means a double problem. Not only are you eating sugar, but your liver is now getting the signalling from your pancreas to start producing sugar itself. Highly processed sugary foods and alcohol cause problems.

Pull Lever 1 almost all the time if you can.


I need to stop snacking after dinner. Dinner’s ceased, over, caput, finished. I brush my teeth. That’s a signal to me to stop eating at that point.


  • Lever 2: When we eat

Even if your diet is fabulous, if you’re snacking and grazing the whole day, you’re never going to reset those hormones back to their baseline. You’re never going to reach glucose and insulin homeostasis. So, beginner trick – stop snacking! This is one of the most important lever to me. I need to stop snacking after dinner. Dinner’s ceased, over, caput, finished. I brush my teeth. That’s a signal to me to stop eating at that point.

The advanced version of that is compressing the eating window down, giving your body a whole lot of time during the day to reset itself. You’ve probably heard about the 16:8 eating window – 16 hours without food and allowing yourself to eat over 8 hours. Or a more advanced solution, 20:4, 23:1, or you might even choose sometimes to go for a longer fast. Intermittent fasting allows the hormones to reset themselves.


  • Lever 3: How much we eat

You might need to sometimes pull lever 3, which is how much we eat. The whole point of the first two levers is that now you’re allowing your brain to read the signals of ‘full’. “You’ve had enough. Stop eating.” But there is a manual override. We’re human, we can override this and carry on eating. I’ve certainly proven I can do that, plenty of other people have as well.

Calories do matter, and we may need to put some behavioural rules around our eating, like smaller plates; one helping; no desserts; no snacking. That will bring down the total number of calories.

Those are the three levers. What we eat – pull it a lot. When we eat – pull it sometimes. How much we eat – if you have to pull that one as well, go for it!


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