Book Review: Always Hungry

Next up for review is Always Hungry. The author, Dr. David Ludwig, is an endocrinologist, researcher and professor at Harvard Medical School and the Harvard School of Public Health. I met him a few times when I was getting my Doctorate and I am a very big fan of his research. 

Introduction

This interesting book presents a weight loss strategy based on blood sugar stabilization. Dr. Ludwig uses his vast research experience to argue that refined carbohydrate foods, and the subsequent swings in blood sugar following their consumption, have much to do with the increases in obesity in the last 30 years. The book is broken down into 2 sections. The first section covers the research in the area of glycemic load/glycemic index in a truly impressive fashion. The second part presents the weight loss program, which includes 3 different phases, meal plans and recipes. The book is 384 pages long. The first section of this book was the best I have read since Dr. Walter Willett’s Eat, Drink and Be Healthy (a must read for those who have not read it yet). 

5 Things I Really Liked About Always Hungry

1) I really liked how Dr. Ludwig explains the hormonal consequences of the foods we eat. He presents a beautiful summary of the research to date on glycemic index and glycemic load and puts a serious hole in the theory that a calorie is a calorie. 

2) Finally, a popular weight loss book that talks about reasonable weight loss. Dr. Ludwig explains that good and steady weight loss is ½ pound to 2 pounds per week. So many people think that their weight loss plan is failing if they don’t lose 5 pounds a week and it is a shame. Slow and steady wins the race with weight loss. You need to give your body time to adjust to the weight you lose. In my opinion, this minimizes the level of “fight back” your body will give in terms of increased hunger and decreased metabolism.

3) I really agree with Dr. Ludwig when he says that refined carbohydrate and sugar consumption are the critical components of weight gain and need to be the focus of weight loss efforts. 

4) Dr. Ludwig recommends the reader consume a source of protein, fat, and low glycemic carb at each and every meal. The addition of the protein and fat attenuates the glycemic response. This will sound familiar to those who have read my book. This is probably because both Dr. Ludwig and I used the same research to formulate our weight loss strategies. This method of macronutrient combination just flat out works if you are trying to lose weight.

5) I also really like how Dr. Ludwig incorporates sleep and stress reduction into his program. These are two critical areas for those looking to lose weight that do not get nearly enough attention.

5 Things I Didn’t Agree With In Always Hungry

1) The book really didn’t stress the importance of resistance training, which I feel is mandatory if long term weight loss is your goal. Resistance training both increases metabolism and spares lean body mass during the weight loss process. 

2) I thought the cardio recommendations were a little on the light side. I have found that women in particular need to do a lot more cardio than Dr. Ludwig recommends in order to achieve and maintain their weight loss goals.

3) The program allows 2 alcohol containing drinks per day. While I can’t deny the health benefits of moderate alcohol consumption, in my clinical experience, this amount of alcohol will dramatically slow down the weight loss process.

4) In the food lists, there is no limit whatsoever on saturated fat and red meat. Foods like beef, full fat cheese, butter, sour cream, and heavy cream can be included at every meal if you want. I found this surprising. Many of these foods have been associated with an increased risk of heart disease, stroke and certain cancers and I don’t know why you would not want to focus on more healthful choices of protein and vegetable based fats.

5) The addition of up to 6 teaspoons of sugar each day and an ounce of 70% cocoa dark chocolate (which adds another 2 teaspoons) was surprising to me. The research Dr. Ludwig presents on the dangers of sugar and its addictive properties is very compelling in the first section. In my experience, the vast majority of those with a weight problem have uncontrollable cravings when consuming sugars and refined grains and they will not stop at just a few servings of these foods. The more sugar they have, the more they want. 

I do believe that there are people who are not addicted to sugar and refined carbs and can have just 1 cookie and stop there. These people are few in number and almost never have a problem with their weight. To me, the only answer is complete sugar restriction. After a 2 week withdrawal period, it is amazing how you won’t care that you are not eating sugar. I can’t think of a single client of mine that has attained their weight loss goal who ate sugar regularly. 

Is Always Hungry Worth Reading?

100% yes! I truly enjoyed this book. Many of my recommendations came from the same research that Dr. Ludwig covers in the first section of this great book. Our approach is very similar and we differ in just a few areas. I believe exercise should get a bit more attention. I believe that saturated fat and red meat should be limited. I believe sugar should be avoided 100%. Lastly, I believe that alcohol consumption should be a bit more controlled. This is an excellent book and a must read for anyone interested in how the food we eat can impact our weight and our health.