David Letterman: If you regard obesity as an illness that is supported by the food industry, which produces a wide variety of unhealthy food and puts them in supermarkets all over the world, isn’t it hard for people because they are confronted by an abundance of food that is bad for them?

Dr. Louis Aronne: Right! Research is showing that eating that kind of food eventually damages nerves in the hypothalamus, the part of the brain that controls weight. You end up with fewer nerves to conduct the signals from your fat cells to your brain. Weight gain, which initially results from environmental and behavioral issues, becomes increasingly physical.

DL: So the whole thing is connected to metabolic, physiological changes?

LA: That’s correct. In fact, researchers at the Boston Children’s Hospital have identified a compound which comes from a traditional Chinese medicine that cuts inflammation in the hypothalamus. The compound was being tested on overweight mice, and they went down to their ideal weight. In other words, an anti-inflammatory caused weight loss in mice. At a scientific level, this represents convincing evidence that there is there is something physical going on in the brain that prevents weight loss. We are working to develop this into a treatment.

DL: When you travel the country, you see people who are walking around, living their lives about forty pounds overweight, and they seem to be okay with it.

LA: You’re right, that is becoming the standard, which needs to be changed. Being overweight can lead to many diseases, regardless of how healthy you feel at the moment. The average woman in the U.S. now weighs what the average man used to weigh. How do we get people to realize it isn’t good to be that overweight?

DL: I remember years ago you told that that I could curb my appetite if ate my protein first, it’s supposed to reduce the craving for carbohydrates.

LA: Yes. We have studied how the order in which you eat your food affects your blood sugar levels. We recently published a paper on diabetes care showing that people with diabetes lowered their blood sugar by 75 points one hour after eating if they had vegetables and protein before carbohydrates, rather than the other way around.

DL: Right. That’s what I was hoping, because you’ve know my symptoms for as long as I’ve know you. I am always hungry, and I can’t control my appetite easily. Some mornings I will have some high-protein granola mix made of nuts, and I don’t know what else they put in—granola stuff they find on the trail—and that will sustain me all day. I can go twenty-four hours with just a bowl of this granola. So that seems to be a bit of a trick, but when I used to drink those green drinks—ugh. You might as well be drinking gasoline, they taste so damn bad. Yuck, that would curb my appetite for a long time. Aside from those two appetite killers, if I have egg whites in the morning, I am hungry in ten minutes. Do they take the protein out of egg whites?

LA: No, there are people, and you clearly are one of them, who need carbohydrates to feel full. Our research shows that you should eat the carbs at the end of a meal. As for the granola, the whole grains are difficult to digest, so the carbohydrate is digested very slowly. When you can actually see the grains, that’s a good sign. It’s when everything is broken down and you take away all of the fiber, which is what you see in a processed white product, that’s not good. That raises your blood sugar very rapidly.

DL: I just like eating. When I was a kid my mom was such a good cook. We had so many fresh vegetables from her garden all summer, and then my mom would can them and we would have vegetables from our garden all winter. The combination of her cooking and the food available to us made me love to eat. There was rarely a time I wouldn’t clean my plate and have two or three helpings. I’d eat so quickly, my mom would always say, “You can slow down. No one is going to take it away from you.” Then one day at dinner a guy came in and actually took it away from me.

LA: Can we quote you on that?

DL: Yeah.

The other thing is I’ve been eating a lot of this artificial pasta, it’s made from polyamide chloride, but it’s not the regular wheat pasta or gluten free pasta. The stuff is horrible, just horrible. So can I just go back to eating regular pasta? If I had real pasta, like twice a week, would that contribute to a weight gain problem?

LA: I think twice a week is fine. Anything you do twice a week is not an issue. It’s when you do it constantly that you run into problems controlling your weight, whatever you want to eat. My advice is to eat a small serving at the end of dinner.

DL: Back to the massive worldwide food production corporations. In trying to feed three hundred plus million people in this country, it’s helped perpetuate this culture of obesity. So I think that all of these companies should be shut down, and people should go back to foraging for roots and berries. For example, on the weekend that’s all we eat—roots and berries.

LA: I guess that’s how you keep yourself in such good shape.