Excess Matters

Tag: insulin

  • The Power of Hormones by Max Nieuwdorp: Summary, Key Ideas & Review

    Book in one sentence: A practicing endocrinologist walks you through every major hormone in the human body, from insulin to oxytocin, and shows why they cannot be understood in isolation from each other.

    What Is The Power of Hormones About?

    Picture the standard medical model of your hormones: a tidy diagram of glands, each one producing its own molecule, each one working in its lane. The thyroid does thyroid things. The pancreas does pancreas things. The adrenals do adrenal things. Clean, separate, manageable.

    Max Nieuwdorp, a professor of internal medicine at Amsterdam University Medical Center, has spent twenty years watching that model fail his patients. His book is a correction. The endocrine system is not a list of glands. It is a communication network, and nothing in it operates alone. Estrogen affects cortisol. Cortisol suppresses the hormones that govern ovulation. Gut bacteria determine how sensitive your cells are to insulin. Stress disrupts thyroid conversion. That chain of influence is not theoretical. It is the reason a hard year can derail your menstrual cycle, a course of antibiotics can trigger months of metabolic disruption, and a sleep deficit can make weight loss feel physiologically impossible.

    The book covers everything: insulin, cortisol, thyroid, growth hormone, testosterone, estrogen, oxytocin, leptin, ghrelin, GLP-1. It moves through the human lifespan from conception to old age, organized as narrative history as much as science (the discovery of insulin, the cortisol story, how the contraceptive pill changed society). Nieuwdorp is not a wellness influencer extrapolating from mouse studies. He is a working clinician who has also published research on fecal microbiota transplantation and insulin sensitivity, and the distinction shows on every page.

    Why Insulin and Cortisol Matter More Than You Think for Weight

    For readers on a weight or eating journey, two chapters stand out: the ones on obesity and hunger, and the one on stress.

    Insulin: blessing and curse

    Nieuwdorp describes insulin as “both a blessing and a curse.” That is not a throwaway line. Insulin is essential to life (without it, glucose cannot enter cells and you die). But in chronic dysregulation, the same molecule becomes a driver of fat storage, systemic inflammation, and metabolic disease. Insulin resistance is the pivot: when cells stop responding to insulin’s signal, the pancreas compensates by producing more, and chronically elevated insulin promotes fat storage while blocking fat breakdown. The body cannot easily access its own stored energy.

    What makes the insulin chapter useful for this audience is that Nieuwdorp connects it to eating behavior, not just blood sugar numbers. The gut’s own satiety hormones (GLP-1, CCK) are released in response to food and normally help the body regulate intake. When insulin signaling is chronically disrupted, that whole feedback loop becomes less reliable. Hunger signals stop reflecting actual caloric need. The relationship between what you eat and how satisfied you feel gets decoupled.

    Cortisol and the cascade it triggers

    The stress chapter does something most popular health books skip: it shows the precise mechanism by which chronic stress becomes a weight and eating problem, not just a mood problem.

    Chronically elevated cortisol suppresses GnRH, which lowers FSH and LH, which shuts down ovarian production of estrogen and progesterone. It also impairs the conversion of inactive T4 to active T3 in peripheral tissues, compounding any subclinical thyroid dysfunction. It promotes leptin resistance, making the brain less able to detect that you have enough stored energy. It disrupts sleep architecture, reducing the deep sleep during which growth hormone is released and tissues repair.

    Nieuwdorp’s clinical example is not exotic: a high-achieving woman with twelve-hour workdays, five gym sessions per week, four to five hours of sleep, absent menstruation, and labs that read as normal. The treatment is not a hormone prescription. It is more food, less exercise intensity, and more sleep. The hormones are not malfunctioning; they are responding correctly to the load the system is under. Stress reduction, adequate calories, and sleep restoration are hormone therapies, whether or not anyone frames them that way.

    How Does Your Body Defend Its Weight Against You?

    The obesity chapter is where Nieuwdorp’s book earns its place on the shelf for anyone who has ever felt like their body was working against them during weight loss. Because it is, and he explains exactly how.

    Ghrelin is the primary hunger hormone, produced by the empty stomach. It drives hunger, stimulates dopamine release (creating food-seeking behavior), and enforces the hypothalamic weight set-point. In people with obesity, ghrelin stays elevated even when there is plenty of stored body fat, while the hypothalamus has become resistant to leptin (the satiety signal from fat tissue). The result: persistent hunger that does not reflect actual caloric need.

    When caloric restriction is sustained, the body mounts a three-part defense:

    1. Ghrelin rises (driving more hunger)
    2. Resting metabolic rate drops (burning fewer calories at rest)
    3. Spontaneous physical activity decreases (conserving energy without conscious awareness)

    That is not a failure of willpower. It is an adaptive physiological response executing a defense strategy. The set-point the hypothalamus is defending is not a number you chose. And it is not one you can override through discipline alone.

    “Ghrelin concentrations paradoxically decrease after gastric bypass surgery, despite the stomach being empty more of the time.”

    That one sentence reframes bariatric surgery entirely. Bariatric surgery works (and produces durable results) not primarily by restricting food intake, but by resetting the hormonal thermostat. GLP-1 receptor agonist medications work the same way: they mimic the gut’s own satiety hormones and shift what the hypothalamus is defending. Neither is “cheating.” Both are working at the level where the problem actually lives.

    What Makes This Book Different from Other Hormone Books

    A lot of hormone books on the market are written by functional medicine practitioners, coaches, or journalists. They tend to focus on a subset of hormones (usually estrogen, progesterone, and thyroid) and emphasize protocols: what to eat, what to supplement, what to test.

    Nieuwdorp is none of those things. He is a practicing endocrinologist with a research background, and this is a medically rigorous hormone book written for a general audience in a way that very few are. A few things set it apart:

    Historical narrative. Each hormone chapter is partly a history of how that hormone was discovered (the story of insulin’s discovery in 1921, the cortisol experiments, the early testosterone research). It grounds each concept in the actual scientific process and makes the mechanisms memorable.

    The full spectrum of hormones. Most hormone books skip oxytocin, growth hormone, ADH, parathyroid hormone, and the gut peptides. Nieuwdorp covers them all, which matters because the interactions are the whole point. You cannot understand why stress disrupts your period without understanding the hypothalamic-pituitary-adrenal axis and its relationship to GnRH. You cannot understand why your gut matters for metabolic health without understanding GLP-1 and its relationship to insulin sensitivity.

    Calibrated caution about self-treatment. Nieuwdorp writes: “It’s clear that you can’t replace or even simulate the body’s own functions by administering hormones. Playing around with hormone preparations yourself can also be dangerous, especially without medical supervision.” For a book that could easily have pitched the opposite message, this is worth noting. The endocrine system’s complexity is precisely why hormone intervention requires clinical oversight.

    What it does not offer is a protocol. Nieuwdorp is more interested in mechanism than prescription. Readers who want the “what to do” alongside the science will need companion books. The related books table below has suggestions.

    Is The Power of Hormones Worth Reading?

    Read this if you have been told your labs are normal while feeling anything but, you want the actual mechanistic explanation for why weight loss gets physiologically harder over time, you are using a GLP-1 medication and want to understand why it works, or you are someone who thinks in systems and wants the full picture before making any decision about your hormonal health.

    Skip it if you want a step-by-step protocol, a supplement list, or a dietary framework. Nieuwdorp is a scientist, not a health coach, and the book reflects that completely.

    One caveat: The density is real. Some chapters (the history sections especially) move slowly, and readers who want a quicker route to the weight-relevant material can focus on chapters 5 (obesity and hunger) and 6 (gut and metabolism) without losing much. The payoff for reading straight through is the cumulative sense of how deeply interconnected every hormone system is, and it requires patience to get there.

    Books Like The Power of Hormones

    BookAuthorBest For
    It’s Your HormonesGeoffrey RedmondReaders who want clinical depth on female sex hormones specifically
    The Hormone MythRobyn Stein DeLucaReaders skeptical of hormone-blame narratives; a useful counterweight
    Thinking, Fast and SlowDaniel KahnemanFor readers who like dense, evidence-heavy science books on how systems shape behavior
    The XX BrainLisa MosconiBrain imaging data on what estrogen loss does to cognition; extends Nieuwdorp’s perimenopause chapters
    Hormone IntelligenceAviva RommThe protocol-forward complement: where Nieuwdorp explains the mechanism, Romm prescribes the intervention

  • Women, Food, and Hormones by Sara Gottfried: Summary, Key Ideas & Review

    Book in one sentence: Keto was designed for men. This is the version built for how women’s hormones actually work.

    What Is Women, Food, and Hormones About?

    Picture this: you and your husband go on the same diet. Same meals, same macros, same commitment. He loses twelve pounds in ten days. You gain two, feel brain-fogged, and quietly blame your own willpower. Gottfried calls this the Keto Paradox, and her core argument is that it isn’t a personal failure. It’s a design flaw in the diet itself.

    Sara Gottfried is a Harvard-trained OB-GYN with 25 years in clinical practice and several previous books (including The Hormone Cure and Brain Body Diet). She’s also, by her own account, a former keto refugee who gained weight on the classic protocol before eventually redesigning it for her own hormonal biology. What’s in this book is the result of those experiments (on herself first, then on hundreds of patients).

    The argument she builds is narrow but solid: the ketogenic diet was developed, tested, and refined primarily on men. Decades of nutrition research excluded female subjects entirely. Dietary prescriptions shaped by that research get applied to women wholesale, without accounting for estrogen cycling, cortisol sensitivity, thyroid function, or the gut bacteria that clear estrogen from the body. Gottfried’s solution isn’t to abandon keto. It’s to fix it for the body that was left out of the original equation.

    Why Does Keto Work for Him and Not for You?

    Gottfried names the specific mechanisms here, which is where the book earns its keep. It’s not that women are just “different” in some vague way. There are four concrete failure modes when women follow classic keto.

    Cortisol spikes. Carbohydrates help regulate the HPA axis (your stress-response system). Cut them completely and many women’s cortisol rises, storing fat rather than burning it. Men don’t experience this the same way because their HPA axis responds differently to carb restriction.

    Thyroid suppression. Aggressive carb restriction can block the conversion of inactive T4 into active T3, the thyroid hormone your metabolism actually uses. The result looks like standard hypothyroid symptoms: fatigue, hair loss, cold hands, slowed weight loss. Women are more vulnerable to this than men are.

    Estrogen recirculation. Here’s the one most keto guides completely miss. Your gut houses a community of bacteria called the estrobolome (their job is to metabolize estrogen so it can be excreted). They need fiber to do that. Classic keto crashes dietary fiber to around 6 grams per day; Gottfried considers 25 grams the floor. When the estrobolome is starved, estrogen gets reabsorbed rather than cleared, and the result is estrogen dominance: weight gain, PMS amplification, breast tenderness, mood swings.

    Inflammation from saturated fat. Some women respond to high saturated fat intake with elevated CRP (a marker of inflammation), driven by differences in gut microbiome composition and how estrogen receptors interact with dietary fat. This doesn’t happen in everyone, but it’s a real pattern that classic keto doesn’t account for.

    “The ketogenic diet has mostly been studied in men and works quite well for them. Women, on the other hand, tend not to do so well on this diet. A man and a woman can go on an identical keto diet and get completely different results.”

    None of these are willpower problems. They’re predictable consequences of applying a male-derived protocol to a female body.

    The Four Hormones That Drive Weight Loss (or Block It)

    Gottfried organizes female metabolism around four hormonal levers. Insulin is the master lever. When it’s chronically elevated, it suppresses every other fat-burning signal in the body, blocks growth hormone, disrupts thyroid conversion, and parks fat preferentially in the visceral (abdominal) region. Her clinical targets are specific: fasting insulin below 5 mU/L, fasting glucose at 70-85 mg/dL, HbA1c below 5.4%.

    The patient case she uses to illustrate this is worth understanding. A 38-year-old woman (Melissa) came in 30 pounds overweight, with borderline thyroid dysfunction alongside insulin resistance. After completing the Gottfried Protocol, which addresses insulin first, her thyroid function improved without any thyroid-specific treatment. The hormones weren’t separate problems requiring separate solutions. They were one tangled system with one primary entry point.

    Cortisol is the second lever, and it’s where most women’s keto attempts unravel. Women are twice as likely as men to experience chronic stress, anxiety, and depression, which means they’re starting from a higher cortisol baseline. Add aggressive fasting or hard carb restriction to that, and cortisol climbs further. Gottfried’s fasting protocol ramps gradually (12:12 to 14:10 to 16:8) to avoid the cortisol spike that sudden OMAD or extended fasting triggers.

    Testosterone gets its own chapter because most women don’t know they have it in meaningful amounts. It’s actually the most abundant biologically active hormone in women (more abundant than estrogen), and it declines steadily from age 20, reaching about half its peak by 40. Low testosterone shows up as muscle loss, fatigue, joint pain, passive mood, and difficulty maintaining weight. One finding that’s genuinely counterintuitive: both caffeinated and decaffeinated coffee lower testosterone in women. The opposite is true in men. Eliminating coffee is among Gottfried’s first recommendations for women with these symptoms.

    Growth hormone rounds out the four. It declines 1-3% per year after age 30, and the decline accelerates with every lifestyle stressor (sugar, poor sleep, stress, sedentary behavior). Women are positioned to recover GH quickly because they produce it in more frequent pulses than men, and anaerobic exercise triggers a disproportionately large GH response in women. A 24-hour fast raises GH by approximately 1,300% in women. Even a 14-16 hour overnight fast produces meaningful elevation. GH is produced primarily in the first 3-4 hours of sleep, which makes sleep quality a direct metabolic lever.

    What Is the Gottfried Protocol?

    The protocol runs four weeks, structured sequentially so each phase sets up the next.

    Week 1: Detox before ketosis. The most unusual element. Gottfried’s rationale: environmental toxins (BPA, glyphosate, endocrine disruptors she calls “obesogens”) are stored in fat cells. When fat burns, they’re released into the bloodstream. Without active liver and gut support, those liberated toxins drive inflammation and contribute to weight regain. Week 1 front-loads cruciferous vegetables, high fiber, MCT oil, and magnesium. Overnight fasting starts at 12-14 hours on non-consecutive days, so the longer fasting window later doesn’t arrive as a shock.

    Days 8-28: Full implementation. The macro formula differs from classic keto in ways that matter. Classic keto runs roughly 10% carbs, 20% protein, 70% fat. The Gottfried Protocol uses a 2:1 ratio (2 grams of fat per 1 gram of combined carbohydrate + protein), with net carbs at 20-25 grams and protein kept deliberately modest at 50-75 grams. The lower protein cap prevents gluconeogenesis from breaking ketosis. Daily ketone testing (goal: 0.5-3.0 mmol/L) replaces vague adherence with actual measurement. Fasting extends to 16:8.

    Day 29 onward: Transition. Net carbs are reintroduced in 5-gram increments every three days while continuing to track ketones. This process finds each woman’s personal carbohydrate threshold (the amount she can eat while staying in mild ketosis). That number is different for every woman and can’t be found any other way. One patient in the book stabilized at 60 grams of net carbs per day, far more than the implementation phase allows, and lost 39 pounds across several protocol cycles.

    Integration: Ongoing. The protocol is designed as a repeatable metabolic reset, not a one-time intervention. Re-enter it when symptoms return, weight climbs more than 5 pounds, or sugar cravings resurface.

    Two sections in the troubleshooting chapter are worth flagging for anyone mid-protocol. Gottfried lists nine plateau-busters in priority order: resistance training first, then food weighing to catch portion creep, L-carnitine, cold exposure, dropping carbs further, and extending the fasting window. She also names seven common derailment patterns (excess calories from calorie-dense fats, alcohol, slow thyroid or adrenal function, constipation, inability to sustain ketosis, severe carb intolerance, and what she calls the “F*ck Its”). Each pattern has a mechanical fix, which keeps women from abandoning the protocol when what they actually need is a small adjustment.

    Is Women, Food, and Hormones Worth Reading?

    Read this if you’ve tried standard keto, followed it closely, and either saw no results or felt worse (more tired, more brain fog, more cravings). Also worth reading if you’ve watched a male partner lose weight effortlessly on the same plan you were both following and never got a coherent explanation for why. The estrobolome section alone is worth the price of admission for anyone with estrogen dominance symptoms (PMS, breast tenderness, bloating, mood swings) that their doctor has chalked up to “just hormones.”

    Skip it if you already have a solid grounding in female metabolic health and are looking for new research rather than a clinical protocol to follow. The conceptual content (the Keto Paradox, the estrobolome, the cortisol-fasting interaction) will be familiar to anyone coming from functional medicine. The four-week protocol itself is still useful, but the book’s value is highest for readers encountering this framework for the first time.

    One honest caveat: the protocol requires real investment. Daily ketone testing, food weighing, macro tracking, a 10-supplement stack during active phases, and ideally lab work. Gottfried doesn’t clearly prioritize which elements matter most when you can’t afford all of them, which is a gap for women with limited time or money. The case studies lean heavily toward 20-39 lb losses, but non-responders and cases requiring adjustment are underrepresented. That’s a fair criticism of a book that otherwise does a genuinely good job explaining why the thing that worked for your husband didn’t work for you.

    Books Like Women, Food, and Hormones

    BookAuthorBest For
    Fast Like a GirlMindy PelzWomen who want fasting protocols mapped to their hormonal cycle across the full month
    Hormone IntelligenceAviva RommA botanical and integrative medicine approach to the same hormonal themes, useful counterpoint to Gottfried
    The Hormone FixAnna CabecaKeto-alkaline hybrid approach for perimenopause and menopause; overlaps with Gottfried on insulin and estrogen
    Eat to Thrive During MenopauseMia HuberPractical nutrition guidance for the menopause transition
    The Menopause Diet PlanHillary WrightRegistered dietitian’s take on eating for hormonal health through menopause

  • Fast Feast Repeat by Gin Stephens: Summary, Key Ideas & Review

    The book in one sentence: A former teacher who lost 80 pounds explains the hormonal mechanics of intermittent fasting so clearly that the protocol finally makes sense — and shows why most people who tried IF and failed were probably doing it wrong.

    What Is Fast. Feast. Repeat. About?

    Picture someone who spent thirty years cycling through every diet that crossed her path: calorie counting, low-fat, low-carb, blood type, bite counting, hormone injections, meal replacement shakes. Someone who yo-yoed up to 210 pounds and tried, genuinely tried, harder than most people you know. That person is Gin Stephens, and she is the reason this book exists.

    She eventually lost over 80 pounds through intermittent fasting and has kept it off for years. She has a doctorate in gifted education and spent 28 years as an elementary school teacher, which means she is trained to read research, synthesize it, and explain it to people who don’t have a science background. She opens the book by announcing exactly who she is and who she is not: she is not a doctor, a nutritionist, or a lab researcher. She runs the largest IF support communities online (hundreds of thousands of members). The book is written from that vantage point, which matters.

    Fast. Feast. Repeat. is the full-length expansion of her 2016 debut, Delay, Don’t Deny. The new book adds more physiology, a structured 28-day onboarding program, a troubleshooting guide for plateaus, and the science behind why the clean fast rules exist at the level they do. If you’ve read contradictory IF advice online (does sparkling water break a fast? can you have cream in your coffee?), this book works through most of those debates with actual reasoning rather than someone’s opinion or a forum thread.

    The central promise is unusual for a diet book: change when you eat, not what you eat, and your body will eventually recalibrate its hunger signals well enough that how much you eat takes care of itself.

    What Is the Clean Fast, and Why Does It Matter?

    Most IF protocols tell you to eat within a window and fast outside it. Stephens goes further by specifying what “fasting” actually means at the physiological level, and the answer is stricter than most people expect.

    The fasting window permits only three things: water, plain black coffee (unflavored), and plain tea (unflavored). That’s it. No cream, no sweeteners (including zero-calorie ones), no flavored sparkling water, no herbal teas, no collagen supplements, no MCT oil, no bone broth, no chewing gum.

    The mechanism behind this is the cephalic phase insulin response (CPIR): within two minutes of tasting sweetness, the body releases insulin. The release peaks around four minutes and returns to baseline in eight to ten minutes. If you’re nursing a sweetened coffee over an hour, you’re triggering insulin release continuously across what you thought was your fasting window. Insulin is antilipolytic (it works directly against fat burning), so elevated insulin during the fast means the body cannot efficiently access stored fat for fuel. Autophagy, the cellular recycling process, is similarly disrupted.

    A few things worth knowing:

    • Zero-calorie sweeteners still trigger CPIR. Stephens cites a 2008 study where participants swished a sweetened solution and spat it out (without swallowing) and still showed insulin release. The trigger is taste, not calories.
    • Black coffee is specifically permitted because its bitter flavor profile does not trigger CPIR. It also supports autophagy and may accelerate glycogen depletion, which helps the body enter fat-burning mode faster.
    • Fats and proteins also break the fast, not because of taste, but because they give the body external fuel to burn (displacing stored fat) and because protein raises insulin and directly inhibits autophagy. MCT oil, butter in coffee, and collagen supplements fall under this rule.

    Stephens addresses skeptics directly. She acknowledges that contradictory studies exist on artificial sweeteners and CPIR. Her position: the downside of the clean fast is minimal (you give up flavored beverages during your fasting window) and the potential upside is significant, so she errs on the side of caution. That framing is intellectually honest in a way that is not common in wellness publishing.

    “Nothing gets between me and my fat-burning superpower!” — Gin Stephens, Fast. Feast. Repeat.

    The clean fast is, in Stephens’ words, non-negotiable. It is also the most common reason IF doesn’t work for people who think they’re doing it correctly.

    What Is Appetite Correction?

    Appetite correction is the concept Stephens considers most central to IF’s long-term success. The term was coined by Dr. Bert Herring (developer of the Fast-5 approach) and describes what happens to hunger and satiety signaling after sustained, genuine fasting.

    Here is the basic hormonal picture. Leptin is the satiety hormone; when it works correctly, it signals “you’ve had enough.” Ghrelin is the hunger hormone; it signals “eat now.” Years of frequent eating and chronic calorie restriction dysregulate both. Ghrelin stays elevated, creating persistent background hunger. The body develops leptin resistance, meaning the satiety signal is present but the body stops listening to it.

    This is why intuitive eating works effortlessly for people who have never dieted and fails spectacularly for people with a long restriction history. It has nothing to do with willpower. The hormonal signaling is genuinely broken, and telling someone with leptin resistance to “eat when you’re hungry, stop when you’re full” is like telling a colorblind person to stop at red lights.

    “It’s not that I didn’t have enough leptin; it’s that my body was no longer listening to it.” — Gin Stephens

    The clean fast, sustained over weeks to months, gradually restores leptin sensitivity and recalibrates ghrelin patterns. Stephens describes the signs of appetite correction emerging: food tastes slightly less compelling when genuine satiety arrives, a natural stopping point appears before finishing a plate, and the constant background preoccupation with food begins to quiet. Once appetite correction is developed, the question of how much to eat mostly answers itself.

    The honest caveat (and Stephens does not fully spell this out): appetite correction as a universal outcome of IF is not as well-supported by research as the CPIR argument is. The mechanism is plausible and consistent with what practitioners report, but there are not yet robust human trials showing that IF specifically restores leptin sensitivity for every practitioner. Many people do not spontaneously eat less during their eating window, at least not consistently. Results vary, and some people find that IF alone, without any attention to food quality or quantity, does not produce meaningful fat loss.

    This does not invalidate the framework. It does mean the “delay, don’t deny, eat whatever you want” framing can be taken too literally by some readers.

    How Does the 28-Day FAST Start Work?

    Most diet programs promise dramatic early results to keep people engaged. The FAST Start inverts that completely: you are instructed not to expect any weight loss during the first 28 days.

    The entire purpose of the onboarding period is metabolic adaptation. The body needs time to learn to access stored fat for fuel, to deplete liver glycogen stores sufficiently, and to begin the process of recalibrating hunger hormones. None of that happens in a week. Stephens offers three entry tracks based on personality:

    1. Easy Does It — Start at 12:12 and gradually tighten the window over four weeks
    2. Steady Build — Skip breakfast from day one and narrow from there
    3. Rip Off the Band-Aid — Start at 18:6 and work inward over four weeks

    The clean fast is non-negotiable across all three tracks.

    On Day 0, you record baseline measurements: weight, waist, hips, chest, neck, thigh, and photos. Then you put them away. On Day 29, you compare. Whatever the result, you accept it as the outcome of an adaptation process, not a fat-loss sprint. Stephens also prepares people for the specific challenges of the adaptation period: headaches and fatigue in the early weeks, possible overeating when the window opens (normal while hunger hormones are recalibrating), and a “wall” around weeks three and four when liver glycogen is nearly depleted but fat-burning has not fully kicked in yet. Naming these experiences in advance prevents the dropout pattern that ends most diet attempts.

    After Day 28, the governing principle is “tweak it till it’s easy.” Window options range from 12:12 up through OMAD (one meal a day), plus alternate-day fasting variants (5:2, 4:3, ADF). Stephens evaluates any configuration through three questions: How do you feel emotionally? How do you feel physically? Are you getting results? If a configuration fails all three after adequate time, it is not the right configuration for you, not a sign that IF doesn’t work.

    One important note for alternate-day fasting: genuine up days must be genuinely up. Eating without restriction on feast days is metabolically necessary. Restricting on both up and down days removes the hormonal signaling that makes the protocol work.

    Is Fast. Feast. Repeat. Worth Reading?

    Read this if you have tried IF before and it didn’t work. The most likely explanation is that the fast was not genuinely clean. This book explains exactly why that matters and gives you the framework to fix it.

    Read this if you have a long history of calorie restriction and chronic dieting and want to understand why your metabolism behaves the way it does. The introduction chapter on metabolic adaptation, drawing on the Minnesota Starvation Experiment and the Biggest Loser study, is worth the cover price on its own.

    Read this if you are already doing IF and have hit a plateau you cannot explain. The troubleshooting chapter is specific, ranked, and actionable in a way that most plateau advice is not. It starts where it should: with an honest audit of whether the fast is actually clean.

    Skip it if you are already deep into IF, your fast is clean, and you are looking for advanced protocol optimization. The book is written primarily for beginners through intermediate practitioners, and experienced IFers may find much of it familiar.

    One caveat: If you have significant hormonal complications (PCOS, hypothyroidism, insulin resistance, or a history with GLP-1 medications), the book addresses these populations briefly but not deeply. The core protocol is designed for metabolically typical people. Some readers will need modifications the book does not fully provide.

    The writing is warm, conversational, and occasionally padded with community anecdotes where tighter analysis would serve better. Stephens’ teaching instincts are the book’s greatest strength and its minor weakness simultaneously: she explains things well, but the editorial hand that would have cut 60 pages without losing the substance was not present. At 320 pages, it runs longer than it needs to.

    Still, it is the most thorough, honest, and scientifically grounded popular book on intermittent fasting written for a non-medical audience. For anyone who has ever wondered whether the problem was the protocol or the execution, the answer is almost certainly in here.

    Books Like Fast. Feast. Repeat.

    BookAuthorBest For
    Delay, Don’t DenyGin StephensStephens’ shorter debut — a useful companion if you want the basics without the full science deep-dive
    Fast Like a GirlDr. Mindy PelzIF adapted for women’s hormonal cycles; more protocol variety and more attention to female physiology than Stephens covers
    The Obesity CodeDr. Jason FungPhysician-level treatment of insulin resistance and hormonal obesity; stronger on the medical mechanism, less practical on everyday implementation
    The Circadian CodeDr. Satchin PandaTime-restricted eating from a research scientist’s perspective; grounded in circadian biology rather than community experience
    The Longevity DietDr. Valter LongoFasting research from a longevity angle; more focused on periodic prolonged fasting than daily eating windows

  • The Hormone Fix by Anna Cabeca: Summary, Key Ideas & Review

    Book in one sentence: A triple-board-certified OB-GYN argues that menopause weight gain and hot flashes are driven by three upstream hormones (insulin, cortisol, oxytocin), not estrogen, and teaches a practical keto-plus-vegetables plan you can test at home with $8 urine strips.

    What Is The Hormone Fix About?

    You’ve cleaned up your diet, cut the carbs, added more cardio. The scale hasn’t moved. Meanwhile, the hot flashes, the 3am wake-ups, the fog that sits on top of your brain by 2pm are all still there, maybe worse. If that’s where you are, Anna Cabeca wrote this book for you.

    Cabeca is a triple-board-certified OB-GYN and reproductive endocrinologist with over twenty years of clinical practice. She is also a woman who, in 2006, lost her eighteen-month-old son to drowning, and watched her own body respond to that grief by going into premature ovarian failure, gaining eighty pounds, losing her hair, and being told she would never conceive again. She was forty, medically trained, and could not figure out what was happening to her own body. The protocol in The Hormone Fix is what she developed to recover. She reportedly did, including conceiving the daughter she had been told was impossible.

    That backstory matters because it earns the voice. Cabeca writes as someone who worked out these ideas on her own body first, not just her patients’. The central reframe she offers is this: the hormones driving the worst menopause symptoms are not primarily estrogen and progesterone. They are insulin, cortisol, and oxytocin. Get those three into balance, and the reproductive hormones follow. Ignore them, and no amount of hormone replacement fully compensates.

    What Is the Keto-Green Diet and How Does It Work?

    Standard ketogenic eating works for many women, for a while. Fat loss, clearer thinking, fewer cravings. Then something shifts. Mood destabilizes, inflammation creeps back, weight stalls, and the irritability is hard to explain if you’re “doing everything right.” Cabeca’s clinical observation is that this pattern has a cause: strict keto makes the body acidic over time, and chronic acidity drives inflammation and causes the body to hold onto fat as a protective buffer.

    Her own experience confirmed it. She tested her urine with pH strips while eating strict keto and found herself persistently acidic. “No wonder I felt irritable,” she writes. The fix was simple in concept: add a large volume of alkalinizing vegetables (dark leafy greens, cucumber, zucchini, broccoli, asparagus, celery) to every meal, so the diet hits both fat-burning and alkalinity simultaneously.

    The plate ratio is easy to remember without counting anything:

    • 75% alkalinizing vegetables (by plate surface)
    • A palm-sized amount of protein
    • A golf-ball circle of healthy fat (avocado, olive oil, ghee, nuts)

    Two types of inexpensive urine strips, tested each morning, confirm whether the previous day’s eating actually hit both targets. Ketone strips show whether fat-burning is happening. pH strips show whether the body is alkaline (target: 7.0 or above). Both are available at any pharmacy for a few dollars.

    A word of honesty here: the claim that food directly changes your body’s pH is scientifically shaky. The body regulates blood pH within a very tight range regardless of what you eat. What the strips actually measure is urine pH, which does shift based on what you eat. The practical result of chasing alkaline urine (eating more vegetables alongside keto) is genuinely sound. The mechanism Cabeca offers to explain why it works is less solid than she implies. (That caveat doesn’t make the vegetables a bad idea. It just means the “alkalizing” framing is doing more marketing work than scientific work.)

    What the monitoring system does accomplish, regardless of the mechanism, is real. It personalizes a population-level protocol. Some women hit alkalinity easily but struggle to enter ketosis. Others achieve ketosis quickly but drift acidic from too much protein. The strips tell you which problem is yours. They also prevent the maddening experience of following a program while actually missing both of its targets.

    Why Does Cortisol Make Menopause Worse?

    Chapter 8 is raw in a way most diet books aren’t, and it’s also where the clinical framework gets personal. Cabeca traces the physiology of what happened to her body after her son died: cortisol at crisis levels for months, progesterone suppressed, thyroid impaired, visceral fat accumulating, oxytocin depleted. The chapter makes a clinical argument that many women going through menopause during high-stress life seasons need to hear.

    Chronic stress is not a mood problem. It is a hormonal problem. Cortisol and progesterone compete for the same receptor sites. When cortisol is chronically elevated, progesterone cannot get in. The result: progesterone deficiency symptoms (anxiety, poor sleep, mood swings) even when blood levels look normal on paper. This physiological reality is well-documented and almost never discussed in the average clinical encounter.

    The dietary implications are manageable. The exercise implications are harder to accept. Cabeca argues that intense cardio worsens the hormonal picture for women with chronically elevated cortisol, because vigorous exercise is itself a cortisol stressor. Her prescription runs against most conventional fitness advice: reduce intense exercise, replace it with walking, yoga, and gentle strength work, and treat sleep as a medical intervention rather than a lifestyle preference.

    She adds breathing practices, gratitude journaling, and nature exposure, framed not as soft suggestions but as cortisol management tools. These interventions have real physiological effects (slow breathing activates the parasympathetic nervous system; gratitude practices measurably reduce cortisol in research settings). Whether the degree of benefit matches the confidence of Cabeca’s prescriptions is harder to pin down, but the direction is right.

    What Does Oxytocin Have to Do With Weight Loss?

    Most people have heard oxytocin described as the “cuddle hormone.” Cabeca makes a bigger claim: oxytocin is a key upstream regulator of wellbeing, and it’s also the one thing conventional medicine cannot prescribe.

    Oxytocin directly opposes cortisol. When oxytocin rises, cortisol falls. When cortisol falls, progesterone receptors open up. On the weight side, oxytocin is involved in satiety signaling and has been shown in animal and human studies to prevent insulin resistance and support fat loss. One 2008 study Cabeca cites found that mice with blocked oxytocin receptors became obese even without eating more food. A 2013 study showed extra oxytocin in humans triggered weight loss.

    “There is a definite physiology behind all this. You’re not going crazy! If you ever experience burnout, emotional disconnection, or withdrawal from things and people you love, it is probably due to cortisol knocking oxytocin down.”

    The behaviors that raise oxytocin reliably include:

    • Twenty-second hugs (below that duration, the oxytocin release is minimal)
    • Sustained eye contact
    • Acts of generosity or service
    • Prayer and meditation
    • Group movement with social components (Zumba, dance classes, group yoga)
    • Sexual intimacy
    • Gratitude journaling

    Cabeca’s framing of these as medical interventions rather than lifestyle suggestions is the book’s most interesting claim. It’s also why the dietary approach alone often fails. A woman eating Keto-Green flawlessly while going through a divorce, caregiving for an ill parent, and sleeping alone has almost no oxytocin inputs. The food cannot compensate for what connection does.

    The oxytocin research is real but still developing. Cabeca applies it with more confidence than the dose-response evidence strictly supports. The twenty-second hug figure, for instance, comes from preliminary research, not a clinical guideline. But the general principle (connection, touch, and warmth measurably affect cortisol and metabolic function) holds up better than it might look at first.

    Is The Hormone Fix Worth Reading?

    Read this if you’re in perimenopause or postmenopause and have tried standard keto, clean eating, or both, and experienced the mood destabilization or eventual stall that many women describe. Also read it if you’ve been told your labs are normal while feeling anything but. Cabeca’s cortisol-progesterone framework explains a lot of that. And read it if you’re already on hormone replacement therapy but want to understand what lifestyle factors might be working against its effectiveness.

    Skip it if you’re premenopausal looking for support with PCOS, endometriosis, or reproductive-age cycle irregularities. Cabeca’s framework is aimed squarely at perimenopause and menopause. Skip it too if you need rigorous dose-response data before adopting supplements. The supplement chapter is thin on that front.

    One caveat: the alkaline science is oversold. The practical instruction it produces (eat more vegetables) is good. The mechanism Cabeca uses to explain why (body pH shifts with food) is not as solid as she presents it. Readers who notice that gap may lose trust in parts of the book that actually earn it. Take the vegetable-heavy eating pattern seriously. Take the pH framing as a useful heuristic, not hard science.

    The practical value here is real. The 16-day plan, the urine strip monitoring system, and the three-hormone framework give perimenopausal and postmenopausal women a coherent starting point that addresses metabolic and lifestyle drivers before (or alongside) conventional hormone therapy. For a lot of women, that starting point is exactly what’s been missing.

    Books Like The Hormone Fix

    BookAuthorBest For
    MenuPauseAnna CabecaCabeca’s follow-up with five different eating plans for different menopause symptoms
    Women Food and HormonesSara Gottfried, MDA similar functional medicine approach with more emphasis on elimination and lab testing
    Fast Like a GirlMindy PelzExtends Cabeca’s fasting angle into a full cyclical fasting protocol for women at all life stages
    The Menopause Diet PlanHillary Wright & Elizabeth WardMore conventional dietitian-led approach; stronger evidence base, less framework-driven
    Eat to Thrive During MenopauseJenn HuberPractical nutrition-forward guide without the keto framing

  • Why We Get Fat by Gary Taubes: Summary, Key Ideas & Review

    The book in one sentence: Gary Taubes argues that fat accumulation is driven by insulin, not calories, and that the “eat less, move more” model has failed for 50 years because it misidentifies the cause.

    What Is Why We Get Fat About?

    Imagine you’ve spent years trying. You tracked calories. You cut fat. You ate smaller portions and went to the gym five days a week. And you still couldn’t keep the weight off. The official explanation (“you’re doing it wrong, try harder”) starts to feel less like advice and more like an insult.

    Gary Taubes wrote this book for you. A science journalist who has won the National Association of Science Writers’ Science in Society Award three times (the only print journalist to receive it more than once), Taubes spent over a decade inside the primary research literature on obesity before publishing Good Calories, Bad Calories in 2007. Why We Get Fat is the shorter, more accessible version of that work. Same argument, fewer footnotes, easier to read in an afternoon.

    The argument, plainly stated: you don’t get fat because you eat too much. You get fat because of what you eat, specifically foods that spike insulin, which then signals your fat tissue to store and hold. Overeating and inactivity are not causes of obesity. They are effects of it, or at minimum, responses to the same hormonal dysregulation. Taubes calls this a reversal of the arrow of causation, and it changes everything about how to think about treatment.

    The book arrived at a moment when the public health consensus on obesity was near-total and its record was not good. Worth reading in that light.

    What Does Taubes Say About Calories In, Calories Out?

    He doesn’t say thermodynamics is wrong. That matters, because critics sometimes frame his argument that way. The first law of thermodynamics (energy is conserved) is correct. If you gain fat mass, you have taken in more energy than you expended.

    What Taubes says is that this observation explains nothing useful about why it happens or how to stop it.

    Saying “you gained weight because calories in exceeded calories out” is like saying a room got crowded because more people entered than left. True. Completely unhelpful if you want to know why, or what to do about it.

    More importantly, the two sides of the equation are not independent. Cut your food intake sharply, and your body responds: metabolism slows, body temperature drops, lethargy increases, hunger intensifies. The Women’s Health Initiative enrolled nearly 50,000 women and had 20,000 of them cut roughly 360 calories per day for eight years. Average weight loss: two pounds. Average waist circumference went up. By the arithmetic, they should have lost over 30 pounds in year one. The body compensated at every turn.

    “Of all the dangerous ideas that health officials could have embraced while trying to understand why we get fat, they would have been hard-pressed to find one ultimately more damaging than calories-in/calories-out. That it reinforces what appears to be so obvious — obesity as the penalty for gluttony and sloth — is what makes it so alluring.”

    The caloric model also carries a moral weight that Taubes finds both unjustified and damaging. If obesity is a failure of energy balance, and energy balance is a matter of choice, then the obese are to blame. Taubes argues this conclusion is wrong, cruel, and gets in the way of actual treatment.

    How Does the Carbohydrate-Insulin Model Work?

    Fat tissue is not a passive storage container that fills up when calories overflow. Fat is constantly flowing in and out of fat cells, driven by enzymes and hormones. Two players matter most:

    • Lipoprotein lipase (LPL): activated by insulin; pulls fat from the bloodstream into fat cells
    • Hormone-sensitive lipase (HSL): suppressed by insulin; releases fat from fat cells to be burned

    When insulin is chronically elevated, LPL is in overdrive and HSL is shut down. Fat moves in. It doesn’t move out. The rest of the body, denied access to stored fuel, registers this as energy deprivation. You get hungry. You get tired. Not from laziness or weakness. From a hormonal signal that says “store, don’t burn.”

    The foods that drive insulin highest and fastest are the most fattening ones:

    • Refined flour products: bread, bagels, pasta, cereals, crackers
    • Liquid sugars: soda, juice, beer, sweetened coffee drinks
    • Starchy vegetables: potatoes, corn, white rice
    • Sugar in all its forms (with fructose, processed by the liver, producing a separate set of problems around insulin resistance and triglycerides)

    Non-starchy vegetables (leafy greens, broccoli, cucumber, cauliflower) barely move the needle. They are fibrous, digested slowly, and produce modest insulin responses. For practical purposes, Taubes says, they are not fattening.

    The reversed arrow

    Taubes’s most counterintuitive claim is also the one with the most supporting evidence. He cites George Wade’s rat experiments: female rats whose ovaries were removed became obese rapidly. When food was restricted so they literally couldn’t overeat, they still fattened. Instead of overeating, they became sedentary. The fat accumulation was primary. The behavioral changes were compensation.

    “We don’t get fat because we overeat; we overeat because we’re getting fat. It’s a simple but critical inversion of cause and effect.”

    If that’s true, then the whole framing of “lack of self-control” as the cause of obesity is backward. The hunger and inactivity that accompany obesity may be biological responses to fat accumulation, not the choices that produced it.

    A note on where the science stands now

    Taubes published this in 2010. Since then, carefully controlled metabolic ward studies by NIH researcher Kevin Hall have found that when protein is matched and calories are closely tracked, low-carb and low-fat diets produce similar rates of fat loss. The insulin response differs, but under strict conditions this doesn’t translate to dramatically different fat loss.

    This doesn’t mean low-carb diets don’t work. In real-world settings they often work better than low-fat approaches, likely because of reduced hunger and fewer cravings. But it does suggest that the carbohydrate-insulin model, as Taubes presents it, overstates the hormonal driver and understates other factors: food reward and appetite regulation in the brain matter too. (Stephan Guyenet’s competing framework, which Taubes dismisses too quickly, deserves its own read.)

    Hold the model as a powerful lens, not the final word.

    What Does Taubes Actually Recommend Eating?

    The practical protocol in the book comes from Eric Westman’s Duke University Lifestyle Medicine Clinic. It is not complicated:

    Remove entirely:

    • All added sugars, all grain and flour products
    • Starchy vegetables (potatoes, corn, white rice)
    • All liquid calories (soda, juice, beer, sweetened drinks)

    Eat freely:

    • Meat, fish, poultry, eggs, full-fat dairy
    • Non-starchy vegetables, leafy greens

    Do not count calories. Do not restrict portions of permitted foods. Eat when hungry, stop when full. Target under 20 grams of net carbohydrates per day in the early phase (ketogenic territory).

    Taubes frames this as less restrictive than it sounds. The foods coming out are nutritionally thin (white bread, pasta, soda, candy). The foods staying in are nutrient-dense. Hunger often decreases once insulin comes down, because the metabolic signal shifts from “store everything” to “burn what’s available.” Many people report the cravings diminish within a week or two.

    The hard part is that Taubes presents this as permanent, not a temporary diet. The hormonal environment that drives fat accumulation returns if you return to refined carbohydrates. That’s a real ask, and he doesn’t minimize it.

    Is Why We Get Fat Worth Reading?

    Read this if you’ve done calorie-restricted diets and found them unsustainable or ineffective, especially if you’ve been told the failure is your fault. Read it if you have metabolic syndrome, prediabetes, or carry most of your weight in your midsection. Read it if you want to understand the biology behind low-carb approaches rather than just being handed a food list.

    Skip it if you’ve already adopted a low-carbohydrate eating pattern and are looking for guidance on maintaining it. Skip it if you’re primarily interested in the psychological and emotional dimensions of eating. Taubes has almost nothing to say about that side of things. Skip it if you want a balanced review of all current obesity science.

    One honest caveat: Taubes writes like a prosecutor, not a judge. He is marshaling a case, and he does it well. He also dismisses competing theories too quickly (the food reward model, above all), and presents the carbohydrate-insulin model with a confidence that subsequent research has not fully justified. The science has moved since 2010. Read The Hungry Brain by Stephan Guyenet alongside this one if you want the more complete picture.

    Still, as a corrective to the shame-based “eat less, move more” narrative, and as an explanation of why insulin matters in fat metabolism, the book holds up. For many readers it lands as a genuine relief: not an excuse, but a better explanation.

    Books Like Why We Get Fat

    BookAuthorBest For
    The Hungry BrainStephan GuyenetThe strongest competing theory: how the brain regulates appetite and why hyperpalatable food short-circuits it
    The Obesity CodeJason FungExtends Taubes’s insulin argument and adds intermittent fasting as a practical lever
    The End of OvereatingDavid KesslerFood industry engineering of hyperpalatable foods; complements the food reward model
    Why We Get SickBenjamin BikmanDeep dive into insulin resistance as a root cause of metabolic disease
    Food RulesMichael PollanPractical eating principles from a different angle; short, readable, reaches similar conclusions