Last week, Oprah aired her celebratory special about weight loss drugs like Ozempic. I’ll be honest — a lot of it concerned me. But this newsletter isn’t about weight loss drugs. It’s about the connection between weight and something much more important: chronic inflammation. Which is why Oprah’s statement midway through the special especially struck me:

“I can eat half a bagel and be fine,” she said, “I just want less of the bagel.”

Sounds great in theory, but here’s the problem: on a cellular level, a bagel does not nourish the body, and neither does half of a bagel. Instead, refined carbs, sugar, and processed foods fuel chronic inflammation, the very process that can cause weight gain in the first place. 

Chronic inflammation is a runaway health crisis that impacts 90% of us. Because chronic inflammation originates in the cells, not on the scale, to solve it sustainably, we have to zoom in before we can zoom out.

Oprah missed the point, but you don’t have to.

Inflammation is created by the immune system

Our immune system is constantly looking for invaders and is equipped to send out the cellular troops at a moment’s notice. If you’ve ever had the flu, you know what systemic inflammation feels like when it’s in high gear.

Modern life has ushered in a new threat in the form of high-sugar, refined, and processed foods. When we consume foods like these, our immune system senses the damage to our cells and releases white blood cells to protect against the threat. This would be ok if it happened occasionally, but the average American now eats 1,200 pounds of these foods per year.

The result: our immune system, which was designed to go “on” and “off” as threats come and go, is triggered by food to stay “on” all the time. The consequence of this looks different for different people.

For most of my twenties, I woke up with puffy eyes and went through the day moving from one craving to the next. I was slowly but continuously gaining weight. I accepted this as part of being alive. Most of us are so used to living with low-grade inflammation that we don’t even realize it’s happening. 

3 ways chronic inflammation and weight gain are linked

Inflammation and weight gain are like two people in the midst of a passionate, co-dependent, toxic love affair. Here’s how it works:

Chronic inflammation causes over-eating and tells the body to store fat

Inflammation raises levels of leptin, a satiety hormone that tells us we’re full. In the short-term, this elevated leptin reduces appetite (one of the reasons you might not feel hungry when you’re sick). But, when leptin remains chronically elevated, our bodies become less and less sensitive to it. As we lose our ability to “hear” this satiety signal, it becomes easier and easier to eat more than our body needs.

Meanwhile, inflammation drives insulin resistance, which primes the body to create and store fat. High levels of insulin make it easy to gain weight and hard to lose it (insulin is so notoriously pro-growth that some body builders use it to bulk up).

Chronic inflammation causes cravings

As insulin resistance develops, our ability to process sugar and carbs declines. This results in more blood sugar spikes followed by crashes. These crashes trigger cravings, intense hunger (even if we’ve just eaten), and activation of the brain’s addiction centers. 

Fat tissue itself is pro-inflammatory

Contrary to popular belief, fat is not an inert blob. Fat is an (incredible) endocrine organ capable of releasing all kinds of chemical signals including hormones and inflammatory molecules. 

The interplay between inflammation and fat creates a damaging flywheel, where inflammation drives fat gain, which drives inflammation, which drives more fat gain...and an infinite loop is created. Escher understood this concept well:

The good news

Now for the good news: From birth, our bodies are designed to thrive and find balance. We can break the cycle of inflammation and when we do, we heal our cells and open the biochemical path to balanced, healthy, natural weight regulation (and much more). 

What you should do about it

The causes of inflammation are multifold, including food, stress, sleep deprivation, and exposure to pollution. We’ll focus on food here with more to come in the future:

The long-term goal is a whole-food diet (like the Mediterranean Diet) without processed foods, added sugars, or refined carbs. Here are 4 things you can do this week to get started and dramatically lower your inflammation:

Add an additional vegetable to every meal

There is an abundant amount of research demonstrating the anti-inflammatory impact of each vegetable added to your diet. Here are two of my favorite veggie hacks:

• Keep the freezer stocked: I always have frozen cauliflower, broccoli, kale, and other vegetables on hand (learn to make frozen vegetables that aren’t gross) and liberally add them to smoothies, stir fries, sauces, and everything in between

• Use vegetables as the “base” instead of carbs: Use cauliflower rice instead of rice, zucchini noodles instead of pasta, and lettuce wraps instead of buns (too depressing? maybe).

Don’t eat dessert for breakfast

Breakfast is the worst culprit of desserts masquerading as real food. Spotted on a recent trip to Whole Foods:

What you eat for breakfast lays the blueprint for the day: a breakfast that nourishes your cells rather than damaging them will reduce cravings, increase satiety, and send your immune system the message that it can relax.

Here are some of my favorite breakfast ideas:

• Monk fruit in your coffee or tea instead of sugar

• Your favorite version of eggs or a tofu scramble

• Chia seed pudding, plain greek yogurt, or cottage cheese topped with keto granola

• Smoothies with frozen berries

• Almond flour pancakes (to save $, make your own almond flour)

• 3-ingredient bagels, Base culture toast, or a whole grain, unrefined bread without added sugar

• Steel cut oats (small portion) topped with tons of nuts and seeds

Get spicy

Spices and herbs are anti-inflammatory powerhouses. Go wild with cinnamon, basil, turmeric, black pepper, ginger, garlic, and more.

Eat one anti-inflammatory MVP per day

Amidst all of the nutrition science research, a few anti-inflammatory foods consistently rise to the top. Commit to eating (at least) one of these per day this week:

• Fatty fish rich in omega-3s, like salmon and sardines

• Olive oil

• Green tea

• Nuts

• Leafy Greens

• Berries 

May your week be filled with fewer cravings, more collards, and nourishment in all areas of your life,

Dr. Lauren Kelley-Chew
@drkelleychew

PS. I was recently a guest on a podcast episode devoted to weight loss drugs, our food ecosystem, and what sustainable health might look like — stay tuned for the release in May!

I’m a Stanford and Penn-trained MD and health tech founder with over a decade working on health optimization in Silicon Valley. Biohacking for the Rest of Us is my answer to medical elitism – I want all people to have access to cutting-edge science that can dramatically improve their health.

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