Home » Fat Chance: Fructose 2.0 by Dr. Robert Lustig (Transcript)

Fat Chance: Fructose 2.0 by Dr. Robert Lustig (Transcript)

366 million diabetics walking the earth, that’s 5% of the worlds’ population. And they are chewing through all the health-care resources.


This was just three months ago, diabetes costs the US $24 billion. Now if we could recoup even a fraction of that, we wouldn’t even need health-care reform. In fact, it’s been suggested that we wouldn’t even need financial reform. Okay, 41% rise in 5 years, this is going up so fast it makes your head spin.

What’s the future going to be like

And here’s the future if we do nothing. Experts predict 165 million Americans, 42% would be obese by the year 2030. 100 million Americans, that’ll be 33%, will have diabetes by 2050, but fear not, because it won’t really matter because Medicare will be broke by 2026.

So, as the Soup Nazi once said: “No health-care for you”. Well, the fact of the matter is, I’m going to be 69 in 2026 and I want my freaking Medicare. And so should you all. The point is we have to do something different, and you know the old adage, right? Of the definition of insanity is doing the same thing over and over again and expecting a different result.

Well I’m here to tell you for the last 30 years we’ve done the same thing over and over and over again and there has been no change in the result. So we have to rethink this, we have to reframe the argument and that’s what we are going to try to do tonight. And I’m going to do it right now.

So here’s the way people view this issue. This is a Venn diagram of all the adults in America: 30% obese over here, and 70% normal weight over here. And everybody assumes that the problem is this group over here because 80% of the obese population is sick in some fashion with type-2 diabetes, lipid problems, hypertension, cardiovascular disease, cancer, dementia, non-alcoholic fatty liver disease, polycystic ovarian disease, etc, etc.

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So if you do the math on this, that’s 80% of 30% of 240 million, that’s 57 million sick, and it’s those 57 million that are bankrupting the country. And so it’s the obese person’s fault only. And that’s the way everyone views this.

This is wrong, this is a mistake, this is a disaster actually, because it is not correct.

Here’s the real story. In fact, 20% of the obese population is completely metabolically normal. They have normal insulin dynamics. They don’t get sick. They will live a completely normal life, die at a completely normal age, cost the taxpayer nothing, they’re just fat.

Conversely, up to 40% of the normal weight population have the exact same metabolic dysfunction that the obese do, they are just normal weight. And so they don’t even know they are sick, until it’s too late, because normal weight people get type-2 diabetes, they get hypertension, they get dyslipidemia, they get cardiovascular disease, they get cancer, they get dementia, etc, etc.

And so when you do the math on that, that’s another 67 million. So that’s actually outclassing the obese, and so the total is 124 million, that’s more than half of all of America.

Now you may remember HIV. Remember HIV? When did HIV become a public health crisis? No, not in the 80s. In 1991.

1979 patient zero, so we first learned about the diagnosis. Throughout the entire 80s it was all about the gays and the addicts. And it was always, it’s their problem, their personal responsibility, their behavior, their fault. And then something happened in 1991, anybody remember what it was?

Magic Johnson, Magic Johnson got HIV. And all of a sudden everyone went “Holly Mother…” you know what and everybody realized, you know what? Everyone’s at risk, and all of a sudden it became a public health crisis.

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So when does a personal responsibility issue become a public health crisis? And that’s what we’re going to talk about tonight. Because this is a public health crisis.

Here’s the slide that demonstrates the phenomenon. So here are two equally weighted adult men, which one’s healthy and which one’s sick. Anybody know? The one on the bottom is sick, right, he’s sick.

Why? All that visceral fat, all that fat surrounding the organs, see this guy over here he’s got big love handles, but you know, so what? In fact, this is perfectly healthy, it’s no problem, because subcutaneous fat is actually kind of good for you. There are actually studies that show more subcutaneous fat, more longevity.

Whereas this stuff, this is the bad stuff, this is the poison stuff over here. So the fact is, standing on a scale doesn’t tell you where your fat is, what does? Well your waist circumference is a good start, and then there’s some lab tests you can do as well. The bottom line is there are a lot of normal weight people who have this phenomenon called TOFI. Thin in the outside, fat on the inside.


Probably some right here in the audience. And they get type-2 diabetes, they get dyslipidemia, they get hypertension, etc, etc, you get the picture?

Everyone’s at risk, because everyone’s exposed, the question is, what it is you’re exposed to? Because obesity is not the problem, it never was. They want you to think it’s the problem, but it ain’t the problem.

What is the problem? Metabolic syndrome is the problem, the cluster of diseases that I’ve just described you, because that’s where all the money goes. Obesity costs almost nothing, metabolic syndrome is 75% of all health-care costs today. And there’s the list right there, everyone with me now? Okay, do I have your attention?

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