Today, I am lucky to have here with me, a specialist in Weight Management and Bariatric Surgery for adults and adolescents, Dr. Robert Cywes. He has been doing bariatric surgery for 18 years, performing over 8,000 surgeries.

This is an episode that originally aired on March 2020, and it was so good we decided to re-release it here today. 

Dr. Cywes’ medical training began in Cape Town, South Africa, where he received his medical degree from The University of Cape Town. In 1989, Dr. Cywes moved to North America and completed a year-long residency in Pediatric Surgery at Ohio State University’s Columbus Children’s Hospital.

After completing his pediatric surgery fellowship at the University of Michigan’s C.S. Mott Children’s Hospital, Dr. Cywes was appointed as an Assistant Professor of Pediatric and Fetal Surgery at Vanderbilt University in Nashville, Tennessee where he did hepatic stem cell research. During this time, Dr. Cywes became increasingly interested in adolescent obesity and the impact of the liver and metabolic syndrome on young patients.

Dr. Cywes’ research led to a comprehensive understanding of the toxicity of chronic excessive carbohydrate consumption as the primary cause of obesity and so-called obesity-related co-morbidities, and he became interested in developing a clinical program to treat obese patients using this knowledge.

Dr. Cywes relocated to Jacksonville, Florida where he joined the Department of Pediatric Surgery at the Nemours Children’s Clinic and Wolfson Children’s Hospital. This led to a national meeting in Jacksonville where guidelines for adolescent obesity surgery were established.

Dr. Cywes established JSAPA to continue his work in both adolescent and adult obesity treatment and surgery, and in 2013 opened a practice in Palm Beach County, Florida. He now works with a highly experienced team of professionals from a variety of medical sub-specialties to better care for obese patients. He has developed the practice into an internationally recognized Center of Excellence for obesity surgery. The practice uses a cognitive behavioral therapy approach that addresses carbohydrate addiction, along with bariatric surgery, to help patients manage their obesity long term.

In this episode, Dr. Cywes opens the show discussing the correlation between carbohydrates and toxic drugs. Our bodies do not need to run on sugar; our bodies prefer a keto lifestyle. Also, Dr. Cywes explains effective methods of treating diabetes and what's wrong with conventional treatments. Stay tuned, as Dr. Cywes discusses dopamine fasting, serotonin loading, and how our feedback controls for survival work.

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[01:10] About Dr. Cywes

• Cywes recognized the connection between carbohydrates and toxic drugs within himself. Addicts are usually not able to see how bad it is within themselves.
• He moved to Canada, where he completed his general surgery residency and specialized in Minimally Invasive Surgery at the University of Toronto.
• Also, Dr. Cywes earned a Ph.D. in Liver Carbohydrate Metabolism and the effect of glucose metabolism on liver transplant immunology.
• Cywes learned that the body doesn’t need to run on sugar. In fact, it prefers a keto method of running. He also learned that fatty liver doesn’t come from the consumption of fat. It happens from infusing insulin and sugar. 

[10:00] About LDL

• LDL is a complex molecule. It’s a truck on the road transporting fat on your body. LDL will lay down fat over an injury. HDL will come along and remove the fat.
• LDL is not causing the injury; it’s desperately trying to heal the injury.
• Think of the liver like a subdivision. You have all the houses which are the different cells. Tiny roads that go to each house. Think about a bunch of garbage that blocks the road. You can’t get food and oxygen downstream to those cells. Eventually, those cells will die. As you infuse sugar into the liver, you will see that swelling.

[14:15] The Difference Between Ketosis and Diabetic Ketoacidosis

• The difference between ketosis and diabetic ketoacidosis is 5.5 – 6 grams of sugar.
• It’s half to one gram difference. It’s an incredibly small difference.
• An apple has 25 grams of sugar in it. That’s a five-fold increase in blood sugar.
• Think about how resilient the body is to take sugar out of the bloodstream.

[16:15] Flaws With Conventional Approaches to Diabetes

• Nothing fixes diabetes. Drugs just slow down the process. Once someone goes on the drugs, they are told to eat sugar.
• There is a misconception that the body has to have sugar.
• If you don’t have carbs going in, then you are not going to have the type 2 effect.
• If you manage your blood sugar tightly, you don’t have insulin resistance.
• Chronic carbohydrate consumption will cause resistance.
• If the body protects itself by resistance, then it doesn’t matter what the source of the insulin is.
• A1C is an injury to blood cells because they are damaged.

[20:35] Effectively Treating Diabetes

• If we are going to treat diabetes effectively, we have to understand how our body protects itself.
• We can treat diabetes without sugar.
• We are relying on people who are dependent on the diabetic manufacturing industry to tell us not to eat sugar. It’s counter-productive.
• How do you tell people that statins are unnecessary?
• No one can get their hands on an inexpensive CGM. You cannot manage a type 2 diabetic without a CGM. Yet, because of the FDA, these things are so expensive that people cannot afford them. CGMs safe lives.

[23:40] The Best Feedback Instrument to Lose Weight

• The best instrument to lose weight is a CGM.
• The worst device to lose weight is a scale.
• You can eat a tub of ice cream, and the scale will go down. You can do a 24 hour fast, and the scale will go up.
• As soon as you put the first spoon of ice cream in your mouth, your CGM will be alarming.

[26:30] Our Bodies Have Feedback Controls for Survival

• For every action, there is an equal and opposite reaction.
• If something is not necessary for human survival, then it doesn’t have a feedback system.
• The systems are very complex at the interface level. The human body will use one molecule to create a whole variety of downstream effects.
• It is ridiculous to tell people to drink water. Your body knows when it needs water - it will rarely allow yourself to get thirsty. There is no need for a mathematical formula to tell us when to drink.
• Alcohol is not necessary for survival. There is no stopping point for our bodies. That is why we have a mathematical formula for when to stop drinking.
• The human body has no need to know when you should stop eating. There is no feedback control for the consumption of carbohydrates.
• People are not fat loading their food, they are fat overloading. It’s not okay to eat a lump of butter with steak attached. Overeating fat will make you feel like crap afterward.
• Part of keto is allowing your body to tell you when it has had enough.

[40:30] Keto is a Metabolic State

• There is so much bullshit in nutrition science.
• The best place to go to is understanding the complexity of human biology.
• Human beings changed to become better with our brains. To develop brain function, we needed a more significant source of animal fat. We hunted and primarily lived on coastlines with easy access to water and seafood. Our brains need animal fat.
• Human beings evolved to become omnivores. Our primary focus is on the carnivore diet when we don’t have access to animal fat.
• If you have to supplement your food with pills, then you are not on a complete diet.

[48:30] Dopamine Fasting and Serotonin Loading

• Carbohydrates are a drug and not food.
• When you get rid of carbohydrates, they will leave deficits.
• People don’t understand that the main reason they overuse carbohydrates is because they have a dysfunctional relationship with a substance that gives them instant gratification.
• If you have a rough day and eat a tub of ice cream; then you’ve had instant gratification.
• Going on a walk requires effort. However, it allows you to process tough issues that drive emotions.
• A healthy person can focus for 20 minutes, then they give themselves a serotonin break like a sip of coffee or a deep breath.
• We have lost track of effective serotonin relief.
• Go for a walk, do something charitable, do something creative.

AND MUCH MORE!

Resources from this episode:

• Check out Dr. Cywes’s Website

Follow Dr. Cywes

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Text: (561) 517-0642

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Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.