Well, I’m not sure what your conceptions are? After a few minutes, Holmes said I was killing him. I was, I’m sure. He was killing me. Sugar is killing us all. To some degree. I hope the invasion of my sensibilities was more aggressive to Holmes than it was to the people watching weekend daytime news. But it helped me hone this idea that I have to deal in ideas in a frank, consumer-oriented way sometimes if I’m going to be productive to public health.

On Wednesday I got to do a longer segment on the local NPR affiliate alongside Dr. David Ludwig, a professor at Harvard Medical School. That was a good discussion, as it always is with host Kojo Nnamdi. Ludwig is a man of ideas, important ideas that he’s been saying for a long time. Here's the most interesting part:

NNAMDI: Many of us have been led to understand that weight gain or loss is simply a matter of willpower, our ability to restore balance to that equation of the calories that go in our bodies and the calories that we use and go out. You've done a lot of research that suggests our basic understanding of that equation is off kilter. How so?

LUDWIG: … Very few people can lose weight over the long term with low-calorie diets. And those who can't are blamed for lack of discipline and willpower. So, according to an alternative view, weight is controlled like body temperature and a range of other biological functions. Eating too much refined carbohydrate has, by this theory, raised insulin levels and programmed our fat cells to suck in and store too many calories. When this happens, there are too few calories for the rest of the body. So the brain recognizes this and triggers the starvation response. We experience that as becoming excessively hungry and our metabolism slows down. ... Eventually we succumb to hunger and overeat. So a better approach, if this theory is correct, is to address the problem at its source by cutting back on the foods that are over-stimulating our fat cells: the refined carbohydrates like grains, potato products, concentrated sugars, especially the refined grains. And by eating this way, we can basically ignore calories and let our body-weight control systems do the work.

NNAMDI: Is it oversimplification to say that your research suggests we’re getting hungrier because we’re getting fatter?

LUDWIG: [No,] that’s right.

Ludwig and co-author Mark Friedman wrote about this in a New York Times article last month headlined “Always Hungry? Here’s Why,” saying that the “simple solution” ingrained in people who want to lose weight “is to exert willpower and eat less.”

The problem is that this advice doesn’t work, at least not for most people over the long term. In other words, your New Year’s resolution to lose weight probably won’t last through the spring, let alone affect how you look in a swimsuit in July. More of us than ever are obese, despite an incessant focus on calorie balance by the government, nutrition organizations, and the food industry. … As it turns out, many biological factors affect the storage of calories in fat cells, including genetics, levels of physical activity, sleep, and stress. But one has an indisputably dominant role: the hormone insulin.

The food industry didn't necessarily focus on calorie counts until recently, but it has definitely embraced it now. Twix and Oreos come in 100-calorie packs. Coke tells you exactly how to burn its calories off. It’s better than nothing, right? Here’s my foray into the realm of nutrition ideas: Eating based on calories is a problem. That’s what I should’ve told T.J. Holmes. It’s really an aggregate of what many nutritionists and writers are saying right now, but: Calorie counting doesn’t work for most people, and it’s manipulated by companies marketing junk. It’s not a good way to think about food.