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Summary

In this detailed video, Dr. Eric Westman addresses the controversial claims that following a carnivore diet causes pre-diabetes or diabetes. Highlighting recent viral social media critiques targeting popular carnivore influencers, Dr. Westman explains why these claims oversimplify and misinterpret key health markers, particularly blood glucose and hemoglobin A1C (HbA1C) levels, when taken out of context. He clarifies what type 2 diabetes truly means—prolonged elevated blood sugar accompanied by elevated insulin—and emphasizes that rising blood glucose numbers alone are insufficient to diagnose diabetes, especially in individuals who consume little to no carbohydrates. Dr. Westman dives into the biochemistry behind glucose metabolism on carnivore diets, such as gluconeogenesis, and explains how blood sugar and HbA1C readings can differ due to longer red blood cell lifespan or lower insulin levels. He critiques typical diabetes definitions as being carb-centric, which overlook metabolic nuances on low-carb or carnivore diets. He concludes that despite slightly elevated HbA1C readings in some carnivore diet followers, these values do not necessarily indicate diabetes or pre-diabetes because intracellular glycation and insulin levels remain low. He also stresses the need for comprehensive clinical evaluation rather than relying solely on standard blood sugar markers and encourages use of continuous glucose monitoring for personalized insight. Dr. Westman reassures viewers that type 2 diabetes often reverses on carnivore diets due to cessation of dietary carbohydrates and reduced insulin resistance. Overall, he urges critical thinking about nutritional misinformation and offers balanced perspectives rooted in current biochemical and clinical understanding.

Highlights

• 🥩 Carnivore diets do not inherently cause diabetes, despite online claims targeting influencers.
• 📊 Type 2 diabetes is defined by both high blood sugar and high insulin over prolonged periods, not just blood sugar alone.
• 🧬 Hemoglobin A1C alone can be misleading in carnivore diet followers, due to differences in red blood cell lifespan and metabolism.
• 🔄 Gluconeogenesis allows the body to maintain blood glucose levels without any dietary carbohydrate intake.
• 🩸 Fasting glucose levels for carnivore diet followers studied were mostly normal and below diabetic thresholds.
• 🛑 Elevated HbA1C in carnivore diet followers does not equal intracellular glycation damage caused by high carbohydrate intake.
• 🔍 Continuous glucose monitoring provides a clearer picture of blood sugar stability on low-carb or carnivore diets.

Key Insights

• 🥩 Carnivore Diet and Blood Sugar: Carnivore diets dramatically reduce carbohydrate intake, thereby lowering insulin production. This fundamentally changes how blood glucose and related markers like HbA1C should be interpreted. Traditional diagnostic criteria for diabetes—developed for carb eaters—do not always apply directly to carnivore dieters. This distinction is crucial in avoiding misdiagnosis based solely on elevated HbA1C or mildly elevated glucose readings.

• 🧬 Glycation Beyond Blood Sugar: Dr. Westman emphasizes that diabetes-related damage is caused not just by elevated blood sugar but by glycation inside cells—when sugar molecules stick to proteins and enzymes, impairing cell function. High insulin levels and carbohydrate metabolism exacerbate this intracellular glycation. In contrast, carnivore dieters with low insulin have much lower intracellular glycation risk even if their blood sugar or HbA1C readings are modestly elevated.

• 📉 Role of Insulin in Diabetes Definition: Elevated fasting glucose without elevated insulin, as seen in many carnivore dieters, does not fulfill Dr. Westman’s definition of type 2 diabetes. Insulin resistance, not just blood glucose, is central to disease pathophysiology. This nuance often gets lost in public discourse, leading to confusion and fear about blood sugar numbers alone.

• 🔄 Gluconeogenesis as a Glucose Source: The body naturally produces glucose from proteins, fats, and lactate through gluconeogenesis, creating precisely the amount needed even on zero-carb diets. This process explains how carnivore diet followers maintain necessary blood glucose without consuming dietary carbohydrates, underscoring that humans have no mandatory carbohydrate requirement for survival or metabolic health.

• ⏳ Hemoglobin A1C Limitations: HbA1C measures average blood glucose by gauging sugar “stickiness” on hemoglobin in red blood cells. However, if red blood cells live longer—as may happen on carnivore diets—HbA1C values can be artificially elevated despite otherwise healthy glucose metabolism. This challenges the general utility of HbA1C as a standalone diagnostic tool in these populations and highlights the need for additional measures like insulin levels or continuous glucose monitoring.

• 🌡️ Importance of Contextual Testing: Using standard diabetic thresholds (like fasting glucose over 100 mg/dL or HbA1C over 5.7%) without considering diet type, insulin levels, or clinical symptoms can lead to incorrect conclusions. For example, the two studied influencers had normal fasting glucose and insulin but one had an HbA1C slightly in the pre-diabetic range. Dr. Westman argues this alone should not lead to a pre-diabetes diagnosis without further context.

• ⚖️ Reversibility of Type 2 Diabetes on Carnivore Diet: Since type 2 diabetes fundamentally involves excess sugar in the blood and insulin resistance, reducing carbohydrate intake and consequently insulin demand—such as on a carnivore diet—allows many people to reverse their diabetic state. This notion is aligned with current low-carb and ketogenic literature showing improvement of metabolic markers in diabetes patients who restrict carbs.

• 🔬 Need for Ongoing Research: Dr. Westman acknowledges gaps in research, including data on red blood cell lifespan and insulin levels in carnivore followers, which would clarify these biochemical phenomena. He encourages transparency and public availability of laboratory data as more studies emerge on carnivore and low-carb populations.

• 🩺 Clinical Practicalities and Broader Health: Carnivore diet followers or anyone concerned about blood sugar should also monitor for diabetes complications such as neuropathy, rather than relying solely on glucose or HbA1C. Drugs, lifestyle factors like caffeine intake, and weight status continue to influence glucose metabolism and must be considered in clinical evaluations.

• 🔔 Critical Thinking on Nutritional Misinformation: The discussion highlights how viral social media claims can spread misinformation by ignoring biochemical complexity and dietary context. Dr. Westman advocates for an evidence-based, balanced approach to interpreting blood sugar and diabetes diagnostics, particularly for non-traditional diets like carnivore.

Conclusion

Dr. Eric Westman presents a nuanced and scientifically grounded argument that the carnivore diet does not cause type 2 diabetes as defined by both elevated blood sugar and insulin levels. While some followers may show mildly elevated HbA1C values, these markers do not necessarily signify pathological glycation or pre-diabetes without corroborating insulin or glucose evidence. The natural physiology of glucose production on zero-carb diets through gluconeogenesis supports metabolic stability despite low dietary carbohydrates. He stresses the limitations of conventional diabetes diagnostic cutoffs when applied indiscriminately and advocates for comprehensive, context-aware testing including continuous glucose monitoring. Ultimately, the carnivore diet may help many reverse type 2 diabetes by eliminating dietary sugars and lowering insulin demand, reaffirming the importance of personalized medical assessment over simplified online narratives.

This episode of the Low Carb MD podcast features Dr. Erin Bellamy, a psychologist and metabolic health practitioner (MHP), who shares her compelling journey into metabolic psychiatry—the emerging field that addresses mental health through metabolic and nutritional interventions such as ketogenic diets. Dr. Bellamy recounts her early experiences working on psychiatric inpatient wards and her research path, which revealed striking historic and modern evidence showing profound mental health improvements linked to low-carbohydrate and ketogenic therapies.

The conversation highlights the strong interconnection between metabolic health and mental health, emphasizing how metabolic dysregulation, particularly in conditions like diabetes and schizophrenia, can directly impact mood, cognition, and psychiatric symptoms. Dr. Bellamy stresses the importance of a multidisciplinary approach, combining nutrition, sleep, light exposure, exercise, and psychological support to build resilience against mental illness.

The podcast also addresses systemic challenges in mental health care such as medication-centric models, long wait times for psychiatric care, and the lack of holistic lifestyle integration. Dr. Bellamy explains her group programs designed to educate and support people with various psychiatric diagnoses through ketogenic metabolic therapy, fostering community and sustained lifestyle change. Throughout, hope and empowerment surface as central themes, underscoring that with appropriate metabolic care and social support, even treatment-resistant symptoms can improve dramatically.

Highlights

• 🧠 Metabolic health is a foundational pillar for improving mental health conditions such as schizophrenia, bipolar disorder, and depression.
• 🍳 Ketogenic diets historically and currently show promising results in alleviating severe psychiatric symptoms.
• ⏳ There is a disturbing research gap between early studies (1960s) and modern psychiatry overlooking nutrition’s role in mental health.
• 👥 Group support and community involvement significantly increase adherence and success in metabolic psychiatry interventions.
• 🚀 Multidisciplinary collaboration including psychologists, psychiatrists, and metabolic health practitioners is critical for integrated care.
• 🔄 Metabolic psychiatry offers hope for treatment-resistant mental illness by addressing root metabolic dysfunctions.
• 🌱 A holistic pyramid approach with nutrition as the base, supplemented by sleep, stress management, exercise, and social connection is vital. Key Insights

🧬 The metabolic basis of mental illness is historically recognized yet underappreciated: Dr. Bellamy points to early research from as far back as 1930s and a pivotal 1965 study showing ketogenic diets improving schizophrenia symptoms. This suggests a biological underpinning of mental disorders linked to metabolic processes, which modern psychiatry has largely sidelined in favor of drug-centric interventions.

🔄 Metabolic dysregulation precedes and exacerbates psychiatric symptoms: The discussion reveals that poor blood sugar control and insulin resistance can precipitate depression and anxiety rather than these mental illnesses being purely psychological or behavioral in origin. This shifts the treatment paradigm toward addressing metabolic imbalances as causal factors.

🤝 Holistic, multi-layered care improves outcomes: Dr. Bellamy’s “metabolic pyramid” model prioritizes nutrition as the foundation, with layers including sleep optimization, light exposure, exercise, stress reduction, and social connection. This comprehensive strategy recognizes that sustainable mental health improvements require addressing environmental, lifestyle, and biochemical factors simultaneously.

💬 Social and clinical support enhances adherence: Ketogenic and metabolic therapies demand significant lifestyle changes, which are difficult without structured support. The podcast underscores the critical role of group programs, peer accountability, and integration into multidisciplinary teams to maintain motivation and long-term success, especially in complex psychiatric populations.

🔍 Current mental health systems inadequately address metabolic health: Patients face long waits for psychiatric care focused narrowly on medications with debilitating side effects that worsen metabolic health. Psychologists are positioned to bridge the gap but are often disconnected from nutritional interventions. A reframing toward metabolic psychiatry could transform treatment protocols.

🌿 Hope and patient empowerment are therapeutic: Offering patients a tangible, active role in managing their health through ketogenic metabolic therapy fosters agency and reduces feelings of helplessness common in chronic mental illness. The ability to control symptoms through diet and lifestyle has profound psychological benefits beyond physiology alone.

⚖️ Flexibility and balance are key: Successful programs encourage realistic planning, allowing occasional social indulgences without guilt, emphasizing control and balance rather than strict deprivation. This practical approach supports mental wellbeing and reduces relapse driven by shame or all-or-nothing mindsets.

This episode illuminates how revisiting and integrating metabolic science into mental health care offers groundbreaking potential for improving lives devastated by psychiatric illness. Dr. Bellamy’s experience and research-based optimism call for a paradigm shift to holistic, metabolism-centered psychiatry supported by community and clinical collaboration.