Your body isn't made of broccoli.

This simple observation forms the foundation of Dr. Eric Westman's revolutionary approach to nutrition and weight management. After over two decades at Duke University, where he's helped patients lose over 26,000 pounds collectively, Dr. Westman has distilled complex nutritional science into actionable clinical pearls that challenge conventional wisdom.

At the core of his philosophy are two deceptively simple concepts: "Eat What You Are" and "You Burn What You Eat." Understanding these principles reveals why so many struggle with weight and metabolic health despite following traditional advice.

The Man Behind the Method

Dr. Eric Westman isn't a newcomer to low-carbohydrate nutrition. As an internal medicine physician at Duke University, he has conducted more than 40 scientific studies on ketogenic approaches. His work began in the 1990s when low-carb diets were considered fringe at best and dangerous at worst.

What separates Westman from many nutrition researchers is his continuous clinical practice. Four days a week, he still sees patients at Duke, applying and refining his methods with real people facing real health challenges.

"I've practiced the best internal medicine of my life taking away medicines," Westman explains, highlighting how his approach often reverses conditions rather than simply managing them.

His clinical experience has shown that the ketogenic approach works across diverse populations. From professors to people with limited resources eating at fast-food restaurants, the fundamental principles remain effective when properly applied.

Eat What You Are

Most people know the adage, "You are what you eat." Dr. Westman flips this concept on its head.

"We're made of protein and fat," he points out. "You don't turn green from eating broccoli."

This observation leads to a profound insight: shouldn't those be the macronutrients we prioritize if our bodies are primarily composed of protein and fat? The human body contains virtually no carbohydrates as a structural material. We're not made of bread, pasta, or even fruit.

When patients undergo body composition analysis in Westman's clinic, he shows them the breakdown of their body: fat, muscle, water, and bone. None of these components is a carbohydrate.

"Look," he tells patients, "you're muscle, water, and fat. So eat protein and fat."

This conceptual framework helps patients understand why protein and fat should form the foundation of their diet. It's not about arbitrary restrictions but about aligning nutrition with biology.

You Burn What You Eat

The second key principle in Westman's approach addresses how the body uses different fuels.

"If you want to burn sugar, eat sugar," Westman explains. "If you want to burn fat, don't eat carbs."

This metabolic reality explains why many people struggle to lose weight despite creating caloric deficits. When carbohydrates are consumed, the body preferentially burns them for fuel while storing fat. Only when carbohydrates are restricted does the body efficiently access stored fat.

Westman references the television show "Naked and Afraid" to illustrate this principle. Participants routinely lose 1-2 pounds per day during their 21-day survival challenges because they're forced into a state of nutritional ketosis by the absence of food.

"They burn their body fat," Westman notes. "That's how they stay alive."

The ketogenic diet aims to achieve this natural fat-burning state without starvation. By restricting carbohydrates to around 20 grams total per day, almost everyone will produce ketones, signaling that the body has switched to burning fat for fuel.

The Fat-Trapping Mechanism

Understanding why carbohydrates prevent fat loss requires looking at hormones, particularly insulin.

When carbohydrates are consumed, insulin levels rise. Insulin's primary job is to move glucose out of the bloodstream and into cells, but it also has another critical function: it inhibits fat breakdown.

Westman describes this as "fat trapping." When insulin is elevated, fat is effectively locked inside fat cells, which are unavailable for energy. This creates a situation where even though someone has abundant stored energy, they feel hungry because they can't access it.

"You eat the carbs, insulin goes up, put the fat in the cell, and lock it up," Westman explains. "You can't get to it, so you're hungry again."

This hormonal perspective flips the traditional energy balance equation. Rather than overeating causing weight gain, the hormonal environment causes overeating by trapping energy and creating hunger.

Westman says, "It's the hormonal change making someone eat."

The Ketosis Advantage

When carbohydrates are restricted sufficiently, the body enters a state of nutritional ketosis. In this state, the liver converts fat into ketone bodies, which serve as an alternative fuel source for the brain and many other tissues.

One of the most remarkable aspects of ketosis is its effect on appetite. Westman states, "In 24 to 48 hours, hunger is significantly reduced for 100% of people using my approach because ketones are appetite suppressants."

This appetite suppression is fundamentally different from what happens on traditional calorie-restricted diets. Rather than fighting constant hunger, patients spontaneously reduce their caloric intake without feeling deprived.

"When I see the Stanford group coming up with this complicated keto, you know, you have to go to classes and learn... my patients don't have time for that," Westman notes. His approach focuses on simplicity and effectiveness.

The Prescription-Strength Keto Approach

Westman's clinical method differs from many popular ketogenic approaches. He emphasizes total carbohydrates rather than net carbs, keeping them under 20 grams daily. This threshold virtually guarantees ketosis for most individuals.

His food list is straightforward:

Unlimited: Meat, poultry, fish, shellfish, and eggs (all zero carb)

Limited: Up to 4 ounces of cheese, eight servings of added fat, and 3 cups of low-starch vegetables daily

Total carbohydrates: 20 grams maximum

This approach doesn't require exotic ingredients like MCT or coconut oil, which is common in internet keto circles. It doesn't mandate grass-fed or organic products, making it accessible to patients of all socioeconomic backgrounds.

"I've had people in Durham who can't afford that stuff eat at fast food restaurants and get great results, reversing diabetes and obesity," Westman notes.

His approach is deliberately simple. More patients can successfully implement the changes by focusing on a clear, actionable plan rather than nutritional perfectionism.

Clinical Results

Westman's approach is proven in his clinical outcomes. At his Keto Medicine Clinic at Duke University, 98% of patients with type 2 diabetes have been able to reduce or eliminate insulin therapy.

Beyond weight loss, patients often experience improvements in various health markers:

Blood pressure normalizes, often allowing reduction or elimination of medications.

Lipid profiles typically improve with increases in HDL and decreases in triglycerides.

Inflammatory markers decrease

Neuropathy symptoms may diminish or resolve

Kidney function can improve

These results aren't theoretical. They represent thousands of patient experiences over more than two decades of clinical practice.

Beyond Weight Loss

While Westman's approach is powerful for weight loss, he emphasizes that the benefits extend beyond aesthetics. The metabolic shift that occurs with nutritional ketosis affects numerous bodily systems.

For patients with type 2 diabetes, the approach often leads to dramatic improvements in blood sugar control. This makes intuitive sense: if elevated blood sugar is the problem, reducing the dietary source of that sugar addresses the root cause rather than just managing symptoms.

Westman points out the paradox of conventional diabetes treatment: "Insulin was used for type two diabetes before insulin was measured in the blood. And when insulin was measured in the blood, it was already high."

This observation highlights a fundamental contradiction in traditional diabetes care. "If a hormone is already high, you don't give more hormone," Westman notes. "That would be like, if your thyroid's high, you give more thyroid. No, you ablate it."

Westman addresses the underlying metabolic dysfunction by focusing on carbohydrate restriction rather than medication, rather than compensating for it.

The Simplicity Factor

The most remarkable aspect of Westman's approach is its simplicity. He offers clarity in complex diet plans and extensive food tracking.

"What keeps me going is I see a reversal of all these sorts of things," Westman explains. "The detail of someone coming into the office, many don't even remember their weight a month or six months ago."

This simplicity isn't just convenient. It's a form of respect for patients' time and cognitive bandwidth. By distilling nutritional science into its essential elements, Westman creates an effective and sustainable approach.

A patient recently thanked him, saying, "Doc, thank you for making it so simple." In that simplicity lies the potential for widespread adoption and lasting change.

The Path Forward

Despite his success, Westman acknowledges that his approach still faces resistance in some medical circles. However, he notes that the landscape is changing as more evidence accumulates.

The principles underlying his method aren't new. He often shows patients a copy of William Banting's diet book from the 1860s and the Osler Textbook of Medicine from 1923, both of which recommended low-carbohydrate approaches for obesity and diabetes.

What's new is the growing scientific validation and clinical experience supporting these approaches. The momentum continues to build as more physicians and patients experience the benefits firsthand.

Westman recommends a simple commitment for those interested in exploring this approach: "Could you just do it for a day or two?" This short-term experiment often provides enough evidence of effectiveness to motivate longer-term adherence.

The future of metabolic health may not lie in novel medications or complex interventions but in rediscovering and applying fundamental principles about how our bodies work. By eating what we are and burning what we eat, we align with our biology rather than fighting against it.

And that might be the most profound clinical pearl of all.