Those who believe that obesity is caused by hyperinsulinemia,a pre-diabetic condition, will cheer this finding. The diabetes drug liraglutide, caused significant dose-dependent weight loss in non-diabetics.

It also lowered blood sugar and blood pressure. A win for those who believe that all of Metabolic Syndrome is caused by a high glycemic diet.

I lean towards the hyperinsulinemia hypothesis, though I have been increasingly interested in the role of Ghrelin in obesity. The problem is that it is difficult to explain the success of bariatric surgery by appealing to hyperinsulinemia alone.

Yes, post surgery patients have to eat smaller meals which means that they should have smaller blood sugar spikes. But, what is to stop them from eating small amounts of chips and soda all day long thus still creating a high insulin environment? Plus, bariatric surgery patients loose a lot more weight than people on a very low carbohydrate diet. This is hard to square with a pure insulin hypothesis.

What seems to be the case, however, is that bariatric surgery patients produce less Ghrelin. In some because the vagus nerve has been severed and in some because the duodenum which manufactures Ghrelin has been bypassed.

So we have an empirical win for the insulin crowd, but the evidence remains quite mixed.