Fatty Liver Expert: Your Liver Is Filling With Fat Right Now - Dr David Unwin

For a quarter-century, Dr. David Unwin did what he was trained to do: prescribe drugs, monitor compliance, and blame patients when they didn't lose weight. He was senior partner of a practice north of Liverpool, financially incentivized to ensure diabetic patients took metformin, and genuinely believed lifestyle advice was a polite add-on to the real work of medicine. Then a patient he'd known for over a decade marched into his surgery and told him off. She'd stopped taking her metformin. Her blood glucose was completely normal. And she was furious: «Did you ever once tell me that bread was sugar, or breakfast cereals were sugar? I had to learn online. This is schoolboy biology. You should have learned that when you were 16.» Unwin was terrified—not of a complaint, but because every word she said was true.

She was one of 40,000 people learning from each other online how to reverse type 2 diabetes through diet, and the medical establishment was telling them they'd die. Unwin checked her labs. It was real: the first case of drug-free remission he'd seen in 25 years. Around the same time, his wife Jen—a clinical psychologist—bought a discounted diet book advocating low-carbohydrate eating. The couple decided to try it themselves, recruit 18 patient volunteers, and meet every Monday night for free in their own time. Within weeks, liver function improved by a third. Weight fell off. Blood pressure normalized. Unwin's own moderate hypertension vanished. His mental clarity returned; he no longer needed a lunchtime nap. «It was like being a younger man,» he recalls. That was 2013. Since then, Unwin has achieved drug-free remission in 157 patients with type 2 diabetes, and published real-world data from hundreds more in pre-diabetes. The results speak for themselves: 93% of pre-diabetics going low-carb achieve normal blood sugar; 73% of early-stage diabetics do the same. Wait five years, and your odds drop to 50%. The message is clear: a stitch in time saves lives.

For years, Unwin believed the model was simple: if you don't eat, you get hungry; if you don't eat for twice as long, you get twice as hungry, rising exponentially until you go mad. Then he tried fasting. And discovered, to his astonishment, that hunger does not increase with time—it fades. The more he ate, especially carbohydrate-rich foods, the hungrier he became. The mechanism is insulin. When you eat a sugary or starchy meal, blood glucose spikes. Insulin surges to push glucose out of the bloodstream and into cells, then often overshoots, causing blood sugar to crash. You feel ravenously hungry again—often within two hours. Unwin's biscuit habit was a perfect example: eat biscuits, blood sugar up, insulin in heavy, blood sugar crashes, panic-attack-like symptoms from low blood sugar, solution is more biscuits. Round and round. The patients who went low-carb in 2013 reported the same revelation: «I'm not hungry anymore.» Unwin wasn't either. He'd been hungry his entire life. Hunger, it turns out, is not a reliable signal of nutritional need when your diet is built on foods that spike and crash your blood sugar.

This insight flips conventional diet advice on its head. «Eat less, move more» fails because it presumes willpower can override biology. But if the food you eat makes you hungrier, willpower is irrelevant. On a ketogenic or very-low-carbohydrate diet, patients often skip breakfast without thinking about it, go hours without snacking, and report feeling satiated on far fewer calories. Unwin describes it as a «superpower»: walking past a Christmas cake or cinnamon bun and genuinely not wanting it, not because you're resisting temptation but because your brain no longer registers it as food. This is not deprivation—it is metabolic liberation. The challenge is getting there. For those with ultraprocessed food addiction, the transition is not a matter of information or education. It is a matter of breaking a dependency as real as any drug addiction, often requiring structured support, continuous feedback via glucose monitors, and in some cases pharmacological assistance with GLP-1 drugs to quiet the cravings long enough to establish new patterns.

Unwin's default position is to use diet first, but he acknowledges that modern agriculture has stripped essential minerals from the food supply. Crops grown in nitrogen-depleted soil contain far less magnesium and zinc than they did a century ago, and magnesium is nearly impossible to obtain in sufficient quantity from diet alone—especially as you age and absorption declines. Magnesium deficiency causes muscle cramps, poor sleep, and in extreme cases, seizures. Unwin learned this when a farmer told him he'd lost 15 cows to «the staggers» (magnesium-deficiency convulsions) and insisted Unwin supplement any cow he bought. Around the same time, a patient Unwin had been admitting to intensive care repeatedly for unexplained seizures turned out to be magnesium-deficient due to medication. Which magnesium? If you're constipated, take magnesium citrate—it has a gentle laxative effect. If your bowels are fine and you want better sleep or mood, take magnesium glycinate or threonate, which crosses the blood-brain barrier.

Vitamin D is the other non-negotiable, particularly in northern latitudes or for anyone who works indoors (or has darker skin, which reduces synthesis). Unwin also endorses omega-3 supplementation for most people, as modern diets are heavily skewed toward omega-6 fats. He is cautious about multivitamins and warns against over-supplementation—patients sometimes arrive with a carrier bag full of pills. The best approach is to test (via blood work), identify genuine deficiencies, supplement strategically, and retest. Tools like Function Health or Neko Health make comprehensive testing accessible and affordable, and results should always be tied to actionable interventions—not just fear. Screening without a plan for what to do with the results creates anxious, worried patients who consume medical resources without improving health. The goal is optimization, not paralysis.