Three years after our first conversation, Professor Roy Taylor returns with the strongest evidence yet that type 2 diabetes is a reversible condition. The five-year results of his DiRECT trial are in, the NHS has built a national remission programme on his work, and the picture is now remarkably clear: lose enough weight to get below your personal fat threshold and, for many people, the disease switches off.
But the ground has shifted since he first joined me. GLP-1 medications have transformed the conversation around weight and metabolic disease, and with them has come a wave of marketing claims, muscle loss anxiety, and confusion about where food-first approaches still fit. Roy is refreshingly direct about all of it: what the drugs genuinely do, what the companies are claiming without evidence, and why the fundamentals haven’t changed.
What We Cover:
- The Twin Cycle Hypothesis and personal fat threshold, revisited: why fat in the liver and pancreas drives type 2 diabetes
- What the five-year DiRECT data shows: durable remission, halved hospital admissions, and substantially fewer cancers
- Why beta cells aren’t dead in type 2 diabetes, they’re being held in “cold storage”
- The 100% rule: what happens if the weight comes back
- GLP-1s in the real world: roughly half the marketed weight loss, and no evidence for a specific anti-diabetes effect
- The muscle loss “hysteria”: why losing 15 kg costs about as much muscle as taking off a weighted vest
- Gestational diabetes as an early warning sign, and why pre-pregnancy weight matters so much
- Ultra-processed food as a “metabolic poison” and the case for regulating it
Roy’s optimism that we can squeeze type 2 diabetes out of society is infectious, and it’s grounded in some of the best evidence in the field. Essential listening for anyone touched by this condition.
To learn more about Professor Roy Taylor’s work, visit his research site at Newcastle University or read his book Life Without Diabetes. Clinicians can also explore his type 2 diabetes remission toolkit for general practice.
- Can You Really Reverse Type 2 Diabetes (00:00)
- The Twin Cycle Hypothesis Explained (01:22)
- Why Fat Gets Stored in the Liver (04:40)
- Is Type 2 Diabetes Just Blood Sugar (11:11)
- What Liver Enzymes Reveal About Fat (13:02)
- How Fast Liver Fat Drops With Weight Loss (15:18)
- What Happens to Beta Cells in Diabetes (20:10)
- Beyond Weight Loss: Amino Acids and Beta Cells (27:16)
- Best Diet Pattern for Low Liver Fat (34:30)
- DIRECT Trial: The 5-Year Weight Loss Results (38:53)
- Weight Loss Halves Hospital and Cancer Risk (43:26)
- Who Actually Keeps Diabetes in Remission (46:46)
- Inside the DIRECT 800-Calorie Protocol (49:07)
- GLP-1 Weight Loss Drugs: Reality Check (52:12)
- How GLP-1 Drugs Actually Work (01:00:20)
- Myostatin Inhibitors and Muscle Loss Myths (01:04:55)
- Gestational Diabetes: An Early Warning Sign (01:09:39)
Resources and links:
Subscribe and stay connected:
Subscribe to The Proof on YouTube, Apple Podcasts or Spotify to ensure you never miss an episode. And don’t forget to follow me on Instagram and X for more insights and updates.
This episode is brought to you by:
38TERA
Consider 38TERA’s DMN prebiotic supplement a daily multivitamin for your gut. Formulated by yours truly and gastroenterologist Dr Will Bulsiewicz. Use code THEPROOF for a discount at checkout.
38Tera ships to the United States, Australia, and New Zealand.
Upwork
Post your job for free at Upwork.com and connect with top talent ready to help your business grow. Find the right talent to support your business and bring your projects to life.
Function Health
Take charge of your health with advanced blood testing and personalised insights. Function Health offers a practical way to track key health markers such as cholesterol, blood sugar, and more. Learn more and join at functionhealth.com/simonhill for a $25 credit toward your membership. Only available to those living in the United States.
Function Health ships to 48 U.S. states, excluding Rhode Island, Hawai‘i, and Puerto Rico.
Momentous
My go-to supplement brand for protein and creatine is Momentous. Use code THEPROOF for up to 35% off your first order at livemomentous.com.
Momentous ships to many countries worldwide depending on local import regulations.
HomeServe
Help protect your home systems – and your wallet – with HomeServe against covered repairs. Plans start at just $4.99 a month. Go to HomeServe.com to find the plan that’s right for you.
HomeServe is not available everywhere. Most plans range between $4.99 to $11.99 a month your first year. Terms apply on covered repairs.
Skylight
Families are better when they’re working together. Right now, Skylight is offering our listeners $30 off their 15 inch Calendars by going to MySkylight.com/THEPROOF.
Skylight ships within the U.S. and to Canada, Australia, and the United Kingdom.
WHOOP
Whoop, the most advanced fitness and health wearable available. Your personalised fitness and health coach to recover faster, sleep better, and train smarter. Claim your first month free on join.whoop.com/simon.
Whoop ships to 56+ international markets, including the US, Canada, most of Europe, Australia, New Zealand, UAE, Singapore, and parts of Asia.
More about Professor Roy Taylor
Roy Taylor qualified in medicine at the University of Edinburgh, and is Emeritus Professor of Medicine at Newcastle University. He founded the Newcastle Magnetic Resonance Centre in 2006 to develop innovative research techniques. Using these new methods, he showed that his 2008 Twin Cycle Hypothesis of the aetiology of type 2 diabetes could be proven in clinical practice. Type 2 diabetes was shown to be a reversible condition of excess fat within liver and pancreas. This has led to widespread practical application including in the NHS with the national ‘Type 2 Diabetes Path to Remission’ programme (commenced 2021). Most recently he validated his Personal Fat Threshold concept by demonstrating that weight loss in people with T2D who apparently were of normal BMI resulted in the same reversal of the basic mechanisms causing the diabetes. This led to the important principle that if a person develops T2D they are simply too heavy for their own constitution.
Between 1985 and 2018 he ran an obstetric medical service which became nationally noted. In particular, the optimum management of diabetic pregnancy and the management of hyperemesis gravidarum using prednisolone were established. His guidelines on management of life-threatening hyperemesis were published by the Royal College of Obstetrics and Gynaecology. He extended his magnetic resonance studies to study the basic mechanisms behind gestational diabetes, leading to a multicentre study demonstrating the value to mother and baby of limiting weight gain in pregnancy.
Starting in 1985 he developed and validated the imaging method of screening for diabetic retinopathy, established the profession of retinal screeners with recognised training and qualification and introduced quality control of screening. All of this resulted in establishment of an NHS national diabetes eye screening programme (commenced 2001) which has decreased rates of blindness in diabetes. It is no longer the commonest cause of preventable blindness in the UK.
He has published books in lay language explaining type 2 diabetes (eg ‘Life Without Diabetes’) and books on retinal screening (eg ‘Handbook of Retinal Screening in Diabetes’). His work has been recognised by award of named lectures. These include: RD Lawrence Lecture of British Diabetic Association 1991; HonymanGillespie Lecture of Edinburgh Medical School 1992; Arnold Bloom Lecture, Diabetes UK 2005; Chennai MDRF Gold Medal Oration on Diabetic Retinopathy 2005; Banting Lecture Diabetes UK 2012; Life Membership of the British Association of Retinal Screening 2012; Harry Keen Rank Nutrition Prize Lecture Diabetes UK 2016; Samuel Gee Lecture of The Royal College of Physicians 2017; Sir Robert W Philip Lecture of The Royal College of Physicians of Edinburgh 2021 and the highest scientific award of the European Association for the Study of Diabetes, the Claude Bernard Prize Lecture and Medal 2024. He was awarded an MBE in 2023.
