#162 - Sarah Hallberg, D.O., M.S.: Challenging the status quo of treating metabolic disease, and a personal journey through a grim cancer diagnosis

The Peter Attia Drive

Sarah Hallberg is the Medical Director at Virta Health and a physician who has spent nearly two decades treating patients with obesity and type 2 diabetes. In the first half of this episode, Sarah discusses how she became a huge believer in the efficacy of carbohydrate restriction for the treatment of type 2 diabetes through her research and clinical experience. Sarah challenges the common beliefs about the role of dietary fat and carbohydrate on the plasma makeup of fatty acids and triglycerides. She also expresses the importance of understanding early predictors of metabolic illness—highlighting one particular fatty acid as the most important early predictor—before finishing with a discussion about how doctors might be able to personalize patients’ metabolic management in the future. In the second half of this episode, Sarah tells the personal story of her own lung cancer diagnosis. She talks about dealing with her grief, deciding to continue her work while prioritizing her family, and how she devised a plan to extend her survival as long as possible.

We discuss:

• How Sarah discovered the profound impact of carbohydrate restriction for reversing obesity and type 2 diabetes [3:15];
• Prediabetes and metabolic syndrome: prevalence, early signs, and the importance of treating early [16:00];
• Overview of fatty acids, how they are metabolized, and understanding what you see in a standard blood panel [29:15];
• The relationship between diet composition and metabolic markers [35:15];
• Why palmitoleic acid is such an important biomarker [48:15];
• The best early indicators of metabolic disease [1:00:00];
• Personalized management of metabolic illness [1:07:00];
• Sarah’s cancer diagnosis and the beginning of her journey [1:15:15];
• The emotional impact of a devastating diagnosis [1:27:15];
• Sarah’s plan to extend survival [1:36:45];
• Sarah’s aggressive treatment plan [1:47:30];
• Life-threatening complications and the return of her cancer [1:59:00];
• Sarah’s reflections on her approach to life with chronic cancer and balancing her time [2:11:00]; and
• More.

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