'In poorer communities, "the thrifty gene theory." is another factor. Here, those who are malnourished as children, or whose mothers were malnourished, are predisposed to store fat. The genetic predisposition is likely a response to a body, malnourished for so long, that when it does get food, it is tricked into "starvation mode," storing fat as a protective measure. By 1996, "Type-2 diabetes...had come home to roost among the poor...." (133) Zooming from 2-4 percent in 1992 to 45 percent of new cases in 1999(134), most apparent in African-American, Mexican-American, and Native-American youth. (134) While the 'thrifty-gene' theory is at work, lifestyle contributes: in a study conducted at Children's Hospital in Boston, researchers found that "just one extra soft drink a day gave a child a 60 percent greater chance of becoming obese." (140)

To underestimate the stigma of fat would be a mistake. "When it comes to fat, the affluent are afraid...they will do anything not to be affiliated with it...fat is seen as the great cheat... the hallmark of the uncontrolled, primal fellow." (150) Critser theorizes, we see people who are overweight as out of control. And the stigmatized feel it.

Critser's book is an in-depth, well-researched, and thoughtful exploration of the 'fat boom' in America, and while health books abound, it has been largely taboo to admit our country's weight problem and the impact on low-income families. Throughout, Critser writes with empathy and intelligence, tracing the origins of the problem to possible solutions. As a formerly overweight person himself, Critser knows that recognizing and acknowledging the problem is the first step toward resolution.