What if everything you think you know about the cause and cure of overweight and obesity is wrong? I mean seriously, harmfully wrong on an epidemic scale. In Why We Get Fat author Gary Taubes makes the passionate and urgent case that people are getting fat and diabetic because the so-called health advice they get is the exact opposite of what’s needed. Backed by a persuasive amount of detail, Taubes explains how our ideas and practices around fatness (and diseases related to fatness) have been corrupted by bad and incomplete science.
More specifically, the long-standing, rigid beliefs formed around the calories in/calories out theory and the role of dietary fat blocks the open consideration of alternative ideas and new information. He claims the ingrained practice of ignoring, rejecting and discounting fact-based evidence makes research seem more like religion than science. “… the individuals involved in this research have not only wasted decades of time, effort, and money, but have done incalculable damage along the way.”
Taubes is on a mission to undo the many misconceptions that “pass for public health and medical advice…and to arm you with the necessary information and logic to take your health and well-being into your own hands.” As an award-winning scientific journalist who spent the past decade rigorously tracking down and assimilating obesity research, he’s uniquely qualified to understand and present the big picture of scientific opinions and results. Despite legions of researchers and billions of government dollars expended, Taubes is the one to painstakingly compile this information, assimilate it, and make it available to the public.
It’s not really surprising to learn that most research is done in a vacuum, so to speak. Researchers don’t typically communicate or collaborate with each other, and there’s little understanding of how a small piece of the pie fits in with the whole. This is one of the major problems to be solved. In the meantime, Taubes does the important and extraordinary work of pulling it all together for us. The scientific evidence he collected is comprehensively detailed in his prior book, Good Calories Bad Calories, which should be required reading for all physicians and health care practitioners. Why We Get Fat has a similar follow-on message, but it’s written for the average person. That said, the content of Why We Get Fat still has a strong scientific orientation, which Taubes does not dumb down, so it may not appeal to all.
The fundamental flaw with obesity research and the proposed cure for it centers around the current interpretation of the law of thermodynamics. This is the law that says calories in less calories out equals body weight. Or, as everyone everywhere knows, the one and only right way to lose weight is to eat less and exercise more. Taubes explains how a simplistic, incomplete view of this law does not account for the regulation of fat tissue by hormones and enzymes, and thereby overlooks the underlying metabolic cause and disorder of fat growth. The role of insulin on fat tissue, for example, is not considered or factored into the thermodynamic equation. “…medical experts have been remarkably uninterested in the fat tissue itself.”
Taubes reminds us that insulin is the primary regulator of fat metabolism. When insulin levels go up, fat is stored, and when insulin levels go down, fat is released. Likewise, insulin is also responsible for distortions and problems with fat metabolism. A common one is the constant over production of insulin from eating too many refined carbohydrates (foods made with flours and caloric sweeteners). This eventually results in “insulin resistance,” a condition where cells stop responding to the insulin. Insulin resistance is a primary indicator of type 2 Diabetes and a cluster of other systemic metabolic problems including high blood pressure, high triglycerides, low HDL cholesterol (the healthy cholesterol), high blood sugar, a big waist, and of course, obesity!
Despite the direct link between fat and insulin, mainstream researchers and the medical community continues to insist dietary fat is the root cause of obesity, type 2 diabetes and the other metabolic problems mentioned above. In fact, the idea that anything other than dietary fat might be the culprit in our diet is nutritional heresy. We’ve been programmed, relentlessly, to cut down on the amount of fat we consume and to eat “heart-healthy” foods like bread, cereal and pasta. These are the same flour-based foods mentioned above, that raise insulin. Saturated fat, by the way, lowers it. Therein is the crux of the contention. Is it dietary fat that’s to be avoided or is it white flour and caloric sweeteners?
Lets look at the national trend lines about fat consumption, obesity and overweight to see if there are any more clues. In the mid 70’s, for example, national fat consumption was around 40%. Today it’s around 33%. This is a statistically significant change that could not have happened by random chance. In the mid 70’s the national obesity rate was around 12%. Now it’s 33%. In the 70’s, the national overweight rate was around 30%. Now it’s 66%. So as a nation we’re eating less fat, but we’re fatter than ever. The low-fat/low-calorie party line has been around 40 years now, and the spectacularly unsuccessful results speak for themselves.
Taubes also has something radical to say about what causes horizontal growth or fat. The conventional, accepted theory is that we eat more, and therefore we grow fat. Taubes, however, says we’ve got it backwards because all growth (whether it’s horizontal, vertical, tumor or pregnancy) is triggered by hormonal stimulation, not caloric intake. Or said another way, caloric intake follows an increase in mass. Teenagers, for example, eat more when they start growing not the other way around. (A teenager doesn’t grow taller because he or she eats more calories.) Similarly, growth in fat tissue, which is stimulated by insulin, drives overeating. It’s truly rare and very exciting to hear a truly revolutionary scientific idea like this one.
If you read Why We Get Fat, as I hope you will, you’ll have to make a special effort not to get angry as you come to realize we cannot trust the research community and health organizations that supposedly exist for our benefit. The book shines an uncomfortable spotlight on “the surprisingly dismal state of nutrition and chronic disease research.”. We deserve better.