Why we read books (and what to do about it): A rare book review

I just finished this book and it was very thought-provoking, so I'm going to jot a few of these thoughts down.



Why We Get Fat (And what to do about it) by Gary Taubes

The book is a well-researched, highly scientific look at obesity, weight gain and loss, the science thereof, and years of misguided notions about weight and how to lose it. I had mixed reactions to reading it, and mixed reactions to the conclusions Taubes draws.

The first half of the book is solid. The writing is engaging, the facts are footnoted within an inch of their lives, and the conclusions drawn are pretty valid. Conventional wisdom about obesity is wrong. "Biology, not physics" is the title of Book One, and it thoroughly explains why "Calories in, Calories out" is meaningless. Taubes analyzes historical trends in treating obesity and how we got to today's conclusions that dietary fat is bad and carbohydrates are preferred as an energy source over fat. If you're looking for good evidence and research on why and how we get fat and the mechanism of research and how conventional wisdom becomes conventional, book one is a doozy and well worth reading.

Book Two, "Adiposity 101", starts off strong. Taubes explains, exhaustively, how insulin works and what the connection is between hormone balance and "excess" body fat. He turns the "But thermodynamics!" argument on its head and shows how biology and hormones work to conserve fat in the body depending on hormone levels. Fat mechanics, how, when, and why the body uses fat stores for energy and how, when, and why fat is stored is explained in great depth and in words a non-biologist can easily understand. He explains sugar metabolism, how it works to sequester fat in the body, and the difference between various types of sugar and how they're metabolized. It's a bit overwhelming, truthfully. But interesting.

I have two basic problems with the book.

First of all, Taubes, with all his critique of conventional wisdom and current medical science in regards to obesity, treats obesity and overweight as a pathology and something to be fought throughout the book. He blames the "obesity epidemic" (and yes, he uses that phrase constantly, to my great irritation) on the food pyramid of the 90s being grounded on carbohydrates, and the avoidance of fat to the inclusion of extra carbs in weight loss dieting and nutritional science. He states over and over that "everybody knows" dietary fat is bad and so avoidance of dietary fat to the inclusion of extra carbs is what caused a surge in obesity. I don't actually disagree with this conclusion, to a point.

He doesn't mention, not even once, that the BMI definitions changed in 1998 to make tens of millions of people "obese" who were merely "overweight" the day before, and tens of millions "overweight" who were previously "normal".

This was the point in the book when my skeptical eyebrow started going up.



My second problem with the book is that while he strikes down fallacies and false conclusions right and left when they suit his purposes, he draws false conclusions and makes deductive leaps over factual grand canyons when doing THAT suits him. For instance, the end of the second part of the book turns into a giant Atkins diet promotion. He states how our caveman ancestors ate high fat, low carb, high protein diets and they were all thin. How do we know there were no fat cave people? We don't. There probably were. But Taubes trots this out as "everyone knows" our hunter-gatherer ancestors were all skinny and fit. He doesn't mention that paleolithic man had an average lifespan of about 30 years, until the dawn of agriculture, when lifespan increased, likely due to caloric security.

http://anthro.palomar.edu/homo2/mod_homo_5.htm

Taubes promotes, heavily, a high protein, high fat, very low carbohydrate, very low sugar diet. He also concludes that following a diet different from what your ancestral forebears followed will make you sick. He uses "not many fat Japanese" and "no fat Inuit until the white man gave them flour and sugar" as examples. But the Japanese don't eat a low carb, high protein diet, typically. So his deductive leap just crashed into the Snake River Gorge like Evel Knievel.

The end of Book Two is basically a extended advertisement for Atkins. (It even includes, in an appendix, a streamlined diet plan that is nearly identical to Atkins plans.) His basis for this? A comparison study over a year that drew the following conclusions: Atkins followers lost 9.9 pounds, traditional diet plan followers lost 5.5 pounds, Ornish diet followers 5.3, and Zone diet 3.3. The chart includes figures for LDL, Triglycerides, HDL, and BP as well, all numbers slightly favoring Atkins excepting triglycerides which strongly favored Atkins.

Ten pounds. In a year. With almost zero carbohydrates.

And those carbohydrate cravings that Atkins dieters often cannot get past? Taubes recommends that you simply stay strong and resist, and it will get easier over time. Seriously. Even though he states unequivocally in part one that putting fat people on weight loss diets results in a "biological imperative" to resist exercise and constant, intense hunger that he states cannot be ignored. Yet he suggests that a similar imperative to eat some carbohydrate, for crying out loud, can be easily conditioned out of the body and mind.

See what I mean about the double-standard thing? Only when it suits him.

Taubes also goes on at some length about how exercise is bad for people trying to lose weight. I don't even know where to start with that. Exercise is good for people who are able-bodied enough to do it, independent of weight. Exercise reduces blood pressure, strengthens hearts and lungs, and improves your mood due to the release of endorphins. Weight has nothing to do with it, but Taubes actually says if one is trying to lose weight, one should not exercise too much.

There is no mention of the fact that thin people also get diabetes, high blood pressure, atherosclerosis, heart disease, and cancer. There is no talk about health parameters outside of weight, how one can improve one's health without trying to lose weight, through healthy eating and exercise. There are scare tactics and weasel words aplenty about how we're all dying of obesity and killing our kids, too, with the bread and sugar and not eating enough fatty meat and berries and leafy green veggies like our caveman gramps did, even though grandparents were pretty much a rarity before farming came along 30,000 years ago.

I'm all for challenging conventional wisdom about nutrition and what makes us fat and if that is in fact an inherently bad thing, and I'm all for challenging assumptions about what makes us healthy or unhealthy, but I am pretty much opposed to ignoring things when it suits you then making deductive leaps that defy any kind of logical gravity when that suits you too. And that's where this book loses me.

I did learn a lot about biology and the science of hormonal regulation of fat and weight, and I do plan to try to reduce the number of carbs and sugar I eat, although I already ate very few refined carbohydrates. When I ask myself would I rather be healthy or thin, the answer is a resounding "Healthy". My lack of gall bladder determines how much fat I can eat and I already pursue full-fat milk, yogurt, cheese, etc even though you can't find full fat yogurt anywhere any more. So Taubes' stripped-down Atkins plan wouldn't work for me on any number of levels.

Sadly, Taubes falls down in this book in the same places most diet books do, the conflation of thin with healthy and with body fat as an absolute liability and evil, and the pursuit and attaining of thinness as the ultimate goal. He mourns the fact that even zero carbs will not be sufficient for some of us tragic fatties to attain thinness. It's unfortunate, because the book is interesting and contains some compelling science. A shame that Taubes had to taint the science by prescribing a diet plan along with it.