Why We Get Fat and What to Do About It

Last month’s newsletter featured a review of Gary Taubes’ book Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease. We received many positive responses from members, and this month we present a follow-up review of Taubes’ latest book, Why We Get Fat and What to Do About It.

First, a quick recap of the main points in Good Calories Bad Calories, as Taubes presents them.

The idea that dietary fat causes obesity, heart disease, and other chronic diseases is simply not true. It’s also false to think that overeating, undereating, or exercise has much effect on weight. Only popular level misunderstanding, manipulated science, or just plain bad science would support these notions.

Instead all the evidence points to sugar and carbohydrates, which cause the secretion of insulin, and disrupt the body’s hormones and metabolism, leading to weight gain, and probably ultimately causing most chronic degenerative diseases. It is the quality of food consumed that determines weight and health.

Taubes knows this reversal will be shocking, unthinkable to some, but implores them to see for themselves that the history and science are overwhelmingly convincing.

Good Calories, Bad Calories stuck to scientific analysis, and while it was clear enough to some readers what the dietary implications were, it caused many of Taubes’ readers (and some Samaritan members) to ask if he had written elsewhere about specific and practical diet recommendations. Taubes explained this situation in the foreword to Why We Get Fat and What to Do About It.

“[A] response I get frequently is from those lay readers, as well as an encouraging number of physicians, nutritionists, researchers, and health administrators, who say that they read Good Calories, Bad Calories or listened to my lectures, found the logic and the evidence compelling, and embraced the message implicit in it. They tell me their lives and their health have been transformed in ways they didn’t think possible. They have lost weight almost effortlessly and kept it off. Their risk factors for heart disease have improved dramatically. Some say they no longer need their hypertension and diabetes medications. They feel better and have more energy. Put simply, they feel healthy for the first time in far too long. You can see these kinds of comments on the Amazon web page, where they represent a large proportion of the several hundred personal reviews at that site.

“These comments, emails, and letters often come with a request. Good Calories, Bad Calories is lengthy (nearly 500 pages), dense with science and historical context, and densely annotated, all of which I believe was necessary to initiate a meaningful dialogue with the experts and assure that they (or any reader) take nothing I say on trust alone. The book demands that the reader devote considerable time and attention to following the evidence and arguments. For this reason, many who read it have asked me to write another book, one that their husbands and wives, their aging parents, or their friends and siblings can read without difficulty. Many physicians have asked me to write a book they can give to their patients, or even to fellow physicians, a book that doesn’t require such an investment of time and effort.”

So, Why We Get Fat and What to Do About It distills down the principles to their essence, and then does lay out an eating—not dieting—plan for weight loss and optimum health.

In the opening chapters Taubes punches some holes in the logic of the entrenched view, that obesity is caused by eating too much and/or exercising too little.

Health authorities are always blaming obesity on prosperity, “too much money, too much food, too readily available, plus too many incentives to be sedentary,” yet study after study shows the fact that obesity in the modern world is associated with poverty. Taubes gives 20 examples of isolated people groups who were healthy until poverty and hunger befell them. They started eating a modern carbohydrate-rich diet because carbs were the cheapest, most widely available food.

Native Americans who were moved onto reservations and began receiving rations of sugar and flour got fat, and they weren’t couch potatoes. So did tribes around the world who moved away from traditional diets and ways of life, joining the industrial revolution late.

As recently as the 1970s scientists and researchers said that obesity was caused by “malnutrition” or “subnutrition,” not overeating. That was before huge infusions of government and drug industry funding distorted the science (more detail about that story is in Good Calories, Bad Calories).

If obesity is a problem of modern prosperity, then why are the poor and hungry more likely to get fat?

Taubes continues to present facts and ask questions that bewilder the medical and nutritional establishment. Why doesn’t undereating cure obesity? The scientific literature shows that it only causes weight loss for a few months, if that, before it is gained back.

Why did the scientific literature once refer to low calorie diets as “semi-starvation” diets? Doesn’t this suggest that at one time the experts understood that it was the quality of calories being consumed that made the difference, not the quantity?

Why does it surprise us that the research shows exercise has surprisingly little effect on weight? Even the American Heart Association admits, “So far, the data to support this hypothesis are not particularly compelling.” Taubes says the “so far” is disingenuous, since there is a hundred years of science.

But more importantly regarding exercise, why is it that we think we can change one side of the energy equation in our bodies, and not effect the other? In other words, exercise makes us hungry, and if we eat the same stuff that is causing problems to make up for our energy expenditure, we aren’t going to get anywhere.

Here’s another question that is often left out of the conversation. Why is that we get fat in one area of our body, and not another? We even know of very strange cases and diseases. Some people have essentially no body fat above the waist, and are very heavy below it, and vice versa. Diabetics get fat accumulations in exactly the place they inject insulin. Doesn’t this suggest something more is going on than calories in/calories out? Surely hormonal, metabolic, and genetic factors are at play.

Taubes goes on to point out that the “thermodynamics” explanation for weight is essentially meaningless. All that theory says is that we are taking more energy in than we are expending. It says absolutely nothing about how or why.

Taubes concludes the first half of Why We Get Fat and What to Do About It with a chapter called “Head Cases.” He argues that health officials, who are supposed to be helping us understand the science involved, are actually way too quick to fall back on the idea that everyone who is fat is mentally or morally weak. As they continue to have no success whatsoever in combating the obesity epidemic, they are essentially saying fat people are all gluttons. This position leaves their job—biology—out of the equation, and conveniently ignores that their dietary advice for the last 50 years may have played a major role in creating the problem. The reader is left to wonder if it is the doctors, not the obese, who are the “head cases.”

Taubes is in a position to make these challenges to the health establishment because he’s spent the last decade reading the research, interviewing health care experts, and giving public lectures to sometimes hostile crowds of doctors and experts. He’s been invited to some of the most prestigious universities in the world, and has even given “grand rounds” at research hospitals. If you search for “Gary Taubes” on YouTube you’ll turn up clips from his lectures, and you’ll see that he has no problem answering the questions he gets, almost always with direct citations of the scientific research.

As impressive as the first half of the book is, the second half is even better. Taubes explains in plain language that anyone can understand what the best science tells us about how we get fat. He graciously granted us permission to run an excerpt (see page 10), where he explains how weight gain is driven by the hormone insulin, which is in turn driven by the carbohydrates we eat. Be sure to get a copy of Why We Get Fat and What to Do About It so you can read his full explanation.

He goes on to talk about how some people do have genetic factors that predispose them to get fat, and how they will have to fight even harder to combat weight gain. He also points out that a mother’s diet can affect a baby’s weight in the womb, and, after it is born, whether it will be more likely to have hormonal and metabolic imbalances that will lead to obesity. Perhaps the most important part of the book is the later chapters explaining the dangers of refined sugar and corn syrup.

At the end of the book Taubes lays out an eating plan, which he is actually just borrowing and updating a bit from many others who have gone before. It’s quite simple.

The first principle is to cut the sugars and carbs. He leaves it up to the individual to decide whether renouncing them entirely or restricting them is what is needed, or possible for him. Some will need to abstain from sugar completely, especially if they have a predisposition to weight gain or some health problems.

Taubes recommends becoming familiar with the glycemic index concept, about which there are many books. You need to become very familiar with the carbohydrate content of foods in order to restrict and replace them.

Speaking of replacing the carbs, Taubes writes, “When you restrict fattening carbohydrates, however, you don’t have to restrict consciously how much you eat. You can eat all you want of proteins and fat, so you don’t get hungry and you don’t expend less energy.”

He continues, “There is no compelling reason to think that fat, or saturated fat, is harmful, whereas there’s good reason to question the benefits of diets that abnormally elevate the protein content.” Again, these are subjects he covered in more detail in Good Calories, Bad Calories.

One note of caution for our Samaritan audience is that Taubes is writing from the perspective of an evolutionary world view. This aspect of his writing is cautious, even muted, in comparison to other nutritionists who are proponents of evolution. They theorize wildly and advocate aggressively, but Taubes has an attitude of humility, recognizing that man is finite, and needs to do the science carefully and thoroughly before jumping to conclusions.

Taubes does accept the view that refined sugars and carbohydrates are so unhealthy because they are a new development in history. Until 50-100 years ago, we just didn’t eat them, at least not in significant quantities. For Taubes, that history is millions of years, and he suggests that it’s possible the human race could eventually evolve the capability to properly metabolize these foods. For now though, he says, the science clearly shows they are devastating, so stay away from them.

Of course this explanation for why sugars and carbohydrates are unhealthy is not incompatible with a Christian worldview. If humans have been around 6000 years, and suddenly changed the content of diets, we’d expect to encounter major problems. The logic still holds.

Thankfully, Taubes does not seem to be a passionate advocate for a “paleo” diet, the way many online nutritional writers are. For that matter, we can also be thankful he’s not associated with any number of extreme positions that many doctors and nutritionists are enamored with, such as environmentalism and new age spirituality.

Christian theologians might say that even though Taubes’ worldview is not Biblical, he pursues truth in the realm of general revelation tenaciously, cutting through a lot of confusion and deception. Since Taubes has made a reputation of challenging and overturning the politically correct “wisdom” in several areas of science, we might even hope that he would turn to the topic of evolution next, applying the same careful scrutiny.

What if he looks at the history and science, and discovers there are no missing links in the fossil record, just a string of frauds? What if he discovers that many accomplished scientists are returning to the idea of geological catastrophism, since we now know canyons and sediment layers can be formed in days, not millions of years? What if he discovers that it is young earth creationists who are on the cutting edge of astrophysics and cosmology?

It’s something to pray for.

Gary Taubes blogs at garytaubes.com. He is the author Nobel Dreams, Bad Science: The Short Life and Times of Cold Fusion, and Good Calories Bad Calories. He has won the Science in Society Award of the National Association of Science Writers three times and was awarded an MIT Knight Science Journalism Fellowship.

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