Why We Get Fat

Title: Why We Get Fat – And What to Do About It
Author: Gary Taubes
Publisher: Alfred A. Knopf, 2011 (First)
ISBN: 9780307272706
Pages: 257

In India at least, a person who had recently constructed a new house is an expert 'architect' among his friends and relatives for a few years after the event. Likewise, one who successfully cut short his body weight has the moral authority to preach and pose as a dietary consultant. My body weight was 93 kg in January 2023, and I was tottering into obesity with no control on food intake. I took an exercise regime of walking 6-8 km daily, avoided snacks with evening tea and replaced rice at dinner with chapatti. Within three months, in April 2023, my weight came down to 76 kg, which is still maintained even though some additions in the food intake had taken place and walking is now reduced to 2 km a day. That was why I was interested in this book, especially at the author's assertion that 'the physicians have a flawed belief system that stipulates that the reason we get fat is that we eat too much and/or move too little. So, the cure is to do the opposite'. This got me intrigued, since I had done the same thing and got spectacular results as expected. Instead of eating less and exercising more, the author recommends a low-carbohydrate diet. This may help dietary fat to get burned for energy and keep the person's weight in control. I now think that this logic may have kept my body weight at the lower level in recent time even without much reducing food nor overindulging in physical activity. Gary Taubes is a correspondent for Science magazine. His articles about science, medicine and health have appeared in several magazines and is the author of many books on the same themes.

It is an established fact in modern medical science that the way to lose weight is to eat less and exercise more. However, Taubes' main argument in this book is that eating less and moving about more is not a remedy for weight gain. Prescribing low calorie diets for obese and overweight patients leads only to modest weight losses that are transient. Exercising more is no guarantee to lose weight. Poorer people do more physical work, but they are claimed to be fatter than affluent people. This is a contentious point, since this is definitely not valid in the case of India. Maybe the author is recounting his experience in the US. However, Taubes does not underrate the efficacy of physical exertion because he admits that 30 minutes of moderately vigorous physical activity five days a week is necessary to maintain and promote health, but there is no evidence to prove that doing so would make us lean. If we increase our physical activity, we will only work up an appetite. It will make us hungry and chances are that we will increase the calories we consume to compensate. The energy we consume and the energy we expend are claimed to be dependent on each other. Change one, and the other changes to compensate. The author underlines this main argument with the claim that the entire science of obesity got caught up in the circular logic of the calories-in/calories-out hypothesis and it has never been able to escape from this stranglehold.

This book also outlines the metabolic mechanism of its argument, along with experimental results. He describes an experiment in rats with its ovaries removed. This resulted in estrogen deficiency. If estrogen is not available, an enzyme called LPL draws fat out of the blood and stores it in cells, making the animal fatter. To compensate for the absence of this fat in other organs, it eats more. If food is then not available in sufficient quantity, it turns slothful to conserve energy. Fatness is thus caused by the better ability to absorb dietary fat. He concludes with the smart-sounding remark that 'we don't get fat because we overeat; we overeat because we are getting fat'. It was the Germans and Austrians who had founded and done meaningful research in the fields related to obesity. After World War II, the anti-German sentiment in the medical community deliberately neglected their work done in this area. The essential mechanism of weight regulation is that fat is continuously flowing out of fat cells and is circulating around the body to be used for fuel and returned to fat cells if it is not used. Fat is stored as a cluster of three types of fatty acids known as triglycerides. The cluster is too large to pass through the cell membrane. Anything that works to break down those triglycerides into their component fatty acids so that it escapes those cells works to make you leaner. There are dozens of hormones and enzymes that play a role in these processes. Insulin is the primary regulator of that metabolism. An enzyme called HSL breaks down triglycerides and release fatty acids to the blood stream. Insulin suppresses the operation of this enzyme, thereby making the animal fatter. The effect of insulin is to make us fatter.

The single most important advice a reader should take from this book is that one should minimize the amount of carbohydrate in order to remain lean. It's the carbohydrates that ultimately determine how much fat we accumulate because the secretion of insulin is linked to the presence of carbohydrate in the blood. Weight loss regimens succeed when they get rid of the fattening carbohydrates in the diet; they fail when they don't. Some people are predisposed to get fat, but this predisposition is triggered by the quantity and quality of carbohydrate we eat. Again, the fewer carbohydrates we take in, the leaner we will be. The book sounds a warning to those with a sweet tooth. Sugar is addictive to humans in the same way the psychedelic drugs are and for much the same biochemical reasons. In the 1960s, the focus was changed to avoid high-protein items like red meat as far as possible and to shift to carbohydrates. The medical community took this step apparently to ward off cardiac problems caused by the higher cholesterol content in red meat. The author opposes this established wisdom, but he quotes only anecdotal evidence in support of his claims. A science writer such as the author should know better than to rely on anecdotal stories which are no better than hearsay. Besides, research conducted around World Wars I and II and till 1980 are quoted throughout the narrative with no comments on whether later research has confirmed or repudiated any of these results. Readers should exercise a little bit of scepticism because he is taking on the entire medical community on his accusation that they are all wrong on this point. He adds that it was in the 1980s that the medical world adopted the fallacious calories-in/calories-out hypothesis. Another factor worth noting is that the author assumes that those foods which humans are adapted to in the long time when hunter-gatherers flourished would be good for us even now. Agriculture and the resultant carbohydrates were in our diet for only 0.1 per cent of our species' total existence. In the remaining period red meat obtained by hunting was the primary source of food. Hence, the author argues, that it will not be bad for our health.

It is to be accepted that Taubes has made a neat argument in favour of including more protein-rich substances like red meat and curtail intake of carbohydrates in our diet to keep our bodies slim. However, his substantiation of the arguments lacks rigour and readers get a distinct feeling that the narrative is not authentic as far as scientific facts are concerned. Some contentions like obesity is associated also with poverty and not with prosperity alone is not readily digestible as also his claim that poorer people are fatter. Another unfounded assumption is that cancer is prevalent in vegetarian societies like the Hindus of India (p. 171). As is common with many hoax theories in the medical field, he argues that big pharma companies intervene in discussions on health to suit their needs. Similar is his bold remark that health officials hesitate to discuss the concepts put forward in this book because it contradicts what they have been telling all along.

The book is recommended.

Rating: 2 Star