Customer Reviews

Why We Get Fat: And What to Do About It (Vintage)

5 star:		(250)
4 star:		(62)
3 star:		(20)
2 star:		(14)
1 star:		(15)

 

 

The brilliant thing about science is that when something is disproved once, it's disproved forever. The not-so-brilliant thing about public health policy is that it has little to do with science.

Everyone in the developed world knows what's causing our obesity epidemic. BBC nailed it: "We eat too much, and too much of the wrong things," and Michelle Obama tells us "We have to move more." Clearly what we need is a balanced diet of lean meats, some good fats, and complex carbohydrates like fruit, vegetables and whole grain bread, and exercise of 30 to 90 minutes per day. Their prescription is completely reasonable and makes intuitive sense.

It is neat, plausible, and wrong. It has in fact been disproved, as nearly as "disproof" can exist in nutrition science.

In his previous book, Good Calories Bad Calories, respected science journalist Gary Taubes exhaustively researched and cited two centuries worth of research in nutrition. He came to the conclusion that none of those recommendations is supported by science, because the fundamental theory on which they're based is wrong. Why We Get Fat is an updated summary of that earlier work, much quicker and easier to read, with some significant points clarified.

The most important point of the book is that all those public recommendations -- the food pyramid, the "eat food, not too much" approach, everything we know about a balanced lifestyle -- is founded on the premise of Calories In vs. Calories Out. That we get fat because we eat too many calories, or we don't burn enough of them through movement. But this is nonsense. It's not just wrong, it is actually not a statement about what causes obesity at all (or heart disease, cancer or diabetes, for that matter.) It is, in Taubes' words, a "junior high level mistake," because it tells us nothing about fat accumulation. If we get fat, by definition we have taken in more calories than we've put out -- but WHY we took in those calories, or didn't burn them, is the key point.

Taubes reviews the scientific literature (rather than the popular press) and presents a conclusion that was common knowledge before WWII, and heresy afterward: we get fat because our fat cells have become disregulated and are taking nutrients that should be available to other tissues. Like a tumor, the cells live for themselves rather than in balance with the rest of the body. And since those nutrients aren't available, we become hungry and tired. Therefore we eat more, and move less.

For the chronic dieters among us, one passage about animal models will explain decades of frustration. Rodents with a particular part of the hypothalamus destroyed would become obese and/or sedentary *as a consequence* of their bodies putting on more fat. "After the surgery, their fat tissue sucks up calories to make more fat; this leaves insufficient fuel for the rest of the body...The only way to prevent these animals from getting obese is to starve them...they get fat not by overeating but by eating at all." Sound familiar?

The problem isn't one of gluttony and sloth, as Taubes refers to it, but of hormone balance. Simply put, some people are more sensitive to the hormone effects of insulin, cortisol, and a few other -ols, than other people are. The more sensitive you are, the more you're likely to get fat, and the more fat you're likely to get, in the presence of even small amounts of carbohydrate -- and in the absence of enough fat.

That's right, this book advocates eating fat. Not just moderately, but as much fat as possible, up to 78% of calories. Not lean meats, not Jenny-O 99.6% fat-free turkey, not skinless chicken breasts, but lard. Yes, lard. The healthy way of eating, according to Taubes, is moderately high protein and high fat. Yes, high fat. About a 3:1 ratio of fat to protein, and almost no carbohydrates. (Telling people to eat a balanced diet containing carbohydrates is, he says, equivalent to telling smokers to include a balanced serving of cigarettes.) And he demonstrates exactly why a high-fat, low-carbohydrate diet is the most heart-healthy approach, as borne out by several dozen recent studies.

While Taubes acknowledges that exercise seems to be good for us for a variety of reasons, weight control isn't one of them. Study after study conducted by proponents of exercise have admitted that they see no compelling evidence for exercise as a weight-loss tool. And it makes sense if you throw out the calories in/calories out model of why we get fat. If we're fat because our fat tissues are starving the rest of our cells of fuel, exercise is just going to make us hungrier and more tired, not leaner and more fit. (It's worth noting that according to Taubes, in the 1930s obese patients were treated with bed rest.)

[This review was edited to clarify the following point.] The main thrust of Taubes' argument, however, surrounds sugar and to a lesser extent any carbohydrate. Insulin is the primary hormone that fixes fat in the fat cells. This is why Type I diabetics lose weight: they're not producing enough insulin. Since insulin is manufactured in direct response to carbohydrates, if you don't eat them, you won't have a mechanism by which to store fat. (Taubes notes that this mechanism is not controversial; it simply hasn't had an impact on nutrition policy.) Taubes argues that any success in standard diets can be attributed directly to the dieter's reduced intake of carbohydrates, especially sugars and particularly fructose.

Once the underlying cause of obesity is understood (hormone balance, not gluttony/sloth) the recommendations on what to do about it are surprisingly simple and therefore brief. This is a book about the science of nutrition, not a diet book, but there is a list of recommended foods in the Appendix. The book does not tell you how to eat in a restaurant. But it does tell you that the issue isn't in your brain, your willpower, your character, your job, your environment or even (except to the extent that you're sensitive to carbohydrate) in your genes. The problem with fat is in your fat cells.

For a lay audience, this book is as good as it gets if you want to read actual science about health and nutrition. If you're of scientific or technical bent, read Good Calories Bad Calories first, then give Why We Get Fat to your parents.

I've read quite a few books that make some of the same points this one does about nutrition. I was already convinced saturated fat wasn't bad, and didn't cause heart disease. I was already convinced that sugar wasn't good for you--nor was a lot of bread and pasta. BUT I had never questioned the calories in/calories out theory. I knew plenty of people carrying extra pounds who exercised a lot and who didn't appear to eat any worse than I did (as a thin person), but I figured they must. I never questioned to think WHY do people eat more than need. The short answer is: glucose drives insulin drives fat. Taubes states that this is inarguable. I thought, well if it is inarguable than if I go read this Biochemistry, Fifth Edition: International Version (hardcover) book sitting on my bookshelf it will say the same thing. Sure enough it did, granted using a lot bigger words than Taubes does. Fatty acids will not be released into the blood stream to be used as energy if the glucose level is high. Thus it is logical to conclude that if you eat a diet that causes your blood sugar to frequently be high, all energy you consume that is not immediately needed will be stored in your fat cells and will not be released. You will not get to use all of the 800 calories you eat at one meal, only the 100 or so you need immediately, and thus you will soon be hungry again, and will overeat. And in contrast if your blood sugar is low and you can access that stored energy you will not be hungry and won't overeat. Also it doesn't matter if you are eating fat or glucose your body will convert what its got to what it needs.

Another controversial claim he makes is that people who have excess weight should not exercise. I am a champion of exercise. How could this be? Honestly his arguments made sense, kind of, but didn't completely convince me. However when I pulled out the Biochem book it says, "Muscle retains glucose, its preferred fuel for bursts of activity...In resting muscle, fatty acids are the major fuel, meeting 85 percent of the energy needs." So there you go. If you are trying to lose weight, and are doing so by keeping your blood sugar low, which is releasing fatty acids into your blood stream, and you want them to be used, versus having your body (ie muscles) crave glucose. Your body will more readily use those fatty acids if it is resting.

The other question is whether ketosis is a desirable state to be in. There is a bit of controversy on this and I haven't resolved an opinion one way or the other. I have epilepsy and know that a ketogenic diet is a viable treatment for epilepsy. I know that there are some societies, particularly the Inuits, that ate a mostly ketogenic diet, so it is not unheard of. Maybe humans are supposed to enter ketosis seasonally? But your brain and muscles do like glucose--can they run as well on a ketogenic diet? Some say they can, it just takes an adjustment period. Either way, I definitely think for a person who has excess weight Atkins is vindicated. Cut your carbs, drop significant amounts of weight (probably feeling crappy in the transition, but resting muscles can use the fuel better anyway so crashing on the couch is fine). When you hit a desirable weight slowly add back a small amount of carbs and start an exercise routine, as it seems exercise is good for weight maintenance, plus it's good for you brain (read Spark: The Revolutionary New Science of Exercise and the Brain by John Ratey) and do that forever. I would really love to see a long term study where the participants stay on the diet.

I found the book very readable and engaging. Will fruit give you fatty liver disease? Will eating more fat really improve your cholesterol profile? How many carbs are too many? I don't know. Taubes makes some guesses, but nutrition is a very complex science that I don't think anyone completely understands. If you read vegan arguments they make many of the same claims that Taubes does (better cholesterol levels, weight management, etc). However it does seem that every major nutritional philosophy pegs sugar as being a major problem. It may be as simple as that. I'll process this information. Read Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health (Vintage). Experiment on myself (finger pokes here I come), and have increased anxiety about what I feed my kids--especially the pasta, bread, fruit and sugar loving one.

Taubes' book is one of the most important books ever written on nutrition. There are thousands of books written on diet and obesity, and the overwhelming majority of them are deeply flawed at best. The so-called advice offered (and now even forcibly mandated by public and corporate powers) is also dead wrong, as will be most of those who trust said advice.

There are many thoughts on why this is the case, and many "conspiracy" theories as to how it came about, some with substantial evidence and outright smoking guns. This area of health is rife with disinformation, misinformation, ignorance, and outright lies.

Taubes does not deal with any of that directly. He does something quite different and important: he uses solid research from the hard literature to make his case in a very precise and focused way. The case he makes is airtight and irrefutable, even from the most hard-nosed skeptic's viewpoint.

The first thrust of this book is to show that the old "calories in - calories out" steam engine view of obesity is not only mildly incorrect, it is so very obviously wrong on so many levels as to completely defy rational thought. While he does not deal with the reasons behind this deadly myopia in the professional, corporate, and governmental world, he does systematically dismember this superstitious silliness with glorious logic and hard evidence.

From the misunderstanding of the application of thermodynamic "laws" in biological systems to the research on obesity and disease connections, he deftly leads the reader to a greater understanding of what the real research on obesity actually says, and what that means in terms of personal health and public policy.

His main concentration is on fat metabolism versus carbohydrate metabolism, and how carbs disturb the delicately balanced fat storage mechanism and cause obesity. He describes the research which backs this up, and has for decades and decades, while being totally ignored by most medical and public health officials. He discusses how long some of this research has shown these things and mentions how it has been consistently ignored.

That's right - carbs. Not dietary fat, not sloth, not moral weakness, not any other of the fad social mythology which passes for "evidence" driven policies and public stances. He details the increased understanding from more sensitive and better done research which essentially proves that our great-grandmothers had a better sense of healthy food than almost all the scientists, dieticians, health agency spokescritters, and gurus who have filled our heads with lies for at least 60 years. (And been accessories to the pain and death of millions of wrongly informed people, I hasten to add.)

His focus is completely on the science, and he does not venture into the politics or economic pressures which created this stupid state of affairs (the vitriol here is mine). While he does not discuss it directly, his book does point out the dangers of trusting science to give hard answers to questions of diet and health. As I point out in my review of Weston A.Price's "Nutrition and Physical Degeneration," science will not be able to give us solid answers to dietary questions for at least another 1,000 years, at the snail's pace and myopic style of current research, some of which is clearly discussed in this book.

I do have some quibbles with him: his statement about being about to get adequate vitamin D from exposure to sunlight is over-simplified to the point of being incorrect. He also advises people to use artificial sweeteners instead of sugars, which is extremely bad advice, given the dangers inherent in most of them. He does not mention the impact of MSG on obesity (it causes obesity - MSG is reportedly used to fatten lab animals for obesity experiments). He does not mention experiments on farm animals in the 1940s which showed that the diet which fattened mammals most quickly was one of grains and vegetable oil. He does not go into the differences in saturated fats, and how medium-chain fatty acids are handled differently in the body. He also does not mention that animal fat is a dense source of critical nutrients, and that saturated fat is crucial in triggering satiation, hence limiting appetite, cravings, and overeating.

Given all that, his work is still ironclad and irrefutable even in its narrow focus. Add in all the rest and you have a overwhelming body of evidence which is more than compelling enough to warrant a major investigation into the reasons why this information has been forcibly withheld from the public (causing untold suffering and death).

I gave it 5 stars, not because it is perfect, but because it is so powerful, so right, and so necessary.

Bottom line: everyone should read this book, period. The information here can literally save your life and that of those you love. Doctors, other medical people, dieticians, and others involved in the public sector dealing with nutrition should read this NOW, before they kill any more people through their ignorance.

As Weston A. Price once responded to a question about how to deal with the disinformation around the subject of a healthy diet; "You teach, you teach, you teach."

Get it and spread the word.

I pre-ordered Gary Taubes' new book "Why we get fat and what to do about it",
It arrived yesterday and I spent the day reading it.
Although I've always been a calorie restricting person,
rather than a "low-carb" person, I loved the book.

I've already read Good Calories Bad Calories several times,
and watched all of his University Lectures on YouTube,
and I've been thinking about these concepts for a few years.
I was worried that Taubes' new book would just seem like old info.
However, this was not the case.

He did a GREAT JOB.
His use of less detail made his concepts far more understandable
for someone like me, who is not a scientist or a medical professional.

I have a lifetime of low-calorie dieting history.
I am female, over 60, and 5'0" tall.
18 years ago weighing 271 lbs I had WLS.
Before my surgery I had lost more than 100 lbs twice
and regained it both times.
The year after surgery I lost from 271 to 160,
but as soon as my body could tolerate more carbs,
my weight began climbing again,
and I had to diet for the next 10+ years to maintain around 190 lbs.

6 years ago, I began using a computer food-journal to record all my food,
and I was successful at a low-calorie diet, losing from 190 to 115 lbs.
I have been maintaining close to that weight for the past 5 years
by continuing to restrict calories.
During the past 2 years I've had to average around 1050 calories to maintain my current weight,
and I've consistently been physically hungry much of the time now for more than 6 years.

Thanks to Taubes, I now realize that by restricting calories,
I also unintentionally restricted carbs.
Could it be that each time I've lost weight in my lifetime it was due to carb restriction?
Could it be that my maintenance difficulties have been due to carb return?
Is it possible that I could go low-carb and maintain my current weight without being so hungry?
This year, I plan to do my own personal Experiment-of-One to find out.

I found the book highly motivating,
and I recommend it to every open-minded person

This book wasn't what I thought it would be. But don't get me wrong, I'm not knocking the scientific research that Gary Taubes brought to the forefront on the reason why low fat, high carb diets don't work. They may work for some people, but I gain weight on that type of eating. And I really appreciate the research Mr. Taubes has done concerning weight loss.

If you are into the science behind low carbing, buy this book - this book is probably the best out there. Otherwise, Google the following - making sure you use Google as your search engine because I tried other search engines and this doesn't come up in the results. As of the date I wrote this review, it should be the first result in the Google search. Type in "17 dots no sugar no starch" and you will get a 13 page PDF file to print out with all the information on the diet, without the research that goes into how it works. It's a PDF file with the title "WHY WE GET". This is the same diet that's in the Appendix in Taube's book.

Added on 10/25/11: Weight loss is slowing down after 3 months, but I have managed to lose 17 lbs. so far. I had a family reunion to attend and I didn't stick to eating low carb, so that initiated a stall, but I'm back on it now.

There are lots of responses about Asians and carbs so I thought I'd share my experiences from living in Japan.
Yes, they eat rice BUT....
There is a BALANCE of foods in the average packaged lunchbox.
A serving of rice is measured, not a free for all ~ it is nutritionally CALCULATED.
They don't eat bread, cereals, pancakes, sweets, candy, ice cream etc as part of meals. Snacking is not common. Cars don't have coffee holders, people never walk and eat (except at festivals). Soft drinks are a treat and they don't seem as sweet there. Cold UNSWEETENED green tea is very very popular and is in every vending machine.
The average breakfast contains: fish, miso soup, vegetables (some steamed and some pickles), green tea, rice, maybe egg. It's very different from what we try to pass off as food. Eating nutella chocolate spread with white bread and a glass of milk for breakfast would be incredulous to an average Japanese. That's not food!
The average lunch box is (in a variety of small portions): meat, fish, vegetables (steamed and pickled), tempura veggies or shrimp, seafood, rice balls with sea weed, sausages, meat balls, fish cakes, tofu cakes, omelet, chicken nuggets etc. All groups are represented and you are expected to EAT EVERY BITE! Veggies are not garnish.
If you Google "japanese bento lunch box" images you'll see a little box full of little portions of an eye pleasing variety of foods. Pickles lower the glycemic value of the rice. There is lots of fiber from the veggies. Oily foods and eggs are represented. But again, no sugar or flour in the box at all. No cake for dessert. Bento boxes are available for pick up everywhere - you can run to the bento store and be back at your desk in 15 minutes with a balanced meal. The meals at the grocery store and even convenience store are really good (for about $5!). You aren't left desperately searching for real food on the go - it's just there for you. Food is made with care and there are so many options.
I should add, I lost 30 pounds after living in Japan for 2 years.
It also helped that there was no Tim Horton's with rows and rows of crack sugar to temp me. And cookies are individually wrapped so you'll look like a real tool unwrapping a dozen of them at a time. People eat meals instead of snacks all day. In short, they don't live on a refined carb roller coaster because they eat a balanced diet that they've been eating for thousands of years (we shouldn't just look at their diet for the brief period after WWII because that's not the real picture).
It's also a mixed bag that the working culture doesn't leave much time for watching tv and snacking.
There are so many nuances. It's hard to express them all in a book review.
Sadly, after I moved back to Canada, I gained back the weight plus 10 pounds within a year.
Sigh.
When I hear the Japanese diet is changing to Western style, I feel so sad. But on the other hand, it's still pretty good there!

I used to be very fat. Obese. 347 pounds. Okay, not one of the biggest losers fat, but, I had hard times breathing, I suffered from depression, insomnia, nausea, dizziness, constant illness, alergies, joint pain, lethargy, apathy, and just plain old uck. I was 18. When I saw that 347 on the scale, I suddenly wanted to take control of my life, I wanted to lose my weight, I wanted my life back on track... I wanted to be one of the skinny people--or at least, healthy people. But what works. When I was 13 I weighed 230 pounds. My parents spent 17 thousand dollars taking me to nutritionist across the USA. I ate six carb servings a day, following the food pyramid, and got fatter. I tried the atkins diet, but a misreading and mishandling of the material had me urinating fire pretty much by the second week, I tried Jenny Craig, Weight watchers, the bible diet, South Beach, and a host of others. You know what. They didn't work... at least, they didn't keep the weight off. I was fat and there was nothing I could do about it.

At eighteen, I decided I had to do something about it. I went to a bookstore, I spent about half of the money I got for graduating high school on health books, and I went home on a saturday, went to my room, and didn't leave but to use the bathroom. I read everything I could, from nutrition, to diets, to fads, to science, until, I decided on doing a strict diet of basic protein (two eggs in the morning), high vegetables, and fruit. THis cleared up the depression, most joint pain, and the apathy. And, I lost 80 pounds and it stayed off, even when I started back into bad habits for more than a year--pasta, subs, calzones. The problem with the diet is that I was worn out, I had no energy, no strength, and, as I would learn, as I still felt flabby and out of shape, my body was eating my muscle--well some of my fat-about 60-40. My insomnia was still there. I'd go to sleep at 6 or 7 in the morning, wake up at noon time because I couldn't sleep nights, and then by four o'clock I needed another nap--if I didn't get the nap, I still wouldn't sleep until six, but, I'd feel very lethargic through the night, and be unable to do anything.

Enter Gary Taubes and his first brilliant book, Good Calories Bad Calories. It's 2009, I hear about it, I buy it, I read it, and I thought it was interesting. But it doesn't catch my attention, it goes against a lot of what I've researched, and, a lot of what doctors told me. I live in my state of lethargy and insomnia, for a year, just figuring I'm a night person, and that's just who I am. Then, in 2010, I'm at a conference, the only places around serving anything good are sea food restaurants, so for a whole week, I'm ordering some form of fish at every meal--since I was still on my vegetable diet, I wouldn't allow myself to order fries every meal, and so I ordered vegetables. This conference took place in the mornings, and I would be exhausted, lasting until the afternoon, my head was hurting, my stomach was sick, but, after two days of the fish protein, I was wide awake, able to sit up and listen and take notes. By the forth night, I went to sleep for the first time in years before one o'clock and woke up at 6:30 refreshed and feeling good. By the end of the six day conference, I had no afternoon slump, my eyes began losing the bags under them, and I could swear my hair was growing back--I had begun thining at the top, I was 22 for God sakes.

SO, I decided protein needed to be a part of my diet, and, through a usual move through the bookstores, I came upon this book and I got it as a belated christmas present to myself. This year has been wonderful. This book was brilliant, along with Paleo Solution by Robb Wolf, The Primal Blueprint by Mark Sisson, Good Calories Bad Calories by Taubes, and The Paleo Diet by Loren Cordain. I sleep regular for the most part, my sex drive is up--and with my constantly improving appearance, it gets used--and where in my family, there's a history of cholesterol problems, high blood pressure, and diabetes, my blood pressure became normal for the first time in my life, my cholesterol went from borderline to outstanding, and my blood sugar sits at a perfect 85.

So, why do I say this is not the only way to lose weight. Because, I'm a stuidous student of weight loss, of health, and I take that serious, meaning I research everything, and test it. A diet of natural fruit and vegetables, for the purpose of weight loss is highly effective as well. A diet of just vegetables, no protein, sugar, carbohydrates, or fat, I've personally witness on multiple occasion put cancer--which can be caused by too high of protein--into remission. So, where he says this is the only way for weight loss, one can safely and effectively do just as well, on a natural fruit and vegetable diet. However, such a diet, I think, runs roughly 20 dollars a day. Where as the Paleo diet can be as low as 10 dollars a day.

Sorry for the long review. This is a great book. My energy and continued weight loss is contributed to the works of people like Taubes, Wolf, Sisson, and Cordain. A great documentary that constantly reference this work is Fat Head, worth the watch.

After having read a previous book by this author, I followed his advice and lost 50 pounds within two months, with dramatic improvements in my cholestoral profile and general health. He is clearly correct, both based on the evidence he cites and personal experience. This is an extremely important book. I also highly recommend his prior book, though it is much more detailed and requires more effort.

I was introduced to Taubes' ideas in a 2011 issue of Reader's Digest. As someone with an obesity problem, I was captivated by the idea that perhaps I was doing it all wrong. Finding the book, I dug in. It's both easy reading and a bit plodding, but well worth the time.

On a personal level, following his general guidelines, I've nearly-effortlessly lost an average of approximately three pounds per week for three months. "Nearly-effortlessly" means no gnawing hunger, no cravings, no binges, and no guilt.

I've incorporated the idea of one "free food" day per week (for me, it's Saturday), on which I can eat anything I want. The catch is, I must follow Taubes' ideas religiously the other six days. Doing that, there's no guilt on Saturday, and the next Saturday is never more than six days away! It's a profound mind trick.

Taubes is reasonable, logical, and his research is, to this layman, impeccable.

When I was deployed to Afghanistan, I lost 20 pounds after I quit eating that extra dinner roll or bread at lunch and dinner. I knew keeping the weight off after I redeployed would be hard. My concern led me to "Why We Get Fat." I wanted hard scientific data to back what the paleo or primal diet authors claimed. I had a hard time believing something so contrary to everything I had been told about what constitutes a healthy diet and lifestyle. "Why We Get Fat" empowered me to truly to decide. I say truly because conventional wisdom ignores data from scientists studying metabolism, metabolic disorders and diabetes.

If you want to understand why low-carb and low-fat diets work or don't work, and how they are healthy or unhealthy, read "Why We Get Fat". The author presents his information in competent prose but the information itself is challenging. He delves into why our biology makes weight loss more complex than simply burning more calories than we consume.

For the record, Gary Taubes' says at the beginning that ethical questions about eating animals, especially animals raised in inhumane conditions, are important but not his focus in "Why We Get Fat." For the same reason, he does not discuss the merits of organic food versus food grown with pesticides or anything about omega-3 and omega-6 fatty acids.

I've been home almost five months now and have kept those 20 pounds off thanks to "Why We Get Fat".