As a practicing physician, I have had a strong interest in obesity for many years, so I work hard to keep up with the latest research on the topic. I was really looking forward to reading "Fat Chance" and I wasn't disappointed. In my opinion Dr. Lustig has set a new standard when it comes to understanding an extremely complex disorder that is ravaging the health of people around the world. Despite my long-standing interest in the field of obesity, I also learned a great deal by reading this excellent book. I recommend that you buy two copies of the book--one for yourself and one for your physician!
The physiology of energy metabolism and fat storage is extremely complex and Dr. Lustig does a great job of walking us through the complex interactions between the hormones that regulate our metabolism and fat storage. He explains how our hormones drive our behaviors, how processed food can become addictive when it stimulates the pleasure centers in our brain and the role of stress in promoting insulin resistance and fat storage.
As he walks us through the science, he hits the most critical points in understanding just why we get obese. These points include:
1. A calorie is not a calorie. Gary Taubes was one of the first people to promote this important idea and Dr. Lustig describes the concept in a way that is easy for just about anyone to understand. It's not how much you eat but rather what you eat that really counts when it comes to your metabolic health.
2. The difference between being fat and sick. This is an absolutely critical point that even most physicians don't understand. He drives home the important point that 20% of obese people are metabolically healthy and up to 40% of people with a normal BMI are metabolically compromised. In other words there is really no such thing as a "weight" problem.
3. The fact that excessive fructose is a chronic toxin. This includes sucrose and HFCS that are now added to most processed foods. Like cigarette smoking, consuming large amounts of sugar won't kill you today but sooner or later the wheels will suddenly fall off, leading you down a road of chronic disease, disability and premature death.
4. The true role of exercise when it comes to health. He points out that exercise is a lousy weight loss tool but a great way to counter metabolic problems. Exercise to boost your mitochondria, not to lose weight.
5. The role of obesogens. Dr. Lustig points out that many chemicals we come into contact with every day are capable of promoting fat storage. This idea may make you a little paranoid, but that may be a good idea.
6. The role of fiber. Dr. Lustig does a great job of pointing out the critical role that soluble and insoluble fiber play in metabolism and obesity. This topic is often overlooked in discussions about obesity and he makes the case that fiber is absolutely critical when it comes to promoting metabolic health.
Once he has thoroughly covered the physiology of obesity, he moves on to the critical "what to do about it" question. In my opinion this is the most critical part of the book. He makes the case that it is important to change your own food environment if you want to be metabolically healthy and he then goes on to promote the idea that for most people this won't be enough--we need to change our entire food system if we want to have any hope of overcoming our massive epidemic of metabolic problems and obesity. In other words we have a huge public health crisis on our hands and we can't solve public health problems by only acting as individuals. We also need a top down approach if we hope to avoid an international health disaster and I agree with his perspective.
We need to change the way our government subsidizes food, we need to tax and restrict the dietary components like added sugars that are killing us or making us sick and we need to educate our population about the true dangers of eating processed foods.
Dr. Lustig certainly has grabbed the bull by the horns when it comes to our national health. Those of us who have spent decades in the trenches seeing the consequences of our toxic diet in our patients know deep down inside that he is absolutely right. Trying to change the behavior of individual patients is a lost cause when they are living in a toxic environment. Yes, it is a big challenge, but in my opinion the cost of doing nothing is so great that we cannot afford to ignore his call to action.
I highly recommend this book and I recommend that you buy copies for your physician and friends. There's no such thing as too much good information.
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About the author
Get on it!
After watching several YouTube videos featuring Lustig and his message about the dangers of sugar and altering the trajectory of my health by protecting my liver (by limiting my intake of fructose) and feeding my gut (with fiber via berries), I'm going to devour these books as I do grass-fed beef (of an animal that eats food from the ground).
