Since this month is all about fad dieting, I picked up the perfect book for reading and discussing this month: Gary Taubes' "Why We Get Fat; and What to do About It". Today I want to talk about his introduction and the first three chapters of the book.
Introduction: The Original Sin
In the beginning of his introduction to his book, Taubes talks about some of the first recordings of obesity and overweight issues among Americans, from the 1930s. Interestingly, this is before the fast food companies that we have today were ever started and yet the people were still faced with obesity. Instead, in history, the 1930s were during the time of the Great Depression, where people had to go to soup kitchens and get in bread lines to find food, and where there was unprecedented unemployment. These people were vastly undernourished, and yet many were still obese. (Taubes, 3)
Today, Taubes tells us that "we are told that we get fat because we eat too much and/or move too little, and the cure is to do the opposite." (5) In fact, there is even a term for this, called the "calories-in/calories-out" or the "overeating" paradigm of excess fat - the "energy balance" paradigm (Taubes, 6). According to the World Health Organization (WHO), "The fundamental cause of obesity and overweight is an energy imbalance between calories consumed on the one hand, and calories expended on the other hand" (Taubes, 6). When looking at the obesity epidemic, Taubes tells us that "fifty years ago, one in every eight or nine Americans would have been officially considered obese, and today it is one in every three. Two in three are now considered overweight, which means they're carrying around more weight than the public-health authorities deem to be healthy." (7)
In this book, Taubes is going to argue that "the calories-in/calories-out paradigm of adiposity is nonsensical: that we don't get fat because we eat too much and move too little, and that we can't solve the problem or prevent it by consciously doing the opposite." (8) Taubes considers this belief to be the original sin, because thinking this way will not lead to solving weight problems and the diseases associated with obesity. He believes we need to rethink our beliefs and ask different questions to get to the real answer: such as, if "obesity is fundamentally a disorder of excess fat accumulation" then what regulates the accumulation of fat (Taubes, 9)?
Taubes believes we need to better understand the hormone, insulin in order to understand fat accumulation. He tells us that there are two factors dealing with insulin that cause fat to accumulate: "first, when insulin levels are elevated, we accumulate fat in our fat tissue; when these levels fall, we liberate fat from the fat tissue and burn it for fuel" and "second, our insulin levels are effectively determined by the carbohydrates we eat - not entirely, but for all intents and purposes." (10)
Taubes says, "in other words, the science itself makes clear that hormones, enzymes, and growth factors regulate our fat tissue, just as they do everything else in the human body, and that we do not get fat because we overeat; we get fat because the carbohydrates in our diet make us fat. The science tells us that obesity is ultimately the result of a hormonal imbalance, not a caloric one." (10)
Why Were They Fat?
Taubes believes that the best place to start talking about obesity, in order to better understand where it comes from, is with the obesity epidemic. When the "researchers for the Centers for Disease Control and Prevention (CDC) first broke the news that the obesity epidemic was upon us, they blamed it on overeating and sedentary behavior", further blaming these factors on "relative wealth of modern societies" (Taubes, 17).
However, the fact that fat is associated with poverty, not prosperity is well-documented - especially in women. So really, it has much more to do with being poorer than wealthy enough to buy lots of food and not move as much. To give reasons or rationale behind the fact that poorer means fatter, people have accepted the theories that "poorer people don't have the peer pressure that rich people do to remain thin", that "fatter women marry down in social class and thinner women marry up", and that "poor people don't have the leisure time to exercise that rich people do; they don't have the money to join health clubs, they live in neighborhoods without parks and sidewalks, so their kids don't have the opportunities to exercise and walk" (Taubes, 18).
When looking back at some of the cultural societies in history, groups such as the Pima Native American Tribe faced both poverty and obesity. Taubes tells us that "maybe the culprit was the type of food" (23). Their diets were very similar to the diets of many Americans today, not necessarily in quantity, but in quality (Taubes, 23). In terms of quantity, many groups like the women from Trinidad, West Indies in the early 1960s were actually eating less than the recommended number of calories for a woman each day, but a third were still obese.
Taubes tells us that today, "if we are fat and can prove that we eat in moderation - we don't eat any more, say, than do our lean friends or siblings - the experts will confidently assume that we must be physically inactive. If we're carrying excess fat buy obviously get plenty of exercise, then he experts will assume with equal confidence that we eat too much. If we're not gluttons, then we must be guilty of sloth. If we're not slothful, then gluttony is our sin." (29)
What experts don't account for is the coexistence of overweight and malnutrition poses a problem to most public health programs because the aims of the programs are to reduce undernutrition, which is in conflict with the goal to prevent obesity. If we want to prevent obesity, then we have to make people eat less; however if we want to prevent undernutrition, then we have to make more food available. (Taubes, 31) So what do we do? This doesn't necessarily pose a challenge to public health programs so much as it poses a challenge to our beliefs about the cause of obesity and overweight (Taubes, 32).
The Elusive Benefits of Undereating
In the early 1900's, the National Institutes of Health set out to research and investigate different aspects of women's health. They wanted to see if low-fat diets would actually help to prevent heart disease or cancer. Interestingly, when asked to heat a diet high in fiber, fruits, and vegetables, the women unconsciously ate diets lower in calories. After following these women for eight years, it was found that they lost an average of 2 lbs and that their waist circumference actually increased (Taubes, 33). This is pretty unbelievable with you consider that a pound of fat contains 3500 calories, and the women were undereating by about 360 calories a day! This experiment showed these low diets to be ineffective for weight loss over time. So if undereating does not promote weight loss, perhaps weight gain is not due to overeating.
In another report, researchers gathered past research results on success rates in treating obesity and overweight patients. They found the results to be "remarkably similar and remarkably poor" (Taubes, 35. According to Taubes, "most of the clinics were prescribing diets that allowed only eight hundred or one thousand calories a day!" (35) Still the results showed that only one in four patients ever lost as much as 20 lbs and only one in twenty patients lost as much as 40 lbs (Taubes, 36).
According to a review by Tufts University in 2007, prescribing low calorie diets to obese and overweight patients leads to, at best, modest weight losses that are transient, or temporary (Taubes, 36). Especially when calories are too low, because you cannot possibly keep eating 800 calories a day for the rest of your life. These low-calorie diets are unsustainable. Even the Obesity Handbook states that "dietary therapy remains the cornerstone of treatment and the reduction of energy intake continues to be the basis of successful weight reduction programs", but that the results of these diets are "known to be poor and not long-lasting." (Taubes, 37)
Taubes concludes his chapter by stating that "if undereating isn't a treatment or a cure, this certainly suggests that overeating is not a cure." (39)
The Elusive Benefits of Exercise
When you are invited to a awesome dinner and told to bring your appetite, how do you prepare? Possibly by working out and not eating very much during the day. Interestingly enough, this same strategy is the premises of many diets. So the same tactic we are given for dieting is what we are given to make us extremely hungry. In addition to the common belief that we have to decrease the amount of food we eat, it is also commonly believed that increasing the amount of exercise we participate in will increase our weight loss. While there are many good reasons to exercise; such as increasing out endurance and fitness, increasing our lifespan, reducing our risk of heart disease or diabetes, and helping us to feel better about ourselves, exercise has been shown to be somewhat ineffective for weight loss (Taubes, 41).
According to Taubes, "in the United States, Europe, and other developing nations, the poorer people are, the fatter they're likely to be. It's also true that the poorer we are, the more likely we are to work at physically demanding occupations, to earn our living with our bodies rather than our brains." (41) So if all of these people working these highly physical jobs and are still obese, how can we possibly think that the calories-out in day to day exercise will make any more of a difference?
After collecting research on long distance, habitual runners, Paul Williams and Peter Wood found that those who ran the most tended to weigh the least, but all of them tended to get fatter with each passing year, even those who ran more than forth miles a week! (Taubes, 45)
Many of the exercise plans for weight loss assume that calories-out will not encourage calories-in. But as I mentioned earlier, more exercise makes people hungrier. Using exercise as a means for weight loss and weight management will never completely work; especially when you consider a piece of bread is 100 calories and a 250 lb man would have to walk up 20 flights of stairs to burn off these calories (Taubes, 48).
The idea of exercise making such a big difference in weight loss did not actually come about until the 1950s and 1960s, when Jean Mayer wrote that lack of exercise helped lead to weight gain. He wrote that "the development of obesity is to a large extent the result of the lack of foresight of a civilization which spends tens of billions annually on cars, but is unwilling to include a swimming pool and tennis courts in the plans of every high school." (Taubes, 49) Taubes believes that from the late 1970s onward, "the primary factor fueling the belief that we can maintain or lose weight through exercise seemed to be the researchers' desire to believe it was true and their reluctance to acknowledge otherwise publicly." (53) In fact, many researchers will only discuss the results that support the belief that physical activity and energy expenditure can effect our weight (Taubes, 54).
Taubes tells us that people have been thinking and studying the idea that exercise can have some effect on weight loss for more than a century, but they still cannot come up with compelling evidence that it is true. Therefore, it probably is not. Taubes concludes by saying, "if reducing calories-in doesn't make us lose weight, and if increasing calories-out doesn't even prevent us from gaining it, maybe we should rethink the whole thing and find out what does." (56)
Join me next week in the continuation of Gary Taubes' book (Chapters 4-9) where we will uncover and learn more about dieting.
Exercise: Today I was really bad and didn't do my workout! :( I'm so mad at myself. I intended on coming home to do a yoga workout since I'm taking care of my sister this week but instead I came home and watched a movie. Bad me. But for today, I suggest getting a good yoga workout in!
Eat: Today's grocery shopping tip is to "Read the Nutrition Facts Labels and the Ingredient Lists". The FDA requires food companies to put Nutrition Facts labels that list the amount of calories, calories from fat, total and saturated fat, protein, carbohydrates, fiber, sugar, cholesterol, sodium, vitamins A and C, calcium, and iron per serving. Requirements for the addition of Trans fats to the list were made in 2006. Other companies will sometimes put other information on their labels voluntarily; such as potassium and mono- and polyunsaturated fats. According to Cooking Light, those who read Nutrition Facts labels are more likely to eat less foods high in saturated fats than those who don’t. You can also look at the ingredients list to make sure the food product does not include any trans fats that are not listed.
Relax: To relax today, I watched an old movie with my sister that I hadn't seen in years: Chicago. This Broadway show is an excellent choice to watch on a girls night or with your female family members. Haley and I really enjoyed watching the movie together.
