Eva's Reviews > Why We Get Fat: And What to Do About It

Notes from Kindle:

“More than in any other illness,” as Bruch said about obesity, “the physician is called upon only to do a special trick, to make the patient do something—stop eating—after it has already been proved that he cannot do it.”

as Voltaire pointed out in his Dictionnaire philosophique, common sense isn’t all that common,

Can it be possible that the obesity epidemic is caused by prosperity, so the richer we get, the fatter we get, and that obesity associates with poverty, so the poorer we are, the more likely we are to be fat?

One remarkable study of the effect of physical activity on weight loss was published in 1989 by a team of Danish researchers. The Danes actually did train sedentary subjects to run marathons (26.2 miles). After eighteen months of training, and after actually running a marathon, the eighteen men in the study had lost an average of five pounds of body fat. As for the nine women subjects, the Danes reported, “no change in body composition was observed.”

“there is no stranger phenomena than the maintenance of a constant body weight under marked variation in bodily activity and food consumption.”

The fact that many people do remain lean for decades (although it’s less common now than in Du Bois’s day), and that even those who are fat don’t continuously get fatter, suggests there is something more going on with this business of weight regulation than can be explained by the notion that it’s all about calories.

Steatopygia, the prominent fat deposits of the buttocks on this African woman, is a genetic trait, not the product of overeating or sedentary behavior.

Why do the lean twins have identical bodies? And why do the obese twins? Why is their accumulation of fat so nearly identical? Are we to assume that they just overate, more or less, by exactly the same number of calories over the course of their lives because their genes determined precisely the size of the portions they ate at every meal and precisely how sedentary they chose to be—how many hours they sat on the couch rather than getting up and gardening or walking?

Breeders of livestock have always been implicitly aware of the genetic, constitutional component of fatness. Those engaged in the art and science of animal husbandry have spent many decades breeding cattle, pigs, and sheep to be more fatty or less fatty, just as they breed dairy cattle to increase milk production or dogs for hunting or herding ability.

Hence, a likely explanation is that the genes that determine the relative adiposity of these two breeds have little or nothing to do with their appetite or physical activity but, rather, with how they partition energy—whether they turn it into protein and fat in the muscles or into milk.

Girls enter puberty with very slightly more body fat than boys (6 percent more, on average), but by the time puberty is over, they have 50 percent more.

In other words, when a girl enters puberty as slender as a boy and leaves it with the shapely figure of a woman, it’s not because of overeating or inactivity, even though it’s mostly the fat she’s acquired that gives her that womanly shape and she had to eat more calories than she expended to accommodate that fat.

It’s characterized by the complete loss of subcutaneous fat (the fat immediately beneath the skin) in the upper body, and an excess of fat below the waist.

There’s a modern example of a lipodystrophy that’s not nearly so uncommon—HIV-related lipodystrophy, apparently caused by the anti-retroviral drugs that people infected with HIV take to subdue the virus and keep full-blown AIDS at bay.

So what we want to know is why this room is crowded and so overstuffed with energy—that is, people. If you asked me this question, and I said, Well, because more people entered the room than left it, you’d probably think I was being a wise guy or an idiot. Of course more people entered than left, you’d say. That’s obvious. But why?

To ‘explain’ obesity by overeating is as illuminating a statement as an ‘explanation’ of alcoholism by chronic overdrinking.”

People who semi-starve themselves, or who are semi-starved during wars, famines, or scientific experiments, are not only hungry all the time (not to mention cranky and depressed) but lethargic, and they expend less energy. Their body temperatures drop; they tend to be cold all the time.

The way Wade explained it to me, the animal doesn’t get fat because it overeats, it overeats because it’s getting fat. The cause and effect are reversed. Both gluttony and sloth are effects of the drive to get fatter.

We are, after all, just another species of animal. Animals in the wild may be naturally fat

No matter how abundant their food supply, wild animals will maintain a stable weight—not too fat, not too thin—which tells us that their bodies are assuring that the amount of fat in their fat tissue always works to their advantage and never becomes a hindrance to survival. When animals do put on significant fat, that fat is always there for a very good reason.

My son’s growth, like every child’s, is caused fundamentally by the action of growth hormones. As he gets older, he’ll occasionally go through growth spurts that will be accompanied by a voracious appetite and probably a fair share of sloth, but the appetite and the sloth will be driven by the growth, not vice versa.

he could get their weight below that of lean mice if he starved them sufficiently, but they’d “still contain more fat than the normal ones, while their muscles have melted away.” Once again, eating too much wasn’t the problem; these mice, as Mayer wrote, “will make fat out of their food under the most unlikely circumstances, even when half starved.”

If a baby rat that is genetically programmed to become obese is put on a diet from the moment it’s weaned, so it can eat no more than a lean rat would eat, if that, and can never eat as much as it would like, it responds by compromising its organs and muscles to satisfy its genetic drive to grow fat.

Similarly, a greyhound will be more physically active than a basset hound, not because of any conscious desire to exercise, but because its body partitions fuel to its lean tissue, not to its fat.

the hump provides a reservoir of fat for survival in the desert, without the camel’s having to keep that fat in subcutaneous deposits, as we do, where the insulation would present problems in the desert heat.

she faithfully injected herself with her daily insulin in the same two sites on her thighs. The result: cantaloupe-sized masses of fat on each thigh.

This is why diabetics often get fatter when they take insulin therapy. (It results from “the direct lipogenic effect of insulin on adipose tissue, independent of food intake,” as explained by the seminal textbook in the field, Joslin’s Diabetes Mellitus.)

Because the insulin level in the bloodstream is determined primarily by the carbohydrates that are consumed—their quantity and quality, as I’ll discuss—it’s those carbohydrates that ultimately determine how much fat we accumulate.

You think about eating a meal containing carbohydrates. You begin secreting insulin.

So cortisol can make us fatter still when insulin is elevated, but it can also make us leaner, just like every other hormone, when insulin levels are low. And this may explain why some people get fatter when they get stressed, anxious, or depressed and eat more, and some people do the opposite.

the higher the blood sugar in the pregnant mother, the more insulin-secreting cells her child will develop, and the more insulin the child will secrete as it gets close to birth. The baby will now be born with more fat, and it will have a tendency to oversecrete insulin and become insulin-resistant itself as it gets older. It will be predisposed to get fat as it ages. In animal studies, this predisposition often manifests itself only when the animal reaches its version of middle age.

But if we’re predisposed to put on fat, it’s a good bet that most fruit will make the problem worse, not better.

Dancel also noted, as Brillat-Savarin had and others would, that carnivorous animals are never fat, whereas herbivores, living exclusively on plants, often

it’s worth remembering that we’ve been cultivating fruit trees for only the past few thousand years, and that the kinds of fruit we eat today—Fuji apples, Bartlett pears, navel oranges—have been bred to be far juicier and sweeter than the wild varieties and so, in effect, to be far more fattening.

Researchers have continued to demonstrate that cholesterol-lowering drugs can prevent heart attacks and apparently allow some people to live longer (at least those who are at particularly high risk of a heart attack). But it has still not been demonstrated that either low-fat or low-saturated-fat diets will do the same.

After six years on the diet, these women had cut both their total fat consumption and their saturated-fat consumption by a quarter, lowering their total cholesterol and their LDL cholesterol below (albeit only very slightly below) that of the other twenty-nine thousand women, who were eating whatever they wanted and yet their low-fat diet, as the final reports stated, had no beneficial effect on heart disease, stroke, breast cancer, colon cancer, or, for that matter, fat accumulation. Eating les...

For women, HDL levels are so good at predicting future heart disease that they are, effectively, the only predictors of risk that matter.

Gardner presented the results of the trial in a lecture that’s now viewable on YouTube—“The Battle of Weight Loss Diets: Is Anyone Winning (at Losing)?” He begins the lecture by acknowledging that he’s been a vegetarian for twenty-five years. He did the study, he explains, because he was concerned that a diet like the Atkins diet, rich in meat and saturated fat, could be dangerous. When he described the triumph of the very low-carbohydrate, meat-rich Atkins diet, he called it “a bitter pill to s...

avoid other foods that might stimulate significant insulin secretion—diet sodas, dairy products (cream, for instance), coffee, and nuts,

(Anecdotal evidence suggests that occasional or intermittent fasting for eighteen or twenty-four hours might work to break through these plateaus of weight loss, but this, too, has not been adequately tested.)

Donaldson said in his 1962 memoirs, no matter how well someone does on the mostly meat diet that Donaldson prescribed, “any disaster that may overtake him, even to the extent of ground moles getting in his lawn, will be blamed on his diet.”

For most effective weight loss, you will need to keep the total number of carbohydrate grams to fewer than 20 grams per day. Your diet is to be made up exclusively of foods and beverages from this handout.