• Why we get fat? No, really, why?

    If you asked me this question — why did this restaurant get crowded? — and I said, well, the restaurant got crowded (it got overstuffed with energy) because more people entered the restaurant than left it, you’d probably think I was being a wise guy or an idiot. (If I worked for the World Health Organization, I’d tell you that “the fundamental cause of the crowded restaurant is an energy imbalance between people entering on one hand, and people exiting on the other hand.”) Of course, more people entered than left, you’d say. That’s obvious. But why? And, in fact, saying that a restaurant gets crowded because more people are entering than leaving it is redundant –saying the same thing in two different ways – and so meaningless.

    Now, borrowing the logic of the conventional wisdom of obesity, I want to clarify this point. So I say, listen, those restaurants that have more people enter them then leave them will become more crowded. There’s no getting around the laws of thermodynamics. You’d still say, yes, but so what? Or at least I hope you would, because I still haven’t given you any causal information. I’m just repeating the obvious.

    This is what happens when the laws of physics (thermodynamics) are used to defend the belief that overeating makes us fat. Thermodynamics tells us that if we get fatter and heavier, more energy enters our body than leaves it. Overeating means we’re consuming more energy than we’re expending. It’s saying the same thing in a different way. (In 1954, the soon-to-be-famous — and often misguided, although not in this case — nutritionist Jean Mayer said that to explain obesity by overeating was about as meaningful as explaining alcoholism by overdrinking, and merely reaffirmed, quite unnecessarily, the fact that the person saying it believed in the laws of thermodynamics.) Neither happens to answer the question why. Why do we take in more energy than we expend? Why do we get fatter?

    That’s Gary Taubes in a post from late last year. The post is worth a full read.

    • Is this really a question? ummm, because eating is pleasant? Specifically, because eating is pleasant now, and overeating is unpleasant much later?

      Surely doesn’t explain every situation, but I bet that statement has an R^2 above 0.7. Go ahead and spend your career chasing after the other 0.3, if you wish.

    • There is an awesome summary of Gary’s book Why We Get Fat here

    • I have an anecdote which may bear on this discussion for about 1/3 of the population of which I am a part. It seconds the comment from Jacob M above with whom I am in complete agreement based on personal experience.

      I am 66 and weighed 155 pounds. At 5-11 I had a moderate BMI yet I used to weigh 135 in high school and college. Most of my extra weight was on my gut and hips. My doctor warned me based on routine blood work that I was headed for type 2 diabetes in 5 years or so if I didn’t lose the extra fat. He told me that about 1/3 of the population is starch sensitive which causes insulin spikes and dips and accumulated waist fat and coupled with lack of exercise, ultimately insulin resistance in the muscles and type 2 diabetes. On his advice I knocked all starch out of my diet that I could identify. This means all grains, potatoes, etc. In other words a very large proportion of the average american diet. No bread, pizza, potato chips corn, rice, etc., per the article at Jacob’s link. To make up for this loss I ate more protein, meat, fat, green vegetables, cheese, etc. and never went hungry. I continued my usual alcohol intake. I never kept track but I would say that with the increased fat intake my total caloric intake did not go down. However the other part of the prescription was 1/2 hour or more of walking every day without fail. I used to walk regularly but not religiously but I began to make sure to go every day. My total walking increased by maybe 20%. The bottom line was that I lost 15 pounds over 2 months, my blood sugar numbers returned to normal, my HDL cholesterol went up and my LDL cholesterol went down. My triglycerides which were low stayed put and my blood pressure which was normal also went down a little. I have since drifted up a couple of pounds but I am still more than 10 pounds under my previous peak weight.

      I basically followed the low glycemic load diet guidelines with perhaps a little more emphasis on starch and maybe less on carbs.

      Based on my experience and what the glycemic load books and my doctor say I think a significant part (maybe 1/3) of the obesity problem in the US results from starch sensitivity and inactivity in an especially susceptible population. Starches and inactivity are ubiquitous in the American diet and lifestyle and approximately 1/3 of the population is especially sensitive to these factors and gain due to the insulin responses discussed in Jacob’s link. I have no connection with proponents of the glycemic load diet other than buying the book from Amazon.

      As an added personal benefit to both of us my wife, who does not share my starch driven blood sugar anomalies, went on the same regimen. This was mostly to keep our food buying simple and to reduce temptations for me in the household but she lost 25 pounds without ever experiencing hunger.

      I give great credit to my doctor for a timely warning. He was informed on the problem because it affected him (and his brother) personally and he had similar results when he limited starches so it was easy to believe his advice.

      I read that airlines have to take into account the increase in the average weight of their passengers in calculating loading factors in their planes and also the added fuel costs. It’s probably a factor in overall health care cost increases since type 2 diabetes is a very expensive disease over time. There many costs to our economy resulting from obesity.

      If more doctors would keep their eyes open for people like me and give appropriate warnings maybe a small dent could be made in the obesity epidemic. What you say about caloric intake versus consumption via exercise is the rule for most people but some significant numbers of us have metabolic peculiarities beyond that simple balance. I am not naive. We are surrounded by temptations which make these dietary changes painful, even to a believer like me. But every person who improves their future health odds is one step to the good.