Why We Get Fat: And What to Do About It

ALSO BY GARY TAUBES

Good Calories, Bad Calories:
Challenging the Conventional Wisdom on Diet, Weight Control, and Disease

Bad Science:
The Short Life and Weird Times of Cold Fusion

Nobel Dreams:
Power, Deceit and the Ultimate Experiment

This book has been in the works for more than a decade. It began with a series of investigative articles that I wrote for the journal
Science
and then the
New York Times Magazine
on the surprisingly dismal state of nutrition and chronic-disease research. It is an extension and distillation of the five years of further research that became my previous book,
Good Calories, Bad Calories
(2007). Its arguments were honed in lectures at medical schools, universities, and research institutions throughout the United States and Canada.

What I tried to make clear in
Good Calories, Bad Calories
was that nutrition and obesity research lost its way after the Second World War with the evaporation of the European community of scientists and physicians that did the pioneering work in those disciplines. It has since resisted all attempts to correct it. As a result, the individuals involved in this research have not only wasted decades of time, effort, and money but have done incalculable damage along the way. Their beliefs have remained impervious to an ever-growing body of evidence that refutes them while being embraced by public-health authorities and translated into precisely the wrong advice about what to eat and, more important, what not to eat if we want to maintain a healthy weight and live a long and healthy life.

I decided to write
Why We Get Fat
largely because of two common responses that I receive to
Good Calories, Bad Calories
.

The first comes from those researchers who made an effort to understand the arguments in
Good Calories, Bad Calories
, who read the book or listened to one of my lectures or discussed these ideas with me directly. I’m often told by these people that what
I’m saying about why we get fat, and about the dietary causes of heart disease, diabetes, and other chronic diseases, makes significant sense. It certainly could be right, they say, with the unspoken implication that what we’ve been told for the past half-century certainly could be wrong. We all agree that these competing ideas should be tested.

I believe, though, that this is an urgent matter. If so many people are getting fat and diabetic in large part because we’ve been getting the wrong advice, we should not be dawdling about determining that with certainty. The disease burdens of obesity and diabetes are already overwhelming not only hundreds of millions of individuals but our health-care systems as well.

Even if these researchers do see the need to address the problem immediately, though, they have obligations and legitimate interests elsewhere, including being funded for other research. With luck, the ideas discussed in
Good Calories, Bad Calories
may be rigorously tested in the next twenty years. If confirmed, it will be another decade or so after that, at least, before our public-health authorities actively change their official explanation for why we get fat, how that leads to illness, and what we have to do to avoid or reverse those fates. As I was told by a professor of nutrition at New York University after one of my lectures, the kind of change I’m advocating could take a lifetime to be accepted.

That is simply too long to wait to get the right answers to these critical questions. So this book was written in part to speed up the process. I offer here the arguments against the conventional wisdom distilled down to their essence. If they certainly could be right, then let’s test them, and let’s do it sooner rather than later.

The other response I get frequently is from those lay readers, as well as an encouraging number of physicians, nutritionists, researchers, and health administrators, who say that they read
Good Calories, Bad Calories
or listened to my lectures, found the logic and the evidence compelling, and embraced the message implicit in it. They tell me their lives and their health have been transformed in ways they didn’t think possible. They have lost
weight almost effortlessly and have kept it off. Their risk factors for heart disease have improved dramatically. Some say they no longer need their hypertension and diabetes medications. They feel better and have more energy. Put simply, they feel healthy for the first time in far too long. You can see these kinds of comments on the Amazon web page for
Good Calories, Bad Calories
, where they represent a large proportion of the several hundred personal reviews at the site.

These comments, e-mails, and letters have often come with a request.
Good Calories, Bad Calories
is lengthy (nearly five hundred pages), dense with science and historical context, and densely annotated, all of which I believe was necessary to initiate a meaningful dialogue with the experts and assure that they (or any reader) take nothing I say on trust alone. The book demands that the reader devote considerable time and attention to following the evidence and the arguments. For this reason, many who read it have asked me to write another book, one that their husbands or wives, their aging parents, or their friends and siblings can read without difficulty. Many physicians have asked me to write a book that they can give to their patients, or even to their fellow physicians, a book that doesn’t require such an investment of time and effort.

So this is the other reason I wrote
Why We Get Fat
. I hope by reading it you will understand, perhaps for the first time, why we do get fat and what to do about it.

My one request is that you think critically while you’re reading. I want you to keep asking yourself as you read whether what I’m saying really makes sense. To steal a phrase from Michael Pollan, this book is intended to be a thinker’s manifesto. Its goal is to refute some of the misconceptions that pass for public-health and medical advice in this country and around the world, and to arm you with the necessary information and logic to take your health and well-being into your own hands.

One word of caution though: If you accept my arguments as valid and change your diet accordingly, you may be going against
your doctor’s advice, and certainly that of the health organizations and government agencies that dictate the consensus opinion on what constitutes a healthy diet. In that sense, you read this book and act on it at your own risk. That situation can be rectified, though, by giving this book to your physician when you’re done reading it, so that he or she, too, can decide who and what to believe. And you might give it to your congressional representatives as well, because the rising tides of obesity and diabetes in the United States and throughout the world are indeed massive public-health problems, not just our own individual burdens to bear. It would help if our elected representatives actually understood how we got into this situation, so they could act finally to resolve it, rather than perpetuate it.

—G.T., September 2010

In 1934, a young German pediatrician named Hilde Bruch moved to America, settled in New York City, and was “startled,” as she later wrote, by the number of fat children she saw—“really fat ones, not only in clinics, but on the streets and subways, and in schools.” Indeed, fat children in New York were so conspicuous that other European immigrants would ask Bruch about it, assuming that she would have an answer. What is the matter with American children? they would ask. Why are they so bloated and blown up? Many would say they’d never seen so many children in such a state.

Today we hear such questions all the time, or we ask them ourselves, with the continual reminders that we are in the midst of an epidemic of obesity (as is the entire developed world). Similar questions are asked about fat adults. Why are
they
so bloated and blown up? Or you might ask yourself: Why am I?

But this was New York City in the mid-1930s. This was two decades before the first Kentucky Fried Chicken and McDonald’s franchises, when fast food as we know it today was born. This was half a century before supersizing and high-fructose corn syrup. More to the point, 1934 was the depths of the Great Depression, an era of soup kitchens, bread lines, and unprecedented unemployment. One in every four workers in the United States was unemployed. Six out of every ten Americans were living in poverty. In New York City, where Bruch and her fellow immigrants were astonished by the adiposity of the local children,
one in four children were said to be malnourished. How could this be?

A year after arriving in New York, Bruch established a clinic at Columbia University’s College of Physicians and Surgeons to treat obese children. In 1939, she published the first of a series of reports on her exhaustive studies of the many obese children she had treated, although almost invariably without success. From interviews with her patients and their families, she learned that these obese children did indeed eat excessive amounts of food—no matter how much either they or their parents might initially deny it. Telling them to eat less, though, just didn’t work, and no amount of instruction or compassion, counseling, or exhortations—of either children or parents—seemed to help.