Book Review: Why We Get Fat, by Gary Taubes

Hey there! Welcome to the first of what will be many reviews of books related to nutrition, food, and health. Heaven knows there should be plenty to go around, considering the minute I finish the last page of one, I’m reaching for another to get started on. I’ve been reading these kinds of books for about nine years now, so there’s a lot of great titles lined up on my bookshelf. Some were published fairly recently, some go way back. In the interest of keeping things current, though, I’ll start with one I just finished. Over time, I hope to revisit and review some of the ones I read a while ago, ‘cuz there are some serious oldies but goodies in the pile.

Today’s menu:  Why We Get Fat and What to Do About It, by Gary Taubes.  For the sake of simplicity, I’ll call it WWGF.

Taubes wrote WWGF as a (much) shorter, more accessible version of his first book, Good Calories, Bad Calories (GCBC). Like just about everyone who understands and supports low-carbohydrate nutrition, I read GCBC not long after it came out. And having read both, if I had to make an S.A.T. analogy here, I would say that Why We Get Fat is to Good, Calories, Bad Calories as watching the Macy’s 4^th of July fireworks on TV is to being there in person, watching the colors fill the sky overhead and reflect on the water of the Hudson River below. It’s nice enough on TV, but it’s nothing like being there up close and in person. WWGF will give you the very basics. But if you want the no-holds-barred, hardcore, “we keep the good stuff in the back room” kind of experience (not that I know anything about that…), you owe it to yourself to read GCBC. I would say Taubes intended WWGF to be a kind of Cliffs Notes version of GCBC, but I’ve been out of high school so long that I don’t know if Cliffs Notes still even exist. (*Checks Internet.* Huh, whaddya know. They do.)

Taubes himself explains that he wrote WWGF in response to requests he had received from hundreds of people who read all 460 pages of GCBC (yikes!) but wanted something their husband/wife/mother/friend would read, and whose eyes would no doubt start to glaze over if they tried to tackle the tour-de-force that is GCBC. He had also received requests from people who wanted a pared-down version they could suggest their doctor read, and vice-versa—requests from doctors who wanted something simpler they could get their patients to read. I say this only to point out that the information in GCBC was so stunning, so eye-opening, and so desperately ripe for an opportunity to lay waste to the vast garbage heap of mainstream recommendations and “conventional wisdom” on weight loss, heart disease, and overall health that the last sixty years has produced, that people were begging him to write another one. 

Best bumper sticker EVER. When you need to destroy something (or someone) in the middle of the night, send in the Marines. When you need to destroy over half a century of bad science and damn near medical and nutritional malpractice, send in Gary Taubes. 

Taubes means business. He’s not a doctor. What he is, is an award-winning science journalist who’s spent years reading medical journals, interpreting research studies, studying human physiology and biochemistry, and personally interviewing hundreds of doctors and researchers intimately involved in conducting those studies and treating patients in clinical settings. He’s got as much right to write a book like this as anyone with M.D. or PhD after their name.

Taubes has been writing for a long time, but he started becoming a household name in the low-carb world in 2002 when his article, “What if It’s All Been a Big Fat Lie?” appeared in The New York Times Magazine. He hit the jackpot again in 2007 with “The Scientist and the Stairmaster” in New York magazine. (You gotta love an article with a subtitle like “Why most of us believe that exercise makes us thinner—and why we're wrong.”)

Nutshell versions:  Taubes's basic premise is that pretty much everything "the experts" have told us about why we get fat and how to get lean again is wrong. Well, maybe not all wrong, but certainly oversimplified to the point of being useless at best, and extremely harmful at worst. At the very worst, recommendations for everyone, across the board—whether you're a 16-year-old cross country track runner or a 78-year old woman with bone density problems—to do the same exercises and consume the same diets (low in fat and animal protein, heavy on grain-based carbohydrates), might even be the cause of the health and obesity quicksand we’ve sunk into up to our eyeballs.

One of the many things I enjoy about Taubes's writing is that by explaining what really happens in our bodies in response to different foods—the hormonal effects of fat, protein, and carbohydrate—it becomes easy to understand why some people do all right on low-fat diets, but why, for many, they’re a complete disaster. And he takes away the moral judgments. In our politically correct society, it seems that overweight people are the last acceptable targets. You can’t make comments about anything anymore: gender, religion, race. But it’s still open season on heavy people. Why? Because we’ve come to believe that people become overweight because of character flaws. Because of moral failings. They eat too much. They don’t exercise enough. They’re lazy and greedy. If they would just put down the cheeseburger and get on the treadmill, they’d be thin. Therefore, if they’re not thin, it’s all their fault.

Well, you know what? That didn’t work for me, and it doesn’t work for millions of people who think they’re doing “all the right things.” Do some people eat too much? Yes. Are some people not moving around enough? Yes. But there are millions of people who do “eat right” and exercise, and don’t lose body fat. You see them at the gym. You see them jogging down the street. You see them ordering fruit smoothies with fat-free frozen yogurt. And you see them staying the same weight, day in, day out, year in, year out. Or maybe you see them gaining weight.

It isn’t that Taubes completely absolves people of taking responsibility for their own health and physique. It’s that he shows us that if we have been doing what we’re “supposed to do” in order to lose weight and get healthy, but are not seeing the results we expect, it is NOT because we’re somehow not working hard enough or are undisciplined. When you follow instructions and don’t arrive at the expected outcome, are you to blame, or is it possible the instructions are?  AAAH, NOW WE’RE GETTING SOMEWHERE.

In GCBC, Taubes spent a lot of time explaining when and how we came to believe that “healthy diets” were low in total fat—and saturated fat, in particular, low in cholesterol (the lower the better), high in carbohydrates, high in fiber, and high in polyunsaturated fats—that is, if you were eating any fat at all. He gave a stunning account of the dirty politics and shoddy science that led to fanaticism about egg white omelets, margarine, and skinless white meat chicken that rivals anything Joss Whedon or J.J. Abrams could possibly imagine—and those guys have some seriously great imaginations. It’s true what they say: the truth is stranger than fiction. Taubes did a stellar job of explaining that so much of what we believe about health and nutrition is based not on scientific facts established after rigorous and unbiased research, but on expedient political consensus and economic convenience.

In WWGF, Taubes focuses more on the dietary implications than the history and politics. After all, that’s what those reader requests were asking for—just the stuff about what we really should eat and why what “they” (doctors, nutritionists, and government health authorities) have told us to eat for over sixty years might well be the very thing that caused the epidemics of obesity, heart disease, diabetes, metabolic syndrome, cancer, and Alzheimer’s we now face. 

Long story short:  Cut back on carbohydrates, especially simple sugars and easily digested starches such as wheat flour. Instead, eat meat, vegetables, nuts, and high-fat dairy. Ditch the morning bagel and glass of OJ; have a ham and cheese omelet instead. Swap out those “heart healthy vegetable oils” (insert eye roll) for saturated and monounsaturated fats found in beef, pork, and butter. Need an afternoon snack? Leave the rice cakes and fat-free yogurt alone and grab some beef jerky and nuts. Skim soy latte? No. Plain coffee with heavy cream. Basically, do the opposite of what we’ve been told to do.

When it comes to nutrition advice of the late 20th and early 21st Centuries,
if the government says go left, you should run right. As fast as you can.

Taubes spends a fair bit of time talking about populations that live on diets of nearly all meat and fat (the Inuit and Masai, for example) and are exceedingly healthy, and contrasting that with things in the good ol’ U.S. of A., where we’ve been faithfully cutting the fat off our steaks and throwing away our egg yolks, yet are sicker and fatter than ever. He points to a lot of things that make you think, but he doesn’t get into the nitty gritty of why these seeming paradoxes aren’t paradoxes at all, like he does in GCBC. 

If I wasn’t already familiar with the points Taubes makes about human physiology (and about LDL, HDL, saturated fat, insulin, and blood glucose), I’d have learned a fair bit from WWGF and probably would have been not a little angry. But after GCBC, I was downright furious. I’m not ashamed to tell you that while my copy of WWGF has some dog-eared pages and highlighting for particularly great passages, my copy of GCBC might as well be dipped in fluorescent yellow ink and is filled with margin notes, many of which boil down to a nice big middle finger and an “eff you” to the medical and nutrition “authorities” who used poorly conducted and even more poorly interpreted studies to hold our entire nation hostage under the low-fat paradigm and who, with complicity from food manufacturers and the pharmaceutical industry, forced us to pray to the high-carb, high-fiber, low-fat, low-cholesterol gods and landed us squarely in the epidemics of obesity, diabetes, heart disease, cancer, and dementia in which we now find ourselves.

Oy. Let me take a breather here. Sorry; this stuff gets me pretty worked up.

No, this is not a picture of me. 1. Beaches don't relax me; they aggravate me.
(I'm more of a woods & mountains girl.)
2. I wouldn't be caught dead in that visor.

Without having already read GCBC and knowing the science behind carbohydrate reduction, I’m not sure WWGF would have been compelling enough to give me the courage to ditch my breakfast of whole wheat toast and light margarine—can’t believe it’s not butter? I can!—and embrace eggs and sausage. It would have raised my eyebrows, sure. It would have made me go “hmmmm…” But I don’t think it would have been powerful enough to shift my entire way of thinking. We’ve been fed (no pun intended) the low-fat, low-calorie “thing” for so long and have believed it so fervently that it would have taken more than a couple of reasonable doubts to make me change my eating habits. (Never mind that the conventional advice makes sense, right? Fat makes you fat. Eat less, move more. Sounds logical! Case closed.) It would have required a slap upside the head so hard that I would have been able to think of nothing but how wrong the “experts” have been. And that’s what GCBC delivered. Over and over. That book slapped me upside the head so many times I’m lucky I can still tie my own shoes.

One thing Taubes points out is that research dollars are too often funneled into studies where the researchers have preconceived notions about what the results should be. Very rarely are studies designed to truly be unbiased, large enough, and of long enough duration to be worth the paper they’re printed on. (This is true even of studies published in peer-reviewed medical journals, sadly.) And because putting overweight, diabetic, atherosclerotic patients on high-fat, high-cholesterol diets is akin to malpractice (at least under the current standard of care), you can imagine how many research dollars are earmarked for clinical trials of low-carb diets.

To remedy this problem—to fill this gaping, sucking chest wound of a void in medical and nutrition research—Taubes recently founded something called NuSI (the Nutrition Science Initiative) with Dr. Peter Attia, a physician who agrees that it’s time for the medical-pharmaceutical-congressional complex (not to be confused with Eisenhower’s prophetic military-industrial complex) to wake up and realize that their current strategies for reducing obesity and chronic illness are not working, and that our nation is likely going to go bankrupt because of it.

Some people are starting to get it. I have to give kudos to Dr. Oz of all people. I respectfully disagree with him on a number of issues, but I have to admit, the guy’s willing to entertain the idea that he might be wrong—and might have been wrong to the tune of giving faulty recommendations to hundreds if not thousands of patients over the years. Recently two episodes of his show gave airtime to doctors that disagree with him on some fundamental principles of food and health. He might be rethinking his stance on cholesterol and whole wheat. (If you happen to check out those videos, be sure to look for parts 2 & 3 of each. They’re all short!) And whether or not he changes his own mind after meeting the doctors he interviewed, he has millions of viewers, and probably a fair number of them were sufficiently intrigued by what they heard to start thinking about these things differently and maybe even seek out some books like WWGF.  

If you have a lot of time to devote to reading, and want your mind blown like never before, read GCBC. If you want something on the lighter side but that will still make you reconsider what you think makes a “healthy diet,” WWGF is a good place to start.

Grade:  B+

Grade for GCBC:  A++ (I’ll try to do a review of it sometime, but you’ve got most of it here already. I can’t say enough good things about this book.)

Some of my favorite lines from WWGF:

“That the official embrace of low-fat, high-carbohydrate diets coincided not with a national decline in weight and heart disease but with epidemics of both obesity and diabetes (both of which increase heart disease risk), should make any reasonable person question the underlying assumptions of the advice.” (p. 182)

“The clinical trials comparing high-fat, high-saturated-fat Atkins-like diets to fat-restricted and calorie-restricted diets of the kind the American Heart Association recommends have been unambiguous in concluding that these high-fat diets do a better job of improving risk factors for both heart disease and diabetes.” (p.223)

“When we eat high-fat diets and avoid carbohydrates, HDL goes up, triglycerides go down, and the LDL in the circulation becomes larger and fluffier. Individually and together, these changes decrease our risk of having a heart attack.” (p.193-194)

“If you give up scrambled eggs and bacon for breakfast and replace them with cornflakes, skim milk, and bananas, your HDL cholesterol…will go down, and your heart-attack risk will go up.” (p.187)

“Anything that makes us secrete more insulin than nature intended, or keeps insulin levels elevated for longer than nature intended, will extend the periods during which we store fat and shorten the periods when we burn it.” (p.125)

“If we believe that our genetic makeup as a say in what constitutes a healthy diet, then the likely reason that easily digestible starches, refined carbohydrates, and sugars are fattening is that we didn’t evolve to eat them and certainly not in the quantities in which we eat them today. That a diet would be healthier without them seems manifestly obvious.” (p.167-168.)