Book Review: Why We Get Fat by Gary Taubes

Taubes. I’d heard the name before, seen it on Instapundit. He was a low carb guy or a paleo or something like that. I didn’t pay him any attention.

Before Daniel and I met, Daniel heard an interview with Taubes on Russ Roberts’ EconTalk and was impressed. Daniel had been trying to eat lower carb in response; but once I took over the cooking, he just ate whatever I made.

Daniel has never complained about my cooking–in fact, he regularly compliments me (and shows the greater compliment of eating even the leftovers). But every so often, he’ll mention Taubes or comment that I should try making a lower carb version of this or that (My husband also has a rather significant faith in my ability to work wonders in the kitchen.)

So I knew I’d need to read Taubes’ Why We Get Fat eventually. I checked it out from the library while we were still dating, but I didn’t get very far.

See, the first chapter of Why We Get Fat seems designed to (forgive my French) piss off nutrition professionals.

Taubes effectively says: “Nutrition professionals say we get fat because calories in are greater than calories out. That’s not true.” He goes on to give example after example of fat but malnourished people. Problem is, he wasn’t giving enough information to differentiate whether actual energy malnutrition was occurring concurrent with obesity or whether what he was describing was kwashiorkor or other non-energy forms of malnutrition. This frustrated me beyond belief–and I gave up after the first chapter more than once.

It’s this first chapter that led to arguments between Daniel and I. I got really upset about how I felt Taubes was dogging my profession–and upset that he wasn’t giving the sort of information I needed to evaluate his claim. At first, Daniel didn’t really believe me that Taubes was so anti-nutrition professionals–so he was feeling pretty defensive, like I wasn’t giving Taubes a chance. After re-reading the first chapter, Daniel realized I was right about Taubes’ antipathy towards people like me–which didn’t really help the matter. No one wants to be proven wrong in an argument with his wife–and much less so if his wife is on rampage because an author (who you think should be taken seriously) has royally ticked her off. So, yeah….We definitely had to communicate our way through the first chapter because emotion was running pretty high.

Moving on.

The whole first half of the book was dedicating to “debunking” (ineffectively, to my mind) the idea that body fat is a matter of energy balance. This was pretty frustrating to me because energy balance is really just a matter of the 1st law of thermodynamics. We can’t store energy (in the form of fat) that we don’t have. Energy balance isn’t really open for debate.

It seemed to me that Taubes was making a common mistake–assuming that the energy balance equation is how much we eat minus how much we exercise. Yes, these are a big part of the energy balance equation, but calories in and out are actually much more complex, influenced by genetics, hormones, environment, and a host of other variables. Eating and exercise are simply the two most alterable aspects of the energy balance equation–which makes them a prime target for intervention.

So, after 70 pages hating on energy balance, Taubes admits that energy balance is a truism–sort of like survival of the fittest–and that what he’s really trying to say is that some other mechanism is primarily responsible for excess adiposity.

Great, I though, as I read the last few chapters of the first section. You could have just told me that at the beginning so I didn’t have to read all this hateful mumbo-jumbo before I could get to your thesis.

At last, in the second section of the book, Taubes was ready to tell the reader what his hypothesis is for why people become obese (literally, why they develop excess stores of fat tissue vs. lean tissue.)

His hypothesis goes like this: Insulin causes our bodies to preferentially store energy as fat, making it unavailable as fuel. Carbohydrate in the diet increases the amount of circulating insulin, which then increases adiposity (amount of fat tissue). Adipose tissue–and an overabundance of insulin–decreases insulin sensitivity, which means we have higher blood sugars. Higher blood sugars make us produce more insulin, which makes us get even fatter. And the cycle continues.

Taubes argues that this mechanism, in which insulin encourages our bodies to preferentially store energy as fat, means that our body will essential “rob” energy from vital processes (organ functioning as well as ability to use it for physical activity) in order to store it as fat. This means that a person can have inadequate energy for body functions while still storing fat.

This is an interesting and plausible mechanism for the problem of obesity (which is ultimately about excess body fatness rather than about body weight). I would love to see this hypothesis tested.

Unfortunately, Taubes seems intent on alienating the very people who have the knowledge and skills to test his hypothesis. Which means he can continue to sell “why your doctor/dietitian/health professional is wrong” books–but isn’t likely to see any change in public health policy.

My conclusions?

I like Taubes’ hypothesis. Right now, it’s just one theory among many regarding the causes of excess adiposity–but it has some definite merits. I’d love to see it tested.

And…I think Taubes is a jerk.

Just sayin’.

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Rating:I can’t decide
Category:Nutrition
Synopsis:Taubes tries to explain why energy balance isn’t responsible for obesity–and what he thinks is responsible
Recommendation: Did you read my review? Okay, then you probably don’t need to read this book. The first half is rubbish, the second a reasonable hypothesis that needs testing. Oh, and I mentioned that the author is a jerk, right?