You can hardly turn on the radio or pick up a magazine these days without hearing about the obesity crisis. We’re told that people are getting fatter and fatter and all their fat will surely lead to death, with a guaranteed spell of diabetes and heart disease to usher them there. All these unsightly fat people are increasing everyone’s insurance rates and taking up all the space on airlines. Don’t they know how fat they are? Why can’t they stop eating those six hamburgers and two bacon sundaes a day and go for a walk? Apparently, the fat is their own fault, and if they (by which I also mean we) would only exercise a little self-discipline and will power, they would get thin and stay thin. And also be guaranteed perfect health until the day they die. Which they won’t do until they are very very old.
Or so the story goes. In Rethinking Thin¸ Gina Kolata, a science and health writer for the New York Times, offers a much-needed alternate narrative. Kolata tells the story of how weight standards have changed over time, shares research on the causes of obesity, and reconsiders the link between weight and health. She intersperses these chapters with a narrative about participants in a two-year weight-loss study designed to determine whether the then-popular Atkins diet or a low-calorie diet was more effective. (The book was published in 2007, not long after the Atkins diet was at the height of its popularity.)
This is an excellent book, one that I’d like to hand out on street corners and give to every single weight loss guru and everyone who says weight loss is as simple as eating less and exercising more, cutting out all carbs and/or sugar, or taking on a “lifestyle change” that involves weighing and measuring every morsel of food you ever eat for the rest of your life. Kolata debunks myth after myth, showing that weight loss is far more complicated and difficult than profit-seeking diet companies would have us believe.
The early chapters focus on the history of dieting, weight loss, and fat stigma. Kolata shows that few of today’s supposedly revolutionary diets are new. What is new is that the standard for a healthy weight has gotten lower. This is all very interesting, but it’s the last half of the book that offers the meat of her research.
When Kolata gets into current research into weight loss, she starts calling into question all those things about weight that “everybody knows.” For example, when discussing the psychological factors that might cause overeating, she reveals that obese people’s psychological profiles are no different from those of thin people. Obesity is not, in fact, a sign of mental problems. When psychiatrists look at the mental health profile of fat and thin people, they cannot tell the difference. Kolata sums up the findings:
There is no psychiatric pathology that spells obesity. And there is no response to food that is not shared by people who are not fat. You can’t say you got fat because you, unlike thin people, are unable to resist temptation. Both fat and thin people are tempted by the sweet smell of brownies or the sight of a dish of creamy cold ice cream. You can’t say you got fat because there is a lot of stress in your life. Thin people are just as likely to eat under stress. You can’t say it was because you used food as a reward. If that is the reason, then why do thin people, who also use food as a reward, stay thin?
Research also shows that obesity could, to a great extent, be genetic. Studies of adoptees and of twins raised separately show that children of obese parents tend to be obese, even when they are raised apart from their parents, which rules out the common notion that fat parents teach their kids poor dietary habits. Studies of rats and mice have revealed that when certain genes that govern feelings of satiety are not present or when they don’t function properly, it can be impossible to ever feel full. People who have this genetic abnormality feel their hunger more and feel their fullness less. So for these people, the advice to eat only when you’re hungry and stop when you’re full is pointless.
An additional complication is that fact that fat people who have lost weight are physically different from people who are naturally thin. A formerly fat person who now weighs 130 pounds must eat fewer calories than a person who got to that weight without dieting (or making a “lifestyle change” that involves calorie restriction). Physiologically, a fat person who has lost weight is not so different from a person who is starving. When people say weight loss is as simple as “eating less and exercising more,” I’m not sure they can actually conceive of how much less food and how much more exercise a formerly fat person requires to stay thin.
Especially interesting to me was the discussion of the starvation experiment conducted with conscientious objectors during World War II. When the participants were put on a starvation diet, they eventually began fantasizing about food, exchanging recipes, and obsessing about every meal. I read a book about this experiment last year and, as striking as this behavior was, I hadn’t connected it with my own food obsessions when I’m on a diet. When I’m consciously watching my calories, it’s hard for me to think about anything but food. If there’s a plate of cookies on a table in a meeting, my mind will drift to them almost constantly. If I’m not dieting, it’s easier to ignore them. This connection also got me thinking about whether the rise in “food porn” and popularity of food shows could be linked to our dieting culture. Does dieting make us think about food more? And is that a good thing?
Probably the most important chapter may be the one on what Kolata calls the “fat wars.” In this chapter, Kolata discusses the possibly false link between weight and health. I’ve long questioned whether this link is as strong as headline writers and diet gurus would have us think. I know from my own experience that I was not at my healthiest when I was at my lowest weight. I weigh more now than I did when I was eating far less healthily and exercising less. The shocking thing about this chapter was not so much that studies have shown that the link between weight and health is tenuous, but the fact that the research has been so thoroughly quashed, sometimes by researchers who have a stake in the weight-loss industry. As a nonscientist reader, I worry a little whenever I encounter competing scientific claims, because I don’t have the knowledge to analyze them properly. But Kolata makes a good case for the studies that downplay the link between weight and health and offers a pretty good critique of the studies that emphasize that link.
I could go on and on about all the important things I learned from this book. Kolata discusses so many things I haven’t even touched on. There were a few holes, and the writing is sometimes dry. The first few chapters really didn’t do much for me, partly because of the focus on fad diets, which I’ve never been a fan of. Any diets that I’ve undertaken have been of the “lifestyle change” variety, along the line of Weight Watchers. But the last half is essential reading. Even if the book doesn’t convince you that the obesity crisis is overblown and the insistence on the necessity of weight loss is ridiculous, it should surely cause you to question the conventional wisdom that seems too often to go unquestioned.
Some readers might find this book discouraging because Kolata doesn’t offer any hope for long-term weight loss. For me, however, it’s profoundly hopeful because it tells me that my own lack of success at losing weight and keeping it off is not my own fault. What’s more, it tells me that the fact that I’m obese may not mean I’m unhealthy. I came to the conclusion a while ago that the best I can do is to try to eat right and exercise regularly. Like most people, I could do better on both these counts, but I also eat better and exercise more than plenty of thin people. Focusing on health rather than weight (which is tremendously difficult to do in today’s culture) actually helps me feel better and overeat less. Whether I lose weight as a result is not even relevant.
If you’re interested in more critique of dieting culture and the rhetoric behind the obesity crisis, check out these blogs: Dances with Fat, The Fat Nutritionist, and the Health at Every Size Blog. These blogs have been incredibly helpful to me as I’ve tried to let go of dieting and focus on health.