“Food Fight” over Why We Get Fat

Last Monday, Dr. B and I attended Endocrine Grand Rounds at Boston University School of Medicine where the guest speaker was diet wisdom doubter Gary Taubes.  We don’t believe the presentation was recorded, but similar presentations given at the University of California at Berkeley, Dartmouth Medical School and elsewhere are readily available online and are well-worth watching (links provided at the end of today’s post).

The audience at the BU Grand Rounds, which consisted of both endocrinologists and nutritionists, was polite until the post-presentation Q&A when a “food fight” erupted over heated exchanges with the guest speaker during which two audience members stormed out of the room.

We were familiar with Mr. Taubes’ work, having read his book Good Calories, Bad Calories published in 2007.  We have also read a draft of his new book, Why We Get Fat and What To Do About It which will be out later this year.

Both books describe the history and development of the conventional wisdom on diet, weight control and disease that Taubes believes resulted in a tragic degradation of American health because that conventional wisdom derived from incomplete or faulty science that was prematurely enshrined as government policy in the U.S. and other other countries beginning in the 1960s. Specifically, that conventional wisdom is the energy balance paradigm otherwise known as calories-in-calories-out. There are many official versions of the paradigm, from various U.S. Government agencies, the World Health Organization, the U.K. Medical Research Council and INSERM in France, but they are all equivalent to the CDC’s version:

“Weight management is all about balance — balancing the number of calories you consume
with the number of calories your body uses or ‘burns off.'”

Mr. Taubes, has reviewed all of the evidence behind this belief and concluded that, despite seeming so unquestionably true, it is actually false and dangerously misleading.

His alternative theory is summarized as follows:

  • Obesity is a disorder of excess fat accumulation and not the result of energy imbalance, overeating or sedentary behavior.
  • Overeating and inactivity are compensatory effects; they are not causes of obesity.
  • We don’t get fat because we overeat, we overeat because our adipose tissue is accumulating excess fat.

In our opinions, Gary Taubes makes a compelling case that much of what we think we know about dieting and weight management is wrong. Given the epidemic of diabetes and obesity (“diabesity”) in the United States (and globally, “globesity”), the healthcare costs associated with these diseases, and new public policies emphasizing wellness and preventive care, patients, doctors and politicians all need to learn and think about what Taubes has to say.

Video presentations of Why We Get Fat

Gary Taubes’ new book is available for pre-order from Amazon.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

2 Comments

  1. Caitlin

    October 12, 2010 at 6:47 pm

    I think it’s so interesting that the calories in = calories out model is so widely used, but flawed. The historical context is also something to note – Taubes says that some of these theories were already being talked about, but due to anti-German sentiment around WWII, people stopped discussing them. There are so many different viewpoints and theories circulating about why we get fat, but these should be put out in the open and discussed more. Without greater awareness, it is difficult to make changes.

  2. Marion

    October 17, 2010 at 6:27 pm

    Taubes always blames carbohydrates exclusively for weight gain rather than total calories. Than why are the Japanese slimmer than most populations with all the rice they eat? This theory doesn’t make sense.

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