Atkins and Low Carb Weight Loss
Gary Taubes book 'Why We Get Fat'
I am almost finished reading the book and am dying to know what others think about it. I got an email newsletter from Atkins.com today that had a link to an interview they did with the author. I thought you all might be interested in reading it! Let me know what you think! Excerpts of his book are also in this month's Reader's Digest.
By Colette Heimowitz, M.Sc.
Award-winning science writer Gary Taubes has written several books and countless magazine articles, but it was his paradigm-shifting 2002 article in the New York Times Magazine that brought him to national attention. In “What If It’s All Been a Big, Fat Lie?" he challenged the beliefs that eating fat makes you fat and that dietary fat is the cause of numerous health problems. Taubes showed how the assumptions underlying this theory are based on flawed research—or no research at all. In Good Calories, Bad Calories, published in 2007, he expanded upon this thesis, rigorously examining more than a century of research on nutrition, exercise and obesity. Taubes and I recently talked about his new book, Why We Get Fat and What to Do About It, in which he continues to subject research and conventional wisdom to his razor-sharp analysis.
Colette Heimowitz: How would you describe the differences between Why We Get Fat and your earlier book?
Gary Taubes: The key points in Good Calories, Bad Calories were buried in a 500-page tome. I didn’t want people to have to trust anything I had written; instead, I wanted them to understand how I came to my conclusions. We needed the book to compel the medical research community, the public health authorities and physicians to take these ideas seriously. And a short snappy book just wasn’t going to do it. But once I had written the bigger book I found out that not all the people I wanted to reach had time to read a long, densely annotated book. Meanwhile, I got all these e-mails and comments from people saying, “Your book was amazing. It changed my life. Now would you write one that my husband [or my doctor, or whoever] would read?"
C.H.: So this book is a shorter read and more digestible?
G.T.: Why We Get Fat is certainly shorter and eminently readable, but it also clarifies certain points. After Good Calories, Bad Calories was published, I was invited to lecture at medical schools and obesity research centers and these lectures helped me learn how to better communicate some of the main points. They also clarified some of these points in my own mind. Meanwhile, I was watching this misguided flood of misinformation about weight and exercise coming from newspapers and magazines. It’s hard to have patience and wait for a paradigm shift. In Why We Get Fat, my goal was to produce an easily read book that patients could recommend to their doctors and that researchers would also read. I knew that the professionals might go into the book assuming it was quackery, but if the smaller format meant they might take it with them to read on a plane flight, for example, then I think that I can suck them in to consider things they hadn’t thought of before.
C.H.: What are the points that you honed in Why We Get Fat?
G.T.: In the first book I talked so much about the misconceptions about the health effects of cholesterol and saturated fat and how we came to believe them that by the time I got to the whole idea of calories in, calories out—what’s called the energy-balance hypothesis of obesity—I wasn’t able to fully address it. All the research and the drug companies’ efforts to do something about obesity are fundamentally driven by the idea that we get fatter when we take in more calories and leaner when we expend more calories. Until I started to lecture on the energy-balance thesis, I didn’t fully realize how nonsensical it is. It doesn’t really tell us anything. As a result, the last 50 or 60 years of research, as well as the attempts by public health groups and physicians to prevent or treat obesity, are completely misguided. I wanted to put an end to that. If people read this book carefully, no one should come away from it still believing that people get fat merely because they take in more calories than they consume—this calories-in, calories-out thesis. I want this book to force the issue.
C.H.: Why has the thesis you deem misguided and nonsensical become the accepted truth?
G.T.: I joke about the way the medical community bought into the cholesterol and saturated fat concept because they were driven by what I call the Jurassic Park motivation. In the movie, about every 10 minutes someone says, “People are dying out there," which is always a good reason to do something, anything, quickly. The fact is that people are dying out there in the real world, which is used as an excuse for why there isn’t time to do the careful science to find out if an hypothesis is actually right or not. Instead, major health organizations jumped to conclusions and hoped they were right. But they weren’t. Then the press jumped on the bandwagon and expert reports were written—many hundreds of pages long—that repeated all this bad science. And we all believed it because, well, everyone else we knew believed it. The result is that tens of millions of obese and diabetic people are being mistreated. Likewise, overweight kids are being tortured with exercise and starvation diets when they’re not fat because they eat too much or exercise too little.
C.H.: What should we be doing instead?
G.T.: We have to address the fundamental cause of obesity and nobody’s doing that. I’m hoping someday someone will show this book to Michelle Obama and she’ll say, “Let’s see if this guy is right because this information is really compelling." Recently, I received an e-mail from a man who is a senior vice president for a bread company. He wrote, “I read your book and much to my dismay, I think you’re right. As a bread maker you’ve broken my heart, but as you say, ‘Science is science.’" What we have to do is address the fundamental cause of obesity and overweight. If we pay any attention to the actual physiological regulation of our fat tissue, and to the clinical trials, that cause is pretty obviously the carbohydrates we’re consuming.
C.H.: You write that most nutritional research is flawed and biased, and even when good research is published with conclusions that don’t hew to the “party line," it’s ignored. Is the problem that academics don’t want to admit they were mistaken in the past?
G.T.: Can you imagine the USDA or the Centers for Disease Control or the National Institutes of Health or the American Heart Association saying, “We’re sorry we caused you to become obese and suffer from diabetes and more heart disease and maybe even more cancer. We just got it wrong. We made a mistake." That’s the problem when public health organizations embrace bad science and give prescriptions based on them—they’re trapped.
C.H.: Public health committees work by consensus. You can have four people who get it and three or four who don’t, but until you get 100 percent buy-in, you’re not going to see any dramatic change. There seems to be more willingness to consider the role of carbohydrates, but nobody is willing to commit to it.
G.T: Yes. But even the willingness to consider the role of carbohydrates is tempered by the unwillingness to perceive that what they’ve been saying about fats is wrong. So then you’re stuck with this weird compromised position. Eat a low-fat diet with a lot of fruits and vegetables, but stay away from processed foods and sugars. And exercise, of course. While this will probably help a little, it still misses the fundamental points. The hardest thing I find is convincing people that there really is a scientific truth here. It’s not just that some diets work for some people and others work for others, and that you can lose weight and keep it off eating Twinkies or potatoes as long as you cut calories. When you think in terms of why we get fat, which is why I called the book that, there are several competing hypotheses and only one of them is right. I can say with absolute confidence that one that is wrong is this idea that you get fat merely by eating too much and exercising too little.
C.H.: Many Atkins followers who have tried to lose weight on other diets prescribed by their doctors were told that because they weren’t losing weight, they must be doing something wrong. Your position removes blame from the equation.
G.T.: There is a spectrum of how individuals partition fuels in their bodies. Our genetic predisposition determines how we tolerate carbohydrates. So lean people’s fat tissue literally doesn’t “want" to store calories as fat. When a lean person eats a large meal his body wants to burn those calories so he has an impulse to do physical activity. His body burns fat easily, he has a lot of energy for exercise and he doesn’t weigh a lot so he can run effortlessly for miles. So the driver is that their fat tissue doesn’t want to accumulate fat or their muscle tissue wants to burn a great share of the calories they take in. They’re predisposed to be lean and to want to exercise.
C.H.: What about a person on the other end of the genetic predisposition spectrum?
G.T.: For those of us who tend to store fat easily, our fat tissue “wants" to accumulate calories as fat. So we take up a large amount of the calories we consume and store them as fat and then we don’t have the energy to exercise. So the sedentary behavior that you see in people who fatten easily is actually an effect of the fact that their fat tissue is sucking up all those calories.
C.H.: But genetic predisposition is only part of the reason some people are fat and others are lean, right?
G.T.: Right. The other component is the environment. We live in a carb-rich environment. For those of us predisposed to get fat, it’s the carbs in the diet that trigger the weight gain. When such people are doing everything doctors and public health authorities tell them they should be doing—like having half a bagel and some soy cream cheese and a bagel for lunch and a salad with a skinless chicken breast for dinner—and still gain weight or can’t lose it, they think that they’re just doomed to be fat. However, in a carbohydrate-restricted environment, they wouldn’t be fat, because they wouldn’t be eating the carbs that make them fat. They might not be as lean as people without that genetic predisposition, but they’d be far leaner than they are now.
C.H.: So genetic predisposition and the type of foods you consume are the causes for being overweight and lacking energy to exercise, not some moral failing?
G.T.: I think that overeating is never a psychological flaw. Olympic swimmer Michael Phelps consumes 12,000 calories a day, but he is not overeating. Overeating is defined by being overweight. Or if you’ve been consistently 25 pounds overweight for years, you’re not overeating. You’re in energy balance just like a lean person. The problem is you’re only in energy balance when you’re 25 pounds overweight. I mentioned an exercise physiologist in Why We Get Fat who is an avid runner. He described himself as “short, fat, and bald" when he took up running in the 1970s. Four decades later, he had gained 30-odd pounds more, run roughly 80,000 miles, the equivalent of three trips around the equator, and now describes himself as “short, fatter, and bald." His belief in the energy-in, energy-out theory is so engrained that despite his personal experience, he still believes it.
C.H.: You could call this ongoing commitment to concepts that clearly aren’t working a collective delusion. As a society, we still believe fat people are to blame for their excess weight and that if they just had more willpower and more commitment to engaging in physical activity and eating in moderation, they, too, could be slim.
G.T.: It’s very much a collective delusion, powered by lean people. How do you convince them that the reason they exercise so much and can eat in moderation is because their body wants to be lean? If you’re lean, it’s hard to understand that the cravings of an obese person for carbohydrate-rich foods, and lots of them, could be as great as the hunger you feel if you go a day or two without food. Being obese is considered a moral failure. But heavy people eat frequently because they’re hungry, and they’re always hungry because of their response to carbohydrates and their predisposition to store the calories they eat as fat. It’s natural to be dubious about this hypothesis, but most medical researchers weren’t actually trained as scientists. They should be able to see that there could be an alternative hypothesis. We don’t know which way the causality goes until we test it.
C.H.: So it’s a chicken and egg situation.
G.T.: Exactly. Are you lean because you exercise or do you exercise because you’re lean? How do you know which of the two is correct? A good scientist would figure out what kind of experiment could determine which is the cause and which is the effect. It’s absolutely critical to our understanding of obesity.
C.H.: In Why We Get Fat, you write that it’s not calories, but the insulin response to carbohydrates that causes obesity in individuals with a genetic predisposition. We do seem to be moving toward awareness that this makes a low-carbohydrate diet a viable alternative.
G.T.: The argument I’m making is that low-carb eating is not just a viable alternative to low-fat, low-calorie diets, it’s that the only way to get fat out of your fat tissues and burn it for the long term is to lower your insulin levels. (And the only way to accumulate fat is to raise insulin levels.) For a diet to work, it’s got to lower insulin levels. And if you look at virtually every mainstream diet, you’ll find that one thing they all do is cut carbohydrate calories and improve the quality of the carbs consumed: they recommend low glycemic impact carbs and they get rid of the sweets, the fructose. If you actually look at the mathematics, most weight-loss diets will restrict carbohydrates more than they restrict fats, even if they describe themselves as low-fat diets, because it’s virtually impossible to lower calories significantly on any realistic diet just by reducing the fat content. Add to that the change in the quality of carbs consumed, which every diet program now includes. That’s why researchers can get people to lose almost as much weight on other diets as they do on Atkins. One you get rid of white rice, potatoes and sugars (in soda and fruit juice), you’ll almost certainly lose weight.
C.H.: Are you saying that any diet will help you slim down if it cuts down on all carbs and includes only low glycemic carbs?
G.T.: The question is what is the dose of intervention you need to solve the problem? The effective intervention is restricting carbs and lowering insulin levels. For some people, only a mild dose of intervention is required and a low-fat, low-calorie diet will work as long as you get rid of the sugars (sucrose and high-fructose corn syrup) and the other high glycemic impact carbs. If you can tolerate the hunger on a low-fat, low-calorie program, you don’t need the Atkins Diet, which is not to say that it wouldn’t work better. However, the heavier you are or the more predisposed to be obese, the greater the dose you need. The functional intervention is always the same: lowering the quantity and/or improving the quality of carbs. Only the level of intervention changes.
C.H.: Gary, this is all fascinating and a great introduction to Why We Get Fat. Thank you and good luck with “forcing the issue."
I got this interview in my email today as well. I was so impressed with the interview. I have his first book, Good Calories, Bad Calories but it's a bear to get through. I'm definitely going to order this book tonight.
Thanks for posting so that everyone can read it.
HW: 249 SW: 229 GW: 149 Age: 63 - Body by Sauceda - 12/2011
I look forward to reading this book too!
From what I understand - he advocates eating protein (mostly in animal meat form) and leafy greens - all you want pretty much but trying to limit it to when you feel you need it. He does not believe in calories in, calories out. Pretty hard pill to swallow after we've been fed the notion that its gluttony and sloth that has gotten us fat. What I'm not clear about is if this is a tried and true theory or if its just his hypothesis.
Ain't that the truth!!! I picked this book up recently since I am going back to low carb. Boy is it ever dense. TMI!!! Anyway, I did get the gist of it, but really would like to understand more about how and why low carb works to lose weight. I read something about fats and proteins are what the body burns when it is being starved. By giving the body mostly fats and proteins, your body thinks it is starving and starts burning stored fat for fuel? If this is so, I find that very interesting.
Anyway, thanks for posting this. I will check out this new book. Sounds like he may be explaining how it all works to be more readable and understandable.
Phyllis
"Me agreeing with you doesn't preclude you from being a deviant."
