Book Review: Why We Get Fat, by Gary Taubes

by | Mar 2, 2011

I hadn’t planned on writing a formal review of Gary Taubes’ latest book, Why We Get Fat, because I already wrote an extensive review of his first book, Good Calories, Bad Calories, and the messages (and my criticisms) are basically the same. But after finishing the book I think Taubes is worth revisiting.

My biggest problem with Taubes’ first book is that it was very difficult to read, and that of course means most people won’t finish it. In Why We Get Fat Taubes repackages the data in a way that is much more logical and easy to digest. The book is substantially shorter, and is mostly free of the rants and tirades that peppered Good Calories, Bad Calories.

Instead, Why We Get Fat takes the reader through a clear and concise explanation of why all calories are not created equal, and that carbohydrates are the reason for the vast majority of the health and weight problems plaguing modern civilization. He also does a fantastic job demolishing the currently prevailing hypothesis that dietary fat and blood cholesterol are the causes of heart disease. They aren’t.

That so few people understand these points is why I recommend everyone read this book. It breaks my heart every time someone writes to me for nutrition advice and proudly points to their butter-less popcorn or baked chips as proof of their already “healthy” diet. Until it becomes common knowledge that fat is good for you and processed carbohydrates are the worst thing you can eat, I think this book is the best resource we have to explain it.

Still I do not agree 100% with Taubes’ conclusions. Though I do think the evidence is overwhelming that all calories are not created equal, I disagree that calories therefore do not matter and cannot be manipulated to help with weight loss. Taubes argues that how much we eat is dependent on our hormone levels (specifically insulin levels) that regulate energy balance, and that depending on this balance we naturally regulate our feeding and energy expenditure (exercise) so that we maintain our weight.

Taubes makes a compelling case that severe calorie restriction is counterproductive in weight management, and I agree. However there is some evidence that a small calorie deficit, on the order of 100-200 calories per day, is within the range of our natural homeostatic mechanisms and can be effective at controlling body weight.

In his book, Why We Eat More Than We Think (another must-read), Brian Wansink explores study after study where environmental cues are manipulated to get people to eat either significantly more, or significantly less than they believed. Importantly, the participants never reported any difference in satiation no matter how much they ate. Wansink argues that people can make small dietary changes resulting in a moderate 100-200 calorie per day deficit that does not affect hunger levels and can be used to effectively control weight.

Similarly, in The End of Overeating (here’s my review) Dr. David Kessler discusses how eating can become uncoupled from hunger when it is associated with external cues, making a strong case that some of us really do eat more than we need to. I think many of Kessler’s points about overeating are valid, particularly for emotional eaters. His argument is further strengthened by individual case studies of people who learn to eat less without experiencing sensations of starvation that are predicted by Taubes. One such example is Frank Bruni’s book Born Round (my review), in which he overcomes his weight struggles by moving to Italy and changing his relationship with food. Bruni is able to maintain his weight even after accepting the job of food critic at the New York Times.

These accounts conflict with Taubes’ argument that people overeat to satisfy a caloric deficit caused by a carbohydrate-induced faulty metabolism. Though there is good reason to believe Taubes’ metabolic hypothesis accounts for a large part of the health issues in today’s society, I think it is premature to conclude that this is the only force at work in why we get fat. Indeed, some research suggests learned feeding cues can directly impact insulin and metabolic pathways even in the absence of food. This data does not refute Taubes’ hypothesis, but rather makes it more complicated than he implies.

Even if we assume Taubes’ metabolic theory accounts for the majority of our health problems, insulin response (the ultimate cause of fat accumulation) should also be affected by eating rate and exercise, and vary among individuals. However Taubes handedly dismisses the possibility that any behavioral modification other than carbohydrate restriction can impact metabolic function because, he argues, we will modify our physical activity to adjust for any nutritional changes. His case is compelling, but not air tight, and my interpretation is that while carbohydrate consumption is clearly very important, there are likely other factors that may also be helpful in controlling metabolism and body weight.

In his book The 4-Hour Body (my review), Tim Ferriss describes how WordPress founder Matt Mullenweg lost 18 pounds by simply chewing each bite of food 20 times. Extra chewing or “masticating” was made popular as a weight loss technique in the late 1800s by Horace Fletcher and is explored in Gina Kolata’s book Rethinking Thin (not a particularly good read). Extended chewing and eating slowly are both effective at inducing weight loss, likely because they slow the glycemic response and almost always result in decreased meal size.

One of the most interesting points made in The 4-Hour Body was Ferriss’ personal glycemic response to a low-carbohydrate diet of just meat and vegetables. He claims that even with this meal he could easily spike his glucose to over 150 mg/dL (this is very high) by simply eating quickly, and that this effect could be controlled by slowing down and taking a full 30 minutes to finish a meal. Unfortunately I could not find a similar experiment in the scientific literature, but Ferriss’ observation suggests that behavioral modification can have a powerful impact on metabolic response independent of diet composition.

My final complaint about Why We Get Fat is that Taubes never considers that individual variation may preclude his theory from applying to everyone. He suggests that while some people are genetically blessed with a higher tolerance for carbohydrates, others will only thrive on an almost zero carbohydrate diet. Unfortunately this is the one part of the book he does not provide data to back up his assertions.

Though Taubes frequently argues the importance of paying attention to outliers, he never explores the possibility that some individuals may actually do better (rather than less bad) on a diet with slightly more carbohydrates. (Let’s assume for now that I mean slowly digesting, natural carbohydrates and not highly processed sugars and grains.) In a healthy person there is no reason to assume that such a diet would induce insulin resistance, and there may be some additional advantage outside of metabolic health for including such foods. I don’t think this is a possibility we should dismiss without solid evidence.

To summarize, Taubes does an excellent job describing the importance of carbohydrates in both weight management and health but oversimplifies the science, particularly neglecting the importance of behavioral factors on metabolism. However, the analysis presented in Why We Get Fat is still the most clear explanation of the relationship between metabolism and health that I’ve found and is an invaluable resource for the general public.

What did you think of Taubes’ latest book?

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12 Responses to “Book Review: Why We Get Fat, by Gary Taubes”

  1. I haven’t read this one yet, but have read his blog and plenty of interviews about it, so take this with a grain of salt. (Don’t worry, it won’t hurt your blood pressure. :-)

    When making general recommendations you have to go with what is most-likely true for the most people. I think it’s clear that what Taubes is saying about carbs and fat is much more accurate for many more people than the alternative that we’re getting from the current mainstream sources.

    Are there outliers? Sure. But eating carbs because some people may thrive on them doesn’t make sense in the face of evidence that most people do better without them. (Or at lease much less than they currently eat.)

    Get up in front of a crowd of people and say, “Fat is good for you, bread is not.” That reaction is what we’re fighting against.

    And on a completely different note, I’m a big fan of the “environmental cues” theory. We replaced all of our dishes and plates with smaller versions that I got from a restaurant supply store. The typical place setting at housewares stores is 40% larger than the average from 50 years ago. Your idea of what constitutes “one serving” is absolutely influenced by the size of the plate you put it on.

  2. Ken Leebow says:

    No doubt, carbs and processed foods are a huge issue.

    However, Gary lost me quickly with this statement in the book: “The first part of this book will present the evidence against the calories in/calories out hypothesis.” And, in great detail he explains how an extra 20 calories a day cannot be responsible for weight-gain. However, using an average per day, is not how we gain weight.

    Yes, calories do count.

    He also completely dismisses our “toxic food environment”. In addition to our toxic food environment, the ubiquity of food leads to unconscious consumption – different from mindless eating. We think this consumption is normal, but it is not.

    There are many factors for why we get fat. One reason: The formula that most people believe is sacred: “Eat Less, Exercise More”.

  3. Tuck says:

    No rants and tirades? Shucks, that’s no fun… ;)

    I just finished GCBC. I really enjoyed it, and I think he’s mostly right so far as he goes. There are some issues that may be confounding, like the effects of wheat, and fructose, but if you go low-carb, you’re eating less wheat and fructose any way.

    I think everyone should be aware of the scam that has been perpetrated on the American public in the diet realm. Read either one of Taubes’ books and you’ll be the better for it, for all their faults.

  4. Chris says:

    I have not read Taubes’ book, but anything that brings public attention to what really makes people fat is good. Perhaps the idea proposed by William Wolcott and Trish Fahey in The Metabolic Typing Diet would address the misgivings with Taube’s book. Wolcott claims we need to find our metabolic type to eat more of certain foods and less of others for our particular body’s needs. In other words, what’s right for my body may not be right for yours. However, we all agree that eating a lot of sugar and processed food is bad :(

  5. Eleanor says:

    One reason extended chewing promotes weight loss is suggested by Richard Wrangham in his book Catching Fire: How Cooking Made Us Human. Chewing gives a head start to the digestive process, allowing the body to extract more of the nutrients from food, rather than having them pass through the body unused, which is what happens when you swallow larger particles. As a result, you absorb more nutrients from less food and don’t need to eat as much. Essentially, you are not what you eat, but what you digest!

  6. Jelena says:

    I have read the book and although a lot of his argument made sense, I couldn’t understand why he seemed to discount the positive effects of exercise. I thought regular exercise made your cells more sensitive to insulin and that exercise helped to clear glucose from your blood. I would have thought that this would be somewhat beneficial if the whole aim is to reduce the levels of insulin secreted, in order to stop energy being stored as fat.

    • Darya Pino says:

      Totally agree, great point.

      • Simon says:

        Agree too, to a certain extent… Having just listened to the book on Audible under less than 100% concentration circumstances, I may have missed a bit.
        But what I personally understood about the exercise issue was solely its relation to weight loss. All his arguments seemed to be directed to the effects of exercise on hunger, replenishment, etc., and did not discuss heart, bone, and other benefits because irrelevant to the specific (or immediate) issue of weight loss.

  7. David Gans says:

    Thank you for this review, Darya. I changed my life after reading “Why We Get Fat,” and I am healthy and much happier with a low-carb diet than I ever was with a low-fat one.

    I agree with your criticisms of the book, at least insofar as my unschooled eye can tell. But I was persuaded that I am one of those for whom carbs are best kept to a minimum, and I am thriving with a lifestyle that leaves bread, potatoes, rice, granola, oatmeal, and other starchy stuff out while including fresh fruit, green leafy vegetables, and modest quantities of squash and the like.

    As Ken Kesey said, “Take what you can use and let the rest go by.” I have gotten great value from Taubes, and I continue to get great value from you. Thanks again!!

  8. Joey Thomas says:

    Hi, is there any other books/or even films that you would recommend if people are going to look at just one. I’m trying to find a good resource for my parents to read but they’re beliefs about fat are hold pretty strong.

    My Mum’s just been told her cholesterol is high and has switched to flora proactive margarine while taking krill oil tablets each day (which both counteract each other in regards to inflammation). Clearly her cholesterol will not budge with that kind of dietary advice and soon she’ll be told she needs to go on statins – it seems inevitable and it’s really important that I can get through to her that she’s doing it all wrong without her putting up a wall of defensiveness. Would love your advice.

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