Review by New York Times Review
IF you had to choose, would you rather be fat or blind? When a researcher asked that question of a group of formerly obese people, 89 percent said they would prefer to lose their sight than their hard-won slimness. "When you're blind, people want to help you. No one wants to help you when you're fat," one explained. Ninety-one percent of the group also chose having a leg amputated over a return to obesity. This is shocking. But it seems less so by the end of "Rethinking Thin," a new book about obesity by Gina Kolata, a science reporter for The New York Times. Kolata argues that being fat is not something people have much control over. Most people who are overweight struggle to change their shape throughout their lives, but remain stuck within a relatively narrow weight range set by their genes. For those determined to foil biology, strict dieting is a life sentence. "I am a fat man in a thin man's body," an M.I.T. obesity researcher who shed his unwanted pounds years ago tells Kolata. He's one of the lucky and single-minded few. Study after study, Kolata notes, has shown that for most fat people the long-term rewards of dieting are modest at best. Yet as obesity rates have skyrocketed, exhortations to eat right, exercise and shed pounds have gone from loud to shrill. Kolata's understandable sympathy for those caught between the ever intensifying pressure to be thin and the stubborn size of their bodies, however, leads her to flirt with an unlikely conclusion: Maybe the outcry over obesity is itself supersized, and being fat isn't really unhealthy after all. Kolata follows a two-year clinical trial at the University of Pennsylvania designed to test the low-carbohydrate, high-fat Atkins diet against a traditional low-calorie, low-fat one. Kolata wrote her book before she had the results for the trial, though a different study, published in March in The Journal of the American Medical Association, found that Atkins beats the low-cal diet for keeping off weight. The diet-versus-diet contest, however, isn't her real story. Instead, she focuses on how little weight those who follow any diet usually manage to keep off. (The average participant on the Atkins diet reported in JAMA lost only 10 pounds over the course of a year.) Kolata tells the stories of four dieters in the Penn trial who are smart and likable. They had the benefit of a professionally led support group and the status of taking part in a well-financed study. They started exercising; they stopped eating mindlessly. After two years, they're a bit lighter. But none achieved the 50- to 100-pound weight loss they strove for (though one lost more than 30 pounds, 15 percent of his body weight). Kolata marshals scientific evidence to explain why keeping weight off is so difficult. (The discovery last month of a garden-variety "fat gene" further backs her up.) Fat people have more fat cells than other people. Their metabolisms are normal but their appetites are larger - after they lose a significant amount of weight, one researcher explains, they often feel "a primal hunger" as strong as the urge a thirsty person feels to drink. Studies of twins and of adopted children show that inheritance may account for as much as 70 percent of weight variance. In one study of adopted children, 80 percent of those with two obese birth parents became obese, compared with 14 percent of those with birth parents of normal weight - and it didn't much matter what the adoptive parents fed the kids. Given such proof of the power of genetics, Kolata asks, why do we continue to insist that fat people can become thin people if they only put their minds to it? She's surely right to push back against bafflement and intolerance, and her argument that we've tilted too far toward blaming fat people's bad habits for their weight is convincing. But Kolata goes so far in arguing for biological predestination that she sometimes seems to completely dismiss the other part of the fat equation - what we eat. In all likelihood, the obesity rate has doubled in the United States since 1980 for all the familiar reasons: fattening food has never been so cheap, convenient and cunningly marketed. "The genes that make people fat need an environment in which food is cheap and plentiful," she writes. It's in a world of giant muffins and bowls of office candy that Americans need wider movie seats and larger coffins. Kolata knows this. She touches on reasons that poor people are more likely than rich people to be overweight, all of them environmental. But she treats childhood obesity as virtually inevitable. In addition to the twin and adoption studies, she cites research showing that teaching kids to eat right in school, and serving them leaner lunches, has no effect on their weights. The researchers concluded that the intervention was too limited - the children's diets needed to change at home as well as at school. But Kolata scoffs at the "popular solution," which is "not to question the premise but rather to increase the intensity of the intervention." Given the rise in obesity, however, is it really credible to put all the blame on our genes - and ignore the gazillion-dollar food industry? And while it's useful to point out that obese people don't have higher rates of anxiety, depression or mood disorders, that doesn't mean these conditions are never a factor in causing obesity in those who are genetically susceptible to it. As some of the testimony of Kolata's own dieters attests, we eat not just because our appetites drive us to but because our psyches do, in search of both pleasure and relief from pain or stress. Rather than go where many authors have gone before, Kolata questions whether the current alarm over obesity is overblown - and whether the culture of dieting isn't itself harmful. The fat wars are less a legitimate public health campaign than a "moral panic," she suggests. In fact, she argues, some recent epidemiological studies show lower death rates for somewhat overweight people than for "so-called normal-weight people" or very thin ones. The data are certainly intriguing. But living longer doesn't mean that fat people are in good health along the way. In fact, they suffer from higher rates of diabetes, stroke, certain cancers and heart trouble. Kolata skirts this, because her argument is that thinness in and of itself is not a goal many people can achieve - or even an important one. She also quotes one expert who claims that "national data" do not show that Americans are in fact more sedentary than in the past. It's a surprising assertion that begs for development. Kolata ends on a quixotic note, by wondering if perhaps Americans weigh more for the same reason that we're taller on average than we were a century ago - because we' re in better health. Maybe the extra pounds even help contribute to this well-being. No one has found the smoking gun in the mysterious fattening of America, but Kolata, following the obesity researchers Jules Hirsch and Jeff Friedman, briefly speculates whether, say, better early nutrition, vaccines or antibiotics somehow "precipitated changes in the brain's controls over weight." It's a twist on the usual evolutionary argument. The problem isn't that we evolved to store fat in times of famine and now can't handle our 24-hour, all-you-can-eat buffet of abundance. We're fat because we're changing in response to the medical strides we've taken. A nice idea, maybe, but one as yet unsupported by evidence. What's more persuasive is Kolata's contention that we should replace the elusive goal of thinness with the goal of better health and greater happiness. Here her argument is eminently sensible: Sure, shape up your body. But mostly, make your peace with it. Maybe it's the anti-fat message that's supersized, Kolata argues, and being fat isn't really unhealthy after all. Emily Bazelon is a senior editor at Slate.
Copyright (c) The New York Times Company [October 27, 2009]
Review by Booklist Review
When New York Times science writer Kolata took an unbiased look at society's war on fatness, she found that the spoils of the conflict fatten the pockets of a multibillion-dollar dieting industry, while most ever-hopeful yet hapless dieters lose only money. Why, then, do we still repeat a mantra--eat less and exercise more --that has failed dieters for 2,000 years? Why, in diet study after diet study, do chubby participants consistently fail to reach their target weights? And why do the majority of dieters end up regaining most of their hard-lost weight, or regaining and then exceeding it? Following up on participants in a two-year clinical weight-loss study comparing the overall efficacies of the Atkins diet and a highly regarded low-calorie, low-fat diet opened Kolata's eyes to the plight of millions who can't seem to measure down to today's weight ideals. The experience led her to examine the millennia-old history of humanity's battle against the bulge. She interviewed several credentialed authorities, and she cites sound scientific evidence that calls in question the productiveness of common weight-loss methods. Her report reveals well-documented intelligence certain to annoy those segments of society and commerce that stubbornly cling to the ignis fatuus that all one needs to be thin is willpower. --Donna Chavez Copyright 2007 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
New York Times reporter Kolata may be the best writer around covering the science of health. Here she offers an eye-opening book that questions all our received wisdom about why we get fat and the health hazards of those extra pounds. In chapters equally entertaining and dismaying, Kolata (Flu) traces the history of dieting fads back to the 19th century; discusses our changing ideas about the ideal body (thinner and thinner); and, most importantly, explains how genetic and biochemical understanding has (at least among researchers) replaced the view of obesity as a lack of self-control. Most dramatic is Kolata's recounting of Jeff Friedman's groundbreaking search at Rockefeller University for the satiety factor, a hormone he called leptin that tells our brains when we're full. The science alternates with moving chapters in which Kolata follows a group of people in a weight-loss study who are trying desperately to get thin-a quest that, as Kolata makes increasingly clear is sadly futile. In her final-and perhaps most surprising-chapter, Kolata blasts those in the obesity industry-such as Jenny Craig and academic obesity research centers-who are invested in promoting the idea that overweight is unhealthy and diet and exercise are effective despite a raft of evidence to the contrary. This book will change your thinking about weight, whether you struggle with it or not. (May) (c) Copyright PWxyz, LLC. All rights reserved
(c) Copyright PWxyz, LLC. All rights reserved
Review by School Library Journal Review
Adult/High School-Much has been written about obesity and its threat to public health. Kolata uses a study at the University of Pennsylvania, comparing the traditional low-fat diet to the Atkins diet, as a prism through which to examine the history and science of dieting. While diet and exercise are touted as the solution to obesity, studies show they aren't always effective. For example, heavy people who diet down to an "ideal" weight do not have the metabolism of those who easily maintain that weight. Instead, they have the metabolism of a starving person. How can anyone spend the rest of their lives in perpetual deprivation? In search of an easy, effortless solution, we turn to science. However, the actual causes of obesity are complicated, involving brain chemistry and development, and may in fact simply be part of becoming a better-nourished human race. Kolata has the ability to explain the science involved clearly and simply. She makes a powerful case for a dispassionate examination of the facts, divorced from the diet industry's promises and hype.-Susan Salpini, Fairfax County Public Schools, VA (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
A dose of reality for would-be dieters, laced with a dash of history, science and sociology. New York Times science writer Kolata (Ultimate Fitness, 2003, etc.) followed participants in a two-year study at the University of Pennsylvania that compared the Atkins low-carbohydrate diet with the LEARN (Lifestyle, Exercise, Attitudes, Relationships, Nutrition) low-calorie diet. To put the study in perspective, she goes back as far as the 19th century to recount various dieting fads: eating soap, chalk or pickles, drinking camphor tea, taking ipecac to induce vomiting, chewing food 100 times a minute. Kolata also takes a critical look at society's changing standards of beauty, from hefty Lillian Russell to svelte Jennifer Aniston, and she presents the findings of nutrition and obesity researchers in the last half-century. She sat in on the Penn study participants' group sessions and here lets them tell in their own words of their hopes and desires, progress, setbacks and problems. At the study's end in 2006, no miracles had occurred. The reality, Kolata reports, is that no matter what the diet and how hard fat people try, most will not lose a lot of weight and keep it off for a long time. Many will keep trying, though, because being fat in America today is difficult. An epilogue suggests that researchers may have been looking for answers to the obesity epidemic in the wrong places. Those who call it a medical disaster may be alarmists, Kolata concludes; perhaps what has been pushing up the nation's average weights is better health. Offers many insights into the world of obesity research and the minds of dieters, but provides small comfort for anyone hoping to discover the fountain of thinness. Copyright ©Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
Review by New York Times Review
Review by Booklist Review
Review by Publisher's Weekly Review
Review by School Library Journal Review
Review by Kirkus Book Review
