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It isn’t the sin of sloth that makes people fat

As leading US science writer Gary Taubes explains in his new book, Why We Get Fat And What To Do About It, doctors and medical researchers have got stuck in a flawed paradigm that suggests that both the cause and cure of obesity are clear: ‘We get fat, our physicians tell us, because we eat too much and/or move too little, and so the cure is to do the opposite.’ This is the ‘calories in/calories out’ approach: we get fat because there is an imbalance between the amount of energy entering our body as food and the amount that is used up by our metabolisms and our physical activity.

Taubes says that the trouble with this appealingly simple explanation is that it is wrong. As he tells me on the phone from his home in Berkeley, California: ‘I’m arguing that calories in/calories out is a nonsensical paradigm and [is also] the reason why there is an obesity epidemic and the reason why obesity researchers have made zero progress in 100 years.’

This is not the first time Taubes has put his ideas into print. Why We Get Fat is a follow-up to his 2007 tome Good Calories, Bad Calories, which aimed to provide chapter and verse on the evidence for a different approach to this topic. The problem was that in being comprehensive in its analysis of the science, the earlier book was a tricky proposition for anyone without a scientific background. In his introduction to his new book, Taubes explains: ‘Many physicians have asked me to write a book that they can give to their patients, or even to their fellow physicians, a book that doesn’t require such an investment of time and effort.’

So what are his central ideas? Taubes takes the story back to basics. Obesity is ‘a disorder of excess fat accumulation’. Once we go back to first principles in this way, rather than starting from eating habits or fitness regimens, then it’s much easier to ask the next question: ‘What controls fat accumulation?’ And the answer to that question is completely uncontroversial, according to Taubes: insulin. ‘When insulin levels are elevated, we accumulate fat in our fat tissue; when these levels fall, we liberate fat from the fat tissue and burn it for fuel’, he writes.

So what controls insulin? On a day-to-day level, it’s carbohydrate. ‘The more carbohydrates we eat, and the easier they are to digest and the sweeter they are, the more insulin we will ultimately secrete, meaning that the level of it in our bloodstream is greater and so is the fat we retain in our fat cells.’ Or as George Cahill, a former professor of medicine at Harvard Medical School, tells Taubes: ‘Carbohydrate is driving insulin is driving fat.’

The logical upshot of this is that to lose the fat, you should eat a low-carbohydrate diet. The trouble is that such diets are seen by many members of the medical community as dangerous, bordering on quackery. Taubes tells me: ‘What I’m saying is that for someone with a serious weight problem, the Atkins diet or something similar is the only way to cure it… but Atkins has been so demonised that people can agree with my analysis and yet cannot agree with the dietary interpretation’. There is, as Taubes shows in this new book, plenty of evidence to suggest that, firstly, low-carbohydrate diets work (or at least, are more likely to succeed than other kinds of diets) and, secondly, that far from being dangerous they are actually beneficial in ways that go well beyond reducing our waistlines….

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