The Pear-Shaped Secret of the Obesity Epidemic

I remember the shocking and memorable photograph that science writer Gary Taubes showed in his book "Good Calories, Bad Calories," to help make the point of obesity as "a disorder of excess fat accumulation" -- a concept and phrase I had never heard before his book. The picture showed a woman who was nearly emaciated on the top half of her body, and more than just plus-size on the bottom half, a drastic difference that left her looking like some old-style carnival attraction. Which half of that woman "ate too much and moved too little?"


I recall I had to take time out of my ranting to friends about what I was reading, to sit in stunned silence over some of the profound "reversal of paradigms" about health and obesity in that book. They were ideas I had never heard before. I credit him for educating me, but the writing was a tribute to the fact that a lot of things have been known for decades, even over a century -- but are carefully ignored, like that elephant in the living room on AA commercials, where everyone pretends the overwhelmingly obvious problem is not there.


Apparently the Germans were on the right track, 75 years ago, but the world was so yonked about the war, the USA just started much of obesity science all over again, this time in English -- and this time, from the armchair of emotional psychology, rather than from the science lab of biochemistry. Oh sure, that's what the world needs -- more Puritan-guilt about biblical sins such as gluttony and sloth, to displace any objective reasoning -- like how some animals have similar metabolisms  and results, even though they can't buy ice cream when upset and they get along very well with their mothers.


Until the Taubes book, my maternal family's experience with being obese, morbidly obese, and severely obese, was as much like the "official government and health agency" story of fat as my seriously dysfunctional, lower-middle-class family was like television's Brady Bunch. I watched that surreal sitcom as a child with the kind of fascinated awe normally reserved for ancient pyramids and alien-looking sea creatures. How bizarre! How does that happen? Is that real?? Tell me more!  It was a lot like the official version of dieting, where in inspired frenzy, desperately hopeful people can calculate precisely how many calories they will be not-eating, and allegedly burning-off, for that simple formula and a promised happy ending. Except you never get your money back with that guarantee.

There is only one body-theology in the church of whole-grains and calories amen. The government-ordained priests of health are now the High Interpretive Intercessors between the layman and science. Doctors in white coats shake their heads at how you cannot possibly be telling the truth or the magic would have happened, and when your 4.9 minutes of personal attention are up, you can get a prescription for statins that for most people won't much help (and for many, especially women, do actual harm) -- drugs that are, except in rare cases, ridiculously unnecessary since several nutrients you need anyway and an eating plan called "real food" will fix you. But the world is expected to abide by the mantra of "eat less and move more," and if that doesn't work out any better for you than it does for most of the rest of planet earth, the front desk can provide a new photocopy of a diet that'd make even perky Marcia Brady want to leap from a ledge.

Then, call it gut-instinct, but you know when it's coming: a nurse (often obese) will express astonishment when you say no, you are not planning to have someone slice open your guts and profoundly screw up your ability to digest nutrients in the name of your being less fat. (Not lean. Just less fat.) Not counting the majority of people you may know who tried it and who are now dead, miserable or as fat as they ever were, there's that little thing about months or years of ongoing nightmare 'complications' followed by doom. As the ultimate in black irony, all those eons of horror followed by death are used as 'success' stories by the "gosh we don't collect those statistics" business world... a surgical industry nearly to the point of drive-thru bypass, even for children. And we thought medieval medicine was appalling. I'll take some Eye of Newt over that, any day.


That doesn't even start on the bozos who want to re-define 'obesity' as compulsive eating -- troubled psychology, and wrong assumptions to boot -- not biology.


**


The official doctrine of nutrition is right there in college textbooks. Science that was out of date decades ago (and things that were never good science, and things that were never even pretending to be science) are in today's college nutrition textbooks, teaching the people who will be doctors and nutritionists (a single-word oxymoron of the times) later. Frustrated at the fight to educate those who should already know better today? Guess what, you'll still be doing it at least a decade from now. 


It's said that science advances one funeral at a time; that not until the 'old guard' of science paradigms die off does allowance of new findings truly come about, but we've improved on that model. Now education sits in textbook pedagogical gridlock, and "remains consistent" a few million funerals at a time, giving advice that was ignorant and dangerous in the 1970's and helped shift a whole culture into diabetes overdrive, but is still being taught in 2012. 


Don't believe me? Pick three major textbook publishers. Get a university-level nutrition textbook from each. Read 'em and weep. Probably that author was taught that decades ago. Probably their textbook author was taught it before then. The authors in 10-20 years are being taught by the books today. You gotta admit, it's impressive--even those sponsoring holy books have to work hard to maintain so much consistency over time.


Nutrition has become a state-sponsored religion. Authorities tell us what science says. I read the language of science, although with serious limits (and limits on journals I cannot begin to afford), and I read the blogs of scientists, doctors and specialists who know the subject and review such things, and I find it just fascinating how science so often doesn't say anything like what the abstract, or the title, or the press release, or the media, or the government, tells the public it says. Or even what the books say, as Denise Minger so eloquently outlined. (For sure, keep avoiding cholesterol and eating grains: somewhere, a cardiologist needs a new sportscar, and you can help each other out before long.)


The congregation of people who are ill or fat are expected to have "faith," even when the official advice doesn't work. Even when it's so far from working it's not even humor anymore. The experts who represent the divine ideal of science will tell us what we need to know and if they say it works, no amount of obvious results saying otherwise matter. It is sacrilege to question the government-approved, agency-represented, and conflict-of-interest funded experts: those whose advice has so spectactularly failed to treat an epidemic of overweight and obesity, that it's now a pandemic of an entire spectrum of nutritional-deficiency diseases, of which issues like obesity (and now even morbid- and super-obesity) are merely one part.


The public wants to believe, because they want a solution, who wouldn't? Follow the paint-by-number plan, the slogans and logos... follow the money. The magazines make it all seem fun. There are even diet dinners (with heavy carbs on the side) frozen for your convenience. If it works, you'll be thin! Awesome. 

• Then strangers shopping won't look at you like you're more vile than an ax-murderer, despite your attempts to wear large loose dark shrouds of clothing that will not offend them with details. 
• Then people who sublimate all their racism, sexism, nationalism and other -ism's into the one "allowed and encouraged" ism of fat-ism will target elsewhere, not knowing that once upon a time you were in that very crowd of untouchables. 
• You won't be walking through a world where lean people get to sit down and rest, but fat people can't because all the chairs have arms and you don't fit. 
• You won't pay for two plane tickets with seats that have hard, curved bottom and back edges, so with high weight pressing against your back and the middle of one buttock, the hours of tense spinal distortion in turbulence costs you a fortune and leaves you crippled.
• All those planes and trains with bathrooms you can't even use because you're too wide will be a thing of the past. (You can "hold it" for three days, right? I once had to. Thanks, Amtrak.)

We're a culture-wide Stockholm Syndrome of fat. Even many of the victims of horrible nutritional advice and barbaric bariatic practices join in condescending identification with the very health agencies instructing us to eat a majority of carbohydrates for carbohydrate-spawned diseases like diabetes (rather like taking more arsenic to cure arsenic poisoning); the very researchers (and peer reviewers) whose approach to science is so bad my 8th grade chemistry teacher would have sent them to the hall; the very medical experts who guide us toward the most brain-opiate drug-addicting and digestive-destroying foods (it's no coincidence that the agency dedicated to supporting the USA grain industry is also the agency insisting on all those grains in the diet...); and let's not forget the official "latest nutrition standards" that fail on more points of real science than they've ever represented.


In war, in terrain combat, it has long been known that killing the enemy is just poor planning. The better goal is to disable an individual sufficiently that at least two or more other soldiers have to change their focus away from fighting, and toward keeping that soldier alive and reaching medical care. The same war-logic works for medicine: the goal is neither to cure nor to kill, both of which remove the consumer's financial usefulness, but to "treat" an ongoing (and ideally slowly degenerating, so it requires more drugs and more procedures for more issues over time) collection of maladies that ensure paying customers forever.


"There is no cure of course, but you'll die if you don't buy this prescription!" -- Best. Marketing. Slogan. Ever.


**


Here's a few little things I didn't learn from official sources.


The average weight gain of the 'obesity epidemic' hysteria is only about 7-10 pounds. As this is on a population bell curve, of course any increase even fairly small would mean a great increase in numbers. So when they say "the number of obese people has doubled!!" that is technically true, but it sure sounds much more extreme than "on average, the population has gained 7-10 pounds."


The obesity increase is not evenly distributed. It correlates with genetics, although more research is needed on this. Next time you read about someone who could not adopt a child because they were too overweight, or editorials on why fat kids should be removed from family, or teenagers surgically gutted "for their own good," or why insurance should cost more, jobs should be less available,  public transportation is fairly unavailable or unaffordable to fat people, consider that this is not evenly applied: some genetic lines are going to be in the cross-hairs of that focus, and others barely so. 


"...it turns out actually that these really obese kids are concentrated in particular ethnic groups and the gene pools are different in different ethnic groups," said Dr. Jeffrey Friedman,  head of the Laboratory of Molecular Genetics at Rockefeller University.   "...some of the most powerful evidence that this is a biological problem and not a "behavioral one" (in quotation marks) is genetics. And so there are a number of ways to assess the genetic contributions to a trait. It turns out if you look for obesity it is probably the second most heritable trait, second only to height, with which it is quite close. Based on estimates that can be done by analyzing twins, 80 percent of the variability in weight can be accounted for by genetic factors." Anybody in the real world knows that some people get huge quickly and with little effort while some eat everything in sight and are beanpoles, but it's nice to see someone like this guy recognize this also. "...So when you see a very obese person walking down the street there’s a very, very significant possibility that that individual just has a genetic alteration that makes them so."


If I mention that obesity is also correlated with poverty, I bet you can guess at least some of the races more prone to obesity (and morbid- and super- obesity) than others. Like the world needs institutionalized prejudice wrapped into everything else, right? 


"Calorie math" is humor when applied to much of the morbid- and super- obese population. Even after gastric bypass, even after weight loss, even in  a metabolic ward, very obese people can survive on less than 'starvation calories' and still not lose any further bodyfat. Really? Are we sure they aren't just lying about their food? Yes, we're sure. Friedman (the modern science rock star whose lab discovered the hormone Leptin), was talking about gastric bypass patients when he said: "...there’s another feature of this surgery that people, I think, ignore, and it’s this: when you do this procedure you limit the intake of a person to about 700 calories a day. Just so you know, none of you could consume 700 calories a day for very long; it is a very small number of calories. Despite that fact, these people still end up being clinically obese at the other end of the procedure. They lose a lot of weight but they would still on average be definable as significantly obese on average after the procedure." "...If they’re consuming 700 calories every day they’re going to be expending more than that. And so what you would find, you would expect to see is as long as they’re that imbalanced they’re going to keep losing and losing and losing and losing. That’s not what happens in these people; they plateau and they stop losing weight at what is definable as a significantly obese level. Now, if I had that procedure you probably wouldn’t see me in profile anymore because I would just get so thin. That’s not what happens to these people and it appears that in the face of reduced intake the body shuts down caloric expenditure and they can’t lose any more weight." "...Now think about it, they’re eating 700 calories a day and they’re still obese. I mean if that doesn’t say that there’s something metabolically different about the obese than the lean, I don’t know what does." 


The Taubes book recounted research where fat rats were starved until they died, and the autopsy showed they still had lots of fat: their body literally sacrificed vital organs to spare the fat. Apparently the "eat less and move more" philosophy didn't work for them either.

**

Here's something fairly new to me: there's an "incurable disease" called Lipoedema--it tends to occur in familes. Although it was named in the USA, it's profoundly under-diagnosed here. You'll never guess how this condition is described officially: "a disorder of excess fat accumulation." Wow, where have I heard that before?! Right: the Taubes book. It turns out this was already known in 1940, when researchers at the Mayo Clinic coined the term -- yet it's nearly unheard of 70 years later. I thought he'd just found a picture of something incredibly rare but telling. It's more than that, as it turns out.


This affects women. Fat accrues between the upper pelvis and ankles (and in ~30% of the cases, arms). The feet are oddly free of it, as if the 'fat suit' only goes to the ankles. The upper body can range from skeletal to morbidly obese, but is not directly involved in the condition, so the top-half of the woman is often vastly smaller than the bottom half. Looks pretty weird. I know because I have a mirror, and other family members who in varying degrees look the same.


It's official with the condition: Diet will not make this fat go away. Even anorexics will merely look exactly like that picture in the Taubes book: skeletal on top, still hugely fat on the bottom. Exercise does not make it go away. Even gastric bypass surgery and the following starvation from that does not make it go away: patients will simply lose weight on the top half of the body, and still be very fat on the bottom. Much like I lost lots of weight on low-carb: pretty much all on the top half of the body. Between loose skin and disproportional fat storage, 'losing weight' just makes one look more like a mutant.


On the bright side, the fat is as far from the vital organs as it can get. On the down side, the fat will keep accruing, especially if the person doesn't get diagnosed (so they are unaware of the situation), and especially if they simply keep dieting, in ever-more try-anything-desperation. Plenty of research backs the ways the body adjusts half a dozen biological parameters to arrange weight regain--which in this case, even if lost off the top half of the body, is likely to return on the bottom, and be trapped there forever.


Fat cells are not inert luggage: they put out hormones and enzymes and affect the entire body. No matter how otherwise seemingly-healthy the person is, guess what happens when they are eventually 100+ pounds overweight "in the hips to ankles?" Their whole body is affected, and additional serious obesity is likely. This condition is hormonal (starts around puberty, although not always apparent then, and kicks in more strongly after a major hormonal event(s)), and it's clearly a disorder of fat accumulation -- the body will not release that energy no matter what.


The human body normally stores energy in fat cells and gives it back to build the body or as motive energy. The weight of a human may naturally vary at least slightly with the seasons. But in this case, both of those things merely add to this fat-bottom-half condition. The fat can form big lumps that interfere with sitting and walking. The fat is often very sensitive, with painful bruising on minor pressure, not helped by growing weight and size from the fat itself as you might imagine. And eventually it can begin to crush the lymphatic system of the legs, leading to an even more dangerous and miserable secondary disease condition called Lymphadema.


I bet you're thinking, "Yeah, but stuff like that is rare." Think again. It's estimated at least 11% of adult women have this. Leaving out women under 15 or over 64 for a moment, we have an estimated 103 million women in the USA. The obesity percentage for adult women is "over 60 percent" so let's say 60% of that is nearly 62 million. (Which reminds me, if public transportation is funded in part by taxes, and the majority of the population is fat, how come fat people can't fit in the bathrooms on public transportation, or have to pay double to be crippled by the only option?) Let's say only 10% have this condition: that's over 10 million people. Odd this is so unknown, given those numbers.


Is anybody diagnosing this and informing women -- before cutting them open in dangerous-to-deadly weight-loss surgeries -- that it won't even affect their primary obesity? Is anybody diagnosing this before various other situations punish them for not being able to get thin? Is it considered before needed surgeries are refused "until they lose some weight?" It's not surprising that the casual world is full of people who will yell "Fat ass!" without concern for the cause of someone's fat, but how come the medical field is doing their equivalent of the same thing?


To put this in perspective by numbers, breast cancer affects just under 12% of women, so it's nearly the same number. 12 million Americans are estimated infected with Hepatitis B. AIDS in the USA has 'more than a million' cases. You hear a lot about those conditions, in part because vaccinations and "treatment drugs" can be sold for them. (Well, and because they are fatal.) There is no known cure for at least 10 million American women with the Lipoedema condition, who may gradually end up with horribly disabling and even fatal secondary results. There is not very much to sell so it's nearly a secret.


If it were better known, it might cause a lot of people to wonder if "dysregulation of fat accumulation" might be an important concept to focus on. They might wonder why that "eat less and move more" plan doesn't work as well as it should for most people. The bigger the person, the more this seems to be so. 


Looking for cause and solution for this condition (which would be unusual, given the current focus on 'eternally treating symptoms' instead) might give insight into obesity across the board. Do the funding parties really want to know?


Much of my overly pear-shaped maternal family has Lipoedema. Several key elements of our bottom-half fat that I always thought made my family uniquely weird, turn out to be case-study obvious instead. Reading how "it has no cure" was demoralizing. But then I realized, I had already stumbled on that realization myself anyway. At least, "so far." That's what they say about diabetes as well, and paleo/lowcarb have reversed that in more cases than we can count.


But think about this: pretty much every other pathological 'disease condition' that mankind has ever found a true cause and cure for, has ended up being a severe ongoing (and perhaps multi-generational) deficiency of some nutrient(s). (At the least, disease is certainly not caused by a deficiency of surgery or drugs.) So perhaps yet-more focus on very dense absorbed nutrition will help. Who knows?


**


What I do know is that the human body is not math, it is biochemistry. I know that the science of stuffing a rodent with soybean trans-fats does not justify saying the rodent's poor health is why humans shouldn't eat steak. I know that modern wheat is a mutant that will make you eat more, mess with your brain in a few ways including addiction, and destroy many peoples' digestive systems, causing anything from joint pain to asthma to reflux to brain fog or depression to syndromes like IBS, and chronic inflammation, which contributes to many diseases, including to being too fat. And I know that medicine is the new religion, where science has become like the old Latin, with 'agency spokespeople' and doctors like priests who 'translate' for us and whom we are not expected to question.


I know that the health agencies are becoming mostly public relations "fronts," with the stalker strong-arm of organized crime available to them via government power, for global mega-corporations. I know that there are many things the public usually doesn't realize, though it's info openly available, such as how in USA and Britain most medium to hard dairy cheese is actually made with GMO soy rennet. I know that there is a spectrum of disease, many conditions, all likely related to improper nutrition and toxins, many of which the medical industry is officially pretending does not exist for years now (such as Morgellon's, chronic Lyme, and many others). I know that any approach or substance which is truly curative and threatens big money is likely to end up squashed and its discoverer curing people with it in prison, if he doesn't die from a conveniently tragic accident instead.


I know that the surreal disconnect between nutrition propaganda and biological reality has created the most intriguing mass psychology experiment since the WWII era. I know that the entire obesity topic is as much a sociological phenomenon as medical: no amount of evidence is sufficient to make most the public question the party line that is so overtly not working... and the identification with the sources of that party line, and the social prejudice against obese people,  is endemic in our culture. In previous eras, the reasonings and groupings of propaganda and public acceptance were different, but the governing intent and public psychology seems eerily familiar. We may be doomed to repeat history for lack of understanding it, but we're doing so in creative new ways.


Gary Taubes released his first book on the review of the science for nutrition several years ago. After reading it, I figured it was a good thing it was long and dense, so you had to be a good reader for it: if the general public really absorbed the situation in the medical world, there might be riots at health agency doors. (His simpler book is "Why We Get Fat.") If you think the world banking situation is a racket, even that has little on the Machiavellian inverted-focus of illness-care... which is then used as a back door for ever-more frightening politics.


I thought the concept Taubes wrote about, the dysregulation of adipose tissue, was so novel. It explained so much -- finally, a model that fit the "reality" of experience for so many, including me. But it turns out that's been known to be an issue since 1940! So why was he the first person to really bring that to the public?


The number of people affected even by just this one condition (Lipoedema) is huge, literally over 1 in 10 adult women. Yet I still don't see any sign that the US or UK governments or their regulating agencies are even looking at this neon-obvious question of why, when the body stores energy as fat (which is normal), it then refuses to give back the energy in that fat (which is not normal, and means that energy stays stored as fat, accumulates, and the person has to eat more to get energy to keep functioning). So as Taubes put it, you don't get fat because you are eating more and moving less; you are eating more and moving less because you are getting fat. If the body wasn't refusing to release it from storage, neither of those other things would be happening.


Some things are known and help a lot, such as reducing insulin in the body, primarily by reducing carbohydrates, especially refined foods. Some other things, like how to "fix" the body if that alone doesn't do it, are unknown. Alas my "disease" won't make much money unless it stays uncured -- although the diet industry is doing unusually well.


When you see folks trying 'alternative' approaches they read on the internet (see the fascinating forum-websites earthclinic.com and curezone.com), consider that some people don't want to just sit around and get more miserable until they die. They actually want to feel better, imagine that. When the groups in our culture entrusted with guidance and science fail to serve those goals with any integrity, the public (or those with enough brains to question things, anyway) will look elsewhere.


The situation in illness-care in the USA and UK is nothing that religion hasn't shown us before. The answers are waiting for a little genuine investigation, some science ethics looking for solutions, not eternal drug dependencies. But like the Church and Galileo, current officials might get away with 300 more years of intentional ignorance, hidden by all that pontificating expertise. As long as they don't look through that scope, they will have "seen no evidence" of the reality so many of us live with every day.


PJ


P.S.: I have a number of 'experiments' with 'alternative nutrients and approaches' to various things that I'll be detailing here for friends over the next six months.

The 10,000 Ways That Don't Work

I've worked 20 hours a day, 7 days a week from last December 9 to May. I worked more like 16/6.5 since then. Starting just at the beginning of November, a bit over a week ago, I have actually been taking time off. I've had 1.5 weekends entirely off now, and 1.5 days (Wednesdays) entirely off now. I've gotten more sleep in the last 10 days than I have gotten in any 30-40 days in about a year.

This has led to the understanding that if you sleep 3 hours a night, you are not going to lose weight, for several good reasons.

I was re-reading my blog, like a 5-year review. I summarized many of the best/worst things I have done since I began this journey:

The Ex-Dieter Complex

They say that ex-Catholics and ex-Smokers can be recognized by others from miles away. I wonder if this goes for dieting, too.

One of the more sociologically interesting things about the whole subject of obesity is how people react to not wanting to be fat.

I don't mean by dieting. (Actually, dieting may be one of the least interesting subjects to me on earth right now. I'm simply not in the zone for it to fascinate me at the moment. I have, temporarily, reduced my eating life to two simple truisms: Eating healthily is good; Eating poorly is bad. This doesn't actually determine my diet. It simply provides moral commentary on it from the background of my attendant guilt complexes.)

I mean by how they behave. There is more to diet-related behavior than what you put in your mouth, of course. Including a good deal of what spews out from it.

Recently I was reading an article from the Sunday Times by India Knight, called Face it, fatty, your genes are innocent (2008Feb10).

There was something curious about it, which was this: the writer, once you waded through the swamp of scathing insult, and if you happened to know something about her aside from this piece, is actually promoting a low-carb eating approach. This is rare enough to see in mainstream media that it's usually almost a celebration.

Alas, the article didn't actually say anything useful enough to do readers any good, but, I don't think that was the point of the article anyway.

***

I feel that what the article reveals is something that has nothing to do with food, but with prejudice, and the way that socially people adapt to living within a culture permeated by that prejudice.

Obesity-ism has gotten so pervasive and so brutal that fat people have begun developing a world-sized case of Stockholm Syndrome. They now identify more with the people terrorizing them than with their own feelings or those of others in the same role, past or present.

In part to psychologically distance themselves from the horrible role of victim, they become the aggressor, victimizing others with the same demeaning and snide, patronizing and invalidating forms of insult that bullies have used since time began, no matter what the "-ism" being practiced.

Knight wrote:

Fat gene, my foot. Funny how it seems to manifest itself only in the prosperous, cake-guzzling carb-and-sugar-laden West. Where are the obese Sudanese toddlers? The porky Ethiopians?

The Gary Taubes book "Good Calories, Bad Calories," debunked the idea that obese people are only found in 'rich' countries. Foods that create obesity are available even to--and often moreso for--the poor. I did appreciate that she recognized carbs as a culprit, obviously, but this didn't seem to take the argument anywhere different than the typically misinformed dietary commentary, which is a bit odd.

She continues:

The excuses that people make for their own fatness drive me mad (I know whereof I speak and am not wholly unsympathetic: I was very fat myself at one point), and you can just see the mileage they’re going to get out of being told that it’s all down to genes. It’s not. It’s down to taking control of your life and down to choice: you can choose to be fat or choose to be normal. You can choose to make sacrifices or choose to be lazy -- and if you choose to be lazy and remain fat, then fair enough, but accept that it’s your own doing and take responsibility for it.

All the mileage they're going to get out of it. I see.

I agree with her on the part about responsibility. In fact, I don't know anybody -- including just about every morbidly obese person I know thanks to my involvement in the lowcarb world -- who would disagree with the above perspective about responsibility.

But then when I step back and think about it, I realize: exactly who, in today's world, is NOT considered responsible for their obesity?

Despite that thyroid can add weight, despite that other hormones can add to weight, despite that physical ailments and medications can contribute to either gaining weight or not being able to lose it, do you ever -- have you EVER -- seen one of the near-infinite number of fattists, in the midst of their sneers and remarks and jokes about fat people, build-in the caveat that perhaps they should be compassionate as it might not be the fat person's fault? No? Because I never have. Ever. Even in the rare cases where a person IS fat and it is genuinely something they did not "do" (even via ignorance or accident), I have never seen anybody of the nature to snark about "fat people" or "why people are fat", make the slightest allowance for that.

So let's turn that perspective a bit: have you ever known a seriously fat person, no matter what their eating habits, who felt zero sense of guilt or shame or blame for their weight? Who honestly believed that no matter what, they were somehow "totally not responsible" for their weight? I know plenty who will say that little they do NOW affects their weight or metabolism, but I never met a fat person who considered themselves completely unresponsible for their weight in the first place.

Sure, I've met fat people who will attribute less cause to their eating than they should, and I've met fat people who have seriously said (and I happen to believe them) that they eat what person X they live with eats, who is 1/3 their size. But I've never met someone who simply projected the entire situation onto some force outside them, like it had nothing to do with them at all. I think I would probably consider that a form of pathology.

Put it this way: I've never met someone who so whined about it being totally not their fault, that they would NEED someone in an article telling them that genetics don't matter, they just need to quit eating pie.

Someone needed to be told that?

On the contrary, what I have mostly seen is a big world filled with people who feel if anything such a ridiculous level of guilt, shame, and humiliation about being fat, that en masse in the USA alone they are willing to spend upwards of 30 BILLION dollars annually to try and deal with it. They are willing to buy and try infinite magazine advice and TV infomercials and books and more, to help them deal with it; they are dedicated to buying frozen meals and attending meetings and counting calories and weighing protein etc. all of this to "deal with it." To deal, in great part, with their sense of overwrought responsibility, with their sense of utter mortification for wearing the modern sin-mark of Cain on the outside: FAT.

They don't feel empowered. They just feel to blame.

So who exactly is this writer trying to save from themselves with the so-witty sarcasms of, "Fat genes, you see. More pie? Frappuccino with sweet whipped cream to wash it down?"

Maybe in her reality, fat people just love being fat, deliberately go out and do something to stay that way every single day, and feel zero sense of responsibility, let alone any nearly crushing, mind-bending shame that results in not wanting to leave the house, feeling like a personal failure, or whatever (I hear many variations on this theme from others over time). All those self-responsible, socially humiliated, media-mortified fatties are living in MY world apparently.

She added:

It’s no good wailing about rising levels of obesity if you show no interest whatsoever in trying to understand why people overeat in the first place. People overeat for psychological reasons, not physical ones.

Hmmm. Well, I do know many people who say they eat for psychological reasons. I personally think we attribute far too much to psychology, and I'd like to see obesity research and approach as a whole get back to biology where it ought to be rooted, and out of the armchair of psychotherapy. But I do agree that getting your head right is the first step (for certain), and that a lot of "eating disorders" have firm correlation with psychology. I simply suspect that nearly every serious eating disorder, however, is at least equally if not moreso rooted in physiology. As long as we simply "blame" people for either over-eating or eating poorly, rather than look at what physiology may be driving that, we're unlikely to learn much.

Blaming psychology for fat is an existing precedent, and one of the reasons why obesity is equated with some failing of character or morality. Because it is not seen as a disease -- as "a disorder of excess fat accumulation" as Taubes put it -- but rather, is seen as a psychological state, it can be grafted onto all the assumptions about what's in your head: gluttony and sloth, greed and laziness, emotional weakness, etc.

So while I agree totally with the "personal responsibility" angle, still what I see is just another harmony to that same getting-very-old insulting refrain applied with a broad stroke to all fat people:

Above all, we need to get to grips with the fact that fatness is a personal choice, one that can’t be blamed on anybody - or anything - other than our own greedy behaviour.

For whatever reason, there doesn't seem to be any ordinary humans involved here, only the far-extreme of greedy gluttons who won't be responsible at all.

It appears since India lost weight, she is now entitled to be just as stereotyping and insulting of fat people now as I'm sure others were when she herself was overweight.

In some people, weight loss brings greater wisdom. In others, it just brings the opportunity to leap over to the other side of the fence, and in the determination to not be a victim anymore, to become one of the victimizers.

It is a bummer when I actually AGREE with 90% of what someone says, and yet despite this, still manage to feel like they provided little in an article which could be construed as helpful in any way, and plenty which is pretty plainly hurtful.

***

It's a fine line. I've seen people who lost weight on low carb have a hard time finding that line: the good intent that wants to demand people take responsibility, step up to the plate (no pun intended), and go to bat for themselves, believe that they have the power to shape their lives and their bodies, and refuse to let anything get in their way, is a GOOD thing.

But there's that fine line to walk, where just on the other side of it, one is ignoring every possible mitigating circumstance, ignoring every detail that makes a unique human situation, and that leaves a person "where they are now" no matter what/how it came to be. That a person IS fat, does not mean they are doing something to be that way right now; it does not mean they don't consider themselves responsible. They may eat better than 90% of the population and work hard at it every day and still be fat.

The whole approach is basically the attitude, "If you want to be fat fine, but don't blame anybody but yourself," but who actually does blame anybody else? Nobody I know. You start wherever you are, and you move forward by believing you can and you're worth it. It is the pompous editorialists who assign blame for obesity: most fat people don't assign it anywhere outside themselves.

The very psychology that makes people feel empowered enough to make a change, that makes people feel strong and optimistic enough to believe they can do it, that this can work for them, is the same psychology that is simply mortified by snappy jibes about their gluttony, by assumptions about their assumed major eating disorders, and by snarky public insults that equate the size of their thighs to the degree of their moral inferiority.

We are taught all our lives to hate fat, and by extension, to resent and belittle fat people. It is not so different than women who clearly hold a sexist bias against women in general, despite being one, because that is the cultural mindset they have grown up in. It is more than possible to grow up inside a culture with pervasive prejudice and, despite being part of that group suffering the bias, to learn to hold that bias yourself.

Even in decent people, even in well intentioned people, the bias still stands out at times, highlighted by the tendency to put emphasis not on proactive shared-empowerment, but rather, on negative demean-the-assumed-weakness.

***

I call it the ex-dieter complex. Now that they lost some weight, and it doesn't matter how, they feel completely at ease not only sharing the same insulting prejudices that the culture at large already suffers, but doubly righteous in doing so, since "they used to be fat."

Fat is one of the few situations of prejudice that would breed this, of course. People cannot behave that way because "they used to be black." Only in the case of obesity can the victim become a stereotyping, insulting bully and actually walk away from it feeling as if they've done those they just insulted some kind of favor.

PJ

Cliff Climbing

Any time I stop doing something I've been doing deliberately for awhile, I tell myself, "I'll revert to my better habits in a day or so." You know that feeling?

Then time goes by, and more time goes by, and eventually I realize I am completely off the wagon, and don't particularly feel like getting back on it. So there.

And then eventually I realize that I actually kind of miss the wagon, miss feeling better, miss feeling like I'm accomplishing something, miss feeling like there is hope. I find myself mourning the loss. I find I want to get my act together.

And so then finally I actually DO it, I'm back on the wagon, I'm happy to be there, and I have a fresh enthusiasm that I obviously lacked previously around the time I hopped off. I might add that I stopped my 12 week cycle 1 week and 6.5 lbs short of my goal. I mean that's just stupid. It's been basically six weeks I've been 'off the wagon' and eating high-carb and not much exercising.

So today, I find myself looking at this straight-up cliff that seems somewhere between impossible, ridiculous, and unfair.

"Didn't I already climb that cliff?" I ask myself. "I could swear I recognize how few handholds there are in that stretch, and how hard it was going up that place over there."

"Why, yes," says my Conscience. "As a matter of fact PJ, you DID climb that very cliff once already. Possibly twice. But then you went off the wagon, see. So those very same pounds of cliff will have to be traversed yet again. So there."

Actually, to be honest, I'm astounded that I am only 21 lbs heavier six weeks later. I believe the majority of that is probably water/glycol-weight and likely to come off in the first couple weeks of a solid induction, taking me back to where I was when I left off. We will see.

Now, I am at 392.5. I was at 371.5 on July 25 when I basically lost interest in everything that related to "me" which happened to include my food, weight, exercise, etc. Of course just around that time, the governor was out declaring my county a disaster area, the 'walking park' was like 30 feet underwater from the flooding, but that is no excuse for not lifting weights or eating right.

As I mentioned previously, I've had a lot of time to think about the stuff I blogged on a few months ago, the "fat politics" stuff. I am going to be taking my weight and the whole "weight loss" angle off the face of this blog. It is not a 'secret' and my info can be found at my lowcarb journal, or a link I'll put on an 'about' page to my weight tracking spreadsheet. But I do believe that lowcarb should be about health, and if a person is to be appreciated or congratulated for how they eat or exercise or whatever, it should be first and foremost because they are making a genuine effort toward health and happiness.

For me, that means losing weight, simply because I am not comfortable weighing nearly 400#. I feel much better than when I weighed nearly 500#, I'll give you that. But I suspect that if I continue reducing that, I'll be better able to do fun things like karate and rollerskating again eventually, and I would really like to do that.

I don't want the lowcarb focus to be "weight loss." First because "fat, not weight" is much more important to focus on. Second, because lowcarb is a health regime. If a person were underweight, they would gain weight on a sufficient protein lowcarb eating plan! So it isn't about a 'diet' to 'lose weight'. It's about improving your life via health. For me this means I lose weight. Others might gain it. Many others might not change that much, but might feel better, feel stronger, increase muscle to fat ratio.

What matters is that lowcarb is cool. The food is great, the recipes are often droolably divine, the health improvements are awesome, and the people are the greatest collection of supernice humans I've met in ANY field online (and I've known quite a few). So my blog will be changing ever-so-slightly over the next week, to shift that emphasis toward health and away from weight-loss. Just so ya know, it doesn't mean that I am not continuing on a journey that includes that pretty front and center. It just means that lowcarb is a larger-vision that deserves a better context than the one I've been giving it.

But I am back on the wagon here.

Stupid freakin cliff. Now I have to climb it AGAIN.

PJ
.

20,000 Leagues Under the Sea

Hey! I AM alive. Hard as it is to believe some days.

Right now I am working like 8am to 2am. It's nuts. So I don't have much time to write and it's kind of hard to formulate ANY thought, let alone a decent blog post. But I will be back soon!

I have several major focuses in my life which tend to take up about 98% of my attention when they are present. At which point, everything else falls away. I go through these focuses one at a time. And when I am with focus X, everybody in focus Y and Z think, "What on earth happened to her?!" and my friends get irked at me and so on.

I guess the reality is that I am a chronically over-committed sort and I can only be with any program "cyclically".

Alas, that seems to include an eating program. I've been ignoring Lowcarb for awhile now but AS OF MONDAY 9/3 I am back on a 12 week plan. I have a nifty spreadsheet for that as well as one for general tracking that I will link on my next post in case anybody else wants to use them.

I haven't had any money for awhile (when I say that I am being quite literal) but I get paid tomorrow so can finally go shopping for REAL FOOD. Not the carbfest nightmare (Ramen is 6for$1) I've been eating while in temporary poverty. I know, some great bloggers have exampled how LC can be done on a budget (Regina at Weight of the Evidence) has more than one good post on that) but I don't think I budget well enough to do it on twice that budget. It's a good thing I have a job is all I can say.

Meanwhile back at the... er, mental world of PJ, I've been doing a lot of thinking about the stuff I blogged on some time ago regarding society bias against fat, and "fat activism" and things like that. It really moved me and made me feel quite differently about my lowcarb public stuff than I used to.

I eat lowcarb--not as often as I should--because for me, it is healthy, it tends to avoid gluten, it definitely avoids carbs, it increases my protein, and I like the food. I am much healthier when I'm eating lowcarb. I feel so sorry for people who, when they diet, are really doing nothing more than being miserable and underfed for awhile but otherwise see little benefit to it besides a slow wasting of muscle that reads on the scale as weight loss so they're happy.

Totally aside from weighing some insane amount I am too frightened to step on the scale to rediscover, I would eat low carb because it's good for me in so many ways. It isn't really about weight loss. Yes, I *want* bodyfat loss -- absolutely! But I want about a dozen other things just as much frankly, all of which matter too. Putting the focus on 'weight loss' first, is kind of misleading because it ought to be about bodyfat, not just pounds. Second, it's kind of overbalanced because it ought to be about health, not just size. And third, it's just incomplete, because LC is as good for me for other reasons as it is for gradual weight loss reasons.

So I think when I get some time (in a day or so--by end of this weekend latest I hope) to come back and blog properly (I have several taggings I must respond to!), I think I am going to take my weight off my blog. I'll keep it on my journal on the forum so anybody can see it if they want, as I link to it with my screen name from here; it isn't that it's a secret.

Recently there was a big drama (actually I think it is quietly continuing) about an eating plan that is, off-paper and into the hands-on practice, basically a starvation diet. Well, I really want the focus on this blog to be "healthy lowcarb yummy stuff and life", not, "the contest to lose scale-pounds by eating a certain way", and partly that's because this mentality about "eat this way to lose weight!" is really part of the same problem that drives people to starvation diets to begin with.

If the focus were on what is healthy for you, what makes you feel good and strong and mentally clear and physically able, then there would never be any confusion about why living on 400 calories a day might be ok. I say this as a person who regularly, if not forcibly on a lowcarb eating plan, lives on sometimes that many calories a day. That is why I'm hugely fat. I ought to be a walking testimony-of-terror to anorexic groups about what mucking up your metabolism in the most serious way can do to a person.

So I'm not saying I don't understand. Eating is inconvenient and time consuming and in general a bother unless I have time and interest. If someone fed me, I'd eat all the time. When my laziness and busy-ness (I am over-"focused" as attention goes) has to compete with food, it often loses. So I am no saint on the food front. I'm just saying that the whole focus on butt-size compared to what goes in your mouth is really part of the problem to begin with, that causes people to starve themselves or live solely on cabbage or all kinds of other bizarre and stupid acts of hysteria to deal with fat. And meanwhile, it means that even the people who should most support the acceptance of 'size' in our society, no matter what it is, are basically playing the same game as those against it, when the primary focus isn't "Hey I'm healthy and happy and isn't this eating plan great" but rather, "Here's how much of that nasty ugly weight I've managed to lose."

Maybe in reality we shouldn't congratulate people for losing scale weight--but for improving their health, which is just as hard-won an effort for people who do this in ways like removing cream from their coffee, or getting off gluten-containing foods, or improving their vegetable intake, as for people who do it by "officially losing weight."

My point is that the whole concept of an eating plan is life-wide. It shouldn't really be about your butt. It should be about your health in 1001 ways, your longevity, your quality of life. Person X who is eating broccoli and roasted chicken but not losing weight if that's the case, is working JUST AS HARD on improving his life as person Y who is eating pepperoni and frankenfoods but losing weight on the scale.

A focus on health would circumvent a lot of problems and put the lowcarb focus where it belongs. I believe this issue of putting the health goals first and weight issues second is the way it ought to be, and I plan to do that with my exercise blog as well. Which I forgot I even owned until recently. Damn, I am such a scatterbrain! Can I blame this on eating all those carbs?! :-)

PJ

The Skinny on Being Fat

Why IS it that some people are fat and others are not?

Dr. Jeffrey M. Friedman, head of the Laboratory of Molecular Genetics at Rockefeller University, said:

...if you think about it in general terms, you can explain differences in weight in the population based on three possibilities.

...one possibility would be that the obese lack will power; this is a point of view favored by lean people, I generally find.

The second possibility that people consider is that we live in a toxic environment and that it's the environment's fault.

And then the third possibility is that there are biological drives that lead us to eat what we eat, and ultimately weigh what we weigh, in the same way as some of us are tall and some of us are short, others of us are destined to be heavy and others lean.

...I think most moderate scientists believe that of course that all three can be relevant, but that biology has really an underappreciated role in accounting for difference in weight, and we know a lot about the system now and so I think there's a powerful set of data that supports that point of view.

{Ira Flatow: So when people are fat and they're overweight, there is a major genetic factor here. It's not as simple as saying "I have no will power" or "I tried the diet, doesn't work." There could be real hard wiring that's the problem.)

Dr. Jeffrey Friedman: ...some of the most powerful evidence that this is a biological problem and not a "behavioral one" (in quotation marks) is genetics. And so there are a number of ways to assess the genetic contributions to a trait. It turns out if you look for obesity it is probably the second most heritable trait, second only to height, with which it is quite close. Based on estimates that can be done by analyzing twins, 80 percent of the variability in weight can be accounted for by genetic factors.

Good grief! 80%? That's.... huge. So much for the just 'eat less exercise more!' solves-all-fat line.

Friedman points out that the belief in leanness is a modern thing, and implies that the expectation that everyone should be thin is itself nonsense:

...Historically, being obese was the desirable body habit as so. If you go to museums… all the rich people in Egypt would pay extra money to have extra chins put onto their sculpture. Rubenesque figures were the vogue in the 1700s. Renoir's characters were all heavy. In aboriginal societies the chieftains were all quite obese. For reasons that -- you all have as good an idea about as I do I guess –- things changed here about what our views of what was attractive in the 60s and it set up an idealized view of what people should weigh and who they should be that just isn't matched by our genetic endowment.

...The problem is not that small amounts of weight that improve health can't be achievable; I think it can be. The problem is that's not what most obese people want or the public wants. The public wants to be normal weight. And so I would much prefer to see that the dialogue and the issue center on improved health and achievable goals rather than setting up some societal construct that says everybody has to be perfectly wonderfully thin, a wish that really runs counter to almost everything science has to tell us about this problem.

I think people should make their best efforts but recognize, but not be prejudicial about the fact, that for many people most of the things you do aren’t going to work. And so my argument is not "we shouldn’t think about the problem, we shouldn’t address it." The issue has to do with "what are we going to do about it." And so I would argue what we shouldn’t do is fall back on simple nostrums like "eat less, exercise more."

And here he talks a little more about the weird social stigma that obesity has, and how illogical it is from a medical science perspective:

I think that to the extent that increased weight has health consequences, people should do their best. It certainly is a good thing to be fit. And it is a good thing to eat a heart healthy diet. And it’s probably a good thing to make one’s best efforts to keep one’s weight under control. So that means not doing much different than what Hippocrates would have recommended. But I think at the same time we have to recognize that those measures are rather limited in their efficacy and that to make the leap therefore that people who are not successful at keeping their weight off are at fault is just wrong headed. And there are all kinds of attributes about each of us that might draw the next person to draw a conclusion about them. But to draw conclusions about obese people, I think, is unenlightened to say the least about what their personal characteristics are.

(Ira Flatow: So to stigmatize them is sort of making fun of the situation that they don’t have much control over.)

Dr. Jeffrey Friedman: I think that’s right and the ironic thing is that I think the more of an outlier one is for weight, the more obese, the more difficult it would be to actually normalize weight. And so if anyone should be stigmatized it would be someone like me who could easily lose 10 lbs. and doesn’t. I think for the people who are really significantly overweight, it’s just who they are -- to a very, very large extent.

... It’d be much better to forget about the stigma and assume people weigh what they weigh, and then encourage people to do what they can to improve their health.

Back to Genetics, he said:

...So when you see a very obese person walking down the street there’s a very, very significant possibility that that individual just has a genetic alteration that makes them so.

(Ira Flatow: So all those years when you saw a very obese person and they said, "I have a glandular problem," they were telling the truth in a certain sense genetically speaking.)

Dr. Jeffrey Friedman: Well I think so. They just didn’t know which gland.

Then he got into some interesting stuff about how the functioning of a morbidly obese body is in many cases simply working differently than others. He used gastric bypass patients for this example.

(Question from the audience 1: When someone has a surgical intervention such that a massively obese person of, let’s say, 400 lbs. or 500 lbs. removes part of his colon and attains a weight more normal to his size, for his height. Does that rewire the person or does that then remold itself into the norm and the body strives to achieve the larger weight yet again?)

Dr. Jeffrey Friedman: ...there’s another feature of this surgery that people, I think, ignore, and it’s this: when you do this procedure you limit the intake of a person to about 700 calories a day. Just so you know, none of you could consume 700 calories a day for very long; it is a very small number of calories. Despite that fact, these people still end up being clinically obese at the other end of the procedure. They lose a lot of weight but they would still on average be definable as significantly obese on average after the procedure.

Now think about it, they’re eating 700 calories a day and they’re still obese. I mean if that doesn’t say that there’s something metabolically different about the obese than the lean, I don’t know what does.

Geez. Me neither.

I can tell people, "I have tracked 3-4 weeks, repeatedly, of my food intake, and my BMR is allegedly like 4000 calories a day minimum, and I'm eating usually <1200 calories a day IF that, AND lowcarb... and not losing weight." And plenty of them think I'm lying. I've actually had people suggest that if only I'd keep a food diary like they do in weight watchers (note: I *do*, or how could I be 'tracking' it??) that surely I would see all kinds of calories I didn't know about. As if 3,000 calories is easy to hide, for someone who has to work hard just to successfully eat 1000-1200 calories a day! My biggest problem is getting my butt into the kitchen to eat anything at all. So it's not like I'm grazing through fields all day and might 'forget' that 'Oh yeah, I ate 3 pizzas or something while grazing through the lettuce greens!', sheesh!

A reference was given me once of a Dr. Phil (I think) episode, where he tells this woman claiming the same thing that she defies the laws of nature, and then "discovers" from her husband that she is drinking thousands of calories a day in soda that she "didn't think counted." What a setup. She's an idiot, yes, but I felt the producers worked hard to find some way to invalidate that and maintain the calorie-myth ... tabloid journalism, essentially.

It's basically insulting. I mean, I've had people argue what they are sure about on-paper. They heard it, or read it. Or, they are a fairly normal metabolism bodybuilder who gained weight from sheer overeating after leaving high school sports or something, and hence when they quit overeating and started working out again, it fell off. It is just not the same.

They think it's a mathematical impossibility. I wish someone would find a way to communicate to the metabolic system how bad it is at math. I'm getting weary of people who would not doubt my intelligence or integrity on any other issue, acting like they're sure I must be lying or deluding myself about what I eat, because they just can't understand the calorie-math and why pounds aren't dropping off me at the speed of light.

The more quantity of food and more often I eat, as long as it isn't excessively of course, the more I lose weight. It's hard to do, after my whole adult life of eating once daily in the evening.

If they’re consuming 700 calories every day they’re going to be expending more than that. And so what you would find, you would expect to see is as long as they’re that imbalanced they’re going to keep losing and losing and losing and losing. That’s not what happens in these people; they plateau and they stop losing weight at what is definable as a significantly obese level. Now, if I had that procedure you probably wouldn’t see me in profile anymore because I would just get so thin. That’s not what happens to these people and it appears that in the face of reduced intake the body shuts down caloric expenditure and they can’t lose any more weight.

But it's all about the 'basal metabolic rate' right? How much exercise you get? He pops the balloon of what I call The Calorie Lie: the belief that to maintain obesity once must eat huge quantities of calories.

This is what sets me off most about conversation with people who seem to assume that every day I proactively DO SOMETHING to STAY fat. Sheesh!

Now this next part is pretty depressing, if eye-opening. This actually goes back to what Jonny Bowden was saying about how they used to measure the detail 'calories burned' by exercise, and it varied radically by person and was way outside what was 'assumed'. According to Friedman, people who are obese and lose some weight (whether this is because they are obese or, more likely I just assume, this is part of WHY they are obese) actually burn FEWER calories in order to maintain the SAME weight as someone else who did not lose weight to get to the same place:

Dr. Jeffrey Friedman: So it turns out – and this was some lovely work done by Jules Hirsch here at Rockefeller [this study, published in the New England Journal of Medicine in 1996, measured the metabolism of people who lost weight through a precisely controlled diet] --] it turns out they burn many fewer calories than you would predict based on their newer weight.

So let me put a finer point on this. Imagine you’re 250 pounds. and you lose 100 lbs. to 150 lbs. Now you ask how many calories does that person burn compared to someone who started out at 150 pounds.They burn like 300 or 400 calories fewer per day when they’re at that reduced weight. Now think about it. That person is hungry and now can only eat fewer calories than the equal weight person to maintain that weight, despite the fact that they weigh the same amount.

So just like Jonny said about how the calories burned in exercise was not consistent between different people, here Friedman makes clear, that even on a daily overall metabolic ratio (not just a limited exercise event), the amount of calories burned is not consistent between different people of the same weight. So Jane and Nancy, if eating the same things, and exercising the same amounts, may result eventually in a fat Jane and a slim Nancy, with no apparent behavioral difference.

And it's possible that this "biases against Jane keeping that weight off." Because eating identical food with identical exercise at the same body weight at point 1, a year later, Jane would be at least 36.5 lbs heavier. Multiply that by a few years and you have a very fat Jane, who never once needed to ingest pounds of bon-bons regularly in order to end up morbidly obese.

More:

(Ira Flatow: What about the other parts that control metabolism? Is it true that some people burn food faster and so it’s not the brain part and it’s just their thyroid, or whatever it is?

Dr. Jeffrey Friedman: A very classic study was done about 15 years ago by a guy named Claude Bouchard. And Claude gathered up a set of identical twins and overfed them 1,000 calories a day for 84 days. And he asked what happened. So these people were in a room, they were given calories, they were forced to eat 1,000 extra calories a day; they should have put on a lot of weight. Some people put on a lot of weight, other people put on hardly any weight at all.

And when they looked, the twins were highly similar to one another, suggesting that there was some genetic predisposition to either put on weight or not put on weight when you were given extra calories. The people who didn’t put on weight activated metabolism because of metabolic circuitry and didn’t put on the weight. And this observation that some people can eat whatever they want and never put on weight and other people put on weight just by looking at it has been more or less proven based on that study, which actually was observed as far back as the 1700s.

Friedman said, regarding the twin studies, that the opposite variant of twins had also been studied, and it STILL comes out to being, at root, a genetic predisposition to gain weight or not, overwhelmingly, not environmental:

...they were then redone with identical twins reared apart compared to fraternal twins reared together. So you’re actually biasing against the identical twins so now the hereditability falls from 80 percent to 70 percent. Still 70 percent -- and the other 30 percent could not be accounted for by the environment for those kids.

And finally, he referred to studies on adopted children, to see if it's entirely about the environment provided by parents, e.g., take a fat mother, with fat children assumedly from "the environment she raises them in," if you put a kid with different genetics in there, will they also be fat?

Another way to look at this, actually, is to take kids who are adopted and ask on average, do they resemble their adoptive parents or their biological parents, making the assumption that some go to one environment, others to the other. They, to a very large extent, resembled their biological parents independent of the environment that their adoptive parents provided.

Well, that's pretty much a measure from all three angles you can measure it, and in every measure, it comes out to be overwhelmingly a matter of genetic predisposition, more than just food intake or exercise.

***

I don't really want to believe this. It sorta makes me want to cry.

And of course, it goes greatly against what we are all indoctrinated with from our dietary plans of choice.

It is not 100% genetics. It is not a 100% failure of people to keep weight off. It's just... 70-80% genetics, and 95-98% failure.

Can I be one of the 2%? Can I modify my eating habits, exercise and lifestyle that the 20-30% can balance out the rest? Can I be the freak of nature that actually succeeds?

Damn. I hope so.

Am I delusional? Probably. The alternative might be suicidal, so it's all I've got.

.

The Obesity Epidemic Hysteria

A few more quotes from Dr. Jeffrey M. Friedman, head of the Laboratory of Molecular Genetics at Rockefeller University, and related thoughts.

Friedman took on some of the hysteria regarding the "obesity epidemic." There's some stuff I didn't realize or hadn't considered.

I actually contacted the epidemiologist named Katherine Flegal, who publishes all the reports that are highlighted in the press every time we hear, in five year intervals, the weight problem has increased dramatically. And I asked her exactly that question. "Well, what about obesity in other countries? Could it be, for example, that the curve in England or Europe has just shifted a little bit to the left?"

Now I asked her the question and she said it might be but no one knows. The data have not been gathered in these other countries in a way that would allow you to compare. So the supposition that this problem is so much worse in the U.S. is not based on actual data.

Regarding the "massive rise in numbers" and "doubling of number of obese" people etc., the foundation of our "obesity epidemic" and related hysteria, he said:

That’s an argument I get all the time because people say, "Well, there’s a huge change in a short period of time in the amount of obesity and that therefore it can’t be genetic." First of all, actually, that’s wrong. Genes in a population can change very rapidly as environment changes. In fact that’s the whole purpose of having variation in a population. As the environment changes in acute circumstances certain variants are selected and then predominate.

But setting that aside actually, I think people have a misconception about the role of environment in this because of misuse of statistics.

Let me explain what I mean. Obesity is distributed in the population. Some people are thin; some people are heavy; most people are in the middle; and you have a curve, a bell-shaped curve.

Now there’s a known phenomenon in epidemiology that when you have a normally distributed trait, meaning a bell-shaped curve, and a fixed threshold that defines a disease, if that average value shifts even a small amount, you get a disproportionate number of people who exceed the threshold.

So let me give you an analogy for IQ here and then I can tell you the actual data for weight. Imagine that 40 years ago the average IQ was 100 and there was a bell-shaped curve. Imagine now that our educational system improves and the bell-shaped curve shifts a little and the average IQ is now 105. With that you could imagine that the number of people who have an IQ greater than 140, so-called geniuses, might have doubled.

Now is it more useful to think about how our education is doing by saying, "average IQ increased 5 points" or "number of geniuses is doubled?" I think probably both are of interest but the former seems to me more informative.

Ok. So how does that analogize to weight? Over the time period that you’ve heard that the obesity rates have quote "doubled" or gone up by 70 percent, the average weight gain is: 7 to 10 pounds.

What?! All this hysteria over "obesity has DOUBLED!" and actually, it only means that the 'average' weight has increased by 7-10 lbs?! But remember that "bell shaped curve". When you move that entire bell-shape on the graph, the number of people it encompasses is huge, so yeah, mathematically, the number of people affected is sort of exponential.

Do you suppose there's a reason why we never hear, "Over the last X years, the average weight has increased 7-10lbs"? Instead of, "The number of obese people has DOUBLED!" Realistically, even a ONE pound shift in that gigantic population bell-curve would have moved a helluva lot of people over that line.

Now I’m not here to argue that that’s not important; it is important from a public health point of view. But if we then say that’s what environment contributes to differences in weight over that time frame, think about the fact that 7 to 10 pounds is almost nothing compared to the hundreds of pounds of difference in weight that you might see in any two people walking around the street today, both of whom essentially have unlimited access to calories.

Some of his comments from a couple years ago sounded similar to what I'm hearing about the current book 'Rethinking Thin'.

...the idea that you can change your weight voluntarily is one that the diet industry has a huge financial interest in. And so anybody can tune into infomercials telling you what you need to do to lose weight is fork over some money to their diet plan, eat it or not eat it and you’ll lose weight. And I don’t think that message and that marketing muscle can be easily counteracted by what scientists have to say about it.

Part of the problem is that that notion fits in with people’s intuition. And this gets very complicated. It’s a control issue; people want to feel like they’re in control of what they eat and what they weigh. But at a certain point you need to ask yourself, "How much am I really in control of it?" Now the problem for feeding is that the time frame with which this drive expresses itself is out weeks to months to actually years. And so by the time the drive exercises its power people don’t recognize it as a drive, and they simply imagine that it’s a loss of will power, not thinking of it as rather an expression of a basic biological drive.

...the available evidence would suggest that the vast majority of people who find themselves at a particular weight -- be it thin, medium, or heavy -- that’s pretty much their weight.

It’s that somehow people think this is something they ought to be able to control. And they accept all these other things you can’t control that are just who you are. But people are very loathe to believe that what they weigh is who they are.

On one of the early ideas about the Fatzi Regime's rush to label children based on their weight, he had a few comments as well:

(Ira Flatow: There was a news item that said New York’s Dept. of Education is considering putting kids weight on their report cards. Talk about stigmatizing kids.)

Dr. Jeffrey Friedman: Well, you know I would ask everybody, listen to what I have to say and then think about the things you’ll read in the press about obese people and then substitute any other human characteristic in there in place of obesity. You’d never get away with it; you’d get arrested or something. I mean, the things that get said!

I’ll give you a few examples. I was listening to Imus in the political campaign and they were talking about Bill Richardson as a possible vice-presidential candidate and a Newsweek reporter says Bill Richardson is being dismissed as a vice-presidential candidate because he’s too obese. What else could you have said and gotten away with? William Sensenbrenner, a congressman, is quoted in the New York Times as saying to the obese, "Look in the mirror because you’re the one to blame." I could go on and on. You have an opera singer fired because they’re too obese. And she correctly pointed out that this is the last bastion of stigmatization in the country.

And so when you read these things, think about it. Should they be putting a kid’s weight on the report card? I don’t know. Probably not.

And what about age? Plenty of us know people who ate anything and everything up to a certain point in their life, where they suddenly began gaining weight, which exponentially multiplied. Most people in lowcarb would consider it a gradual development of insulin resistance, based on the standard American diet (and I am referring to the USDA diet, not necessarily to chronic junk food). But might some of it relate to age? Or might those factors overlap? And if some of the "increase in obesity" is correlated with age, how might that affect the statistics? And if it affected the statistics, would that feed into the "obesity epidemic" hysteria?

Now, it’s a fact that people and animals get heavier as they age. We don’t understand why that is. It appears that leptin levels go up and some people lose leptin sensitivity as they age. We have no idea why. I’ll just digress to one other point that gets to your issue about the 7 to 10 lb. average weight gain. When you look at these data, they’re not corrected for age, And so, if the population is aging, that could contribute also to the perception that weight is changing.

He is not only blessedly aware of the flaws of the "BMI" as an evaluation, but of the issue related to weight and fitness. If you can take a person who is obese yet who plays three sports and is otherwise completely healthy--and I've known several people (and several teenagers) like this--then clearly obesity and health are not mutually opposing things.

The most important thing is what your general health is. If you’re overweight and not diabetic and not hypertensive and not hypercholesterolemic, then there’s a lot less to think about than if you’re diabetic and hypertensive and hypercholesterolemic. My own opinion, and this is just an opinion, is if you’re overweight and otherwise healthy, I would say try to be fit, try to eat a heart healthy diet and minimize your risk factors and try to enjoy yourself.

If you’re diabetic and have these other problems, then make your best effort to lose weight to the extent that it improves your health, do your best as you would for anything else.

Ira Flatow: So you said, you can be fit and overweight at the same time.

Dr. Jeffrey Friedman: Right.

I'd never actually thought about the 'obesity epidemic' being a sort of overhyped-hysteria. I mean, I think it's good that this increase is recognized, but let's get real, none of the authorities are recognizing the primary factors (sugar/carb overdose from an early age, and some researchers think as much as 50% of the population is probably sensitive to wheat/gluten and other primary foods that the official food pyramid insists be the dominant eating) that are massively contributing to weight gain and insulin resistance and eventual diabetes.

So since they are not even looking at the most fundamental cause for change, yet the hype is endless about this problem, what are we looking at here?

***

Years ago I did a study on media, for my own interest, and discovered that the news in general, on TV and in magazines, is not as much informative as predictive. Literally, when you look at it in retrospect, you actually see such a pattern that you start feeling like everything you were "officially told about" was part of some larger plan to "set up" a situation or presentation for something else that was planned ahead of time. Eventually, when I was watching the nightly news and writing down what was being said, I started asking myself, not, 'Is it true?' but rather, 'Why do 'they' (whomever 'they' is) want me to believe this?' which turned out to be a far more useful question.

So after seeing Dr. Friedman's comments, and this from a 2005 lecture no less!, about how the potential age increase in the population (which we know we have thanks to the baby boomer population) can increase the stats, and how the 7-10 lbs average increase on a bell curve would of course make a big change in the numbers, I started thinking, "Since they don't really want to look at the most legit science for solving it, and since the official recommendations are still corrupted by corporatism, then why is that they want us all to share the hysteria about this change in numbers?"

I think there are probably
-- (a) profitable drugs which will get approved sooner than they should because of this hysteria, and that's being relied on;
-- (b) legislations which will get passed that would never ever fly otherwise, but will get pushed through thanks to this hysteria, and that's being relied on;
-- and surely some things I haven't thought of yet.

It's not really paranoia or conspiracy thinking, it's just "precedent" from having observed news and related trends in the past and seen how it plays out in other subjects. I can't help but wonder if the 'hysteria' is being 'encouraged' behind the scenes because of the "power" it provides.

Remember the recent British report, which had US doctors involved as well, that first suggested radical "intervention" into the lives of children and families including taking kids from parents and even forcing gastric bypass surgery, they actually said OUTRIGHT that they didn't have the evidence to back their recommendations being what was right, but that the urgency of the situation demanded action. In other words: thanks to the hysteria, we no longer even have to prove something is a good idea before we radically invade the rights of the populace.

Maybe a little less hysteria and a few more people like Dr. Friedman would be useful. Not only for education and research, but for the actual political rights of individuals, children and families.

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Racism in Obesity Discrimination

Most folks who have been on a lowcarb eating plan for awhile already understand that individual metabolism is, well, individual and not really predictable. But I think a lot of people wouldn't argue that a predisposition to being lean or overweight might have a genetic basis.

Think a minute about what we mean by genetic. Does that mean that some races of people might be "more" genetically prone to obesity based on the current eating habits of our world, than others?

Yes, that's what it means.

Now think about the rampant and unabashed prejudice levied against obese people culture-wide.

Let us say, just as a hypothesis, that native Americans, known to be genetically susceptible to alcoholism more than most other races, were also genetically susceptible to obesity.

So if we choose to discriminate against obesity, as a culture in a myriad of ways, what we are really doing is "cloaking" racial prejudice in our obesity prejudice, because a disproportionate number of folks from certain races will suffer compared to others.

Sure, people might (maybe) be as prejudiced against white folks who are obese, but the reality is that if someone is arbitrarily deciding whether a person is too fat to adopt or if a child is too fat to be allowed to live with their family or too fat to deserve a job, there is a whole lot of "soft" room for discrimination in there, since obesity is a nice blanket over the top of it.

When Western governments are talking about "intervention" that dramatically invades the privacy and rights of individuals and families, this becomes a radical and racial issue.

Here are some selected quotes from Dr. Jeffrey M. Friedman, head of the Laboratory of Molecular Genetics at Rockefeller University.

Ira Flatow: You said that we don’t have enough data to understand why there’s been a 7 to 10 pound. weight increase. Do you have a hypothesis of your own about why this might be?

Jeffrey Friedman: What I think is happening is this. It turns out that that weight increase isn’t uniform across the population, and there’s actually really good epidemiologic evidence to suggest that. I think that a lot of the weight gain is concentrated in specific ethnic groups.

...I think that what we’re seeing now is ethnic groups that are predisposed to obesity are now getting access to unlimited calories. And I think that has a lot to do with that weight increase. And there’s some evidence to support that but it’s not definitive. Actually a lot of the epidemiologic data that you would really want to understand things like this is lacking.

...it turns out actually that these really obese kids are concentrated in particular ethnic groups and the gene pools are different in different ethnic groups.

So eventually we'll be able to say something like, if you're Native American, your chances of being biased against even by government agencies, is ___% higher than if you were say, Romanian.

If there is a higher chance that someone native were obese than there is that someone Romanian would be obese, then if we pretend a child or parent's obesity is mostly about environment (hence they should receive family "intervention" by the government), we are saying that natives inherently less-deserve to raise their own kids, because more of them are fat than some other racial groups. (Remember this is hypothetical.)

So, if you're white enough (or whatever) to luck into thinner genes, you're probably ok, but we'll have to round up more of the kids from those darn (check one susceptible-to-obesity race)'s kids, 'cause they are just too damn fat so much more often.

Do the cultural leaders of the races most genetically predisposed to obesity realize this? Realize that not taking any issue with "obesity issues," means building-in institutionalized bias against their people?

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A Big Fat Opinion

Do you ever notice that everybody has an opinion about how people get fat, and how people should lose fat? Always.

Over the last 17-18 years since I got fat, I've had the opportunity to experience quite an "up-close and personal sociological evaluation of how people react to other people who are fat." This would probably be a more pleasant study if I were not the fat person in question, of course, but it's no less interesting, despite that.

Most of us have experienced at least some of this. You may be sitting in a restaurant with several acquaintances. One of them, usually someone pointedly overweight themselves, but who is clearly delighted to observe that you are more overweight than they are, will suddenly become the Grand Vizier of Dietary Advice. (The probability of this happening is in direct proportion to their guilt about what they themselves are eating.)

They may assure you, some sincerely and some patronizingly, that you definitely should eat the junk they are eating because the entire secret of weight loss is just "portion control" and "moderation." The implied translation, of course, is: If you didn't eat like an uncontrollable pig all the time, you wouldn't be fat. They don't really mean that consciously, most would never say such a thing, but the theory underlies their advice: obviously, you're fat, so if you "ate moderately" they assume you would not be... you see where that goes.

They will assure you that if a person just gets adequate exercise, these things take care of themselves. Of course, the fact that your metabolism might require a triathalon to compensate for the dinner they want you to eat so they'll feel better about doing so themselves, escapes them. They assume that the fellow on the left who is thin and wiry despite eating enough for three people, has the identical metabolism as yourself, who is clearly fat despite eating less than everyone there.


Dr. Jeffrey M. Friedman, head of the Laboratory of Molecular Genetics at Rockefeller University (and the researcher who discovered the hormone leptin, which plays a crucial role it appears in how our body regulates our weight), said about obesity:

I think in contrast to almost every other medical condition where the lay public would just leave it to the scientist to inform them about what causes it, what the nature of the problem is, and what we should do about it, obesity is a condition where absolutely everyone has an opinion. Everybody has a deeply held set of personal beliefs about what causes the problem.

Well, I think fat is like the baffling tax code (and resultant nightmares about scary amounts of money you owe).

Plenty of people are lucky just to balance their checkbooks properly. The convoluted complexity of human metabolism is more than even the experts have a grip on at the moment, let alone the laymen. And it certainly doesn't fit into the sound-bite over-simplied spoon-fed media our culture has become as addicted to as we have to carbohydrates.

Humans love to feel like they know what they're doing, and what the answers are to things. We like it when everything has a place and just WORKS. No ambiguity, no confusion, no complexity. Nothing subjective. Only WE are allowed to be subjective: the rest of the world is not. When we are subjective, it is our right, our feelings, and who we are. When anything or anyone else is subjective, if we disagree, it is probably that they are irrational. Of course. If they were sensible, they'd agree with us! :-)

We are bred from childhood to fear fat. Fat is bad. Fat is the Other. Fat brings mocking, derision, abuse, social shunning, and pity. This is culturally bred into all of us and isn't even conscious in most cases. So when the question of fat comes up, the last thing anybody wants, is to feel it's an impossibly confusing morass of unfinished science and unanswered questions; we have no real handle on it. Survival instinct alone makes us want, makes us need, to feel like we have the formula and answer to fat, so we have power over it. The fact that we don't know is irrelevent. If we feel we know, I think our subconscious fear-based psychology feels better about the whole thing.

The persistent denial of an entire culture in regards to obesity, coupled with a nearly hysterical panic about it, only emphasizes this. Research studies have had some interesting findings on this sociological subject. Some people say they'd rather be seriously injured than fat. Some college kids say they'd date a wife-beater or drug-user before they'd date someone noticeably overweight.

As a culture, our attempt to 'stamp out fat' has been even less successful than our alleged war on drugs. We supply endless quantities of alcohol, and caffeine. The ghastly long-term abuse of cocaine-level drugs such as the entire class of drugs similar to Ritalin (and worse), for children as young as 2 years old, is mind blowing. (Every 'school shooter' in the news, was a kid officially drugged by parent/government/school for years, did you know that?)

Yet despite how easy it is to give someone enough legal drugs to have them wipe out families of four on the highway, efforts continue to outlaw vitamins and herbs without prescription for being "dangerous", and if a high school girl shares Midol for monthly cramps with a friend and is seen she can be suspended. We're completely schizophrenic about the drug issue in our culture. It is a WAR on drugs. A war in which the profiteers appear to be profiting (the war on drugs helps fund the covert military operations congress will not approve or the public cannot know about), and the problem continues to get worse instead of better. With that kind of 'help', we could be at least ten times worse off within years.

And so it is with obesity. Magazines neatly couple drool-able foods with the latest diet fad and both on the front page. "Healthy recipes" in them tend to be blood sugar grenades allegedly made 'healthy' by using low-fat margarine and whole-grain flour... rather than a recipe that was more healthy by being, well, less UNhealthy. We constantly model near-impossibly skinny women as 'the ideal'. We have endless ways of enforcing both subtly and overtly the 'sin' of someone being fat and daring to show up in public, and then we wonder why people especially young women develop anorexia, binging, bulemia, and other eating disorders. If our 'war on obese people obesity' is as successful as our war on drugs has been, we can expect to have a far worse problem 5 and especially 10 years from now. The only real difference is that the diet industry is not funding black ops. We assume.

As Dr. Friedman said, everybody has an opinion. I agree. I have never met a person who openly said something like, "I have no idea how someone would get or stay thin." Everybody, but everybody, believes they know the way, and this includes nearly every obese person I ever met, every person who never had to diet in their life, and so on.

Many years ago, a research paper published in the parapsychology (psychic research) field reviewed the perceptions and opinions of scientists outside the field about the subject. (For those who don't know, many of the leading parapsychologists are/were legit reputable physicists and engineers and other hard scientists, before they dared touch the subject, which is the kiss of death to any science career: we are not allowed to ask those questions.) Pretty much all the scientists had an opinion about it (hint: it was definitely not a good one). Pretty much all the scientists believed that their opinion held scientific merit because they were a scientist, and they believed that they had enough information to have a right to opinion.

But when interviewed, it turned out that pretty much all of them were completely ignorant of the real science in the field, and their entire edifice of opinion was based on media: movies, magazines, comic books and fiction, and hokey commercial advertising. None of them knew anything about the real science, nor had they ever looked, nor did they want to know--but that did not keep them from pushing their 'expert opinion' on others with almost no provocation at all.

It is like being raised to dislike people who are a certain race or religion: You cannot reason with a belief that is not based on reason. We are bred to some prejudices, and they are constantly enforced culture-wide. Fat is one of them.

More from Dr. Friedman in the next few posts.

PJ