“The Fat of the Nation”
The Fat of The Nation not measured well by scales
This week HBO began airing a four part series on obesity called “The Weight of the Nation”. This program is a collaboration between The Institute of Medicine (IOM), the Centers for Disease Control and Prevention (CDC), the National Institutes of Health, the Michael and Susan Dell Foundation and Kaiser Permanente. While I applaud their effort to focus our attention on obesity, unless you’ve been living in a cave for the past few decades the obesity epidemic is pretty self-evident. We don’t need more focus on obesity–we need effective solutions.
With all the heavy-duty scientists involved in this project you would at least hope that they get the science right but unfortunately that doesn’t seem to be the case. Let’s start with their title. It doesn’t make a lot of sense to talk about a weight problem because from a scientific standpoint, there really is no such thing as a weight problem. Obesity is defined as excessive body fat. That means that if you are obese, you have too much fat in your body relative to muscle, bones, organs and water. In other words obesity is a body composition issue. Your weight tells you absolutely nothing about how much fat is in your body. When you look at groups of people, those with a higher weight on average have more fat in their bodies but you are an individual, not a group. When I treat a patient I want to know if that person is obese. That’s why I never rely on weight when it comes to managing obesity.
Body mass index is a height/weight formula that is supposed to be more accurate than weight alone for determining obesity. When is the last time your height changed? Thus BMI is just another way to look at weight. We can thank the National Institute of Health for deciding years ago that it’s too expensive and too much trouble to measure body composition so they promoted the use of weight and BMI to measure obesity. Fortunately, I ignored their unscientific advice and over the years I have taken over 18,000 body composition readings on my patients. The first thing I noticed was that some normal sized people and even some thin people have excessive body fat and thus quality as being obese. Obese thin people—how is that even possible?
Good question. The experts not only decided to take shortcuts when it comes to measuring obesity, they also skimped on science when it comes to the cause of obesity. The groups in this project still believe that obesity is caused by excessive calories and lack of exercise. You know the line—to lose weight you need to eat less and exercise more. While this may be true, if you are obese you need to lose fat, not weight. Losing 10 pounds of muscle by under-eating makes you more obese, not less.
If you look carefully at the science, there is very little evidence that excessive calories and lack of exercise is the cause of obesity. It is clear that mammals including humans can eat a broad range of calories without storing extra fat if they stick to the food that they evolved eating. The easiest way to get mammals to store excessive fat is to feed them excessive fructose mainly from sucrose (sugar) and high fructose corn syrup and high glycemic (rapidly absorbed) carbohydrates mainly from grains.
These two food elements will consistently cause excessive fat storage whether you under-eat, eat a normal amount of food or over-eat. Sure if you eat a lot of food loaded with sugar, HFCS and high glycemic carbohydrates, you will tend to store more fat and get bigger. If you under-eat and eat some of this type of food, you will lose lean body mass, store too much fat and lose weight. That’s why anorexics have excessive body fat but you need to measure their body composition to see it.
Thus from a scientific standpoint obesity is strictly about fat, not weight, BMI or size.
If you ignore the issue of fat as these folks seem to do, you will never have a chance of reversing the obesity epidemic. “The Weight of The Nation” focuses very well on the issue of obesity but then goes on to promote the same old approaches that have been used for years without success. I agree with Gary Taubes in his recent Newsweek article “Why the Campaign to Stop America’s Obesity Crisis Keeps Failing.” Gary understands the science and it’s straightforward enough that you can understand it too. What baffles me is how some of our best scientists, physicians, government agencies and foundations can utterly fail to understand these basic and simple scientific principles. They could start by renaming their documentary “The Fat of the Nation”. This site is dedicated to promoting a scientific approach to help you lose excessive body fat and I could care less about your weight or BMI.
And we promise, we won’t ignore the elephant in the living room. Not for a minute.