The Evolution of Obesity [Hardcover]

The book is well written and covers the subject quite extensively. It is sometimes repetitive but reading is never boring. If you never read anything on the subject of Evolution of Obesity, it will bring you close to the current knowledge on this fast changing subject. However, if you have a more academic interest on the theme and already read review papers, it is unlikely that it will add much to your current knowledge. It may call your attention to different approaches to the subject that you were not aware of and that is good anyway.

This book is a sobering, but much needed, overview of the complexity of the obesity issue, a public health issue that has recently acquired prominence. Although it does not appear to have been written for a general audience, it contains numerous insights on appetite, appetite, meals, and their genetic, biochemical, and social components and origins. It you are interested in a deeper understanding of obesity, the reward is worth the effort.

As examples of the insights in "The Evolution of Obesity", I would cite two that I found particularly informative. First, the biochemical signals involved in appetite and fat storage (e.g., insulin and leptin) are active and play important roles in systems other than metabolism. Recognition of this is very important, because it implies that it is extremely unlikely that a "magic bullet" will be found to treat obesity. Second, even a relatively lean person has sufficient energy stored as fat to satisfy basic requirements for about a month! From this point of view, excess fat is clearly maladaptive, and is associated with a state of chronic internal inflammation. The human body does not appear to have a way to recognize and dispose of excess fat (adipose tissue). Carbohydrate and fat calories consumed are either used directly or stored. There is apparently no way to directly shrink adipose tissue other than through the usual metabolic pathways. It seems to me that this supports the author's concept that humanity evolved in a calorically-limited environment, but now that there is virtually unlimited access to high energy density foods, the metabolic system is unable to effectively cope with it.

One aspect of obesity and metabolism that the authors do not address but I wish they would have is the question of mass and energy with respect to food and adipose tissue. Basically, the issue is that adipose tissue and obesity are characterized by weight (i.e., in terms of mass), but foods are characterized by calories (i.e., in terms of energy). The basis for the interchangeability of these terms is assumed, but the discourse on obesity would benefit from a clear explanation for it. I think I can guess why this is done, namely, a mass balance for metabolism (mass of food in = change in body mass + mass of metabolites out) would be very difficult to measure.

The book makes it clear that human metabolism is exceedingly complex, and that we are a very long way from a detailed understanding of it. This situation will undoubtedly disappoint and frustrate the food police, since it will be impossible to find a single villain on which obesity can be conveniently blamed.

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