Rethinking Thin Hardcover – May 3 2007
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From Publishers Weekly
Starred Review. New York Times reporter Kolata may be the best writer around covering the science of health. Here she offers an eye-opening book that questions all our received wisdom about why we get fat and the health hazards of those extra pounds. In chapters equally entertaining and dismaying, Kolata (Flu) traces the history of dieting fads back to the 19th century; discusses our changing ideas about the ideal body (thinner and thinner); and, most importantly, explains how genetic and biochemical understanding has (at least among researchers) replaced the view of obesity as a lack of self-control. Most dramatic is Kolata's recounting of Jeff Friedman's groundbreaking search at Rockefeller University for the "satiety factor," a hormone he called leptin that tells our brains when we're full. The science alternates with moving chapters in which Kolata follows a group of people in a weight-loss study who are trying desperately to get thin—a quest that, as Kolata makes increasingly clear is sadly futile. In her final—and perhaps most surprising—chapter, Kolata blasts those in the obesity industry—such as Jenny Craig and academic obesity research centers—who are invested in promoting the idea that overweight is unhealthy and diet and exercise are effective despite a raft of evidence to the contrary. This book will change your thinking about weight, whether you struggle with it or not. (May)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
*Starred Review* When New York Times science writer Kolata took an unbiased look at society's war on fatness, she found that the spoils of the conflict fatten the pockets of a multibillion-dollar dieting industry, while most ever-hopeful yet hapless dieters lose only money. Why, then, do we still repeat a mantra--"eat less and exercise more"--that has failed dieters for 2,000 years? Why, in diet study after diet study, do chubby participants consistently fail to reach their target weights? And why do the majority of dieters end up regaining most of their hard-lost weight, or regaining and then exceeding it? Following up on participants in a two-year clinical weight-loss study comparing the overall efficacies of the Atkins diet and a highly regarded low-calorie, low-fat diet opened Kolata's eyes to the plight of millions who can't seem to measure down to today's weight ideals. The experience led her to examine the millennia-old history of humanity's battle against the bulge. She interviewed several credentialed authorities, and she cites sound scientific evidence that calls in question the productiveness of common weight-loss methods. Her report reveals well-documented intelligence certain to annoy those segments of society and commerce that stubbornly cling to the ignis fatuus that all one needs to be thin is willpower. Donna Chavez
Copyright © American Library Association. All rights reserved
Top Customer Reviews
diet, through Banting and Fletcher, to Ancel Keys' starvation studies,
and intersperses the history with an account of a contemporary UPenn study of Atkins vs. LEARN diets. The book features a particularly good summary of Albert Stunkard's work on obesity.
Her conclusion may seem grim -- every diet mentioned eventually fails to override most dieters' set points, and the fat comes back. In
one particularly despairing moment, she asks "how obesity researchers
can keep doing study after study, advertising for subjects, ... starting them off again and again on a path whose outcome they must know for sure".
Kolata throws out a few lifebelts of hope at the end, mentioning
recent leptin studies, and work on PYY3-36 (an appetite suppressant).
It's clear that the conventional wisdom (diet n' exercise) in pop culture weight loss has failed for most people.
Instead of slashing your wrists, I would suggest that readers of
this book also look at Seth Roberts' Shangri La Diet (the book or his
web site). This is the first serious attempt I've heard of to try to
lower a dieter's set point, instead of continually fighting against it.
It has worked for quite a few people, and it's unfortunate that many
people won't even try it, and remain mired in the same false hope
syndrome that Kolata discusses at the end of her book.
The book also discusses the fatphobia rampant in society, and the effect it has on people who do not meet the ideal.
It's a great read.
Most Helpful Customer Reviews on Amazon.com (beta)
We have been led to believe that obesity is a relatively recent development in U.S. society, but this apparently is not the case. The stories of weight loss strategies and weight attitudes from even 100+ years ago are fascinating to read about. Discussion of our past attitudes about what is fat and what is a desirable weight shows that these attitudes have changed substantially through the years: for example, flappers of the 20's, who most of us vaguely recall to have been quite thin, would actually be considered overweight by today's extreme standards. The "Gibson Girl" ideal of the early 1900's would be considered absolutely obsese today.
Studies and experiments which have been done to figure out the "why" of overweight show that everything is still not well understood about weight gain, obesity, and weight loss. There are still more questions to be asked and not yet enough answers, and to complicate things each person is unique in physiology. Genetics is thought to play a strong role, and studies of twins and adopted children reveal the genetic component plays a strong role in your weight and how easily you can gain or lose excess weight.
Don't read this book expecting to find some new weight loss miracle. There are no real solutions in this book, but rather, it can give you a more realistic and educated understanding of what you are up against in the weight loss wars. Being realistic is half the game. As studies continue and knowledge increases, this book is necessarily "unfinished". But it gives you a good perspective at this point in time. The information presented will be viewed by some as discouraging, especially those who are searching for a quick and sure-fire weight loss plan. This book makes it fairly obvious that may never happen. And one good thing you realize after reading this is the extent to which we are all manipulated by those who profit from the weight loss industry. You come away from this book with a "buyer beware" attitude which will serve you well in not being duped into yet another weight loss product that doesn't work.
I read an article by Kolata in the New York Times a few days ago that was based on this book. I thought that the article was excellent, stressing the heritability component in obesity, and pointing to the failures of weight-control diets. I rushed to get the book, fully expecting fuller, more satisfactory explanations -- a truly book-length treatment of this important subject.
But the book here is actually no more than an article that has been heavily padded with cutesy anecdotes so as to achieve the physical corpulence of a book.
There are interesting (but not original) descriptions of diet fads throughout the ages. There are interesting (but depressingly familiar) accounts of failures of diets. There is an interesting account of animal studies on obesity. There are interesting accounts of twin studies that point to high heritability of obesity. And then there is endless prose that over-interprets all this: to wit, obesity is inherited, nothing can be done about it.
There is also an instance of gross malpractice of journalism. In the introduction, Kolata tells us that her book is the story of a high-science, two year long, carefully planned study of diets: Atkins versus LEARN. In chapter after boring chapter she gives us personality sketches of some of the participants and trivia about the progress of the study over the two year period. Then, at the end, while we wait for her to tell us the outcome, she tells us that, well, no, she can't say. The scientists haven't had the time to write up the results. Come on, Ms. K., if you don't know the outcome you shouldn't have bothered us with all that chatter about the wall color in the research room or what the weather was like on the first day of the study.
Journalistic malpractice isn't the worst thing about this book. The worst thing is that the author hasn't engaged with the intellectual problem that she posits. Her overall point is that obesity has very high heritability, i.e. that it is overwhelmingly determined by genetic factors. But then she also reports, as if this had nothing to do with her thesis, that numerous studies have shown that obesity is also strongly influenced by social class, the lower classes having higher rates. Now if that is true, what is the relationship to the high heritability ? Is lower class membership equally determined by genetic heritage ? Is it the same gene, or group of genes ? What, in other words, is the relationship between the claimed heritability of obesity and its correlation with class ? It doesn't seem to have occurred to Ms. K. to worry about such questions.
The main point of this book -- which is very well-researched and scientifically-based -- is that people, contrary to the popular thinking in our society, are not fat because they are lazy or lack willpower. In fact, there is little evidence to support the common notion that people, through diet and exercise, can lose mass quantities of weight and KEEP it off. The best research shows that our overall size/weight (which is related to our hunger) is genetically and chemically determined. So basically, yes, oftentimes fatter people eat more (though not always), but their hunger is not something that can simply be overcome through "willpower" -- at least, not for a lifetime. It would be like resisting the urge to breathe -- that's how primal it is.
All this may seem very discouraging to the average person (who is bound to be discontent with their current weight, thanks to modern ideals), but Kolata poses the question we may have forgotten to ask: Who says we all have to be skinny anyway? When the research shows that the highest life expectancy belongs to the slightly "overweight" (extremes of thinness and obesity still are not as "healthy"), why do "health scientists" still insist that the majority of us need to be thinner, for our health?
The answer, of course, is that our society does not accept fatness. Kotala's anecdotes illustrate the pervasiveness of this belief. But could it be that, just as people are taller on average now than they were 100 years ago -- a phenomenon that is commonly accepted as a sign of increased nutrition and prosperity -- that humans are evolving to be heavier as well? After all, in some epochs and societies, extra weight is considered a sign of health and wealth.
Some readers may be frustrated because Kotala does not draw a neat conclusion at the end of this book, but she should be respected for not resorting to the sweeping generalizations made in so many "health books." The author cannot be discredited because she does not answer all of our questions about weight loss -- the topic is simply too vast to address scientifically. As Kotala notes, there is already a myriad of quality research on nutrition and exercise, so she does not discuss it further. Her book is meant to be considered in conjunction with this knowledge.
Kotala's message is NOT, "Since weight is largely hereditary, you shouldn't even bother to watch your diet or to exercise." Taking Kotala's contribution to the research on weight loss and health into the broader perspective, a more suitable conclusion is: Eat a healthy diet and exercise regularly, for the proven health benefits of both; but accept the fact that the state of `optimum health' comes in many different shapes and sizes. "Overweight" does not necessarily mean "unhealthy"- just as "thin" does not always indicate "healthy."
I would recommend this book even to people who do not struggle with their weight, because Rethinking Thin serves as a human rights manifesto for fat people. (Yes, I said "fat" - perhaps it is the more PC term than "overweight," which implies that a person has "too much" of something and therefore needs to change.) They are constantly subject to the judgment that being fat is somehow a character defect - and worst of all, they perpetuate the belief by believing it themselves. But the research cited in Rethinking Thin challenges this gospel that fat people just need to "try harder" in order to be "normal," i.e. thin. The thin person who preaches discipline will gain compassion from Kolata's perspective, and the naturally large person will be empowered.
Kolata's arguments are bound to be controversial - or, simply dismissed - because the thinking that equates thinness with virtuosity is so deeply ingrained in our culture. But it is about time our society stopped judging a person's character based on their size. While I do not expect this book to get much "press" (it certainly won't have the backing of the diet industry), I do hope that many, many people read it... and, as a result, hopefully they will realize that discrimination based on weight is just as intolerable as any other form of prejudice - sexism, racism, etc. - that was once deemed acceptable in our society.
One of the things that has always bothered me about the science of dieting and obesity control is how often those who have NO training, NO education and no studies or research to base things on feel that they can get up on a soapbox and proclaim "I absolutely know that all fat people....(fill the blank)." One such poster here claims that fat people think a diet Coke will cancel out the calories of a Big Mac and fries! Really? How does he know this? Does he have ESP? Does he know for a fact that slim people don't also drink Diet Coke (because THEY DO)? Why does he attribute this behavior to stupidity and denial? After all, while the Diet Coke doesn't "cancel anything out", it is a couple hundred calories less than a regular Coke -- isn't that a GOOD THING? No, it is easier to to ridicule and judge a fat person, because "we all know" that a fat person can't ever be hungry (they don't deserve their hunger) and they don't deserve to eat the same foods that other people do (Big Macs, etc.). They only deserve to be in a permanent state of semi-starvation, forever, in punishment for the sin of eating too much.
Another poster here gives the anecdotal tale of HIS OWN WEIGHT LOSS on the low carb type of diet -- it obviously "proves" that anyone can lose weight this way, because of course the experiences of ONE PERSON apply to the other 180 million overweight people in this country. Never mind that he has only kept it off for 3 years, and the gold standard is five years. Let's talk to Mr. "La Vida" at the five year mark. I'll bet my last nickel he has regained all the weight, just like ALL the particpants in the NIH study that Ms. Kolata details.
And how about the guy who gives the story of his own weight loss....IN HIGH SCHOOL. A teenage boy, who is still growing, and only 1 year ago, but yeah, this is meant to apply to EVERYONE, even menopausal women. Or the woman who quotes the National Weight Registry, which tracks successful dieters...all 5000 of them, out of a population of maybe 180 million overweight Americans...that's like 1/10 of one percent. The numbers speak for themselves.
The point is: this is non-science...or maybe "nonsense" would be more accurate. Individual annecdotal stories mean nothing -- it would be like doing a story on retirement planning and someone pipes up "Oh I don't need to plan my retirement because I won the lottery!" Well, the rest of us won't win the lottery, so we need good information to plan our lives.
Ms. Kolata is NOT saying give up or don't try to lose weight. What she's saying is "look at the science"....scientists don't do research to try and prove a point they already believe (or they shouldn't if they are true researchers)...what they do is LOOK AT THE FACTS and report them. The FACTS are that 97% of diets utterly fail, and that dieting makes you regain more weight than you lost. Exercise and healthy eating are good for your health long term, and offer many benefits, but weight loss IS NOT ONE OF THOSE BENEFITS.
Yes, food deprivation will make you lose weight BUT in the long run you will regain all that weight plus more. We WANT to be able to control our weight down to the last ounce, but at this point in human history, we simply do not know how to KEEP WEIGHT OFF. Losing weight and then simply regaining it is worse for you than never losing it in the first place! And that doesn't even take into consideration the heartbreak and discouragement of putting all that work (the patients in the NIH study doggedly worked on their diets for two solid years) only to reap NOTHING in the end.
What we need in this country is the humility to say that we simply do not know why some people are heavier than others. The decency and honesty to admit that we don't have all the answers, and that it will require a lot more money and research and instead we are WASTING our precious resources pursuing "diets" and "exercise plans' that are proven over many decades to lead to failure. That in the meantime, while we don't know what causes some people to be fat and others to be thin, we need to treat the heavier people with human courtesy and respect. That's all she is saying, and it is a message that American society desperately needs to really listen to and hear in their hearts.