Tuesday, July 31, 2007

Book Review--Rethinking Thin

(It's on my sidebar as an EWHAED rec).

Just last week, I finished New York Times writer Gina Kolata's new book, Rethinking Thin. Kolata's served as a science journalist for The Times for almost 30 years, and has published a handful of books, including Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It and Ultimate Fitness: The Quest for Truth about Health and Exercise.

In Rethinking Thin, Kolata sets out on a similar quest for truth, this time concerning the diet industry and our societal obsession with (and relentless pursuit of) being thin. In the fashion of Paul Campos's The Diet Myth and Laura Fraser's Losing It, Kolata tackles head on the diet world, the concept of the obesity "epidemic," and the idea that dietary control may result in sustained weight-loss. A University of Pennsylvania study comparing two popular diets (low calorie vs. low carb) sets the backdrop for Kolata's historical account of how we've gained weight, lost it, and then, inexorably, gained it back.

You know the "willpower" argument--the mantra we hear almost daily that encourages us to keep trying harder to lose the weight? As Kolata writes, "Who could miss the drumbeat of messages from scientists and weight loss experts, the incessant hectoring year in and year out, assuring fat people that everything is possible for those who really, really try." Well, Kolata debunks that myth with support from the science of weight, highlighting the genetic influences associated with body type. She confronts the notion that fat people are to blame for their size, instead offering a literary montage of research studies suggesting we really don't have much control over what we weigh. It's a never-ending battle against our genes, and quite frequently, concerning our expectations, they simply just don't fit.

Kolata's account is cultural at times, referring to images of the Gibson girl, socio-political at others, documenting the negative correlation between obesity and socio-economic status, and even meticulously scientific, discussing hormones and chemicals, like neuropeptide Y and oxyntomodulin, suspected to relate to hunger and weight.

It's also sentimental--we follow the journey of four dieters in the university study, empathizing with their loftiest weight-loss hopes and dreams. Even Kolata, the objective science journalist gets drawn in by the diet allure, as she cheer leads the fateful four:

I wanted it so much that I began to suspend disbelief. I knew, I knew, the science and the overwhelmingly convincing evidence that most obese people will not be able to diet, get thin, and stay at a new low weight. But. . . I allowed myself to think that maybe, just maybe these people would make it. Maybe they would fulfill their dreams.

A whole science of obesity and weight loss seems be similarly hopeful, forever searching for the weight-loss holy grail. Kolata writes:

I'd often wondered 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. Could it be that the researchers too fall for the dieter's delusion?

Or, as Kolata notes, and as others have documented before her, can an entire industry rest on the possibility of autonomic weight control, be invested in studies and products that propagate this myth?

And, the assumption that fat is bad is similarly endowed with individual, institutional, and corporate backing. As Kolata points out, a lot of people have a lot to lose if we're to continue to show that being fat is not consistent with the dire health consequences the media and diet industry would like us to believe. In fact, publication of opposing studies is often displaced by those (which, incidentally, are often not as statistically sound as their counterparts) that champion the idea that if you are fat, you will die. Kolata states:

I'd like to think also that as the population gets fatter, there might be a rethinking of the risks of a few extra pounds. When health data have not supported the alarmist cries of a medical disaster in the making, could society perhaps let up on the beleaguered fat people.

Could we? We're so invested in some of these beliefs, challenging them would require a vigilant shift in focus, an active rebellion against the status quo, and a voracious curiosity and search for the truth behind the scenes. Kolata writes: "If nothing else, I believe that that research by scientists who have open minds about obesity and its causes and consequences is starting to open doors." With help from Kolata's exposé, we may eventually arrive at a place where the "age-old assumption that the perfect diet will somehow emerge" is as much a scientific blunder as the thought that the world was flat or the idealistic misconception that physical exercise should be effortless.

Thankfully, Kolata gives us a running start.


Sarah said...

thanks for the review. I think she's one of the better science writers around. If this book is as good as her book on flu is, I'm sure I'll get a lot out of it.

Jeanne said...

Thank you for writing this review! I've added this book to my (ever-increasing) reading list.

Oh, my queendom for more time in the day to read! 8-)

Chuckles McGee said...

"Kolata tackles ...the idea that dietary control may result in sustained weight-loss."

"She confronts the notion that fat people are to blame for their size, instead offering a literary montage of research studies suggesting we really don't have much control over what we weigh."

You make it sound as though fat people can somehow violate the laws of physics. Fat people aren't fat because they consistently consume more calories than they expend- it's their genetics!

While genetics might predispose people to obesity, such a nearly static factor in the short-term cannot explain the fact that obesity rates have more than doubled in the US since 1980. Clearly factors, I don't want to say "in a person's control", but certainly more alterable than genetics have caused this change.

And yes, sustained dietary control in conjunction with regular physical activity does result in sustained weight-loss. Most people inevitably end up not sustaining their dietary control and experiences constant unhealthy fluxes in weight- but this does not disprove my assertion. It's unfair to say fat people are that way "because it's their fault" or "they lack willpower"; on the other hand, willful or not, most fat people are that way because of the lifestyle they lead.

A life-long change to a healthy diet, coupled with regular physical exercise, is enough to prevent obesity in essentially every case. Whether people can make that life-long change, willful or not, will largely determine their weight in the long-run.

Meowser said...

You are wrong, Chuckles. You are just plain wrong. I know fat people who exercise like hamsters and exercise the kind of "dietary control" you can only have nightmares about, but aren't thin and aren't getting close to it and probably never will. I myself probably eat half of what I did five years ago (and I didn't start out inhaling massive buckets of food) and exercise twice as much (and I wasn't totally sedentary then either), and my weight hasn't changed. Seriously, ask my doctors, my weight is identical to what it was five years ago, almost to the ounce.

I know you don't want to believe that couldn't possibly be, that things like dieting history and medication usage and yes, genetics could play a part in what someone weighs, but sorry, it's all true.

(Admin: If you're going to delete the troll post feel free to delete mine also.)

WifeMomChocoholic said...

I found this book somewhat depressing, but it really confirmed what I already knew. I'm not terribly overweight, nor have I ever been. However, every time I have lost weight and dropped below "overweight" status, I cannot sustain the lower weight without 2 hours of exercise a day and a 1500 calorie diet that leaves me hungry and cold all the time. In time I just can't take it and start eating more, regaining the weight.

Rosalie said...


Chuckles certainly acknowledged the role of genetics, dietary history, medical conditions in determining weight. I'm sure that there are plenty of people who, despite cautious eating and ample caloric expenditure, have trouble losing weight. In those cases you are right - it is not about willpower, it is not about control. It's about the complex mechanisms of biology that we have not fully understood.

However, these cases are more often the exceptions rather than the rule, especially when you consider the fact that thttps://www.blogger.com/captcha?type=IMAGE&captchaKey=1ihe098dmjt4l
Visual verificationhe rise in obesity corresponds to the rise in wealth&industrialization (which both amplify the opportunity of eating) as well as the rise in sedentary jobs (leading to less calorie expenditure).

Like kolata said, it's important to remain open-minded and unbiased when discussing the controversial subject of weight - and I think that requires a weight-neutral standpoint - not fatpositive, not fatphobic.

Jain said...

I am glad that people of science are delving into the reality of overweight for only when it is totally understood will a real reversal of this condition occur.

And besides genetics, the cultural aspect is equally important. It seems to me that people really are 'stuffing' emotions on a massive scale just so they can deal with each other without going 'postal'? This truly is a society that pushes 'Go along to get along.' Not really very healthy for each individual person :(

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Anonymous said...

I am not quite so optimistic that this book will have any positive effect on societal impressions. I am sure it would be a good read- her writing is easy to read and absorbing, even if I don't always agree with her positions. But we have gone too far down the skinniness-is-godliness path to change course so easily. Sadly.

To wifemomchocoholic, I think we can INDIVIDUALLY change course. I am "overweight" by the BMI scale- along with such lazy sloths as Andy Roddick, Yao Ming and George Bush. I am so happy that finally, at age 50, I can honestly say that I no longer care. I know it's hard to expect someone, especially a woman in America, to have that attitude but if you could, trust me, it is SO freeing. I am very fit and in good health, and that's all that matters to me.

Megan said...

Read the book. Went to my therapist the next week and discussed how the book convinced me that dieting is futile.

Convinced me, despite/because (?) been at this weight/eating disorder obsession for too long.

Good read.

Lyss said...

I think that, for the most part, the concensus here has been there is a lot more to dieting and maintaining a "normal" weight than genetics, willpower, what have you.
Although I have no medical or nutrition credentials, I have myself been struggling with an eating disorder for over a year now, and can say one thing for it. I realize that the weight I am at now, or even the weight I want to acheive in the future, is one that will be difficult, if not impossible to maintain once I get there, and the possibility of my yoyoing afterwards increases substantially. However, I like to think of myself as the kind of perfectionist who does not take kindly to hearing what I can and should do according to some social statistic. So it's a matter of saying "You're not like these people, and you can be the exception." I am aware that to maintain this weight I will probably have an eating disorder throughout the entire course of it all, but if that is what we are willing to accept, then so be it.
I know it's irrational thinking, and I am not pushing eating disorders on anyone, but merely comparing my own struggles with eating to, say, someone on a low carb or low calorie diet. It's the same concept. It has become a matter of what we will accept within ourselves. I wish I could say I would be fine at a higher weight if it meant I didn't have to deal with eating issues. But I am not there yet, so can deal for the time being.
I apologize if I have offended anyone, I just thought I would give another point of view.

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