Dietitians, Doctors and Aunt Sally

It’s never ending… this assertion that energy conservation explains why we get fat. Being and becoming fat is simply explained by an equation of eating a lot and not exercising enough. 

I have to get over my outrage at this thinking, this flight of causation, and instead recognize that it isn’t outrage but rather disappointment that I’m feeling. I can’t expect most people to know better since they are bombarded with this supposition of energy in and energy out. My disappointment lies with those steeped in biology or even physics that also concede to this conventional thinking. 

Even the most educated, such as dietitians and doctors and aunt Sally, poke fat people with their misunderstanding of how we get fat and what we need to do about it. You would think these “experts” should know better, or at least be modest in their supposed understanding. After all, the gaining and losing of fat tissue is not as simple as the energy model proposes, and intervention based on the model has correlated with a worsening epidemic of obesity for 50 years.

You would think these “experts” should know better, or at least be modest in their supposed understanding.

These experts assert that obesity takes hold when people eat too much and don’t exercise enough. This apparent clear causation provides the opportunity for fat people to cure themselves. Eat less and move more God dammit. It’s that simple. 

Business as usual – eat less and move more

Well it’s not that simple, and if you are struggling with weight loss, your struggle is rooted in this lazy thinking. Among the misconceptions is that fat people are cured if they are semi-starved until they’re thin. The entire misguided history of obesity research derives from a similar misconception.

When the lean or fat are semi-starved, they’ll lose weight. But when the semi-starvation ends, the lean person will go back to being lean, and the fat person will go back to being fat. Therefore, eating less is the treatment for the symptom of excess fat, but it doesn’t cure the predisposition to become fat.

The question that the dietitians and doctors and aunt Sally should ask is why some people have to semi-starve themselves to become lean while others are lean and effortlessly remain so?  

When children are starved, as in a famine, their growth is inhibited. Nonetheless, we don’t assume a child’s eating is what makes them grow. Tumor growth is inhibited when starved, but we don’t assume the starvation is reversing the tumor condition.

…we don’t assume a child’s eating is what makes him grow.

It was in the 1960s that scientists demonstrated the storage of fat in fat cells is regulated by hormones and neurological factors that are only indirectly related to how much people eat and exercise. In other words, fixing the obesity problem requires fixing the hormonal factors, not starving the fat cells and the body of fuel.  

The experts pointing out that energy conservation is a law of physics are wrong in thinking it says anything meaningful about why we get fat. We can think about energy as we think about money.

Economists would never say that dollars cause wealth even though the logic is identical to calories cause obesity. If we’re wealthy, we made a lot more than we spent. If we’re fat, we accumulated a lot of energy in fat tissue. We ate more energy than we expended. Likewise, only a comedian would state there are 20 people in a room because 20 more entered than left.

…only a comedian would state there are 20 people in a room because 20 more entered than left.

But these statements say nothing about why we get wealthy, why a room is crowded, or why we get fat. Energy balance is a law of physics. It does not specify the cause of gaining weight.

My hope is that conventional thinking will someday include an understanding that the disorder of excess fat storage requires focusing attention on the physiological mechanisms that regulate fat storage. That seems obvious, yet dietitians and doctors and aunt Sally have not been thinking this way. This is the cornerstone of the injustice that fat people struggle with.

There are many physiologic pathways that regulate fat storage, and it is complicated. Dumbing down the endocrinology and neuroscience into a conservation of energy model is kind of weird. Come on experts, can you at least mention one hormone, the hormone insulin. Insulin plays an important role in storing our fat and allowing our fat to be used for energy. Maybe that is a good place to start. 

What do you think? Is lazy thinking misinterpreting the biology of fat storage? Wouldn’t you think, after 50 years of increasing rates of obesity (particularly so in children) there would be an outcry against “eat less, move more”? It’s not working! Right?