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The Obesity Epidemic — Is Medicine Scientific? 909

An anonymous reader writes "An award-winning science author, Gary Taubes, has written a book that pans the medical community's treatment of the obesity epidemic. What is interesting is that it looks like the medical community is behaving in a very unscientific manner. Taubes points out that the current medical orthodoxy — that consuming fat makes you fat and exercise makes you thin — has no basis in research. In fact, all the available research points in quite another, and more traditional, direction. Here's the (excellent) podcast of an interview with Taubes on CBC's 'Quirks and Quarks.' So, has medicine become a non-science? Is it mostly a non-science? Somewhat?"
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The Obesity Epidemic — Is Medicine Scientific?

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  • Ugh... (Score:2, Insightful)

    by SeekerDarksteel ( 896422 ) on Tuesday November 20, 2007 @03:09PM (#21424377)
    Not more of this low-carb propaganda bullshit. Calories make you fat, regardless of whether they come from fat, sugars, or starches.
  • Science? (Score:1, Insightful)

    by Anonymous Coward on Tuesday November 20, 2007 @03:15PM (#21424481)
    There's money to be made. Stop interfering.
  • moderation (Score:5, Insightful)

    by 192939495969798999 ( 58312 ) < minus math_god> on Tuesday November 20, 2007 @03:15PM (#21424503) Homepage Journal
    what about eating in moderation with exercise? Why does it have to be so extreme, i.e. no sugar, no fat, "no" something?
    The recommended amount of exercise is 30 minutes per day -- it's actually a fair amount, if you're biking or jogging 30 minutes per day, and eating in moderation, i.e. let's say within the FDA guidelines for diet, and you're still overweight, then you might have a medical need for weight treatment. Otherwise, try all of those things first.
  • by eldavojohn ( 898314 ) * <eldavojohn&gmail,com> on Tuesday November 20, 2007 @03:16PM (#21424523) Journal

    It's done wonders for me.
    I think that's the number one problem with diet plans these days. People assume that since it worked for them it will work for everyone else. I don't think that's the case.

    To answer the questions of the summary, I don't think it will ever be an untainted science so long as the government, businesses & religion stick their noses in it. Couple that with the difficulty of applying the scientific method to humans (average life span of 75 years and ethical problems) and I think you'll see why medicine is a 'non-science.'

    Patents, legislation & belief in what is good for you are what ruin medicine. Look at all the Hindu medicine that was ignored by the West for the longest time because it was ... well, Hindu.

    Medicine will continue to be a non-science no matter how hard the community tries. The public's assumptions and beliefs that "Since I can eat McDonald's every day and be thin, everyone should be able to" merely exacerbates the situation.

    I eat whatever I feel like and I'm in great shape. This is not the case with the majority of Americans.
  • strawman logic (Score:5, Insightful)

    by mugnyte ( 203225 ) on Tuesday November 20, 2007 @03:17PM (#21424535) Journal
    "For 50 years, the advice on dieting has been very clear..."

      Um, hardly. This kind of sentence attempt to draw the reader into a sense of agreement from their most-remembered anecdotes so that the rest of the premise is seen as new. But in reality, fad dieting advice is all over the map and has been since it was part of pop culture, which goes back a *long* way. Spoonful of mercury, anyone?

      The only good dieting advice has been through a good understand of one's own body. Allergies, lifestyle, location, education, economics, etc all play roles in what chemicals you put in your and how you burn energy.

      This book's position is just another in the lineup of positions taken about the human GI system and energy usage. There are many strategies, both workable and not. Unless you know yourself well, no change is a worthwhile change - its all so much guessing.

      Additionally, one has to ask the philosophical the goal to eat yummy/available food or live [potentially] longer lives? There's no one answer, really.

  • by bigdavex ( 155746 ) on Tuesday November 20, 2007 @03:17PM (#21424541)

    In fact, according to Mr. Taubes, everything the medical profession advocates, in terms of eating and exercise, is at best a waste of time, and at worst, may actually be killing us. He says it isn't fat we should be worrying about, but instead carbohydrates, especially white flour and white sugar.

    OK, who doesn't recommend whole grains and avoiding sweets for overweight people? The quacks are all over the place, but I think we know (and have known) that vegetables & whole grains are the way to go.
  • Re:Ugh... (Score:1, Insightful)

    by Anonymous Coward on Tuesday November 20, 2007 @03:19PM (#21424591)
    Calories make you fat

    I propose that the increase of mass of a person is equal to the mass they take in minus the mass they shit and piss out, give or take a few O2 and CO2 gasses inhaled and exhaled, regardless of the number of Calories present in the food. While it's clear that the composition of mass taken in would affect how that mass is used in the body, it's not so clear that having a greasy burger makes you fatter even by the amount of grease and fat in the burger (as suggested by the greasy shit you have afterwards).

    It's not medicine that's being unscientific, it's all the people who are so damn certain that if bad things happen to someone they must have done something bad, because otherwise their whole faith collapses in on themselves. Obviously God would only have made you an ugly fat loser if you sat around on your ass all day while shoving cake and greasy burgers down your gaping maw, therefore all ugly fat losers must have sat around on their ass all day eating crap.
  • by bigdavex ( 155746 ) on Tuesday November 20, 2007 @03:21PM (#21424623)

    I eat whatever I feel like and I'm in great shape. This is not the case with the majority of Americans.

    What do you like to eat?
  • Re:Ugh... (Score:2, Insightful)

    by BECoole ( 558920 ) on Tuesday November 20, 2007 @03:21PM (#21424627)
    The plain fact is that you can eat more calories without getting fat when those calories come from fat and protein. This has been known for hundreds of years and was even documented in the 1800s.
  • geeze (Score:3, Insightful)

    by nomadic ( 141991 ) <.moc.liamg. .ta. .dlrowcidamon.> on Tuesday November 20, 2007 @03:22PM (#21424649) Homepage
    So, has medicine become a non-science? Is it mostly a non-science? Somewhat?

    You think this article is about "medicine" in general? This is about a tiny branch of medicine dealing with nutrition and public health.
  • by physicsboy500 ( 645835 ) on Tuesday November 20, 2007 @03:24PM (#21424685)
    I have a big gripe with saying the "medical community" or stereotyping the entire medical field as saying diet and exercise is the only component to obesity.

    For the last thirty years, medical advice on obesity has been very clear. Eat less and exercise. But what if that was all wrong, a big fat lie, as Gary Taubes would put it?

    In fact, according to Mr. Taubes, everything the medical profession advocates, in terms of eating and exercise, is at best a waste of time, and at worst, may actually be killing us.
    Of course medical advice is clear. Exercise does make you healthier and stronger. It helps your immune system and metabolism. It is true that you should only exercise the amount you are able, and that over-exercising can put added and unnecessary strain on important organs which can be dangerous. One thing that the medical field is learning though is that a good portion of your body shape is due simply to genetics. The "medical community" has not been caught up and derailed by the "diet and exercise" bandwagon. They are currently doing more and more research into the amount we are affected by our own genes.

    There are some doctors who do not have the absolute latest information and they will sometimes claim that diet and exercise are the only thing that is making someone larger and there are (of course) a few scam artists trying to make a buck off the "simple little pill" or "this is the only piece of equipment you need to be thin" commercials and insatiably people will fall for it.

    The point is, the medical field is right in giving this person that advice. He should eat less, he should exercise. It WILL make him healthier. It may not make him look like Brad Pitt, and he (probably) always be larger than normal, but just because a component of obesity is genetics does not mean everything to do with obesity is genetics. It also does not mean the "medical community" is stuck in the stone age with "non science."
  • Not more of this low-carb propaganda bullshit.

    I understand your anger, but the issue here is whether the low-carb propaganda is really bullshit or not. It is a matter that should be investigated, otherwise those dismissing it as bullshit would effectively act as anti-low-carb zealots, instead of following the scientific method.

    Also, we have to wonder why the US (the country where the Food Pyramid originated) is also where the "fatness" phenomenon originated, and why the countries that start to follow the "american way of life" (fast food, sedentary life, high-calory carb snacks) tend to follow american's fatness. This phenomenon, at least country-wise, behaves like an epidemic.
  • Re:moderation (Score:3, Insightful)

    by Moraelin ( 679338 ) on Tuesday November 20, 2007 @03:35PM (#21424903) Journal
    Well, making a broad generalization, is because people

    A) want miracle solutions, and

    B) preferrably ones that require less effort on their side, and

    C) want more to look like they're doing something, than to actually do something. (The incompetent manager syndrome.)

    So between something like (I) just eat less calories than you use, and something like (II) just stop eating bread, the latter will win on all accounts.

    The latter requires less discipline and willpower, less counting, less putting up with meals that taste insipid for lack of fat, no getting off the sofa and exercising, etc. It's simply less effort. And it's sold with enough hocus pocus and scientific-sounding words to sound like magic to the uninitiate. (Somethimes it does have some science behind it, sometimes it doesn't, but that's all irrelevant anyway to Joe Sixpack who wouldn't know what a complex carbohydrate is if it bit him in the arse.) And it's something as conspicuous as it gets. You don't have to wonder whether you're doing it right. See, it's without bread! I'm doing something!

    Now again, I'm not saying that Atkins is necessarily bad. But there was plenty of other stuff which didn't have any scientific basis and got swallowed by the masses anyway, on account of the three points above.

    Between (1) all the effort of exercising and dieting, and (B) conspicuously waving some magic wand, the average Joe Sixpack will choose the latter every single time. That's all I'm saying.
  • Re:Ugh... (Score:4, Insightful)

    by rucs_hack ( 784150 ) on Tuesday November 20, 2007 @03:36PM (#21424925)
    Not more of this low-carb propaganda bullshit

    What annoys me is low carb stuff tastes bad, so they up the salt content, or put more of other things that improve the taste but make it bad for you in other ways.

    Eating healthy means cooking a lot of your own food from ingredients, not pre-packaged food, and getting exercise every day. Exercise is an important part of a healthy diet, you digest food better if your body isn't always being carried around everywhere by cars or sat in chairs.

    Eating healthy doesn't even mean low fat, it can involve fat, suger, salt, anything, provided you eat reasonably, are aware of what your eating (meaning you cook a lot of it yourself) and get that exercise.
  • Yes and no. (Score:5, Insightful)

    by Valdrax ( 32670 ) on Tuesday November 20, 2007 @03:40PM (#21424983)

    Calories make you fat, regardless of whether they come from fat, sugars, or starches.

    This is absolutely true. You can't dispute the fact of this statement taken in isolation. In isolation.

    However, it's a fine example of blinding yourself to the causes. The questions at the heart of the debate between low-carb and low-fat diet proponents are the following:
    1. Does eating certain types of food allow for the intake of more calories before being satisfied? (e.g. Pork vs. chicken; fruit vs. Twinkies)
    2. Do certain foods increase hunger? (i.e. Effects on insulin and other hormones)
    3. Do certain foods have other health issues than weight? (e.g. Saturated vs. unsaturated fat; sugar-intake & diabetes.)

    So just saying calories are calories is like saying BTUs are BTUs and putting heating oil in your gas tank in the hopes of getting better MPG.
  • by bodhijon ( 991528 ) on Tuesday November 20, 2007 @03:42PM (#21425017)
    Isn't it possible that your weight loss is due to "cutting out enormous amounts of carbs and sugars," including the 1k calories and soda, and not to the extra olive oil and cream? Congrats on losing the weight, I don't want to undercut that, but the subject line of your comment seems like a bit of a logical leap.
  • Somewhat (Score:3, Insightful)

    by ahoehn ( 301327 ) <andrew.hoe@hn> on Tuesday November 20, 2007 @03:46PM (#21425083) Homepage
    Is medicine science? Sometimes.

    Being married to a medical student who's going through a year of trying different specialties has been very illuminating. Some specialties, like pathology, are almost entirely scientific. Others, like orthopedics are largely mechanical, as are most surgical specialties. Specialties like family practice and pediatrics involve a fair bit of science, but also depend heavily on personal interactions. And of course every physician, just like every person, is subject to their bias.

    My wife and her fellow medical students frequently talk about how for your first two years of medical school you're taught science, and for your last two years of medical school you're taken through the hospital and told how everything you just learned is useless.

    If medicine could be reduced to a set of scientific rules, it could be practiced by robots. Until that happens, we're stuck with our un-scientific doctors.
  • by mtgarden ( 744770 ) on Tuesday November 20, 2007 @03:47PM (#21425107)
    By increasing my exercise, hitting a minimum of 10,000 steps a day, consuming less "sweets" and smaller portions of food, I have lost 20+ over the last three months. I have worked to lose the weight in a manner that creates a sustainable eating and activity style for life.

    This has been working for me. Who knows about you, but I suspect that with some self-discipline and a change of habits, most people could lose weight.

    On this point, I read a great humorous book (true story) about a man's effort to lose weight: []
  • by igotmybfg ( 525391 ) on Tuesday November 20, 2007 @03:49PM (#21425151) Homepage

    Nor is he a research scientist. He is an author, and his goal seems to be to sell books, not to add anything to the scientific community.

    I have found that if I eat more calories than I burn, I lose weight (and vice versa!), no matter what kind of calories they are. When I go on long hiking trips, or field exercises with my military unit, I'm very active and burning more calories than I take in, and I lose weight. Conversely, when I sit at home for a week and eat turkey and watch football, I gain weight.

    Incidentally, if you have a problem with your plumbing, then it's clear that an auto mechanic probably won't be able to give you good advice; if you have a problem with your plumbing, you should talk to a plumber. In the same way, if you want information about your body, you should probably get it from your doctor, rather than some random person who had a Bright Idea and wrote a book about it.

  • Re:Ugh... (Score:5, Insightful)

    by RobFlynn ( 127703 ) on Tuesday November 20, 2007 @03:54PM (#21425271)
    You basically said it here -- the "diet" doesn't matter so much -- if people would stop eating foods that suck and if they'd get up off their butts sometimes, then they will be healthier.

    My mother has been overweight for some time. She has a medical condition which caused it. She ate well and exercised and she was still overweight. She just couldn't do anything about it. Doctors prescribed her some medication to help the issue, but itcaused all kinds of problems, so she went off it. She gained the weight back. People like that are pretty much the only ones I feel sorry for when it comes to weight.

    Hell, I could stand to lose a good 30lbs myself. And ya know what, I'm the one to blame? I'm a computer programmer that sits around eating crap all day. That's my fault. I also used to be very fit, and that was also my doing. I ate well, actually, more than I eat now, and did a little bit of exercise.

    It just takes a little effort and common sense. Most people want the magical easy solution...
  • by badasscat ( 563442 ) <basscadet75@yah o o .com> on Tuesday November 20, 2007 @03:56PM (#21425297)
    I understand your anger, but the issue here is whether the low-carb propaganda is really bullshit or not. It is a matter that should be investigated, otherwise those dismissing it as bullshit would effectively act as anti-low-carb zealots, instead of following the scientific method.

    Ok, here's your scientific study:

    Asians eat carbs with almost every meal (rice, noodles). They are thinner than us. End of story.

    Excess calories make you fat. That's a law of physics; I have no idea why some people dispute it. It's like arguing with the law of gravity. The only question is whether calories coming from different sources are absorbed more slowly or quickly, but the end result is the same unless you're exercising to stay in shape. A calorie is a unit of energy and if that energy is not used, it must be stored. Energy doesn't just disappear into thin air; when you consume it, you either use it or you store it.

    And I really don't think there are any scientists out there saying otherwise; I don't know of any scientist saying "eating fat makes you fat" or even "eating carbs makes you fat". The only time that's ever said is in the context of certain types of high-fat or high-carb foods generally being higher in calories, which is true. Although again, Asians eat plenty of fatty meats along with their carbs and they're still thinner than we are. The reason is they just eat less. Which means fewer calories.

    Not rocket science. And we've got all the knowledge we need.
  • Re:Ugh... (Score:4, Insightful)

    by ShieldW0lf ( 601553 ) on Tuesday November 20, 2007 @03:56PM (#21425309) Journal
    Medicine is scientific where it can be. Any time in which you must observe a group that consists of humans, you are incapable of running multiple tests across multiple generations. You're dead before you find out what long term effect a lifestyle can have.

    As for being fat. If you eat like a predator, you'll have a body like a predator. If you eat like a herbivore, you'll look like one.

    So, eat huge portions of animal flesh, late in the day, and stay away from sugars and starches, and you won't look like a cow.

    The more you force your body to get its energy from fat, the better it will get at doing it.
  • by raddan ( 519638 ) on Tuesday November 20, 2007 @03:56PM (#21425317)

    Medicine will continue to be a non-science no matter how hard the community tries.
    This is untrue. While there are many questions which science is ill prepared to investigate, this is not one of them. Science cannot answer questions about metaphysics, mysticism, and so on, because those subjects have nothing for the tools of science (thesis, antithesis, and synthesis) to work on.

    Medicine is complex. But that doesn't stop or discourage scientists. The world is complex. Science has always, and will always, face this issue. Medicine is a perfect subject for the application of science. Do physicists give up because certain things are not directly observable? Those working in public health have to work with what they're given.

    I would much rather my doctor give me advice based on years of compounded peer-reviewed research than an opinion based on anecdote. Because, without science-- that's what you're talking about.
  • Re:Ugh... (Score:5, Insightful)

    by NeutronCowboy ( 896098 ) on Tuesday November 20, 2007 @04:02PM (#21425435)
    You're like every customer who calls into customer support: they know the symptoms, are vaguely aware of the underpinnings of the machine and are absolutely convinced they know what the issue is.

    Do yourself a favor, and treat your next interaction with your doctor like a call with tech support: understand that they know more about how the system is supposed to work than you, understand that you know more about how your system works than them, transfer that knowledge to them, and be patient while they wade through the standard troubleshooting steps (did you reboot your machine? do you get enough sleep/vitamins?).

    You'll actually have a chance of getting some use out of them, and live a better life.
  • Re:Ugh... (Score:3, Insightful)

    by TheMadcapZ ( 868196 ) on Tuesday November 20, 2007 @04:08PM (#21425523)
    This is a good scenario on how it is supposed to work, but most doctors spend so little time with a patient that they do not listen to you, they assume they are always right. It is more profitable for a doctor to kick business towards a drug company than it is to actually help cure you of what is causing your symptoms. I wish it worked as you describe. maybe there are a few doctors out there that still help people, I wish I had found one.
  • by cbr2702 ( 750255 ) on Tuesday November 20, 2007 @04:16PM (#21425651) Homepage
    "Excess calories make you fat. That's a law of physics; I have no idea why some people dispute it. It's like arguing with the law of gravity. The only question is whether calories coming from different sources are absorbed more slowly or quickly, but the end result is the same unless you're exercising to stay in shape. A calorie is a unit of energy and if that energy is not used, it must be stored. Energy doesn't just disappear into thin air; when you consume it, you either use it or you store it."

    This would require human waste to have no caloric value.
  • by Kohath ( 38547 ) on Tuesday November 20, 2007 @04:27PM (#21425811)
    Now, most of the food in Spain except for the ham, seafood and churros is bordering on objectively disgusting, but everyone I saw over there is very thin.

    What do you mean "but"?

    If most food were "bordering on objectively disgusting" in the US, folks would eat less of it and be thinner.

    I think this is the #1 cause of obesity. Our food is damn tasty by any standard. And even though tastes differ, there's something great for everyone. Eating food in the US is a positive experience beyond satisfying hunger. So people eat it past the point where they are hungry for it. And they get fat.
  • Re:Ugh... (Score:4, Insightful)

    by SetupWeasel ( 54062 ) on Tuesday November 20, 2007 @04:30PM (#21425873) Homepage
    Umm. I don't agree with the low-carb fad, but using conservation of energy as your rationale is utterly moronic and has no relevance to the issue. It is a gross oversimplification, and ignores any process that might selectively absorb (or not absorb) and store (or not store) different compounds. Of course the energy is conserved, the question is how and where it is conserved.
  • Re:Ugh... (Score:3, Insightful)

    by Kohath ( 38547 ) on Tuesday November 20, 2007 @04:41PM (#21426071)
    Of course the energy is conserved, the question is how and where it is conserved.

    Calories are energy. Fat is energy storage. Using more energy (Calories) than the energy (Calories) you consume will always result in less energy (Calories) stored.

    Yes, this is a simplification. But it can not be contradicted. There is no magic.
  • by sitarah ( 955787 ) on Tuesday November 20, 2007 @04:47PM (#21426173) Homepage
    "Calories in, calories out. It's so easy!" You are missing the point and the reason all these low-carb, low-fat, low-whatever suggestions exist. Calories in, calories out works in a lab environment where you can measure intake, consumption methods, and waste precisely. You cannot do that with humans. There are too many variables.

    1) You don't know what your calories out are.

    You have no idea what you are really burning, standing around, unless you get a battery of tests performed to check your metabolism, lung function, and body heat during any given activity.

    There are a ton of things that affect your metabolic rate; your core temperature, insulin levels, sugar sensitivity, allergies, your inclination to fidget, whether you are building muscle at a given time, whether you are healing wounds or recovering from sickness. There has even been researching suggesting that 3 months of consistent exercise actually changes your energy consumption at a mitochondrial level. Did you know soy and broccoli reduce the level of iodine in your body and therefore inhibit metabolic function?

    2) You don't know what your calories in are.

    You know what the government knows about broccoli: that if you light it on fire, it burns at x rate, and it leaves behind x waste. They extrapolate its structure from there. That has nothing to do with how well your body actually digests the food and uses that energy. You could have an extremely acidic stomach, or lock up calories with excess fiber, or drink too much and hurry food through your intestinal track before you can extract all its energy.

    You also don't know how well-marbled their test steak was, how saturated with water their chicken breast was (did you know supermarket chicken is injected with saltwater?), or how aerated their whipped cream was. This will all lead to a difference in caloric value. These little differences all add up.

    These diet plans that discard certain foods do so with the idea that we might be able to find a diet that works by minimizing a variable; eat fewer carbs to reduce insulin levels, isolate sugar sensitivity, eat less wheat to minimize allergies, eat less meat to reduce hormones, salt, and saturated fat, etc.

    Asians are genetically different; they have different musculatures (they might have smaller thighs, for instance, meaning they burn less calories because that's a very large muscle group), different insulin levels, they may produce heat differently than Europeans due to their environment. There's also cultural differences; less dairy, more lean meat, etc. You're just not making an apples to apples comparison.
  • by wurp ( 51446 ) on Tuesday November 20, 2007 @04:51PM (#21426253) Homepage
    Everything you list there simply says that doctors are required to know stuff. Ostensibly that stuff is derived from scientific studies, but knowing a fact derived via science is not at all the same thing as knowing how to do science.

    Science is about observation, forming hypotheses, building good experiments to validate them, performing those experiments, and using statistical methods to reason about the implications of the results of your experiments.

    Just because you remember a bunch of things you are taught doesn't mean you know science. If you don't have some backbone of researchers doing science to verify the stuff you think you know, it's not science, it's just stuff.
  • by km9 ( 1191897 ) on Tuesday November 20, 2007 @04:52PM (#21426275)
    It may feel scientific to blackbox a complex biological system and say you must lose fat if you change the thermodynamic equation - end of story. But that's not science.

    Science would be to actually test how well diets and/or exercise work on a group of people. And over and over for decades such studies have shown that the weight lost is very small, and what weight is lost isn't maintained. That goes for studies of animals too. That's science. And it is true that most clinicians ignore that science and give advice based on a hypothesis that has been for the most part falsified by in vivo studies.

    The reason the hypothesis fails is because the system that's been blackboxed regulates fat homeostatically. Just like hydration, carbon dioxide levels, and temperature are regulated - fat mass is also regulated - largely through hypothalamic monitoring of circulating leptin and insulin levels.

    What most people don't understand - because they don't plug numbers into the equation - is how closely the body has to maintain the energy balance. A 1 or 2% overage or underage will rapidly lead to massive obesity or death by starvation. So there's a very powerful and very finely tuned system that controls how much we eat and how much we expend by monitoring our fat mass. This is true of the very fat and the very thin. It makes sense when you think about it, but most people don't.

    So the body aggressively tries to maintain homeostasis - that is keep fat mass within a given range - by adjusting appetite, metabolism, the relative deposition and breakdown of lean mass and fat mass, and the various forms of physical activity. You have some conscious control over some of these factors, but when you start falling outside the comfortable range - whether or not you are still "fat" - you are fighting homeostatic controls that are very hard to keep at bay long term.

    (Generally people who are well below their comfortable range feel extremely hungry, tired and slothful, cold, depressed, etc. And most of all they become obsessive about food. As you can see these are all the body's ways of trying to encourage a positive energy balance. And it's no way to live.)

    This kind of mechanims is why it would be very difficult to maintain dehydration indefinitely without drinking. And this is also why it's easy to hold your breath for 10 seconds, but not 3 minutes.

    Most fat people - like most thin people - are staying within their range - and most who aren't trying to lose weight and thereby weight cycling maintain remarkably stable weights - just higher weights than we would like.

    The real long-term solution to obesity will probably come from finding ways to manipulate the set point so that individuals with dangerously high weights don't have to live their entires lives battling (for the most part futilely) powerful internal regulatory controls just to maintain a weight loss. It is possible that the set point can also be prevented from going too high - but that too is just a hypothesis at this point, and how that can be accomplished isn't clear.

    But that understanding among obesity researchers is why most of the focus on obesity is now on prevention in children. And why the research is targeting earlier and earlier ages - including the prenatal environment. I'm not entirely sure that that's a clear-headed strategy because as of yet there have been no interventions shown to be successful at preventing obesity in children either. But there is less evidence than in adults that the project is futile.

  • by Anonymous Coward on Tuesday November 20, 2007 @04:54PM (#21426307)
    His being or not being a doctor has no direct relationship to him being right or wrong. That's an inverse argument from authority.
  • by ArhcAngel ( 247594 ) on Tuesday November 20, 2007 @05:05PM (#21426481)
    Ok, here's your scientific study:

    Asians eat carbs with almost every meal (rice, noodles). They are thinner than us. End of story.

    EXTREMELY scientific....thank you

    Excess calories make you fat. That's a law of physics

    Wouldn't that be a law of biology or perhaps chemistry?

    I think this chart might be useful-

    The emphasis on performance and beauty in modern America has greatly increased American's stress levels overall. To cope with said increased stress please pick from the list below:

    1) Exercise (You're joking right? that takes time, effort, and sweat)
    2) Smoking (that's so twentieth century. Besides it causes lung cancer and stuff)
    3) Drinking (I'm morally upstanding and do not imbibe! humph)
    4) Socialize (What if other people think I'm weird or somthin?)
    5) Eat (Everybody eats. Nobody will notice if I eat a little more than usual. I don't have to feel guilty.)

    Every item in the above list requires a relatively substantial investment or has a stigma attached to it except eating. Obesity takes time but eating provides immediate comfort rewards without being conspicuous. I can speak from experience. I have been overweight most of my life and no one has ever questioned me about my eating habits but if I pick up a beer I get several astonished looks from people I know.

  • by ceoyoyo ( 59147 ) on Tuesday November 20, 2007 @05:08PM (#21426527)
    Medicine is becoming more scientific, thus he emphasis on scientifically trained doctors. It didn't used to be that way though. Medicine is a very old profession, predating rigorous science. There's still a lot of medical knowledge that isn't strictly scientific, but we haven't gotten around to studying scientifically yet. There are also a lot of older physicians and surgeons (particularly surgeons) around who may not have as good a grounding in scientific method.

    It's definitely not the case with anybody educated in the last decade though. I'm on the science side of clinically oriented research and we work side by side with practicing clinicians. When they argue they cite papers and large studies.
  • Re:Ugh... (Score:3, Insightful)

    by QMO ( 836285 ) on Tuesday November 20, 2007 @05:09PM (#21426535) Homepage Journal
    You may want to check this [] page to see a different perspective. Most interesting to me is in the second paragraph on the page.

    Glutamate is a naturally occurring amino acid that is found in nearly all foods

    The human body also produces glutamate and it plays an essential role in normal body functioning.
    So, glutamate isn't inherently bad for you.

    Sodium isn't inherently bad for you either.

    Put them together and what do you get?
    Something that splits up into those two harmless pieces almost immediately.

    Compare to
  • Re:Ugh... (Score:5, Insightful)

    by pragma_x ( 644215 ) on Tuesday November 20, 2007 @05:16PM (#21426673) Journal

    As for being fat. If you eat like a predator, you'll have a body like a predator. If you eat like a herbivore, you'll look like one.
    I know this is tongue in cheek, and I tend to agree, but it made me think. I sure do want some BBQ right about now.

    To be fair about it, predators also eat the bone, blood, organs, entrails and even the ruminate inside. They need to since flesh (muscle and skin) doesn't have the mineral and vitamin content an animal needs to survive.

    So, be sure to have a nice slice of kidney pie, bone meal, some chitins, and liver with that hamburger! Yum-o.

    Honestly, you'll get farther eating like the omnivore you are: meat, vegetables, herbs, fruit and few processed carbs and sugars.
  • by mathmathrevolution ( 813581 ) on Tuesday November 20, 2007 @05:21PM (#21426745)
    What are you talking about? Spanish cuisine is fabulous. They really get the spice right and produce very rich dining experiences that are actually quite healthy. Tortilla Espanola, Paella, Sopa de Mariscos, Fabada Asturiana, Gazpacho: all of these are great dishes. If you honestly prefer American "cuisine" (fast-food, processed food, junk food) to Spanish cuisine (made with real ingredients like honest-to-God plants and animals) ... well, I'm not going to argue with you. But I think its tragic that your palate has become so acclimated to the industrial by-products of our nation's subsidized corn surplus that it can't even recognize real food anymore.
  • by drooling-dog ( 189103 ) on Tuesday November 20, 2007 @05:26PM (#21426849)

    However, he provides and discusses a solid body of relevant and eminently respectable (Lancet, JAMA, NEJM, etc..) citations to support his claim.
    Keep in mind, though, that he cherry-picks his evidence to an extent that would never pass peer-review itself. He's also misrepresented quite a few of his sources to the point where they're too angry to talk to him anymore.

    I wouldn't dismiss everything he says out of hand, but it's important to note what the weight of the available evidence says, and not just the 5% of it that he cites (sometimes wrongly) in support of his thesis. Unfortunately, those seeking a simple classification of all foods into unequivocal "good" and "bad" categories are probably never going to be satisfied with the state of the science.

    On a final note, I'd caution against anyone who has all of the answers but says that the "research establishment" is involved in some sort of massive, sinister conspiracy to suppress them. Things just don't work that way.
  • Re:Ugh... (Score:2, Insightful)

    by Kohath ( 38547 ) on Tuesday November 20, 2007 @05:28PM (#21426883)
    If you understand this, it should be obvious that digestion can be a fairly complex process, not all food is equal, and you can't measure the "calories" in a food as if you had a gas gauge.

    Yes you can. No matter how complex the process, energy is neither created nor destroyed. It is either used or stored. If you use more energy than you take in, the deficit is made up from the body's stored energy. This results in weight loss if continued over time.

    It's amazing that there's even an argument. What's next? Gravity doesn't pull things down because sometimes there is wind and they go a little sideways for a while?

  • by Jesus_666 ( 702802 ) on Tuesday November 20, 2007 @05:31PM (#21426921)
    Our food is damn tasty by any standard.

    Except for the fact that your bread sucks (I mean, it's not even gray). And you don't know how to make sausages. And you coat everything with sugar. You don't know how to make proper beer, either. Or chocolate.

    Let's just agree that there are a whole lot of standards our there, okay? The fact that fast food is poular around the world doesn't mean that all American cuisine is. Unless American cuisine consists of nothing but fast food, in which case I feel sorry for you.
  • by nunyadambinness ( 1181813 ) on Tuesday November 20, 2007 @05:40PM (#21427061)

    I'm not splitting hairs at all.

    I'm sorry, but yes you are. Given the context of the discussion, it's pretty ridiculous to bring up calories from sources we can't digest. They're irrelevant.

  • by squidfood ( 149212 ) on Tuesday November 20, 2007 @05:40PM (#21427065)

    -Doctors routinely change their treatment regimens based on an ignorant patient's suggestion. (else why would pharmas invest so much in TV ads and drug bimbos?)
    -Doctors are more than happy to mandate strict entry requirements, but not require that they be routinely re-tested based on the latest science.
    -Why there's so much subjectivity in medicine (why doctors can disagree on treatment).

    Let's use slashdot terms. The MDs are the engineers and the Med PhDs are the physicists. An engineer needs to learn physics, but in designing buildings day-in, day-out, he may rely on specific products that were even the subject of marketing (concrete, fasterners, etc.) and may have to listen to the needs of the ignorant patients (in other words, the architects). He has to make his own effort to keep knowledge current, may rely on his own rules of thumb that other engineers disagree with, and sometimes the most competent engineer falls behind the cutting edge. And yes, he can make mistakes, and there are incompetent ones.

    But damn if the buildings aren't solid.

  • by TrekkieGod ( 627867 ) on Tuesday November 20, 2007 @05:42PM (#21427101) Homepage Journal

    Calories in, calories out works in a lab environment where you can measure intake, consumption methods, and waste precisely. You cannot do that with humans. There are too many variables.

    You don't know what your calories out are

    You don't know what your calories in are

    Which would be a great point if I was trying to determine exactly how much I should eat to lose 10.3 lbs in 35.7 days. However, I don't need anywhere near the precision you're talking about there. There aren't "too many variables." There's only one variable that matters: Calories. So I don't know exactly how many calories the broccoli I'm eating or the meat I'm eating has. However, those tests are pretty good estimates in telling me the calorie density of foods, and I can substitute more calorie dense foods (like chocolate cakes) with less calorie dense foods (like fruits) and know that I'm eating less calories. Then I can weigh myself and see if I'm losing weight. If I'm not, I can eat less and / or exercise more (use up more calories) until I do start losing weight. It will work. Guaranteed. Because the only thing that matters is that I eat less calories than I use up and I will lose weight. It doesn't matter what the exact numbers are.

    And I lost 50 lbs recently by doing just that. And my roommate lost 100 lbs by doing that. And another friend lost about 40. I don't know anyone who actually stuck with said method and didn't lose weight. And if I did know someone, and verified it, I'd tell him to go claim James Randi's prize, because it would be a physics-defying supernatural event.

    Now to be fair, it can be complicated, because of the psychological aspects of dieting. Dieting sucks, and if you don't stick with it, it won't work. I have cravings for chocolate cakes and I hate fruit. So any diet that gives you a little cheating room and is based on substituting calorie dense foods with less calorie dense foods is likely to be more successful then diets that give you extremely small portions of food and don't allow you to ever have days off, simply because I'm not likely to have the willpower to stick with that second diet. In addition, you need to make sure you're getting your proper nutrition from whatever diet you're at if you want to remain healthy.

    So, there are diets that are better than others, but the losing weight equation just boils down to calories.

  • by Rutulian ( 171771 ) on Tuesday November 20, 2007 @05:57PM (#21427341)
    1) You don't know what your calories out are.
    2) You don't know what your calories in are.
    Asians are genetically different

    Yes yes, those are all variables, and there are a ton more. But you're missing the point. The specific variables that determine an individual's metabolic rate and efficiency are important for accurate quantification, but irrelevant to simply monitoring your diet. Just look at your body and make comparisons every several months. Are you putting on muscle mass? Are you putting on weight? Are you losing hair? Do you feel sluggish during the day or are you energetic? Are you losing weight? These are all questions that can be easily answered qualitatively by someone who is paying attention. Then start looking at your diet and exercise. How much food are you eating? How much exercise are you getting? What kinds of food are you eating? What kinds of exercise are you doing? If something undesirable is happening (ex: gaining weight by storing fat), is it because your food intake has increased? Or has your diet changed? Or are you exercising less? Again, questions that can be easily answered by someone who is paying attention. Once you know the answers, you can take corrective action.

    The metabolic details of what is going on is good to know, and research should continue in this area, but don't pretend appropriate corrective action can't be taken just because we don't know all of the details yet. The thing is, people want to talk their way out of the consequences of their behavioral choices. Yes, it is hard to start exercising if you aren't already in the habit of doing it. It is hard to stop eating McDonald's for dinner when you come home after work and are tired. But, simple corrective remedies have existed for ages, and if you just act on them you can live healthier. Is a low-carb diet better than a low-fat diet? Maybe. But that's a question that isn't going to be answered thoroughly for quite some time. In the meantime, start eating less and exercising more. Avoid things that are known to be very bad for you, like trans-fats, and use moderation when deciding what to eat. Some caffeine is ok. Too much is probably not. Some refined sugar is ok. Too much is probably not. Etc....
  • by carlcmc ( 322350 ) on Tuesday November 20, 2007 @06:18PM (#21427609)
    He espouses the notion that lower cholesterol levels are not healthier. That statement is so much total bunk that it is on the order and level of other statements like "Smoking doesn't cause cancer" "The earth is flat" etc.

    Conclusive proven evidence shows that the lower your cholesterol or the more you *lower* your cholesterol, the lower the risk of heart disease related events etc. Not even worth our time to discuss. A frank waste of time and valuable intertubes!
  • by m2943 ( 1140797 ) on Tuesday November 20, 2007 @06:38PM (#21427889)
    I'm a darwinist, I think the problem will take care of itself.

    Obesesity doesn't kill people fast enough to keep them from reproducing.
  • by tooslickvan ( 1061814 ) on Tuesday November 20, 2007 @06:38PM (#21427901)

    Our bodies were designed to walk a minimum of 35-40 Kilometres a day
    You may have your numbers mixed up because 35-40 Kilometres (22-25 miles) a day is the limit of a normal person can walk in a day, not the minimum.
  • Re:Ugh... (Score:3, Insightful)

    by node 3 ( 115640 ) on Tuesday November 20, 2007 @07:14PM (#21428359)
    Your answer is absolutely correct. The problem is it answers the wrong question. People aren't asking, "physically, why is my weight what it is", but, "diet-wise, what can I do to lose weight?". Simply answering, "either decrease input, or increase output," is physically correct, but does not answer the question, "what *can* I do?" No one has full rational control over what they eat. Evolution couldn't allow that.

    Eating the same foods, but less, is not a generally viable long-term solution. The main reason is that it's exceptionally difficult to maintain a diet where you parcel out your calories based on a desired result. Generally, the amount of food we eat is dictated by hunger, which is why it's extremely difficult to significantly (and sufficiently) the *amount* of calories we eat of any particular food in the long term.

    Fortunately, not all foods affect hunger in the same way. This means that we can indirectly affect hunger by the foods we *do* choose to eat, which will naturally lead to a different caloric intake. So instead of the *extremely difficult* task of eating less indefinitely, we can instead take on the much easier (but not necessarily "easy") task of changing *what* we eat, to effect the same weight-related results.

    That's the "input" side of the equation. There's also things that can be done to affect the "output" side. But *neither* side is properly addressed by merely saying, "conservation of energy."
  • by MBraynard ( 653724 ) on Tuesday November 20, 2007 @07:33PM (#21428577) Journal
    True - at least calorically (sp?). Certainly not taste-wise.
  • by Colin Smith ( 2679 ) on Tuesday November 20, 2007 @07:53PM (#21428849)

    I'm sorry, but yes you are. Given the context of the discussion, it's pretty ridiculous to bring up calories from sources we can't digest.
    No, you are wrong. This discussion is largely being predicated on the statement that any one calorie is just like any other calorie. That weight gain is a simple matter of calories consumed minus calories burned. Clearly this isn't the case. I've just given an example where the chirality of an otherwise identical molecule with determines the usefulness to the body.

    The same is true for fats, proteins etc, it isn't a simple case of calories in and calories out, they all push specific chemical processes which have specific effects on the body and it's function. If the balance is wrong, people become malnutritioned. Replace calories supplied by sugar with calories supplied by proteins and there is an entirely different effect on the body.
  • Re:Ugh... (Score:3, Insightful)

    by jafac ( 1449 ) on Tuesday November 20, 2007 @09:10PM (#21429635) Homepage
    I agree; that there HAS to be more to it (obesety) than simply Calories_in-energy_expended=stored_fat.

    I tried several diets, including weight watchers, and was even temporarily successful on the Atkins diet. At one point, when I was 230 lbs, I was eating a certain quantity of food per day, and had a certain quantity of physical activity per day, and just plain not losing weight.

    Now; I am on a pharmaceutical appetite suppressant. I'm maintaining 180 lbs. During the weight-loss phase of this program, I was eating the same quantity I was eating while I was on that diet. I was somewhat LESS physically active on this program than I was on the previous diet, on a day-to-day basis. Over a given time period for these parameters, I lost weight on the appetite suppressant, where I didn't lose weight on the straight "suffer!" diet. I don't feel hungry on the appetite suppressant. That's the only real difference. The mental state of *feeling hungry* seems related to how much of the food I ate - was actually processed and stored to maintain my weight. That's the only way I can explain it.

    Personally, I'm sticking with this program - because now that I am down to a lighter weight, the wear and tear on my joints is far less, and it is a LOT easier (ie. less painful) for me to exercise regularly.

    The conclusion my doctor came to; as he developed this program - is that there is a relationship between the modern diet, caloric availability, appetite, and how appetite controls how much the body stores. And for many people, this relationship is a broken system that results in obesity - and the only way some people can control it is to suppress the appetite sensation part of the system. Some people can control it by simply exercising more, and/or eating less. Those people are not afflicted with this disease.

    What happens to the calories?

    I don't know - there's tons of excretion going on. Probably hidden there. It's getting flushed out of my system without being absorbed, or maybe it's getting broken down; but the energy is going into some other chemical process that is generating waste products that are flushed out (fats? oils? who knows?). I guess it would probably be useful if someone's "output" were analyzed too.

    But it's extraordinarily ignorant for someone else to come out and say: "just eat less!" because it's not a simple linear relationship. I know what I ate on my previous diet, and I know what I'm eating now - I was 230 then, I'm 180 now, I was doing 30 minutes a day 4 days a week on the treadmill then, I only have time to do that 2 days a week right now - I don't know any other way to explain it.
    (granted - when I finish classes, I'm ramping my physical activity back up - the bonus here is, at 180 lbs, I'm not in severe pain for 2-3 days after working out, like I was at 230 lbs).

  • Re:Ugh... (Score:2, Insightful)

    by tie_guy_matt ( 176397 ) on Tuesday November 20, 2007 @09:28PM (#21429795)
    Something that has been known for hundreds of years is automatically correct if it has also been backed up with experimental evidence for hundreds of years. Taubes claims that the carb theory fits the experimental evidence better than the fat theory. He then challenges the medical community to prove him wrong.

    If you can't prove the carb theory wrong and you can't prove the fat theory as being correct than eating a low fat diet is about as useful as breaking out your lancet to blood-let yourself.
  • Re:Ugh... (Score:4, Insightful)

    by MidnightBrewer ( 97195 ) on Wednesday November 21, 2007 @01:39AM (#21431691)
    The reason that predators have the bodies that they do is that they have to go chase after their prey and burn up a lot of energy patiently stalking their next meal. They also sleep a lot in order to conserve energy, since their meals have the annoying habit of not wanting to be eaten, making them less plentiful than, say, grass, which is pretty much everywhere and is far less likely to struggle.
  • Re:Ugh... (Score:3, Insightful)

    by innerweb ( 721995 ) on Wednesday November 21, 2007 @08:14AM (#21433499)

    I am a diabetic, and have been for probably 20 years. I have had to pay special attention to my diet and its effects by keeping a diary of what I eat, how much insulin I use, how I feel and what my weight and SIZE are.

    Anyone can loose weight by not eating. At the extreme, this is known as anorexia. I have been down both roads, low carb and low cal. I have lost weight on both, but on the low cal diet, eating foods that are supposed to be very good for you, I was always getting sick. I was tired all the time and I had a hard time focusing. I did loose some weight, but not near enough. Yeah, that USDA recommendation really worked well. Not!

    Then, I started in on the Adkins diet and lost most of the rest of the weight. I felt better, had more energy and the best part, my blood serum levels of ldl, cholesterol and other negative indicators became very good. In fact my ldl became so low on the diet that I was told to increase it (Yes, ldl does serve a useful purpose and not having enough is bad for you).

    I was walking and bicycling on both diets and taking a good vitamin. I value my sleep, so I don't let myself skimp on that. I did notice that I needed about 2 hours more per day on the normal diet to feel at my peak and stay healthy. I also noticed that my insulin requirements dropped by about two thirds on the Adkins diet.

    I had a precautionary heart exam performed this year, and the arteries around it are in perfect condition (no blockage whatsoever).

    What is the moral of my experience? We are individuals with unique bio-chemical compositions. Maybe 99.5% similar, but that last .5% can be an extreme difference in how we need to live. The Inuit lived on nothing but meat and fat, and look at how healthy they were. A group of people may exist for thousands of years on a particular diet, and without medicine, as a group they adapt to live on that diet. If they do not, they die. Pretty simple stuff. The whole idea of one diet fits all is ignorant unscientific BS. The food pyramid has its start in supporting agriculture, not science. It seems like the right thing on the surface, but then again so did keeping foul odors away to prevent disease, or blood letting to get rid of the bad fluids in a sick person.

    Technologically, we have to grow beyond these concepts to become a healthier society. With the discovery of genes and other determining factors of the human growth and development, we have the chance to truly understand why things work the way we do. Instead of spouting one size fits all BS, we need to put much more effort into understanding the variations in our composition that make people respond differently to foods, medicines, light sources, sounds, socialization, etc. Anything less is ignorance and belongs in a certain museum in Kentucky.


"The eleventh commandment was `Thou Shalt Compute' or `Thou Shalt Not Compute' -- I forget which." -- Epigrams in Programming, ACM SIGPLAN Sept. 1982