Why do we get fat

Chapter 3 The Original Sin of Obesity (2)
Fifty years ago, one in ten people was obese; now, one in three is obese.Two-thirds of the human population is now overweight, children are getting fat, teenagers are getting fat, and even newborns are getting fat.Despite the obesity epidemic for decades, the notion of "energy balance" weight loss has become so ingrained that health officials assume we're getting fat either because we're not following their advice to eat less and move more , or because we have not controlled ourselves well.

In 1998, Malcolm Gladwell wrote about this paradox in The New Yorker: "We are told we don't need to eat more calories than we burn if we don't You can’t lose weight if you keep exercising.” He also wrote: “The fact that few people actually follow this advice may be our problem, or the advice itself. Orthodox medicine naturally tends toward the former, while weight-loss books tends towards the latter. Considering how often orthodox medicine has been wrong in the past, this conclusion is not unreasonable on the face of it. Its correctness is debatable."

After discussions with several authorities, Gladwell concluded that "the problem is with us."We "lack the self-discipline and the necessary means" to eat less and move more.He also suggests that bad genes pull more fat from our diets because of our extreme lack of control over what we eat.

As I will argue in this book, the problem lies entirely with orthodox medicine, which not only convinces people that obesity is caused by eating too many calories, but gives false advice about it.I will demonstrate the absurdity of the supposed link between calorie balance and weight loss.We neither gain weight by eating more and moving less, nor will consciously eating less and moving more solve the problem or prevent obesity.This is the original sin of obesity.Arguably, until this error is understood and corrected, we will never be able to solve our own overweight problems, let alone the social problems that arise from obesity, diabetes and their associated complications.

That being said, I'm not implying that there's a magic bullet for quick weight loss, at least not without a cost.The question is, what exactly do we have to do to stay in good shape?

The first part of this book presents evidence against the hypothesis that calorie balance is associated with weight loss.This section will tell you many phenomena that this concept cannot explain at all.Why do we always believe it, and what mistakes we make as a consequence.

The second part of the book introduces a new way of thinking about obesity that was embraced by European medical researchers long before World War II.They argue, as I do, that the idea that obesity is caused by overeating is irrational, since all foods that build body—whether it’s height, weight, muscle, or fat—require people to overeat.For example, children will not grow taller and stronger if they are not naturally gluttons, allowing themselves to take in more calories than they burn.They are eating so much because they are growing - this is overeating and they need to take in more calories than they expend.Growth hormone, which is secreted by the body, drives growth and development in children, and there is good reason to believe that the growth of fat tissue that leads to overweight and obesity is also caused by the hormone.

Therefore, European medical researchers before World War II hoped to start from the idea that "obesity is fundamentally a disorder of fat accumulation" instead of defining obesity as "a disorder of energy balance and Consequences of Overeating".

Once we start thinking, then the natural question is, what can control fat accumulation?Hormones and enzymes that contribute to the natural accumulation of fat may be key factors in determining whether some people gain weight and others do not.

Sadly, very few members of the European medical research community survived World War II. By the late 20s and early 50s, neither these doctors nor their research on obesity had been heard from.But it was then that the question "what can control fat accumulation" was answered.Facts have proved that the two essential factors that determine the amount of fat accumulation are related to insulin.

First, when insulin secretion levels increase, fat is deposited in adipose tissue; when it decreases, fat is released from adipose tissue and burned like fuel. This view has been known since the early 20s and has never been controversial.

Second, the level of insulin secretion is mainly determined by the sugars we consume.The more digestible, sweeter sugar we eat, the more insulin we end up secreting, which means higher insulin levels in our blood; so the fat stays in the fat cells. “Sugar makes insulin, and insulin makes obesity,” George Cahill, a former professor of medicine at Harvard Medical School, told me recently. In the 20s, Cahill did some early work on the regulation of fat accumulation; in 50, he co-edited the 1965-page book "The Outline of the American Physiological Association" published in the United States .

In other words, orthodox medical research itself clearly shows that hormones, enzymes, and growth factors regulate our fat tissue just as they regulate other tissues in the body.So we don't get fat from eating more, it's the sugar in our diet that makes us fat.Research tells us that obesity is ultimately caused by a hormone imbalance, not a calorie imbalance.Specifically, eating digestible, sugar-rich foods stimulates insulin secretion.Such foods include: refined sugars (including flour and grains), starchy vegetables such as potatoes, and table sugars (such as sucrose and fructose syrup, etc.).These sugars do make us fat, and because the accumulation of fat makes us feel hungrier, we eat more, and because we are sedentary, we are more likely to gain weight.

This is the fundamental reason we gain weight, and we must understand and accept this if we want to lose weight and keep it off.Perhaps, more importantly, we doctors must also understand and acknowledge this.

If your purpose in reading this book is simply to know the answer to the question, "What should I do to stay lean or lose excess body fat?", the answer is this: Stay away from foods rich in sugar. The sweeter, or easier to digest — liquid sugars like beer, juice, and soda are probably the worst — the more likely you are to gain weight, and you should avoid them.

This is certainly not a new idea, it was accepted common sense before the 20s.Foods rich in sugar—bread, pasta, potatoes, table sugar, beer—were once thought of as the sole cause of obesity.If you don't want to gain weight, then don't eat these foods.It's been the subject of a string of weight-loss bestsellers since.However, this basic fact is misused, distorted and misunderstood by proponents of "restricted sugar" diets and those who insist it is a dangerous fad, including the American Heart Association. I will discuss these two points again later.If my arguments are enough to convince you to make corresponding changes in your diet, all the better.In addition, many clinicians treat their obese and diabetic patients with their own weight loss methods.Based on this, I will synthesize the weight loss knowledge I have learned from them, and give readers some corresponding weight loss suggestions based on this.

For more than 60 years since the end of World War II, the question of whether calories or sugar cause obesity has been debated.It looks more like a religious question than an academic one.Various belief systems have been added to the discussion of how to structure a healthy diet, making the purely health medical discussion of "why we get fat" completely clueless.Academic discussions pale in comparison to vivid ethical and social issues.These questions have nothing to do with science itself, so to speak, and there is no place for scientific argumentation.

In a typical sugar-restricted diet, the sugar in the diet is replaced by a significant, if not greater, portion of animal products—starting with eggs for breakfast and ending with meat, fish, and poultry for lunch and dinner.The implications of this should be considered.Is our dependence on animal products already bad for the environment and getting worse?Is livestock production a major contributor to global warming, water scarcity and pollution?When thinking about healthy eating, in addition to thinking about what is good for ourselves, should we also think about what is good for the planet?Do we have the right to kill animals for food, or to put them to work to produce food?Is it true that only vegetarians, even absolute vegetarians, can live morally and ethically without spiritual burden?

All of these issues deserve the attention of individuals and society as a whole, but they have nothing to do with the scientific discussion of why we get fat.This is what I intend to explore in this book, as Professor Hilde Bruch did more than 70 years ago.

The most important questions are:

Why do we get fat?
Why are our kids fat?
我们 该 怎么 办?
[1] Each calorie is equivalent to 4.2 joules.

(End of this chapter)