‘Original sin’ of obesity research: idea that fat people are greedy and lazy

The world-first international low-carb, high-fat summit, a gathering of global experts on nutrition gathering in Cape Town from February 19 to 22 has been looking at why people get fat and what to do about it.  A special focus has been current dietary guidelines,  the role of carbohydrates and whether saturated fat is the health demon we’ve been led to believe it is. Speakers have suggested that dietary advice experts have been giving for the past 40 years are looking like a ‘big fat lie’ . – MS

By Marika Sboros

La monstrua desnuda (1680), by de Juan Carre de Miranda.
Picture: IW Public Domain Mark 1.0

The idea that people get fat because they eat too much and exercise too little is the “original sin” of obesity research, says US science and investigative journalist Gary Taubes.

It has become “written in stone, passed down from the mountain”, yet it has no science behind it, Taubes told the first international summit on low-carb, high-fat (LCHF aka Banting), that opened in Cape Town on February 19, co-hosted by sports scientist Prof Tim Noakes.

Taubes is co-founder of the US-based Nutrition Science Initiative, a non-profit organization devoted to reducing the individual, social and economic toll of obesity and its related diseases by improving the quality of science in nutrition and obesity research, and author of best-selling books on nutrition, including Good Calories, Bad Calories, and Why We Get Fat.

His summit presentation, titled Why We Get fat, Adiposity 101 and the Alternative Hypothesis of Obesity, looked at the so-called “energy imbalance hypothesis”, the idea that obesity is an “energy imbalance disorder” that results from too many calories consumed, and too few expended.

In biblical terms, obesity is seen as the result of gluttony and sloth, he said, the result of increased prosperity, sedentary living, and the presence of a toxic, “obesogenic” (energy dense) food environment.

‘Black swans’

It’s an idea that has become “written in stone, passed down from the mountain”, he said, and preached by the World Health Organisation, and on public health websites cross the globe, despite no scientific foundation.

By way of example, Taubes quoted Kelly Brownell, director of the Rudd Centre for Food Policy and Obesity at Yale University saying: “Cheeseburgers and French fries, drive-in windows and supersizes, soft drinks and candy, potato chips and cheese curls, once unusual, are as much our background as trees, grass, and clouds… few children walk or bike to school; there is little physical education; computers, video games, and televisions keep children inside and inactive; and parents are reluctant to let children roam free to play.”

The counter example to this shows up in research into what Taubes calls “black swans” – populations scattered across the globe with high levels of obesity but without toxic “obesogenic” environments. In the US these include the Sioux, South Dakota Crow Creek Reservation, African Americans in Charleston, South Carolina, black populations in South Africa, factory workers in Chile, and women in Trinidad, where a third over 25 are obese despite the per capita daily diet less than 2000 calories (and 21 % fat) – “fewer calories than recommended by the United Nations FAO (Food and Agricultural Organisation).”

Research has been available for years to show that eating less doesn’t work to treat and cure obesity. Taubes quoted Hilde Bruch, German-born American psychoanalyst, who specialized in eating disorders and obesity, who said in 1957: “More than in any other illness, the physician (treating the obese patient) is called upon only to do a special trick, to make the patient do something – stop eating – after it has already been proved that he cannot do it.”

More recently in 2002, a Cochrane Collaboration report stated that weight loss achieved in trials of calorie-restricted diets is “so small as to be clinically insignificant”.

Likewise, Taubes said exercising more is also shown not to work to help obese people slim down. For example, American Heart Association and American College of Sports Medicine guidelines on physical activity in 2007, state that while it is “reasonable to assume that persons with relatively high daily energy expenditures would be less likely to gain weight over time, compared with those who have low energy expenditures, so far, data to support this hypothesis are not particularly compelling”.

Compelling research

So if it’s not eating too much, and exercising too little, what is behind obesity epidemics?Taubes said the research is clear, and shows that the likely explanation is hormonal – the role of insulin that is released when the diet is high in carbohydrates and too low in saturated fat.

Another speaker on the panel was Dr Peter Bond, Chief Medical Officer, Old Mutual and Emerging Markets.

What was the global life assurer doing at this controversial health summit? Well, Bond told the gathering that the science on LCHF was compelling enough to persuade the company that it could make a contribution to society by becoming the summit’s major sponsor.

He made it clear upfront that Old Mutual was not necessarily endorsing LCHF, or any other diet, but it was clear that current dietary and health advice was not working.

His presentation was titled “Is the Dice Loaded?” and began with reference to World Health Organisation (WHO) reports saying that “the world’s most rapidly spreading sustained pandemic is not HIV/AIDS but diseases of lifestyle, of which obesity is the most dominant”, and estimating that “at current rates the world’s obese population will outnumber those suffering from starvation by 2025”.

Bond gave sobering statistics on the state of South Africans’ health, and saying there was a clear need to “elevate preventative medicine to the level it deserves and not only do it, but, more importantly, have the desire to do it,” he said.

“We have clearly failed to date.”

In the words of former Dr Harry Seftel, former University of the Witwatersrand medical science professor, Bond said: “It is time to change our deathstyles to lifestyles.”