Fat Chance, written by Dr. Robert Lustig of “Sugar: The Bitter Truth” fame. Dr. Lustig is an internationally renowned pediatric endocrinologist who has spent the past sixteen years treating childhood obesity and studying the effects of sugar on the central nervous system, metabolism and disease. He is the director of the Weight Assessment for Teen and Child Health Program at UCSF Benioff Children’s Hospital; a member of UCSF Center for Obesity Assessment, Study and Treatment; as well as a member of the Obesity Task Force of the Endocrine Society.
I’ll make a promise to you right now: there is not one statement made in this entire book that can’t be backed by hard science.” ~ Dr. Robert Lustig
Fat Chance Week One – Part I. The Greatest Story Every Told
Chapter 1. A Fallacy of Biblical Proportion
Chapter one lays out the grim facts and statistics of the current obesity pandemic and how it relates to the demise of our health. Lustig proposes one doesn’t die from obesity but what obesity does to the organs due to the diseases that travel with it. The list includes heart attack, heart failure, stroke, diabetes, cancer, dementia, cirrhosis of the liver. He also points out that normal-weight people die of these as well arguing that it’s not the obesity that kills but metabolic syndrome. The term metabolic syndrome is used to describe metabolic disorders that include obesity, type 2 diabetes, high blood pressure, lipid disorders and heart disease. As if that isn’t enough, there’s more destruction to health that is associated, non-alcoholic fatty liver disease, kidney disease, polycystic ovarian syndrome, and the list keeps growing, orthopedic problems, sleep apnea, gallstones and depression. Obesity and metabolic syndrome are often interchanged, however they are not the same and one doesn’t cause the other. We are teased to read on to find out what causes both obesity and metabolic syndrome.
And now the shocking statistics:
- The number of American children who are overweight is now surpassing twenty million.
- Every one of the health conditions listed above are now found in children as young as five years old.
- Our children will be the first generation of Americans who will die earlier than their forebears.
- One third of all new diabetes diagnosis are in the teen population.
- Over 40% of death certificates list diabetes as the cause of death.
- There are now 30% more people who are obese than are undernourished worldwide.
- It is projected that by 2015, 2.3 billion people will be overweight and 700 million obese.
- Non-communicative diseases, diabetes, cancer and heart disease, are a greater threat to world health than are infectious diseases.
- Being thin or of normal-weight is not a safeguard, up to 40% of normal-weight people have insulin resistance, a sign of chronic metabolic disease and of that group another 20% have a fatty liver.
Chapter 2. A Calorie is a Calorie — or Is it?
Chapter two opens with the long-held debate, is a calorie a calorie. The common assumption, is that if one is overweight, it is their fault as they choose to eat more and move less or both. All of the stakeholders, those who sit at the “Table of Blame”, in some way profit from the “a calorie is a calorie” dogma. Lustig says there are three problems with “a calorie is a calorie”, 1. there is no way anyone can actually burn off the calories supplied by our current food supply, 2. all fats, proteins and carbohydrates are not the same and 3. we’re not eating more of everything, we are eating more of one thing, sugar, more specifically fructose. This chapter concludes with this thought, “the quality of what we eat determines the quantity and whether or not we burn it.”
More eye-opening statistics:
- Until 1980, 15% of the adult population had a BMI above the 85th percentile indicating either overweight or obesity. Currently the statistic is 55%, and by 2030, it’s expected to be 65%.
- The majority of obese kids will be diabetic and cardiac cripples by the time they are 50.
- 80% of obese people are suffering metabolically.
- According to the USDA the total consumption of protein and fat remained constant as the obesity pandemic accelerated. The intake of carbohydrates increased.
- The consumption of fructose has doubled in the last thirty years and increased six times in the last ten.
Chapter 3. Personal Responsibility versus the Obese Six-Month Old
Chapter three starts with the story of Sienna, a now one-year-old with both high cholesterol and high blood pressure, who was obese by six-months of age. Reflecting back on the previous chapter, when it is believed that “a calorie is a calorie” this implies that obesity is about personal responsibility. Implying that an overweight or obese person makes the conscious decision to eat more and move less or both. Lustig gives us six reasons to doubt why personal responsibility is the cause of obesity, 1. obesity is not a choice, 2. diet and exercise don’t work, 3. the obesity epidemic is now a pandemic, 4. even animals are getting fat, 5. the poor pay more and 6. the greatest rate of increase in obesity is in the youngest patients. While everyone else argues about who is to blame for this mess, we are left with Lustig’s words, “the obesity pandemic is due to our altered biochemistry, which is a result of our altered environment.”
A few more shockers:
- Significant weight regain has been seen in up to one-third of patients who have had surgery for weight loss.
- Numerous sources show that almost every lifestyle intervention works for the first three to six months. But then the weight comes rolling back on.
- The number of people who can maintain any degree of weight loss is extremely small.
- If obesity were just an American problem it would be an epidemic. It is a worldwide problem making it a pandemic.
- Malaysia which at one time had a problem with malnutrition now has the highest prevalence of type 2 diabetes on the planet.
- The change that ties all the countries of the world together is the “American diet”.
- In wealthier areas of San Francisco, nearly every block has an organic food store, the poor areas get a fast-food franchise.
- The age group that shows the greatest rate of increase in obesity in the last decade are 2-5 year olds.
Fat Chance Week One Discussion Questions
1. Chapter one is titled a Fallacy of Biblical Proportion, what do you think is the “fallacy”?
2. Obamacare is going to put 32 million sick people on the insurance rolls by 2019. What provisions for the prevention of chronic disease needs to be put in place for this to be successful?
3. Lustig states to lose your stubborn subcutaneous fat you have to become a gym rat, as vigorous exercise is the only rational way to prevent weight regain. Do you agree or disagree and why?
4. Before reading this book, what did you think caused obesity? How about metabolic syndrome?
5. Is a calorie a calorie? If not, then how do you explain why people who go on controlled calorie diets lose weight?
6. Do you sit, or have you sat at the table of blame? Which chair?
7. Knowing that the Food Pyramid was not based on science, do you think the government should have a role in what we eat? How about what is offered in school lunch programs, daycare programs, nursing homes, etc.
8. Is there any level of personal responsibility when it comes to being overweight or obese?
9. How many times have you gained and lost weight? Have you lost weight and kept it off?
10. Who is to blame for Sienna’s obesity?
Now It’s Your Turn
Use the comments to start the discussion. You can use one of the questions listed above or your own. I trust the discussion will stay on topic and be respectful of each opinion. It’s okay to disagree but no personal attacks.
Week Two – January 25
Part II. To Eat or Not to Eat? That’s Not the Question – Chapter 4. Gluttony and Sloth – Behaviors Driven by Hormones, Chapter 5. Food Addiction – Fact or Fallacy, Chapter 6. Stress and “Comfort Food”
It’s not too late to get in on the discussion. Download the electronic version of Fat Chance HERE and get reading!