The Skinny On Fat. Our Obsession With Weight Control.


Shawna Vogel


1999 WH Freeman & CO, New York, NY

Ms Vogel's book is a whirlwind tour of the tangle of conflicting information.

At one point she seems to have an answer to the conundrum that if we gain weight by the environmental influences (= too much fine food and not enough work etc..) then why is it so hard to lose? She begins to explain (p76) that when we gain weight or lose weight the body adjusts and resists the change - the set point thing. Then she goes on to cite an editorial by one William Ira Bennett, a physician at Cambridge Hospital in Massachusetts, to the effect that our set points can be reset by those same influences. NEJM 1995 332:10,673-4. OK, so the thermostat (adipostat) can not be beat by diet and exercise but it can...? For this self contradicting assertion, Dr. Bennett cites in turn 2 references: Peck JW. Rats defend different body weights depending on the palatability and accessibility of their food. J Comp Physiol Psychol 1978; 92:555-70. and Wood PD. Impact of experimental manipulation of energy intake and expenditure on body composition. Crit Rev Food Sci Nutr 1993; 33:3679-73. Both of these references are easy to dismiss as NOT explaining how our adipostats can be reset. The first one is about rats and rats are well known to increase their weights and fat stores by a rich diet. This is not true of humans. I leave it to you to verify for yourself that there is nothing to the exercise-as-adipostat-resetter in the second reference, although there are lots of other interesting issues brought up in this article. This important mystery remains unsolved.

And so it goes. As we will see with all the obesity pundits, she comes down in the final analysis on the fact that you'll weigh whatever you will no matter how or how hard you strive to fight it. As with all those same pundits she is inconsistent. There are many anecdotes and references to the "weight gain" and "weight loss" that she said was impossible. For example p 115, "...regular exercise is the strongest predictor of whether someone will lose weight and maintain the loss." On page 143 and 144 there is some interesting discussion about the beta-3 receptors on brown fat which turn on energy consumption and heat production. She says that Merck, Smith Kline Beecham, Squibb, Pfizer and Eli Lilly have all filed patent applications for compounds that target the human beta-3 receptor. I did not know that. But since this was 10 years ago, I suspect that progress is slow.

Her random stories make for easy reading despite the aggravations mentioned. One aggravation that I won't raise my blood pressure about here (see "TV" in my articles), is the standard vilification of TV as a cause of obesity in children.

Ms Vogel concludes somewhere near the end of her book, "...but the vast majority (of authorities) say that there will never be a pill that will let you eat what you want, remain sedentary, and not gain weight." That's true, authorities do say that, but I beg to differ with those authorities.