Skylar Burris's Reviews > Rethinking Thin: The New Science of Weight Loss--And the Myths and Realities of Dieting

Rethinking Thin by Gina Kolata
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Feb 13, 2009

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bookshelves: sociology, health
Read in February, 2009

Abandon hope, all ye dieters who crack the cover of this book. If you have an arminian bone in your body, this book may well depress you. The gist of it is: if you are overweight or obese, you will always be overweight or obese; no matter how hard you struggle, and no matter how successfully you diet over the short term, you will always revert to being fat. It’s no use trying. Your weight is predestined. And the rest of the world will probably never accept that and will always think of you as a lazy slob. Cheery, no?

I give this book three stars because it really was a fascinating history of dieting, of the changing standards of “ideal” weight, and of recent medical discoveries in the field of obesity. I also liked it because it leveled a blow at the "do something" mentality of Americans when it comes to fashionable crises, reminding us that just because chicken little is screaming for a multi-million dollar grant, the sky is not therefore necessarily falling. However, I did find the book too fatalistic and ultimately too simplistic in its biology-only explanation for obesity.

It’s not because I am a naturally thin person that I say this; I have struggled with my weight all my life, and I have been my supposedly “ideal” weight for only one year of my life, when I maintained a strict, 1,300-calorie-a-day diet and did 20 minutes of aerobic exercise daily without alteration. Once I stopped the exercise and diet, of course, I gradually gained it all back. But there WAS a choice involved. I chose to lose the weight, and I chose to stop living like a soldier on rations. My brother and I are both genetically inclined to be overweight, but I am borderline obese and he is not. Why? Because he has consistently exercised for several hours a week every week of every year of his life, and I haven’t. Quite simple, really. But the author speaks as though behavior has nothing AT ALL to do with weight. I certainly don’t assume every obese person I see is a lazy slob, but nor do I, as the author seems to do, assume that every normal-weight person I see is simply a lucky dog who hit the biological jackpot. In fact, most normal weight people I know work hard to maintain a normal weight; they exercise much more often than I do, they eschew sweets much more often than I do, and when they see themselves creeping up out of the “normal” range, they go on a diet until they are back down in the normal range. For these people, consistent, prolonged exercise has become a way of life. Periodically limiting what they eat has become a way of life.

Diets and exercise, the author says, don’t “work” to enable people to lose weight and keep it off. To prove that they don’t “work,” she relates case after case in which a person lost weight and maintained a lower weight on a diet, but then gained it back after he stopped sticking to the diet and started eating more or exercising less. This is a strange definition of “work.” Isn't it somewhat absurd to expect that you only need to diet once, and as soon as you reach a lower weight, you can go back to living as you lived before and yet remain at that weight? It would be rather like a student who studies for a geometry test, manages to pull his grade up from a C to a B+, stops studying, and then is frustrated and disappointed when he doesn’t get a B+ on the Trigonometry test next year. He then concludes, “Studying doesn’t work.” No, studying “works”; you just can’t stop studying after a single test. You have to study your entire academic life if you expect to continue to excel. The studying metaphor has another parallel. Just as some people are naturally smarter than others, some people are naturally thinner than others. For some, just a little effort at study can pull a grade from a B to an A+; for another, a great deal of effort may only manage to pull a D to a C. Nevertheless, that doesn’t mean “studying doesn’t work.” And it doesn’t mean the D student has no choice but to be a D student. (It does mean not everyone can be an A student, but, in our society, it isn't just in the realm of weight that we expect no one ever to be left behind. We Americans, after all, are entitled to perfection. There are no natural limitations, only inadequate programs.)

Virtually all diets work to enable a person to lose some weight (or maintain his current weight) FOR AS LONG AS that person actually sticks to the diet. The author never defines what she means by "will power" when she says lack of will power has nothing at all to do with obesity, but what is will power if not sticking to something? The problem, of course, is simply that most people, myself included, do not WANT to diet their entire lives (or, as is more fashionably said, make a "lifestyle change."). And the problem for overweight people, who are, it turns out, simply born hungrier than thinner people, is that sticking to a diet is very, very difficult, much more difficult than it is for a thin or normal weight person. You are, as I know from experience, basically in a constant state of hunger. So your choice is between (A) Always feeling hungry and never really enjoying the social function of food or (B) Being overweight or obese. Given the choice, many people choose B. It’s not a pleasant choice, but just because you don’t much like either option doesn’t mean you don’t have a choice.

Everything in this book is calculated to make the overweight or obese person throw in the towel. Not only is the gospel of doom preached (No obese person is capable of sticking to a diet for life. Not one! And loosing weight and keeping it off for two or three years is meaningless if ever you gain it back!), but the author also insists that, really, being overweight or even obese isn’t unhealthy at all. In fact, it may be healthier than being a normal weight. She cites a study where overweight people had a slightly lower mortality rate than normal weight people. Of course, this is just one study weighted against others that suggest all manner of health complications related to obesity. But those who have criticized this study (for instance, those who have pointed out that the study includes smokers, who are more likely dying early from smoking than from being a normal weight), she reasons, are just practicing “attack science” because they have a vested monetary interest in promoting the idea that obesity is unhealthy. And while I can certainly be persuaded that a few extra pounds won't hurt a person and may provide a buffer for lean times, she never really defines what she mean by "obese" or "overweight" or "very obese," and throughout the book she tends to lump together degrees of heaviness as though they were all the same level of issue (or non-issue), when in fact they are quite different things possibly with different causes and certainly with different associated risks. It's one thing to say to the woman who is 80 pounds overweight that she really needs to lose weight to improve her health and quite another to say it to the woman who is 15 pounds overweight.

I certainly do think it is time for more people to say that our ideas of “ideal weight” are ridiculously unrealistic and that not everyone can be thin. But we don't need to say that obesity is healthy or inevitable. We just need to revise how we define "ideal weight" and encourage people to be more concerned with living healthy lives, eating healthy foods, and exercising regularly than they are with the number they see on a scale. This book would not have been so overwhelmingly bleak if the author had simply taken a different track. If she had not been so fatalistic, but had said instead, “Look, some people are naturally thinner or heavier than others. If you’re overweight, you do have a limited, but not an absolute, range of control over what you weigh. You probably aren't ever going to be thin, but if you eat better and exercise more, you will be healthier and you will weigh less than you weigh at this moment. Don’t worry if you’re not your ideal weight; just try to live a fairly healthy life. Most of all, exercise. After all, physical activity is a better indicator of overall health than body size.” To return to my previous metaphor, you may not be able to ace the test, but that doesn't mean you shouldn’t study hard for it and at least improve your grade. But that’s not really what she says. What she says sounds more like, “Don’t bother trying to do anything. You’re doomed by biology and by a prejudiced society.”

I'm back to this again, but when people say that “diets don’t work” to keep weight off, it is somewhat like people saying “abstinence doesn’t work” to prevent STDs. They don’t really mean “abstinence doesn’t work.” They mean, rather, that “abstinence is hard and we can’t realistically expect people to remain abstinent for life.” Likewise, dieting is hard, only more so. I know that. But, please, can we stop pretending that people are utterly controlled by their biology? That they go through life as biological zombies guided by chemicals and never by choice or personal desire or personal priorities or even their surrounding environment? Can we stop saying that just because something is very hard to do, it doesn't "work"?

Some people do value their physical appearance more than others, just as some people value saving sex for marriage more than others. Take Kolata’s example of the puzzled dieter who doesn’t understand that, while he would never touch food that wasn’t kosher, he can’t manage just to restrict himself to the foods that are on his Atkins diet. How can this be? It never enters his mind, or Kolata’s mind, that perhaps his religion is a more serious priority for him than either his appearance or his health, that he believes in his God more than he believes in the medical opinion of his doctor. The very idea that people have different values, different priorities, and therefore different drives to work more or less for different things nowhere enters Kolata’s picture. In fact, NOTHING but biology enters her picture of why people eat as much or as little as they do—no environmental factor, no psychological factor, nothing but chemicals.

But human beings are not animals (at least not metaphysically speaking) who eat only to survive. They are complex, spiritual beings living in community with one another, motivated by a tangled web of biological, psychological, communal, and religious urges. To take all of this off the table when it comes to something like eating, which is itself very often a communal activity, is to be extremely simplistic. Well, the average rise in American weight can’t possibly have anything to do with environment, because we had McDonald’s 50 years ago. So let’s take environment off the table. It can’t possibly have anything to do with psychology, because overweight people are no more likely to be neurotic than normal-weight people, so let’s conclude that there is NO psychological element WHATSOEVER involved in eating at any time. We must just be more obese, on average, as a people, because we (we Americans, not necessarily we humans) have evolved genetically as a species over the past 50 years. Isn't that rather simplistic logic? (I do wonder why it didn’t occur to her to ask whether fat people simply have more children than skinny people. That would be a very simple biological explanation for the societal rise in obesity over the past 50 years.)

So, in the end, I’m conflicted about this book. I think someone had to say that our ideas of “ideal weight” are too low, and that the obesity industry has a vested interest in maintaining these unrealistic perceptions, and that good health has more to do with how fit you are than how thin you are, and that our country has become too obsessed with obesity as the fashionable cause di rigour. While it’s nice to hear what I’ve always suspected—that being overweight is not as deadly as the histrionics imply, and that most people who are thin are thin because they naturally tend that way—I’m not quite ready to jump on the Calvinistic bandwagon with both feet and say that nothing I do matters or that I wouldn't be better off if I at least lost 15 pounds. I’m borderline obese. This book could either make me throw in the towel in despair, or roll up my sleeves in defiance. Either way, yes, she’s right, I won’t be slim five years from now, because there's no way that I, personally, am going to stick to a 1,200 calorie diet for life or exercise six hours a week. But I might very well be on the low end of overweight, instead of on the low end of obese, and I might very well have more energy and better health, if I don't take the defeatist attitude that nothing I do matters, that I will always be obese because I happen to be right now. Kolata may be right. I may only have “some control” over a certain “range” of weight that is “20-30 pounds” above or below my natural weight. But that still means I can weigh anywhere from 105 to 165 pounds (and, as a matter of fact, I’ve hit both that low end and high end in my adult life). That still means that, depending on how I choose to live and how much effort I choose to expend and how much hunger I choose to endure, I can be slightly underweight, normal weight, overweight, or obese! Some people may not have this wide a range if they are starting from a higher biological middle point, but they probably still have a choice between being obese and overweight, or between being morbidly obese and obese. I wish Kolata had not so casually dismissed the importance of that range of limited choice. Her attitude is very negative: “You can only choose B or C, and you want A. Therefore you might as well have no choice.”
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02/26/2009 page 100
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Comments (showing 1-4 of 4) (4 new)

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message 1: by booklady (new)

booklady (sigh) Good points all! Thank you! Sometimes I still wish it were a bit easier . . . I think.

Skylar Burris All the time I wish it were a lot easier. LOL.

Skylar Burris I didn't miss that. I got that. But the fact that that is true for some obese people does not mean that it is true for ALL obese people , which is the part the author didn't seem to get.

message 4: by Kara (new)

Kara "just because chicken little is screaming for a multi-million dollar grant, the sky is not therefore necessarily falling"


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