Rethinking Thin

Rethinking Thin: The New Science of Weight Loss--and the Myths and Realities of Dieting by Gina Kolata
My rating: 4 of 5 stars

Perhaps the most interesting aspect of this book is that it provides a history of dieting that goes back to the 1800s. According to Kolata few of today's revolutionary diets are revolutionary but rather recycled versions of some other previous approach. Interestingly, most didn't work then and they don't work now. Sure, they may provide some temporary weight loss, but generally speaking, the overwhelming majority of people who lose weight on a diet will gain it back.

Kolata skillfully weaves the stories of several would be "losers" into the narrative. They are participating in a two-year study that compares the Atkins diet to a more traditional low-fat diet. Their story is sad and familiar. Many have lost weight before, only to regain it back. Most believe that this time will be different. Only it isn't, which leaves Kolata to postulate that maybe, just maybe, weight loss isn't realistic. At one point she even questions if being overweight is indeed as unhealthy as we are being told. She argues that the health risks of all levels of obesity with the exception of the morbidly obese aren't associated with poorer health outcomes. In fact, in a study she cited, individuals who are in the first and second classification of obesity actually lived longer.

I think what gets lost in this particular book and others like it is that the authors talk about overweight as if it were a narrowly defined condition. Yet, there are huge differences between being 10 pounds overweight and being 150 pounds overweight. Kolata also seems to overlook that the failure of "dieting" may be more a reflection of the diet and less a reflection of our ability to lose weight and keep it off.

At one point, Kolata, citing Jeffrey Friedman - a molecular biologist who discovered leptin, suggests that maybe the increased incidence of overweight and obesity is a natural progression of our genome. After all, we are getting taller. Why not fatter?

This is the second book I've read recently that questions the health risks associated with being overweight. Unfortunately, the study referenced investigates weight as it relates to incidence of death. It is very possible that the behaviors that lead to weight gain and not the weight itself is to blame for things like the rise in diabetes. And while death is certainly a poor health outcome, living with diabetes, even if it doesn't shorten your life, can impact its quality. Kolata seems to ignore this. I get the point that she is trying to make. Our focus on weight and weight alone is misled. It is more likely that it is the behaviors that lead to overweight and obesity and/or result in weight loss that may be relevant to our health as opposed to the weight itself.

All in all, I felt the book was very informative. I enjoyed learning more about the history of dieting. I also found the interviews with the two-year study participants to be eye-opening albeit a little disheartening.