Dr. Sara's Book Club #1. 3 Reasons Why We Get Fat (Plus Lunch with Gary Taubes)

taubes, garyWhat if everything you know about why we get fat is wrong? We are kicking off the start of my new (and FREE!) Dr. Sara’s Book Club with that question, plus many excellent answers and solutions.

First, the backstory on why we get fat (and whom I listen to). Not sure you’ve noticed that there’s a ton of noise on this topic, yet there shouldn’t be. It turns out that the answer to why we get fat may be all wrong.

There’s an intrepid guide who cuts through the noise and tells us where we stand and what to do, based on best evidence. You know how I do the happy dance when folks understand and follow best evidence.

Name: Gary Taubes.

He’s not a doctor, nor a celebrity. He’s not a CEO or COO with an expensive ghostwriter. Fortunately for us, Gary is a journalist with the highest integrity when it comes to scientific scrutiny and evidential hierarchy. He wrote a superb book, provocatively titled: Why We Get Fat: And What to Do About It. And he’s my neighbor.  Somehow I persuaded him to meet me for a long and lovely low-carb lunch last week.

Meet Gary Taubes (He’s Got Your Back + Your Fat).

Ready to turn your thoughts about fat upside-down? Did you know that the obesity epidemic has been affecting Americans since the 1930s? That’s surprising to most because that means rising obesity rates predate the advent of fast food, televisions in every household, and supersized sodas brimming with high fructose corn syrup.

That’s just one of the eye-opening gems in Gary Taubes’ latest book, and it’s hardly the last. Perhaps you’ve been following my own writing for years about the importance of eating dark leafy greens, consuming fat in order to lose fat, and limiting the refined carbs, but Gary is my go-to guy. He understands good science and how it works. Even more rare, he understands what we know and what we don’t.

Start with Why. End with Why. (Oh, Just Explain the Why All the Way Along.)

Why-We-Get-Fat2Gary’s book debuted more than one year ago, but it’s still the freshest content in the crowded space of food, diet, and how to turn the corner on obesity. His book is a robust distillation of his larger oeuvre, Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health, which dispels the calorie-in-calorie-out myth of the USDA and most conventional food guidelines, and offers up five years of rigorous synthesis. He published Good Calories, Bad Calories in 2007 and if you’re one of my practitioner trainees, you must immediately buy both books. Now. Before the bad carbs you just ate spike your blood sugar and then make you foggy, distracted, and less smart. Visit Amazon’s Gary Taubes Page right here, and get to 1-clicking!

As one reviewer stated regarding Why We Get Fat: “Less dense and easier to read [than previous book, Good Calories, Bad Calories] but no less revelatory.”

Gary shared with me that when he published the longer book, doctors begged him to write a simpler version for their patients. Even better, consumers pleaded with him to write a simpler version to give to their doctors.

Let The Truth Set You Free (+ Lean)

I love many aspects of Gary’s synthesis. In fact, in order to make life as easy for you as possible, I created my Top 10 list of what I most love from his two books. (You know how my brain loves Top 10 Lists for some archetypal reason… or perhaps just years of watching too much David Letterman.)

As a doctor geek who spent an extra year at Harvard Med School serving as a research fellow studying molecular biology with the American Heart Association, I love that Gary refutes decades of poor advice from the prevailing nutritional mafia. Specifically, he counters the dogma, still popular today but misleading and unproven, that people should “eat less and exercise more” in order to lose weight and master heart health. Overall, the studies are ambivalent and poorly designed. So Gary co-founded a nonprofit to fund rigorous research into the unsettled questions that remain about why we get fat. As he explained to me over lunch, positive energy balance (energy intake exceeds energy output) describes what has to happen when someone gets fat, but not why they get fat.

American Heart Association Is Dispensing the Wrong Advice

Even in 2013, the AHA informs us on its website that you must begin your heart-healthy diet with the following nonsensical strategy: “Start by knowing how many calories you should be eating and drinking to maintain your weight. Don’t eat more calories than you know you can burn up every day.” Why is it nonsensical? Because the only way you know if you’re eating and drinking more than you burn is if you’re getting fatter.

Yes, indeed – here’s that myth of positive energy balance again. It’s not just the AHA that believes and dispenses the wrong advice. Jillian Michaels is a believer in this myth. Maybe you are too, and that’s cool, but it’s time to update your conceptual model with the best evidence.

The Conventional Wisdom in Nutrition Is Naive

Modern science somehow convinced the public, including me, with its faulty argument of “calories in, calories out.” When I was fat and 35 after having my first kid, my doctor told me: “Sara, it’s just simple math. Exercise more and eat less.” I wanted to smack him, and cry. That moment was humiliating, because it suggested my problem was one of willpower, but more importantly, he was dead wrong. Fortunately, it was a defining moment for me, and Gary shows us why.

garytaubes_catI imagine the calorie myth has been forced upon you, too, by well-intended doctors, government agencies, and the media. However, if we look at the millions of people who struggle with their weight, the hundreds of diets and exercise plans (98 percent of which fail miserably), and the incredibly complex matrix of the human body, such an explanation raises a red flag, especially to this doctor. Calories alone do not explain the rising obesity epidemic. There is something else to blame.

It won’t surprise you that I agree with Gary: The prevailing calorie-based paradigm about fat gain and loss needs some serious disrupting, and I’m grateful that he is the leading edge. But the edge is still bloody, and we need your help to re-paradigm and spread the word.

Do your part and buy the book. Talk about it at cocktail parties – trust me, you will engage most people in the room because food and calories are as controversial as politics and religion, but far more objective. There’s data to back you up.

In Why We Get Fat, Gary successfully refutes modern misconceptions surrounding obesity and weight gain, and then dives headfirst into his novel synthesis of the best science. He gives a clear explanation about the complex systems and feedback loops that govern metabolism and weight gain, including genetics, epigenetics, hormones, and growth factors. But you don’t need to master the synthesis – he’s done the work for you and it’s bloody accurate. Trust me: Trust him.

Less Is More, More or Less

The first bit of proven advice is ridiculously simple. Stop eating the frickin’ carbs – the bad carbs.

It’s not rocket science. It’s also not cold fusion, although Gary happens to be an expert at that too (and wrote a book about the folly of cold fusion back in 1993).

All you really need to know about the backstory is that insulin drives fat storage. Insulin is the hormone that works to put fat in fat tissue. And excess refined carbs are driving up your insulin levels.

That’s it. Easy. Mind your insulin by cutting the refined carbs.

Insulin is a fat storage hormone, and is released into your system to help break down blood sugar into glucose. The higher your blood sugar, the more insulin is released…and the more fat is stored away for a future rainy day (or famine, which had an evolutionary advantage in centuries past). Some of us, myself included, do this more readily than others. The best evidence demonstrates that obesity is a result of the vicious cycle created by a high sugar/carbohydrate diet. That leads to high insulin, which leads to fat storage and sugar cravings. Around and around we go, until we don’t know where our belly fat leaves off and our sugar cravings begin.

Yes, Virginia: Your problem is hormonal. All paths of fatness lead back to that rascal hormone, insulin.

“The science tells us that obesity is ultimately the result of a hormonal imbalance, not a caloric one.” – Gary Taubes

Dr. Sara’s Top 3 Lose-the-Fat List (Or How to Make Gary Taubes’ Recommendations Astonishingly Simple)

  1. Carbohydrates make you fat, not calories.
  2. You must eat fat – good fat — to lose fat. Repeat after me: “Fat is not the enemy.”
  3. Protein and fat are essential to your health; carbs are not.

Want the full Top 10 List? Click here to get it.

Your Low Carb Call-to-Action: Lose the Beach Floatie

If you struggle with a spare beach floatie around your waist, man boobs, or just more fat than you want, there is one main point you should take away from Why We Get Fat: limit your carbs. Swapping out sugar and refined carbs for kale, spinach, and wild-caught salmon will lean you out. I’m not going to give away all of Gary’s wise recommendations – you must buy his book for that.

So much wisdom, so little time! There is much more to this life-altering book. Forget the latest trendy Paleo book because Gary has the real goods and offers all that you need to step into action, get lean, and get healthy. I consider it your sacred duty to learn the why, how, and what of crafting your optimal lean body mass, and then to maintain it and proselytize. It’s sacred because this goal is not just about vanity. Gary’s proven strategies will make you sane with food and reverse your vicious cycle into a virtuous cycle that just may save your life. Science shows that lean body mass is right up there with the telomeres that cap your cells as a key marker of longevity.

Gary makes science that can be dull come alive – so much insight into the wonderful tango of hormones and nutrition and metabolism that I want all of you to have a copy.  While you’re at it, get a copy for your family and friends who struggle with fat – even the skinny fat people – whose hormones are unbalanced, too – since they may be even at higher risk than the obese. But that’s a conversation for another time.

I want this book on every shelf in America! You can get your copy on Amazon or, hopefully, at your local independent bookstore. Your lean body mass and sound mind will thank you! And don’t forget to get my Top 10 Take-aways, right here!

Join Dr. Sara’s Book Club!

Want first access to Dr. Sara’s book reviews, live Q&As with the authors, and other exclusive content? Join Dr. Sara’s Book Club today – it’s 100% free! www.saragottfriedmd.com/bookclub



  1. Taubes, Gary. 2007. Why We Get Fat: And What to Do About It
  2. American Heart Association (accessed 8/22/13) http://www.heart.org/HEARTORG/GettingHealthy/Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp