For anyone who has ever wondered why some people can eat to excess without gaining weight while others cut way back on calories and still put on the pounds, Sylvia Tara has some answers. In The Secret Life of Fat: The Science Behind the Body’s Least Understood Organ and What It Means for You, Dr. Tara delves into the biochemistry of fat production, utilization and accumulation in our bodies. Most of the books I have reviewed on this website have been selected to counter the author’s perspective on a specific food issue. This book is different. It is well researched and well written. The author’s basic premise is that fat is an organ and that we need to understand its role in the body. To come to terms with fat we must work with it rather than fight against it. The author goes to great length to distinguish between visceral (located under the stomach and the cause of many of our health problems) and abdominal (stored under the skin and of less health concern) fat. The book is organized into three sections—differences in human physiology, differences in the food/human interaction, and how to overcome fat. Having read many books about Ameica’s weight problems, The Secret Life of Fat provides a much broader perspective on the science related to obesity and associated disorders.

Where this book is at its finest is when it interweaves stories of real persons facing real crises involving too much or too little fat with relevant scientific research. Most of these disorders are exotic cases, but it is at extremes that science tends to operate and where we can learn important information on medical disorders. Throughout the first section Dr. Tara explains the science in nontechnical language that is easily understood. Occasionally, her words become overly technical and may be difficult at times to follow for those without a background in chemistry or biochemistry. Anyone who becomes a bit overwhelmed should stick it out, however, as this section presents great insight into the complex world of fat and obesity.

Unfortunately, in the first section she does release some of the same old demons vilified in other books of much less scientific merit. For example, in Chapter 4 we meet Kathy who pursued a degree in genetic engineering after her youngest child started school. Upon graduation she took a job in industry and was promoted to a management position that required frequent travelling. Then she began to gain weight due to a sedentary job and too much fast food. Was it really the fast food? Or could it have been the collegial meals at upscale restaurants when one or more adult beverages were served that were to blame? Or a combination of both? Or something else? Later, we learn that although sumo wrestlers are grossly overweight, they store most of their bulk as abdominal fat rather than the less healthy visceral fat. Upon retiring, however, we are told that consumption of processed foods is responsible for a switch in the wrestlers from primarily healthy abdominal fat to a greater accumulation of visceral fat. Was it really processed food or was it the difficulty of cutting back from a 5000-7000 calorie-a-day regimen combined with a drastic reduction in physical activity? I don’t know the answers to these questions, and maybe the author thoroughly investigated both cases, but it is so easy to blame fast food and processed food because everybody seems to believe that these are the main causes of obesity.

Unlike many food writers of the day, Dr. Tara believes that the balance between calories consumed and calories burned is the major reason for weight loss or gain in an individual. The first section of the book explains the differences encountered by different persons. In the second section of The Secret Life of Fat, she moves on to other causes of obesity that do not directly relate to the amount of food consumed or level of physical exercise.  Continuing the intermixing of stories of real persons with the scientific research, she unveils the presence of viruses and their role in weight gain for some people. She also introduces us to the microbes in the gut and the potential genetic causes that capture more calories out of our food than a typical person. Women are more likely to put on fat than men, and ethnicity seems to play a role in adding unwanted pounds. Also covered in this section are the effect of hormones on fat storage. Who knew obesity could be so complicated!

The final section of the book delves into how we can work with our fat to remain slim and trim. Her primary solution is to focus on reducing calorie intake and increasing physical activity. She indicates that first one must get a handle on food intake before developing a successful exercise program. One size does NOT fit all—what works for one person will probably not work for another. She encourages each of us to learn what is effective for us and what is not through a series of trials and errors. What distinguishes a successful dieter from an unsuccessful one is persistence. So it all seems to come down to willpower—or that fat persons have no one to blame but themselves. I found this conclusion to be disappointing as it seems to argue against much of what she presented in the first two sections.

But wait there is more! In the next-to-the-last chapter, she uses what she has learned to date to diagnose her problem and treat it. This is where a very good book comes off the rails for me. Some of her self-diagnoses seem to be a stretch—particularly when the science presented earlier in the book dealt with extreme cases, not ordinary people. I am somewhat sympathetic to the author’s plight as I went through a similar process with an early-awake sleep disorder which I battled for many years. Both Dr. Tara and I became obsessed with our missions. Instead of working with her fat, however, as she claims in the introduction, she engages in full-scale battle to defeat it. In the end after many fits and starts she is able to lose 20 pounds or so at the cost of having to ignore hunger-pangs and fighting the temptation to eat the food she craves. Before she started her personal fight against fat, blood tests revealed values of a healthy person. Was the skinny figure she became really healthier than the heavier-set one she was determined to change? Will she be able to retain her desired weight or will she succumb to too much food and a re-expanding waistline? Only time will tell.

I highly recommend this book for anyone who wishes to gain a better understanding of the complexity of obesity and a scientific perspective on the subject. For anyone looking to reduce weight using science to help, this is not the book to read. A better, but less uplifting book to read explains why it is so hard to lose weight and keep it off would be Rethinking Thin by Gina Kolata. The theme of posts on this website for the month of May will be rational eating by avoiding extreme dietary approaches and engaging in mindful rather than Mindless Eating.

Next week: Do calories matter?