Hungry Gene, The: The Science of Fat and the Future of Thin

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Hungry Gene, The: The Science of Fat and the Future of Thin

by: Ellen Ruppel Shell

Topics include: obesity scientists, obesity pandemic, satiety factor, leptin injections, fetal programming, obesity surgery, weight loss medication, obese gene, gastric bypass, obese mice, body weight regulation, leptin levels, weight loss drugs, obesity drugs, leptin receptor

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From Publishers Weekly
More than 1.1 billion people worldwide are overweight or obese. How and why did the world get so fat? Shell, a journalist and codirector of the Program in Science Journalism at Boston University, explores the issue from many angles including the roles of genetics, pharmaceutical companies, the food industry and social class. She charts the growth in scientific research on obesity and obesity treatments in the last decade (from stomach stapling to the notoriously dangerous drug Fen-Phen), explaining the biology of metabolism that makes it so difficult to circumvent the body's appetite. Shell also explores the lifestyle culprits behind obesity, traveling to Micronesia to document the residents of the island of Kosrae, whose average life span has plummeted in recent years due to the introduction of high-fat Western food. Though she lucidly explains the physiology of fat, Shell fills the book with chatty profiles of patients and doctors ("Rudy Leibel is a small man and trim... He has a degree in English literature, and a weakness for poetry") and her prose reads like that of a glossy magazine. There is also much in the book that may be familiar to readers; the spotlights on new obesity treatments are compelling, but it will come as no surprise that too much high-fat, calorie-dense food and too little exercise trigger obesity. On the other hand, given that Big-Tobacco-style class-action lawsuits against fast food companies are under consideration, some may find Shell's arguments for the regulation of junk-food TV advertising, among other measures, timely and provocative.
Copyright 2002 Cahners Business Information, Inc. From Library Journal
This is not quick-fix diet book. It's a science journalist's study of why we are fatter than ever (60 percent of Americans should be skipping dessert today) and what is being done about it.
Copyright 2002 Reed Business Information, Inc. From Booklist
Science journalist Shell brings science, history, and economics to bear in this penetrating look at how and why an increasing number of people in developed nations are obese and what can be done about it. Shell outlines the life-threatening illnesses posed by obesity--hypertension, diabetes, and heart disease. She explores historic public and medical opinions on obesity--from attributing it to lack of moral fortitude to classifying it as a genetic disorder--and the various cures, including starvation and stomach stapling. Shell also offers a fascinating cast in the scientists, doctors, and patients who are tracking down the causes of obesity. Despite the general lack of public sympathy for the obese, the predicted profits to be made on weight reduction are fueling a growing conflict between scientific discovery and commercial interests. Readers interested in health and science will enjoy this fascinating book, although be forewarned that some descriptions may be too graphic for some readers' tastes. Vanessa Bush
Copyright American Library Association. All rights reserved Gregory Mott, The Washington Post
"Compelling.Shell takes us into the wide world of obesity, seeking answers." Jan Gardner, The Boston Globe
"Draws parallels between Big Tobacco and Big Food that arechilling." The Minneapolis Star-Tribune
"Provocative.[Shell] is as adept at explaining the physiology of fat as she is at chronicling the desperation of the obese." Jon Weiner, Pulitzer Prize-winning author of Beak of the Finch
"A clear, inviting, and entertaining look at this fascinating subject, and at the sociopolitical underpinnings to the mysterious obesity pandemic." Charles Mann, author of Noah's Choice
"Shell gives everyone, thin and heavy alike, reason to hope that obesity won't become the cancer of the 21st century." Jon Weiner, Pulitzer Prize-winning author of Beak of the Finch
"A clear, inviting, and entertaining look at this fascinating subject, and at the sociopolitical underpinnings to the mysterious obesity pandemic." James Fallows, National Editor, The Atlantic Monthly
"A fair-minded, clear, and fascinating book.... An authoritative introduction to the next big public-health threat." - Booklist
Science journalist Ellen Ruppel Shell brings science, history, and economics to bear in this penetrating look...fascinating Eric Schlosser, author of Fast Food Nation
"In The Hungry Gene, one of America's finest science writers tackles one of our most urgent public health issues." Alan P. Lightman, author of Einstein's Dreams
Ellen Shell's THE HUNGRY GENE is important, richly informative, and written with flair. About the Author
Ellen Ruppel Shell is a correspondent for The Atlantic Monthly and writes for Discover, The New York Times Magazine, Smithsonian, and other publications. She is associate professor and codirector of the Program in Science Journalism at Boston University.

Reviews:

Super-sizing the proles
Science journalist Ellen Shell notes near the end of this fascinating study about being fat and how we got that way that "Twenty-seven percent of Americans are already obese." She predicts that, unless something is done, "virtually all Americans will be overweight by 2030, and half will be obese." (p. 230) Why? Lack of will-power? Lack of exercise? Our genetic constitution? Ignorance? Indoctrination through advertising by the fast and junk food industries? Answer: all of the above except lack of will-power. When it comes to eating, will-power really has nothing to do with it. Food is a "drug" we can't quit cold turkey. Abstinence is impossible. We must eat, and so the temptation to overeat and/or eat the wrong foods will always be with us. Not only that but we are constantly being bombarded with messages from the purveyors of food to eat this, eat that, eat more, more and more. Super-sizing the proles is a massively huge business. So what to do? Are we looking at a future in which most of us are round mounds of huffing and puffing blubber subject to diabetes and an early death? Shell is hopeful. She believes that if we can somehow regulate the fast food industry in a manner similar to way we are regulating the tobacco industry (see the final chapter), if we educate the public, and turn down the constant din of fast and junk food advertizing, and keep sodas and junk food out of our schools while increasing exercise programs especially for school children, there is hope. However, as Shell illustrates graphically by the story she tells on herself to end Chapter Ten, it is more likely that instead of exercising, we will get into the car, "rev the engine, and steer toward dinner." Regardless of how daunting the public health task of reducing obesity is, Shell makes it a fascinating read. She writes about the morbidly obese and their struggles with stomach stapling and gastric banding; about cultures lured away from their native diets by Spam, pizza and sugared sodas so that virtually everyone from child to adult is fat and many are diabetic (e.g., the Kosraen islanders of the South Pacific); about "Natural Born Freaks" (Chapter Three) children born with a genetic defect that makes them constantly hungry no matter how much or how often they eat; about being hungry during wartime or during food-deprivation experiments in which the hungry can think and talk of nothing but food and more food; and especially about "Big Food" which views critics as "food cops...intent on using junk science to build a socialist nanny state" (p. 230) As I read the book and followed Shell's research I could see her learning the melancholy lesson that "Obesity represents a triumph of instinct over reason" (p. 221). I could sense her early optimism giving way to a realization that "The labyrinth of genes, peptides, and hormones regulating food intake is dense and byzantine, extremely difficult to fool or to manipulate." (p. 147) This is a lesson that Shell presents well. What it means is that all those scientists looking for the magic pill that will allow us to "lose pounds fast" (and incidentally make big bucks for themselves and their employer) are not likely to be successful any time soon. Most of us know, as Shell reports, that people who go on diets of any kind may initially lose weight, but almost invariably gain it all back and usually with pounds to boot. The reason quite simply is that we can't fool mother nature. The evolutionary mechanism has structured in us the very fine ability to eat when there is a bounty of food so that we can put on fat to survive the inevitable times of lean. This is what we are good at. It is one of our talents. Mother nature isn't about to leave fat-storage to chance in human beings anymore than it leaves reproduction to chance. Dieting is just a mimicking of a time of lean. It has no lasting value as fat-reducing behavior. Shell's prescription for individuals is the obvious and the very difficult one: turn off the TV, get off the couch, don't get into that vehicle, in fact trade the entire TV/car culture in for one in which we walk a whole lot more, actively recreate a lot more, eat more fresh fruits and vegetables and less high-fat and high-carb foods...in other words do those things that in fact we are not likely to do. This is a very readable, well-researched, and incisive look at what is rapidly becoming the number one public health problem in not only the United States but world-wide. Shell covers the subject well and writes the kind of prose that turns pages and makes a difficult subject readily accessible.

Skillfully meets a pressing need for real information
This book a a truly superb work of science journalism. It tells a complex story of diverse research threads with sometimes contradictory conclusions, and it tells it incredibly well. By the time you finish this book, you will have a much better idea how to realistically interpret for yourself the claims for the latest diet or latest exercise machine or weight loss pill or program. You will have a much better idea what is "in your genes" and what is not, what you can attribute to "slow metabolism" and what you can't. In bringing together all of this diverse research and telling its story so well, this book is a landmark in explaining what sorts of things we can control, and where we are spinning our wheels. Not only is the story of obesity research interesting and relevant to all of us, but it is extremely difficult to get the whole picture. Each article and each news story tends to cover what is novel or most fascinating about research, and the solution the author is promoting, and usually ignores the background and the consensus already formed. The Hungry Gene covers all of the central lines of research: the modification of behavior, the influence of genes, the way the body regulates its own weight, the role of food industries and marketing, and makes each set of findings clear. Equally important, the author makes it clear what we still don't know about human weight control. There simply isn't any non-technical source to find out what is known about obesity, and the technical sources don't tell the story nearly so well, and they tend to be speciallized to a particular field. The Hungry Gene brings it all together coherently. An important and highly relevant education-in-a-book on a deeply interesting topic. Hard to beat a bargain like that. It's rare to find a book that meets such a pressing need for scientific information in such a skillful way.

From the title and abstract, I'd hoped to find an interesting and readable exposition of the known biochemical mechanisms regulating appetite, from the insulin/glucose cycle to protein encodings for hormonal messengers that regulate appetite, and possibly some discussion of stress and crisis-related changes to the body's delicate chemistry. The first half of the book delivered somewhat on the title's promise, recounting at high-level some of the early genetic research into obesity and identifying key scientific discoveries in the field from the last couple hundred years. The author's accounts of academic in-fighting and jockeying between competing genomics researchers in the early '90's was pretty interesting, and I looked forward to reading about more pieces of the puzzle falling into place as research continued with better and more widely available technology later in the decade. But at this point, the book took a bit of a turn to discuss the impact of fetal (mal)nutrition on the expressed genome. While also an interesting field of research, I was really wondering where the author was going... unless there's been an invisible and widespread epidemic of starved and/or gorged mothers giving birth over the last 50 years, it's hard to see how the learnings about the role of fetal environment in could be actionable in reversing the alarming trend toward obesity. And then the book left biochemistry behind completely, reprising Schlosser's Fast Food Nation in the space of the last few chapters. I guess the author meant to construct a single argument along the following lines against obesity/overeating being a behavioral problem: (1) There are genetic factors that (almost) deterministically control eating behavior, whether in mice or humans. (2) It's not completely deterministic, though, because ultimately a genotype interacts with an environment and expresses as a particular phenotype (as proved by the impact of fetal malnutrition), and (3) the environment we've provided in Western developed nations is terrible; it encourages all the wrong outcomes. Unfortunately, this thread of reasoning is neither particularly cogent nor necessary... if your point is that the proliferation of fast food and sugary soda is causing the obesity epidemic, you really don't need to detail the impact of leptin or CCK on the hypothalamus to explain what's going on. The Hungry Gene ends up reading like two separate books: a brief but interesting introduction to the biochemical nature of appetite, and one on the evils of Big Food. I don't disagree with the author's polemic against McDonald's et al, but it feels a little out of place given the book's title.

Obesity Marketeers
While one can be grateful and admire the authors' acknowledgement of the marketing of obesity-just how much the obsessive desire of normal weight people to be stick thin body builders viciously escalated today's obesity epidemic is, of course as with all these eat less move more, political books never really examined. To her credit she is more sympathetic than scolding, and acknowledges homo sapiens' stunning ability to survive famine through "famine" metabolism control, (I wish I could regulate my heater so effectively in the winter!) and superior carb storing ability as fat. (If only I could get this kind of return on my bank acct. for such minimal but constant deposits!) The hope based on ignorance of this physiological truth is what the diet industries profits from with it's-hello-eat less! starvation sports drinks and reducing teas. This is the real evil cuplrit here-NOT Fast food! Who was believing that fast food supersized meals were beneficial to your health anyhow? No one, at least in that industry, was preying on false hope and America's moral obsession with thinness and fitness. In that sense "health bars" such as Jamba Juice, where one gulped down thousands of calories of fructose and fat free soy while the other hand slammed one's face with fat free carbs hoping to regain one's compromised modern health is the real problem. The junk food eaters woud've always been part of America's once stable fat percentage, but over looked is what compounded and created the Obesity epidemic one hears about ad nauseum: those miserable, self-loathing healthy eaters adhering tragically to the eat low fat replaced with earth sustaining carbs-move into the gymn self-flagelaters who found themselves more and more exhausted, deprived and self-blaming only to wake up fatter somehow. AT least anorexia had paid off-this was just killing you slowly and making you feel like a corpse in sweats. The majority of said "victims" were not cheating-which is truly heroic and unfathomable in the face of the kind of out of control cravings this way of eating sets you up for. Talk to the Great Generation who starved through the forties and rejoiced at having plenty again, bragging about having enough to even add back the more expensive meats. (This is why I don't buy the class argument! Produce, grains, low fat protein like soy and tuna recommended here for thinness are the cheap food! One has only to make a slight effort to eat these instead of Mc Donalds.) At this point obsesity was stable, appetites were satisfied, blood sugar was under control, and most importantly, the American obesity rate was stable. It is with the new food pryamid, (Any child attending school between the '70s and '90s remembers it.) when loading up on unsatisfying side dishes instead of building blocks stimulated a sort moral deprivation, fat cutting movement. Look at how the charts climb, notice how obesity rates, not to mention diabesity and all the other living deaths, (if not eventual deaths) became as out of control and all consuming as one's blood sugar. IT would be nice to see some acknowledgement of this reality, which could offer hope, since people can't very well give up eating altogether - Rather than chastising those already living like prsion camp laborers to do what they've been desperately trying to do-eat less, move more. I guess the shockingly frustrating trend where we've been eating less and weighing more is just something that will not be acknowledged for a very long time, and I keep hearing about how all of America will have eaten itself to death by then. The Roman empire certainly had a more admirable way of doing itself in, and we're not even enjoying the good stuff.

Phat start...thin finish
Keeping the food theme alive, I'll start by way of analogy... Have you ever dined at a fine restaurant, had a well planned, beautifully executed and thought provoking meal, only to have the entire experience scuttled by a ho-hum dessert and a burnt cup of coffee? Such was my encounter with The Hungry Gene. Author Ellen Shell, a consistent contributor to the Atlantic Monthly, is among the top science writers in the United States today and she adroitly demonstrates her literary and research skills in every piece she creates. This book is no exception as she sets the stage with great finesse and takes us through a brief monograph of the philosophy and treatment of obesity from ancient history to the mid twentieth century. She then moves to the early theories of genetics and obesity and on to the core of her book, the absolutely riveting story (full of juicy back-stabbing details and deal making) of Dr. Jeffrey Friedman and his research team's obsessive search for the magic genetic bullet to cure obesity, and the resulting avarice of the pharmaceutical industry in trying to procure and apply the research. Shell then elaborates on the genetic ties to obesity through a chapter dedicated to the Kosrae people (an indigenous Micronesian population brought to obesity by the Westernization of their foodways) and a chapter concerning pediatric and adolescent obesity illustrated through the study of children conceived and born during the Nazi siege of Holland of 1944-45 and additional prenatal research performed by Dr. David Barker, a Southampton, UK based epidemiologist. These studies are sited in support of the strong correlation between a pregnant mother's food intake and a child's pre-disposition towards obesity. It's at this point the waiter pulls up the rather Spartan dessert cart featuring a tired looking cheesecake, a lonely slice of apple pie and coffee made fresh...this morning. Because in what reads like stream of consciousness, Shell tries to use childhood obesity as a bridge to the final chapters which are essentially a political harangue of the food industry and food marketing. Her points for the most part are well taken and quite valid, but they seem out of context for the case she was building previously on scientific and empirical evidence. Also there are several authors who frankly wear the mantle of angry reformer better than she: Greg Critser's, "Fat Land", Marion Nestle's, "Food Politics" and Eric Shlosser's, "Fast Food Nation" are infinitely better articulated and have more compelling arguments condemning the big business of food. There's a telling line in Shell's Acknowledgements section: "Current Atlantic Monthly editor Mike Kelly not only ran excerpts of this book in the magazine, but suggested that I direct at least some attention to what he called the 'marketing of obesity' - a brilliant stroke". That's exactly what the conclusion of this book feels like - a well intentioned afterthought encouraged by an editor. For me, perhaps the greatest irony to be savored from the swelling (excuse the back to back puns) number of publications concerning the weight problem and obesity pandemic, is that even after all the scientific, psychological, and sociological pundits have weighed in, we're still faced with the same admonishments our mothers gave us starting as far back as the Eisenhower administration, namely turn off the television, go play outside, no candy before dinner, don't eat so fast, and finish your veggies.