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Treat obesity as physiology, not physics : Nature News & Comment

Posted Feb 27 2013 9:46am

“It is better to know nothing,” wrote French physiologist Claude Bernard in An Introduction to the Study of Experimental Medicine (1865), “than to keep in mind fixed ideas based on theories whose confirmation we constantly seek.”

Embracing a fixed idea is one of the main dangers in the evolution of any scientific discipline. Ideally, errors will be uncovered in the trial-by-fire of rigorous testing and the science will right itself. In rare cases, however, an entire discipline can be based on a fundamental flaw.

As a science journalist turned science historian, I have written at length about how and why this may have happened in obesity research. I have suggested that the discipline may be a house of cards — as, by extension, may much research into the chronic diseases associated with obesity, such as diabetes.

As readers of this blog know, I am a Gary Taubes admirer. The title of this opinion piece says it all for me. Obesity is driven by physiology...in other words, the complex hormonal logic of the body. NOT by physics, the laws that we mostly associate with non-human matter. While physics is immutable, the body is able to change the game from moment to moment and it does so by responding differently to varying situations, like the specific content of our food and our current nutritional status.

As you know, I also believe that the obesity epidemic may be multi-factorial and include many other causative agents that have, when taken together, reached a tipping point. But Gary Taubes' contention that our beliefs about calories/ in calories out have led us down the garden path is right on as far as I'm concerned. And his focus on carbohydrates and insulin fluxes as the final common pathway for weight gain echo what I've seen for many years in practice.

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