Good Calories, Bad Calories: The Mythology of Obesity, or The Mythology of Gary Taubes?

In my last post on Gary Taubes and his book Good Calories, Bad Calories, I stated that I would do a chapter-by-chapter critique of the book, starting with Chapter 14, "The Mythology of Obesity".  In this chapter, Taubes begins to create a mystery that doesn't actually exist.  He does this through a combination of logical fallacies, selective quotation of out-dated scientific data, and leaving out existing data that conflicts with his statements.

Taubes opens the chapter with this sentence: 

"Critical to the success of any scientific enterprise is the ability to make accurate and unbiased observations."

He then goes on to say:

"...if the initial observations are incorrect or incomplete, then we will distort what it is we're trying to explain."

Taubes is correct in these statements.  Unfortunately he doesn't follow his own advice.  He notes the hypothesis that obesity is due to excess calorie consumption and/or inadequate physical activity, and then says that this hypothesis fails to explain the evidence and observations. 

However, what Taubes fails to realize is that it only fails to explain the evidence and observations when you leave out important information regarding that evidence or those observations.

Taubes's First Big Boo Boo

Taubes makes his first big mistake on the very first page of this chapter.  He writes:

Lean people will often insist that the secret to their success is eating in moderation, but many fat people insist that they eat no more than the lean - surprising as it seems, the evidence backs this up - and yet are fat nonetheless.  As the National Academy of Sciences report Diet and Health phrased it, "Most studies comparing normal and overweight people suggest that those who are overweight eat fewer calories than those of normal weight."  Researchers and public-health officials nonetheless insist that obesity is caused by overeating, without attempting to explain how these two notions can be reconciled.

The last statement in that paragraph is blatantly false.  These two notions have been reconciled over and over again in numerous studies.  It is well established that overweight people underreport their food intake on average.  In fact, there is a huge volume of literature of on huge that it is surprising that Taubes missed it all.  The underreporting is quite severe.  One study comparing obese twins to their non-obese twin counterparts indicated underreporting of 764 calories per day.  Another study indicated obese subjects to be underreporting their calorie intake by over a thousand calories per day.  This is just a fraction of the data that is out there.  Yet, Taubes selectively quotes out-dated research that relied on self-report of food intake.  Taubes's reliance on out-dated and low quality data will be a consistent theme through the remainder of his book.

The phenomena of underreporting is verified when you supply overweight people with the amount of calories they claim to be eating.  In one study, women who claimed to be eating 1200 calories per day were supplied with that actual amount of food intake.  What happened?  They lost 1.7 pounds per week.  George Bray reported on a similar clinical experience.

My own clinical experience also verifies this.  For example, we had one individual who was not losing weight.  She swore to the dietitian that she was following the program.  One day, her husband came into the dietitian session with her.  He ratted her out and said she was eating 8 tablespoons of peanut butter per day and wasn't recording it in her food log.  That's over 800 calories per day of food intake that she wasn't reporting.  It is no wonder why she was not losing weight.  This is not to say that everyone who underreports food intake is blatantly lying about it.  Many people simply do a poor job of estimating their food intake.  But the fact is, people underreport their food intake.

Taubes, through selective cherry-picking, tries to create a mystery where there is no mystery.  He calls the idea of energy imbalance a "hypothesis", yet fails to consider not only the data mentioned above, but all of the controlled studies that demonstrate experimental overfeeding to create weight gain.  Researchers insist that overeating causes obesity because that's exactly what the data shows, despite Taubes's attempts to spin it otherwise.

The "Carbohydrate or Calorie" False Dichotomy

Taubes moves on to discuss data from the National Health and Nutrition Examination (NHANES) survey.  From 1971 to 2000, this data showed an increase in calorie and carbohydrate intake (as a percentage of calories) in the U.S. population, while fat intake decreased.  Taubes then states:

This increase in energy intake...was "attributable primarily to an increase in carbohydrate intake."...The NHANES data suggest that either calorie or carbohydrates could account for the increase in weight...

Taubes creates a false dichotomy here by asserting that either the increased calorie intake, or the increased carbohydrate intake, was responsible for the weight gain.  However, it's not "either/or" because the two are not independent of each other.  The increased carbohydrate intake IS the increased calorie intake, so you cannot separate the two.  Taubes creates a dichotomy where none exists.

Anecdotes and Newspaper Articles are Not Scientific Evidence

Taubes goes on to discuss physical activity.  He talks about the "exercise explosion" of the 1970's and 80's, implying that Americans were more active than ever.  However, what does he cite to support this?  Some anecdotes and newspaper articles from the New York Times and the Washington Post.  He also cites statistics on the revenues of health clubs.

It is absurd to imply that physical activity is high based on some newspaper articles and gym revenues.  For example, many people join gyms but don't go, or go infrequently.  And no matter how many Americans were supposedly partaking in the "fitness revolution", it is not statistical evidence of how truly active Americans were.   Also, formal exercise only represents a small portion of total daily energy expenditure.  When it comes to physical activity, we are concerned with all physical activity throughout the day, not just formal exercise.  Gym memberships and the "fitness revolution" are not indicative of 24-hour energy expenditure.

If you look at the science rather than anecdote, you get a different picture.  While there isn't good survey data regarding physical activity from the 1970's and early 1980's, the CDC does have data on leisure-time physical activity trends from 1988 to 2008:

Now, this is just leisure time physical activity, and not 24-hour activity.  However, you can see that the trend was mostly flat, with a slight downtrend in this decade.  This data indicates that 1/3 of Americans participate in no leisure time physical activity at all.  Taubes's numbers on gym memberships are meaningless, and his claims of a "fitness revolution" do not hold when you look at the data.

There is also data out of the Minneapolis-St. Paul metropolitan area between 1980 and 2000.  The percentage of individuals engaging in physical activity for 30 or more minutes, at least 5 times per week, was only 8-12%.  Only 1% participated in 60 minutes daily.  While this is not national data, the results were similar to what has been observed on a national level, and contradict Taubes's implication of an "exercise or sports epidemic" in America.

There is also data estimating the cost of mechanization (dishwashers, elevators, cars, etc.) to our daily energy expenditure.  It is estimated that we expend an average of 111 calories per day less, which, if not compensated by lower food intake, would result in substantial weight gain over many years.

In the usual fashion, Taubes creates a physical activity paradox where none exists.

The Poverty/Obesity Relationship:  Not A Contradiction After All

Taubes moves on to address another apparent contradiction...that obesity rates tend to be higher among the poorest members of society.  Taubes considers this a contradiction for two reasons.  First, he presumes that the poorest members of society are also the hardest-working, have less access to labor-saving devices, and thus are the most physically active.  Second, he presumes that they are undernourished and do not eat very much.

Of course, these are both assumptions.  Interestingly, Taubes criticizes advocates of the thrifty-gene hypothesis for making assumptions.  Perhaps Taubes should take a look at his own assumptions.

When you actually investigate the scientific data, you will find that Taubes's assumptions do not hold.  First, let's look at the presumption of low calorie intake.  There is a wealth of data that shows that the calorie intake of people living in poverty is not low.  In fact, people in poverty are more likely to consume energy-dense foods, because energy-dense foods are much lower in price.  There is an inverse relationship between the energy density of foods and price.  Here is a chart showing food prices from Seattle supermarkets in 2006:


You can see that the least expensive foods are both the fats and the refined carbohydrate foods, so one cannot simply point a finger at carbohydrates here.  In fact, there is a several thousand percent difference between the cost of vegetable oils and sugars compared to fresh produce.  It is very easy to overconsume calories when eating energy dense foods.  In fact, the energy density of foods plays a role in regulation of food intake, and high energy-density foods lead to passive overconsumption (meaning you consume more calories without noticing it, or without adequate feelings of fullness).  For a given volume of food, the greater the energy density of your diet, the more calories you will eat.  Thus, you can actually spend less and eat more.

People in poverty are more likely to underreport their food intake.  They are also  more likely to skip breakfast, which can result in appetite dysregulation and greater daily energy intakes (interestingly, adolescent breakfast skippers also have lower carbohydrate intakes).  Also, low-income urban neighborhoods have a high density of small food stores, which carry mostly energy-dense foods.

Let's also look at the presumption of high activity.  This does not hold when one looks at the data.  According to NHANES, leisure time physical inactivity is higher in people below the poverty line compared to people above the line.  This is particularly true among women, where obesity rates also tend to be higher.

On top of all that, Taubes fails to consider that obesity rates for higher socioeconomic classes increased at a higher rate than lower socioeconomic classes from 1976 to 2008.

The bottom line is that poverty does not mean chronic energy deficiency or high physical activity.  In fact, impoverished populations with true chronic energy deficiency have almost no obesity.

Pima Problems

Taubes continues to get it wrong when he moves to discuss the Pima Indians, again relying on old data from the 1800's and eary 1900's, including journals and anecdotes rather than rigorous scientific research.  He discusses how the Pimas went from food abundance to poverty when placed on reservations, along with a corresponding rise in obesity.  He implies that it could not have been due to an increase in energy intake or a decrease in physical activity.  His support for that?  Anecdotes from anthropologists.  Taubes relies heavily on anecdotes from anthropologists Frank Russell and Ales Hrdlicka.  Taubes comments how obesity was most prevalent among the Pima women, who also (supposedly) "worked considerably harder than the men", and mentions how Russell was not particularly confident that the Pima were no longer active (I'm not sure how Taubes can infer Russell's level of confidence from written words).    He mentions the low fat intake of the Pima (24% of calories, according to data from the physician Frank Hesse), and the high intakes of refined flour, sugar, and canned fruits.  The implication, of course, is that it's the carbohydrates causing the obesity, not elevated energy intake and/or reduced energy expenditure.

When one looks at more modern, higher quality scientific data, we get a different story.  There is a group of Pima Indians living in a remote region of the Sierra Madre Mountains in an area only recently accessible by road.  These Pima have experienced little change in environmental conditions, and continue to lead the traditional lifestyle of the Pimas of the 1800's.  A number of studies have compared these Pima Indians to the U.S. Pima Indians living on reservations.  Rates of obesity are dramatically lower among the Mexican Pimas compared to the U.S. Pimas, while physical activity levels are 2.5-7 times higher.  Direct measurements of energy expenditure using doubly-labeled water have shown the energy expenditure of the Mexican Pimas to be 600 calories per day higher than U.S. Pimas.  The Mexican Pima Indians have a diet of over 60% carbohydrate, and around 26% fat.  Estimates of the traditional Pima diet before the influx of the white man place the carbohydrate intake even higher at 70-80% carbohydrate.  So much for carbohydrate causing obesity!

Chapter 14:  Nothing But Mythology

The bottom line is that the vast majority of the information in chapter 14 is misleading and based on very selective reporting of mostly old, low quality data.  Unfortunately this journalistic style of Taubes continues through the rest of the book.  Supposedly Taubes did 6 years of research for this book, yet it took me only a few days of PubMed searches to find better research.  Chapter 14 is more an exercise in confirmation bias than true scientific inquiry.

I will discuss Chapter 15, "Hunger", in a future blog post.

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10 years ago

Thank you so much for ripping Gary Taubes a new one.He kept implying throughout “why we get fat” that calories didn’t matter but even most prominent low carbers like Dr eades and Dr atkins admitted you should not overeat.There’s even pictures of him online giving talks on how calorie restricted diets are ineffective when he is clearly sporting a gut himself even though he has a tall frame .Yes low carb can be helpful for people who are obese but it is by no means a magic bullet.

10 years ago

james krieger is a dumbass

11 years ago

The main thing I get from reading this blog article and related commentary is this: Everyone of us filters what we read to support our preexisting conclusions. When I go through the article and the comments, it makes me wonder how many of you read every word of the book. Not skim or speed read. Reread paragraphs and thoroughly apply it as an experiment of one. Just because it works or didn’t work for you doesn’t invalidate it for others. These studies should focus on multiple studies (100 or more people) of 1 person at a time instead of groups.… Read more »

11 years ago

I believe the truth lies somewhere in the middle. Calories aren’t irrelevant, but their journey through all the bodies of the world ain’t as simple as calories in, calories out. I am amazed that anyone could be satisfied with the explanations of conventional wisdom has had to offer so far… On the other hand, I experienced going from slim to skinny eating thousands of calories while drastically cutting down on cardio.

There is no way Taubes knows everything, but he has offered the most satisfactory explanation for what I’ve been through.

vientre plano
11 years ago

I believe that avoiding processed foods is the first step to be able to lose weight. They can taste fine, but packaged foods have very little vitamins and minerals, making you take in more in order to have enough electricity to get with the day. If you’re constantly feeding on these foods, switching to cereals and other complex carbohydrates will help you to have more electricity while eating less. Good blog post.

11 years ago

So on the one hand you accuse Taubes of cherry picking. On the other hand, you blatantly cherrypick the issue of under reporting, which as Taubes non-controversial source clearly states applies to both overweight and lean people alike.

What are you going to do next? Tell us that black people kill people but neglect to tell us that other races do as well?

11 years ago

oncologists happen to use Metabolic Typing and individualized diets (for some, this meant high protein/fat diets) all the time in treating aggressive cancer patients. i scratch my head as the rest of the fitness/health world is busy analyzing calorie is a calorie arguments when it’s really all about how the body responds to a particular calorie. we all know the body can make thousands of minute changes in blood pressure, pH, osmolality and volume regulation in a day. what makes you think it can’t regulate something much broader such as appetite? counting calories is retarded, no animals nor pre-modern man… Read more »

11 years ago

man you guys are still counting calories? nobody is overeating because oops i didn’t know this pizza was 2000 calories. they overeat because of the hormonal state or the hunger state the body put them in. if you’ve never experienced severe overeating and obesity yourself, then you don’t know an ounce of what its like. it’s like someone trying to discredit what a schizophrenic went through but is healthy themselves. maybe not all of Taubes’ assertions are right or backed up by research. but the important point is that those who are obese (who ate the same American diet as… Read more »

11 years ago

@ Laurel – You make some good points, especially your last one about why we’re fatter now than 50 years ago. Actually, I do think it has something to do with the “extreme” diet mentality that has been fostered in this country over the last couple of decades. However, contrary to what FA proponents, or those marketing weight loss surgery, say, diets (i.e., eating less than one’s body needs) work and have always worked for folks to lose weight. There have been enough controlled experiments to validate the calorie balance theory. Keeping it off, as you noted, is a different… Read more »

11 years ago

Some interesting comments and arguments here. The problem as always: it’s ALL CONJECTURE (even Mr. Taube’s theories) unless you have real world proof. Have a great theory about weight loss? I don’t care what it is — low carb, high carb, no sugar, high fat, low calories, exercise — whatever. Go out and find 100 fat people. No — FAT WOMEN. That should present no problem in a nation with 66% of us overweight or obese. And those women should be AT least 30 yrs old, and have had at least one biological child (pregnancy, affecting weight and hormones) and… Read more »

11 years ago
Reply to  Laurel

I certainly agree with the last part of your comment Laurel. No doubt many, if not a proveable majority if some mass survey were to be done, of overweight/obese adults got that way trying to diet and riding the weight rollercoaster. I’m quite sure it was the cause of mine! As James has written about, dieting does two things: it lowers metabolism, and it makes the body more efficient at using energy to fuel activity, IOW you burn less doing the same activity as before, and not just because you weigh less, but less than you would have had you… Read more »

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