Taubes begins by talking about how pre-World War II scientists
studied genetics and endocrinology and developed the theories
that he presents in this book.

He cites 1908 German scientist Von Bergmann who first
used the term “lipophilia” which means “love of fat”.

Von Bergmann considered obesity a disorder of fat accumulation,
and worked to learn about how fat tissue was regulated.

 Von Bergmann said this is different from tissue-to-tissue and person-to-person.
Just as some parts of the body tend to grow hair and some don’t,
some people are hairier than others; and some people are fatter;
and these people fatten easily, and it often seems
that there’s nothing they can do about it.
Other people are lean and have trouble gaining weight.

Taubes says that in the 1920s Bauer, a genetics and endocrinology scientist,
adopted Von Bergmann’s ideas. At that time it was a new idea that
genes could give characteristics and a predisposition for diseases to people.

Bauer said that fat tissue in obesity is like malignant tumors….

“In those who are predisposed to grow obese,
fat tissue is driven to grow, to expand with fat,
and it will accomplish this goal, just as the tumor does,
with little concern about what the rest of the body might be doing.

The abnormal…fat loving…tissue seizes on food-stuffs,
even in the case of undernutrition…
It maintains its stock, and may increase it
independent of the requirements of the organism.
A sort of anarchy exists; the fat tissue lives for itself
and does not fit into the precisely regulated
management of the whole organism”

Taubes says that by the late 1930s the concepts of these German Scientists
were accepted in Europe and were catching on in the U.S.
but within 10 years, because of World War II, they vanished.

Germans and Austrians had founded and done most of the research
in nutrition, metabolism, endocrinology, and genetics,
which are all the fields relevant to obesity. 
 But World War II interfered with their studies,
and after WWII, anti-German sentiment in the U.S. resulted in authorities
treating the German medical literature as though it didn’t exist.
Taubes states:

“Once the psychologists took over in the 1960s
and obesity officially became an eating disorder
--a character defect but in kinder words—
any hope that authorities would pay attention
to how the fat tissue was regulated effectively vanished.”

Taubes says that after World War II
only a few researchers continued with the genetic line of thought.
Endocrinologist, Astwood, was one of them.

 In 1962 Astwood states that many enzymes and hormones
have been indentified that influence fat accumulation.
Some of those liberate fat, others put it there.
Ultimately, these competing regulatory forces
will determine the amount of fat to be stored in any single person
or at any single location on the human body.

What if something went wrong it one of these regulatory processes?
Astwood said

“Suppose that the release of fat or its combustion
(burning for fuel) was somewhat impeded,
or that the deposition or synthesis of fat was promoted;
what would happen?

Lack of food is the cause of hunger,
and to most of the body (fat) is the food;
it is easy to imagine that a minor derangement
could be responsible for a voracious appetite.

It seems likely to me that hunger in the obese
might be so ravaging and ravenous
that skinny physicians do not understand it.

This theory would explain why dieting is so seldom effective
and why most fat people are miserable when they fast.[/b]
It would also take care of our friends, the psychiatrists,
who find all kinds of preoccupation with food,
which pervades dreams among patients who are obese.

Which of us would not be preoccupied with thoughts of food
if we were suffering from internal starvation?
Hunger is such an awful thing
that it is classically cited with pestilence and war
as one of our three worst burdens.

Add to the physical discomfort the emotional stresses of being fat,
the taunts and teasing from the thin, the constant criticism,
the accusations of gluttony and lack of “willpower”,
and the constant guilt feelings,
and we have reasons enough for the emotional disturbances
which preoccupy the psychiatrists.”

 Taubes believes we need to understand what Astwood understood,
and what the Obesity Experts before World War II accepted.
Taubes says

“Both gluttony (overeating) and sloth (sedentary behavior)
will be the side effects of any regulatory derangement, minor as it may be,
that diverts too many calories into fat tissue for storage.”

This concept is extremely interesting to me, and, upon reflection,
I can see how it does align with my own experience.

It’s a bit scary to think that in certain instances,
my Fat, even when I’m starving, could work to protect itself,
and might even work toward increasing itself,
taking away energy/calories that the rest of my body needs.

However, this idea is the only Theory I’ve come across
that might explain to me what has actually been happening
with my own body during the past 2 years of my 5 years of maintenance.
Calories-in/calories-out simply doesn’t explain it.

In my current experiment, I am basing my eating Behavior
on the possibility that this Theory could be true.
An interest in my Results motivates me to follow through…day-by-day.

 Taubes starts out by talking about lab rats that had their ovaries removed,
became ravenously hungry, overate and became obese. Then, in a second experiment
the researcher took other lab rats, and after this surgery, put them on a strict diet
where they couldn’t eat any extra food. These rats got just as fat by becoming
completely sedentary. When estrogen was returned, the fat rats became normal weight.

The researcher explained it this way

“The animal does get fat because it overeats
It overeats because it’s getting fat.
The cause and effect are reversed.
Both gluttony and sloth are effects of the drive to get fatter.

They are caused fundamentally by a defect
in the regulation of the animal’s fat tissue.
The removal of the ovaries literally makes the rat stockpile body fat;
the animal either eats more or expends less energy, or both, to compensate”

Taubes talks more about enzymes,
and then says that in dealing with Obesity, medical experts have
ignored the fat tissue because they’ve decided the problem is Behavioral,
and lies in the Brain, not the Body.
He says, if medical experts were discussing growth disorder instead of fat disorder
the subject would be hormones and enzymes regulatory growth.
But when discussing a fat disorder,
which is defined by the symptom of abnormal growth of fat tissue,
the hormones and enzymes that regulate fat growth are considered irrelevant.

Taubes says…
this is the cause of obesity.

“those who get fat do so because of the way their fat happens to be regulated
and that a…consequence of this regulation is to cause the eating behavior (gluttony)
and the physical inactivity (sloth) that we..assume are the actual causes.”

He states Three Laws of Fat (Adiposity),
and gives examples and explanations of how they work.

The First Law
Body fat is carefully regulated.

The Second Law
Obesity can be caused by a regulatory defect so small
that it would be undetectable by any technique yet invented.

The Third Law
Whatever makes us both fatter and heavier will also make us overeat.

Taubes gives illustrations and examples of each of these laws, a
nd how they work….
One of his examples was the Zucker rats, which are genetically predisposed to get fat.

“when these obese rodents are starved to death…
the animals die with much of their fat tissue intact.
In fact, they’ll often die with more body fat than lean animals have
when the lean ones are eating as much as they like.

As animals starve, and the same is true of humans,
they consume their muscles for fuel, and that includes,
eventually, the heart muscle.

As adults, these obese animals are willing to
compromise their organs, even their hearts and their lives,
to preserve their fat."

 Taubes says….

“If this is true of humans,
and there’s little reason to think it’s not,
it is the explanation for..
the extremely poor but overweight mothers with thin stunted children.
Both mother and children are indeed half-starved.

The emaciated children, their growth stunted, respond as we’d expect.
The mothers, however, have fat tissue that has developed its own agenda…
It will accumulate excess fat, and does so,
even though the mothers themselves, like their children,
are barely getting enough food to survive.
They must be expending less energy to compensate.”

 Taubes then talks about the existence animals
whose genes have been manipulated
so they are leaner than they’d otherwise be.
Those animals will remain lean even when force fed,
and he says this is probably done
by increasing their expenditure to burn off calories.

He says just like gluttony and sloth
are side effects of a drive to accumulate body fat,

 eating in moderation and being physically active
are not evidence of “moral rectitude”.
Rather, they are simply metabolic benefits
of a body that’s programmed to remain lean.

Taubes concludes by saying that the evidence implies
that we don’t remain lean because we’re virtuous
and get fat because we’re not.
He says when we grow taller,
it’s hormones and enzymes that are promoting our growth,
and we consume more calories than we expend as a result.
When we grow fatter, the same is true as well.

“We don’t get fat because we overeat;
we overeat because we’re getting fat.”

I find it easy to believe in those three “laws” that Taubes states.

It is harder to accept Taubes’ Reversal of what is commonly believed
about the Causation of Obesity, and consider overeating and inactivity
to be “side-effects” of a (perhaps genetic) “defect of our fat regulation”,
because it is very Different from my usual Way to Think about Obesity.
Still….it COULD be true…..
I need to spend a lot more time considering this whole concept.

What Taubes said about the Zucker rats really struck home for me.
That parallel provided me with a possible answer to a question
that has been bothering me for some time.

Due to my interest in Eating Disorders,
I’ve spent quite some time studying Anexoria.
I am aware that the teenage dream of looking like a fashion model
is beyond the capability of most Anexorics,
because losing weight doesn’t turn an Endomorph
into an Ectomorph…only into an Emaciated Endomorph.

However, I’ve been puzzled by Documentaries that
follow real-life young females with Anexoria
who are in danger of death from loss of heart muscle
….when I can SEE many of those girls
are STILL A BIT PLUMP.

Many of the females in those studies are very, very thin
but also, some of them are not.
I’m seen plump cheeks, large (natural) breasts,
rounded tummies, large thighs…
and in fact…they appear to be “overweight” .

These girls clearly still have quite a lot of fat on their bodies,
but according to medical authorities,
their bodies are shutting down life-supporting functions.

This sounds like the same problem as with those Zucker rats.
 

Taubes says calories-in/calories-out is a damaging theory.
It reinforces what appears to be obvious, which is:

“Obesity as the penalty for gluttony and sloth”

He says it is Harmful because…
It is partly responsible for the growing number of obese;
It directs attention away from the real reasons we get fa;,
It reinforces the perception that fat people have no one to blame but themselves.

Instead of making us question our assumptions
about calories-in/calories-out..... .

...The fact that eating less FAILS as a CURE for obesity
is taken as evidence that fat people
are incapable of following a diet and eating in moderation
and they are blamed for it.

Taubes says

“There has to be a reason…
why anyone would eat more calories than he or she expends,
particularly since the penalty for doing so is
to suffer the physical and emotional cruelties of obesity.
There must be a defect involved somewhere;
the question is where.”

“The logic of calories-in/calories-out
allows only one acceptable answer to this question.
The defect cannot lie in the body—in the enzymes and hormones
that control how our bodies turn what is eaten into fat—
--because this would imply that something other than overeating
was fundamentally responsible for making us fat.
And that’s not allowed.

So the problem must lie in the brain.
And more precisely, in behavior,
which makes it an issue of character.

So, both eating too much and exercising too little are Behaviors,
not Physiological states,
a fact made even more obvious by the use of the…terms -- gluttony and sloth.”

Suggesting as an answer that fat people
respond to food restriction just as animals do
--that they reduce their energy expenditure
while experiencing increased hunger—
opens up the possibility that
the same physiologic mechanism that drives fat people
to hold onto their fat—even when semi-starved—
--might be the cause of their obesity in the first place.

This thinking is not allowed under the calories-in/calories-out theory.
So instead it is said the diet didn’t work
because the fat persons failed to stay on it.
They are blamed lack of willpower,
a lack of strength of character
to eat in moderation the way lean people do.

Once the fundamental cause of obesity
is established as overeating, 
blaming behavior—a lack of character and willpower—
is the only acceptable explanation.
The fat have a “perverted appetite”.

Taubes talks about the History of how this “insidious logic”
invaded the American science community in the 1920s,
and continued through the second world war.

He says the only thing different now
is that experts word it in less demeaning terms.
Like referring to obesity as an Eating Disorder,
which has become common since the 1960s. 
 He says by the 1970s “Behavioral Medicine” emerged to treat fat people with
“behavioral therapies” which are ways to make the fat eat like the lean.
When speaking of these behavioral treatments, Taubes says

“None of these therapies has ever been shown to work..
even so..many are still with us today.”

Taubes says that today most of the leading authorities on obesity
are psychologists and psychiatrists…
people whose expertise is in the ways of the mind,
not of the body.

He points out

“Imagine how many more dead diabetics we’d have
if victims of that disease
were treated by psychologists instead of physicians.

And yet diabetes and obesity are so closely linked…
...that some authorities have taken to calling the two disorders “diabesity”,
as though they’re two sides of the same pathological coin,
which they assuredly are.”

Taubes concludes with

“So long as we believe that people get fat because they overeat,
because they take in more calories than they expend,
we’re putting the ultimate blame on a mental state, a weakness of character,
and we’re leaving human biology out of the equation entirely.”

He says it’s a mistake to think this way,
and he will give us a better way to think about it in the rest of the book.

This chapter very much rings true for me.

I have a life-time of personal experience
in being blamed for failing to eat in moderation,
despite extensive and almost continual efforts to do so.

For me, this started at puberty and continued until
this present time when I began weighing in the normal range.

 I’ve experienced this issue with regards to
parents, siblings, boyfriends, husband, children, and other relatives;
friends, acquaintances, and strangers, teachers, potential employers,
Doctors, Psychologists, “Eating Disorder” specialists, Diet Counselors,
but most of all with my own accountability.

Details of my History are in the "About Me" section.
Personally, I’d very much like to have a better way to think about it.

Taubes says,

“the energy we consume
and the energy we expend
are dependent on each other….

These are dependent variables, not independent variables.
Change one, and the other changes to compensate.

To a great extent…the energy we expend from day-to-day
and week-to-week will determine how much we consume,
....while the energy we consume and make available to our cells…
will determine how much we expend.

The two are that intimately linked.
Anyone who argues differently is treating an extraordinarily complex
living organism as though it were a simple mechanical device.”

A 2007 article by the dean of Harvard Medical school and his wife,
who specialized in obesity research said

“An animal whose food is suddenly restricted
tends to reduce its energy expenditure
both by being less active
and by slowing energy use in cells, thereby limiting weight loss.

It also experiences increased hunger
so that once the restriction ends,
it will eat more than its prior norm until the earlier weight is attained.”

Taubes says  that the diet advice
given by our Health Authorities is wrong;

“eating less and/or exercising more
is not a viable treatment for obesity or overweight
and shouldn’t be considered as such.

It might have short-term effects…
Eventually, our bodies compensate.”

I believe Taubes is correct in his statements here,
and I know that, in my own body,
my food-intake and physical activity are connected.

After a day, or days, of little food-intake
I feel more tired and sleepy,
and I don’t feel energetic enough to accomplish my normal tasks,
let alone add in extra physical activities
I find that I can “push through these physical feelings” for awhile,
but exhaustion always seems to catch up with me.

After days of a great deal of physical activity,
I find myself ravenously hungry.
I can choose not to eat extra food….although it is difficult,
but eventually if I don’t eat more food
I wind up taking a very long nap….
which, of course, reduces the physical energy I’m using.

I’ve now had 5 full years of maintaining a large weight-loss
by eating less and exercising more.
I can report that this appears to work better in the short-term
than in the long-term for my own body,

During the past 3 years, each year it has become more
difficult to eat only the amount of food it takes to maintain my current weight,
AND, each year, I have found myself with less and less energy
for physical activities.

I am looking for Alternatives,
which is one reason that I am interested in the theories in this book.

Taubes starts out

“The very notion that we get fat because we consume more calories
than we expend would not exist without the misapplied belief
that the laws of thermodynamics make it true.
…
Obesity is not a disorder of energy balance,
or calories-in/calories-out or overeating,
and thermodynamics has nothing to do with this.”

There are three laws of thermodynamics.

“The first one…is known as the law of energy conservation:
all it says is that energy is neither created nor destroyed
but can only change from one form to another.”

He goes on

“All the first law says is that if something gets more or less massive,
then more energy or less energy has to enter it than leave it.
It says nothing about why this happens.
It says nothing about cause and effect.

It doesn’t tell us why anything happens;
it only tells us what has to happen
if that thing happens.
A logician would say that it contains no causal information.”

As an example,
Taubes suggests that instead of talking about why we get fat,
we could talk about why a room gets crowded.
In this example the energy we’re discussing is energy in entire people,
rather than just their fat.

So, we want to know why this room is crowded and so overstuffed with energy (people).

If I said, “the room is crowded because more people entered than left,”

You’d say…”Of course…But Why?”

If I then said, “rooms that have more people enter than leave
will become more crowded. There’s no getting around
the laws of thermodynamics”.

You’d say…”So what.?”…because I still haven’t given you any reason why.
I’m just repeating the obvious.

Taubes says

“This is what happens when thermodynamics is used to conclude
that overeating makes us fat.
Thermodynamics tells us that if we get fatter and heavier,
more energy enters our body than leaves it.
Overeating means we’re consuming more energy than we’re expending.
It says the same thing in a different way.

Neither happens to answer the question why.
Why do we take in more energy than we expend?
Why do we overeat?
Why do we get fatter?”

He goes on:

"The vast majority of experts who say that we get fat
because we overeat
or we get fat as a result of overeating
…are making the kind of mistake
that…should earn a failing grade in a high-school science class.”

Taubes says maybe we should start with the 1998 National Institutes of Health report
that said:

“Obesity is a complex, multifactorial chronic disease that develops from
an interaction of genotype and the environment.

Our understanding of how and why obesity develops is incomplete,
but involves the integration of social, behavioral, cultural, physiological,
metabolic and genetic factors.”

I’ve read many books and online discussions about
the First Law of Thermodynamics.
So, despite my lack of knowledge about such Scientific issues,
I am familiar with what that First Law says.

Usually in these discussions, people wind up arguing about things like
the differences between energy burned inside an open container
and energy burned inside a closed container.

Frankly, this tends to make my eyes glaze over,
and I want them to talk about something more interesting to me,
or at least, something I could better understand.

I like the fact that Taubes gives a simple explanation 
of the First Law of Thermodynamics
and how, while that Law is always True,
it doesn’t explain what causes of obesity.

Also I definitely agree that obesity is a very complicated disease
and that no one completely understands how and why it happens.