INTERVIEWER Marc Hellerstein thought that the obesity epidemic was caused by people being sedentary?
TAUBES He believed that the key is whether you’re sedentary compared to how you used to be. When I told him about the Pima and the Sioux Indians and this 1981 study of obesity in oil field workers, he had an excuse for everything. So the Pima and the Sioux Indians, they lived on reservations, so they could be obese because they were relatively sedentary, at least more sedentary than they used to be. And the oil field workers, well, theyâ€™re Mexican-American, so they have some kind of â€œthriftyâ€ gene going. You knowâ€¦this is what pathological science is: a field in which you can find a reason to explain away all negative evidence. In pathological science, it’s no longer possible to refute the hypothesis. Remember, science is about trying to test your hypothesis and refute it, but in a field like this, if you test it and come up with a counter-example, the counter-example is just explained away with whatever comes to mind. Negative evidence never means anything. So you have an obese person whoâ€™s sedentary, thatâ€™s proof of my hypothesis. If you have an obese person whoâ€™s very active — at least, compared to most people today — the Sioux indians, for instance, who were so poor they had to walk down to the river to get their drinking water; who had no televisions, no cars; they had to walk outside to evacuate their bowels — those people are obese because they used to be more active than they are now.
INTERVIEWER Iâ€™ve never heard that before: “They used to be more active.”
TAUBES But thatâ€™s the implication of Hellerstein’s knee-jerk reservation hypothesis. They may be poor, and they may be out working in the fields, so compared to us, theyâ€™re active, but compared to their former life, theyâ€™re sedentary. See what Iâ€™m saying?
INTERVIEWER Yeah, I understand the logic. Iâ€™ve just never heard it before.
TAUBES Well, the reason youâ€™ve never heard it before is because youâ€™ve never heard anyone have to explain why obesity was common in an impoverished Native American tribe in 1902 or in 1928. When confronted with that observation, they have to come up with an explanation so that they donâ€™t have to question their hypothesis. I happen to challenge someone who believes the conventional wisdom unconditionally, and thatâ€™s the response I get: â€œWell, theyâ€™re living on reservationsâ€.
INTERVIEWER Does he do research on weight, on obesity?
TAUBES Absolutely, he does.
INTERVIEWER That’s unfortunate.
TAUBES This is why the field is in the position itâ€™s in. These people believe so strongly in the calories in/calories out/gluttony/sloth combination that they no longer function as scientists. They canâ€™t imagine the existence of an alternative hypothesis. So everything they see, they have to find a way to interpret it so that it supports what they already believe to be true.
INTERVIEWER They donâ€™t see that theyâ€™re operating differentlyâ€¦
TAUBES â€¦than other scientists.
INTERVIEWER Do they see that theyâ€™re not making progress?
TAUBES No, because that gets blamed on the obese. If you believe that obesity is caused by sloth, then the reason fat people are fat is because they don’t have the moral fortitude to go run ten miles every day the way you do.
INTERVIEWER Well, people have been saying that for 50 or 60 years. So the fact that theyâ€™re saying the same thing now as they were saying 60 years is a sign, to me, that theyâ€™re not making progress.
TAUBES Yes, that’s a very good sign, but these people don’t realize they’re saying the same things and doing the same experiments and making the same mistakes that their predecessors made a century go because they don’t bother reading that literature. For reasons I still don’t really understand, these people see no reason to pay attention to the history of their field. Imagine if physicists saw no reason to pay attention to Einstein and Plank and Maxwell and Heisenberg? I mean, these guys all lived a century ago, why would anyone want to know about them or the experiments they did? But in physics, mathematics and even biology, the history is carried along with it. As the science progresses, it takes with it the successful ideas and the students learn about the history along with the science. In obesity research, World War II just cut all of that off. For whatever reason, several generations of researchers grew up with this belief that the history of the field doesnâ€™t matter. And so they don’t even know or care that they’re saying the same thing and doing the same experiments that their predecessors did 100 years ago. And then this latest generation is full of young molecular biologists, and they start the clock in 1994, when leptin was discovered. Theyâ€™re not aware that theyâ€™re not making progress, because they believe that nothing of value was done until 1994.
INTERVIEWER The birth of a new world. In your book, you seem to place weight on the fact that Atkins was disliked by people he went to school with. Did I read that wrong?
TAUBES I think that was part of it. I think the fundamental problem with Atkins is that his book emerged in 1972 , when the low-fat dogma was really beginning to be taken seriously, not just by the heart disease researchers, but by physicians and public health authorities. It was viewed as a great triumph of modern medicine. We finally understand what causes heart disease. Then Atkins goes out of his way to throw the high-fat nature of his diet out there: â€œYou can eat Lobster Newberg, double cheeseburgers, and porterhouse steaks” (like my New York Times Magazine cover). The AMA always had this philosophy that even if people wanted to lose weight, they should go to their doctor and discuss it with them. You shouldnâ€™t go on a diet without your physicianâ€™s guidance. So here Atkins was end-running all of that. Then he was saying â€œeat a high-fat diet. Itâ€™s harmlessâ€. He actually said â€œItâ€™s good for you.” If you read Atkins, he read a lot of the papers I read. His understanding wasnâ€™t tremendously sophisticated, but he didnâ€™t have the advantage I had, of coming along 40 years later. For the time, he was doing pretty damned good. He believed that triglycerides were the problem, not cholesterol. He believed that insulin was a problem. He was a working physician; he didnâ€™t have the time that I did to read all of the research, and to have the internet available to allow him to track down all of the references. But the establishment thought his diet was dangerous. And then Atkins made these claims that he had patients who consumed 5000 calories a day and still lost weight, so they also believed Atkins was a quack, a shyster trying to sell impossible dreams. And they thought this because they believed that calories in/calories out was all that mattered. They had this inherent belief that in order to lose weight, you have to restrict calories; Atkins said you didnâ€™t. So, to these establishment nutrition types, Atkins was saying that the laws of thermodynamics can be ignored. So they had reason to think that Atkins’s diet couldnâ€™t possibly work, on the one hand, and that it would kill you, on the other. So these â€œresponsible physicians,â€ as they perceived themselves to be, felt an obligation to suppress this threat to the public health. The fact that they knew Atkins personally, that some of them had worked with him and gone to medical school with him and didn’t particularly like him, made it all that much more . . .
TAUBES Yes, irresistible. One of the things I mentioned in my lecture was something I didnâ€™t realize this when I wrote the book. Atkins proposed that one reason carbohydrates-restriction worked is that it stimulated the secretion of something that British researchers in the 1950s had called Fat Mobilizing Hormone. The joke is that you didnâ€™t need a Fat Mobilizing Hormone; the thing you have to do to mobilize fat is lower insulin levels and the way to do that is to remove the carbohydrates from the diet. That’s what mobilizes fat from the fat tissue. But Atkins was doing what a lot of diet book authors do, which was combing the literature for everything and maybe anything that might support his argument. He talked about insulin, but he also talked a lot about Fat Mobilizing Hormone, which was controversial at the time but not an outrageous idea. At the time Atkins wrote the book, this Fat Mobilizing Hormone had yet to be nailed down, and it never would be. The fundamental requirement to mobilize fat, as I said, is to lower insulin. So, the American Medical Association publishes this famous article dedicated, effectively, to establishing that Atkins has no credibility and one of the ways they do it is to discuss how Atkins was wrong about this idea of Fat Mobilizing Hormone. Then in the same paragraph they also say â€œin order to mobilize fat, you have to lower insulinâ€. Then they go back to talking about how Atkins jumped the gun on Fat Mobilizing Hormone . So they know that insulin controls fat accumulation, and they say actually acknowledge it in the article, but only in the context of it supporting the argument that Atkins has no credibility. They never mention that the way to lower insulin — and so, apparently, to mobilize fat from the fat tissue — is to eat less carbohydrates, which is exactly what Atkins was recommending. I was writing my response to Gina Kolata’s review when I first really noticed that sentence, and it jumped out at me. â€œHoly shit!” These people knew what regulates fat tissue, and they know what regulates insulin. They just donâ€™t care. Thatâ€™s how dedicated they were to trying to squash Atkins.
INTERVIEWER It didnâ€™t matter whether evidence supported them or that there was something there that they couldnâ€™t explain. It just mattered that he was wrong about something.
TAUBES All they wanted to do was establish that Atkins was not a credible source, and people shouldnâ€™t follow these bizarre practices of nutrition, or whatever they called it. One of the things Iâ€™m curious about is whether, from here on, the American Heart Association and other health authorities will continue to refer to low-carb diets, the Atkins diet, as these fad diets. Even though, if nothing else, as I point out in the book, these diets constituted the preferred medical treatment of obesity for 150 years, or 100 years, until the low-fat diet came along. It’s the low-fat diet that’s the fad.
INTERVIEWER Thatâ€™s an interesting point. What is the fad diet? Is it the absence of the Atkins Diet, or its presence? Which is temporary?
TAUBES The idea that you could somehow lose weight by removing fat and increasing carbohydrates is as ludicrous as the idea that you could do it by eating ice cream for any extended period of time. Iâ€™m sure thereâ€™s something about the ice cream diet that works in the short term. Iâ€™m not sure, but I wouldnâ€™t be surprised.
INTERVIEWER Was your response to Kolata’s review published?