I picked up a book at the drugstore Saturday. Had seen various people on the internet mention it and was curious. The book is Why We Get Fat.

It's pretty interesting. Lots of biochemistry in it. The part that I've run across before jibes with what I know. It turns a lot of conventional wisdom on its head: explains exactly why diets don't and can't work; why calories in, calories out, is so simplistic as to be stupid; that people aren't fat because they eat more and exercise less, they eat more and exercise less because they're fat; and a whole lot of other stuff.

And if you think about it, a lot of the surprising stuff actually makes sense. I'll pause and say that if you google this book you'll see a lot of people disagreeing with it fairly vehemently. And if you read their disagreements after having read the book, you'll see that they didn't really read it and pay attention.

Here's the deal with calories in/out, hoping that I'm summarizing and paraphrasing correctly.

The calorie is a unit that describes heat. It doesn't describe fat and the two are not synonymous. Anyway, it's true that you put energy into a system and you get the same amount back out. But you have to ask yourself what form the energy comes back out in.

A growing child uses a lot of energy just to grow. I remember when F was middle-sized, skinny as a piece of string, and eating like there was no tomorrow. I would prepare a meal for the three of us and fix three identical plates. She'd be done with hers and looking around when R and I were only half finished, and one of us would just shove our plate over to her and let her finish it. She absolutely needed all of the fuel she could get to reach the towering height of 5'4" that she now enjoys, not to mention the grueling process of going through puberty and all that.

Then think about your immune system. When you have a virus typically you feel very tired and run down. You want to rest a lot. And you should, because energy that otherwise would be available to your muscles has been diverted to run those anti-disease processes. People who try to keep up their activity level in the face of this are very foolish. You are competing with your own immune system, which is trying to save your life. Kind of dumb when you think about it that way.

All of your organs have processes that they run, that require energy. Your heart, for instance, constantly requires energy to keep pumping 24/7.

And of course your muscles need it all the time, to hold you upright and to let you walk around and exert yourself.

Some of the calories that you take in are stored by your fat cells. Fatty acids in the bloodstream move into the fat cells and are attached to glycerin to form triglycerides. They're stored like that until you need them, for instance to keep your body processes running while you are asleep and not eating, and the triglycerides are then broken down again and the fatty acids re-released into the bloodstream.

One might now reasonably ask how the body partitions available energy into all of these things. This process is driven by hormones, which as I learned in cell & molec all those years ago, are chemicals that move from the cells where they are produced into different cells to effect changes there. Insulin is a very important hormone. Adrenaline is another. There are sex hormones, of course. All of these play a part in deciding where to put those calories.

The thing is that if your body, for whatever reason, puts a disproportionate amount of fat into fat cells for storage, two things happen: you get fat, and your body is deprived of energy it otherwise would have had available for all of those other processes. So you have to eat more to keep up, otherwise you are actually malnourished. And exercising is unpleasant and difficult because you simply do not have enough energy available to your muscles, to do it easily, and it makes you even more hungry and tired.

Calorie reduction diets do not help because the fat storage will still take place with whatever fatty acids are available, and now you are even hungrier and suffering more from lack of food.

I read this with a growing sense of anger at all of the fat-shaming I've seen and heard about through the years. "Quit stuffing your face." "Step away from the donuts." "If you'd just get up off the couch once in a while -" Wow.

So what's to do if you are one of those people? Two things:

1 - Reduce, as much as possible, your carbohydrate input. This is anything starchy and anything with added sugar. What this does is to decrease your body's production of insulin. Insulin causes you to burn up any blood sugar first before you get to the fatty acids - and this is important because excessive blood sugar is very bad for you - and in order to do this it encourages your fat cells to grab and hang onto fatty acids. Dietary carbs -> increased insulin production -> fat storage. By the way, it's possible that the obesity -> type 2 diabetes thing is backward. If you become insulin resistant your body produces more and more to try to control your blood sugar until you burn up your beta cells, and that leads to more and more fat storage.

2 - To make up for the energy loss from not eating sugar, you have to eat meat and you have to eat fat. This is a real stumbling block for a lot of people because they are so accustomed to thinking that dietary fat makes you fat. But if you reduce carbs AND fat you will get so run down and feel so bad that you can't keep it up. So on some of the negative reviews of the book you'll read, yeah yeah, nothing new here, we all knew to cut back on sugar and include lean cuts of meat in our diets - well, no, the book doesn't talk about lean cuts of meat, it talks about meat with fat.

I will offer a couple of personal observations and then I will shut up.

1 - I had a bout of bad heartburn last November, lasting all one night and all the next day, and had to really review what I had been eating, and what I'd eaten when I'd had heartburn before. This led me to stop eating sweets. It's hard, because I have a real sweet tooth, but pain will get you to do things nothing else will. Stopped eating fluffy bread at the same time for similar reasons. I have lost 12 pounds since then. And I didn't really need to - my BMI was already in the normal range. Didn't do it for weight loss but it happened anyway.

(Will add that I did go to the doctor to get checked out. I wanted to be tested for H. pylori, and he added gall bladder disease and pancreatitis. All of that came out negative.)

I want candy now and then - love Butterfinger bars, love them, and Reese's cups - but when I feel that I want that I poll my stomach. How do you feel, stomach? I ask. And my stomach says: I feel great! No heartburn. No feeling swollen or gassy. No coughing at night from reflux. Why would I interfere with that. People will tell you that one donut, or whatever, won't hurt you. Well, I went through a little withdrawal period when I stopped the sweets, and have slipped up once or twice and had just a little bit, and had to go through it again. Once again, why would I want to do that to myself.

2 - The back of the book has a brief sample diet, like what are the kinds of things that you would eat if you wanted to put this into practice. The lunch it describes is exactly what I had worked out for myself, from trial and error, over the years, to get me through the afternoon without being hungry and without being sleepy. I pack a week's worth of lunches at a time, on Sunday, in those disposable serving-saver tubs that you actually can wash and use over and over. I parcel out a container of mixed spinach and arugula among the tubs. Add two different raw vegetables. This week it's asparagus and tomato. I add a tablespoon of sesame oil or olive oil for taste and energy - had been doing that since well before I read this book - and a sprinkle of basil. And some kind of meat. This week it's roast beef that I cooked Sunday and cut into bites. I bring one of these to work with me each day, along with a can of sparkling water to drink. For snack at 4:00 or so, to get my second wind and keep me from being more than pleasantly hungry at supper time, I bring a four-ounce tub with either cottage cheese (NOT low fat) or plain yogurt and either blueberries, raspberries, or sliced strawberries. (You have to watch it with yogurt. Flavored yogurt has a truly ridiculous amount of sugar in it. I don't know why they do that - it's so sweet you can't taste the yogurt.)

So there it is. I recommend the book for anyone interested in nutrition, not necessarily just weight loss. You can get it here.