The book Fat Chance is written by Robert Lustig, M.D. a pediatrician. He is the director of the UCSF Weight Assessment for Teen and Child Health Program, a member of the Obesity Task Force of the Endocrine Society and the president of the Institute for Responsible Nutrition. Lustig cuts through the hype often associated with nutritional advice by basing his book on scientific study, historical fact and recent statistics. He tells us that obesity is not a behavioral aberration, a character flaw or an error of commission. It isn’t even one disease, it’s many. It’s the end result of several possible metabolic pathways. He states that 80% (note that this number isn’t 100%) of obese people are suffering from metabolic syndrome. He also states that 40% of non-obese people are also suffering from it.

Lustig presents the biochemistry underlying the development of obesity. If you don’t understand my summary of what he presents and want to understand this better, then this would be one of several reasons to read this book. The ventromedial part of the hypothalamus (VMH) processes feedback from the body and tells us to continue to eat or to stop eating. Cells in the small intestine send peptide YY into the blood stream to get to the VMH to generate the perception that you’ve eaten enough. It takes a while for food to get to the small intestine. Thus Lustig advises us to eat slowly, wait twenty minutes before eating a second portion and consume lots of fiber to get what we’ve eaten to the small intestine faster. The hormone insulin, produced by the beta cells of the pancreas, helps the glucose from our food get into our cells. Fat cells make a hormone called leptin that gets back to the VMH and also tells us we’ve eaten enough.

Lustig explains how too much sugar leads to the cells’ insensitivity to insulin which leads to the VMH becoming insensitive to leptin. Thus a person doesn’t feel full despite having eaten enough and they keep eating. Thus becoming obese is a biochemical problem.

Lustig tells us how obesity has increased about the world in the last thirty years with the increase in sugar consumption. For many people in various parts of the world, soda is cleaner than the local water supply. Sucrose, the sugar molecule, is a disaccharide. It’s a glucose component and a fructose component joined together. It’s fructose that makes things taste sweet and bumps up the insulin. High fructose corn syrup is a processed product in which half of the glucose components have been converted to fructose. It’s in too much of our food.

You can wait for the government to make restrictions on the food industry. That may take a long time. In the meantime, Lustig tells us to eat more fiber, both soluble and insoluble. He says that the fiber is taken out of fruit drinks, which have as much sugar in them as soda. Thus he advises us to eat the fruit, not drink the juice. He advises us not to go on a diet, which means changing your food ingestion for a short while. It has to be a lifestyle change that we stick with. The more processed a food item is, the less frequently we should eat it. We want to improve our muscle sensitivity to insulin- there’s only one way to do this, through exercise. Eat breakfast with protein, stop nighttime bingeing and sleep more. And did I mention exercise? Like I said, it’s got to be a lifestyle change. Reading this book my be the encouragement you need to make that change for better health.