Archive for May, 2017

Greetings Fat Heads!

Well, still here. Hope you had a great Memorial Day weekend. Special thanks to all vets and their families. Tom and family are back from the 2017 Low Carb Cruise, happily exhausted. I’m looking forward to getting the full report. I told him if he wanted to wait until next week, I’d fill in Thursday with an “evidence-based” rant.

Anyway, when I left off at the last post, Jimmy Kimmel’s son was doing great and I was in a bad mood. Not about Mr. Kimmel’s son of course. That was the wonderful part. The level of care we have available in this time and in this country is beyond the imagination of what was available to the richest people and kings even a few decades ago.

I wasn’t even particularly stirred up over Mr. Kimmel’s making the availability of the miraculous procedure that saved his son somehow tied in with keeping Obamacare intact. Between being a dad just past a major health scare and living in La La Land among the economically illiterate (seldom right, but never in doubt) I’m okay with him calling it any way he wants. I put it in there with the “all brides and babies are beautiful” protocol. It accomplishes nothing to argue, and it’s just plain rude.

The rest of the Idiocracy, however, deserves no so respect. Instead of politely giving Jimmy’s emotional description props and then moving on, they treated his completely sincere and completely uninformed comments on insurance and Obamacare as the Magnum Opus of the health care debate.

At any rate, I stated toward the end “It’s not like we don’t have major issues with the health care system in the good old U.S. of A. But the issues are with the availability of dollars, not doctors, …”

There are issues with dollars. As I mentioned, I was aware of Kimmel’s son’s condition because The Oldest Grandson had the same thing – and the same miraculous treatment – when he was born just about ten years ago (yes—before Obamacare).

His mom, my daughter-in-law, pointed out that back then just his hospital tab was over $300,000, which would break anyone without insurance, not to mention that he’s facing at least two more surgeries. Under insurance as it mostly existed prior to the current debacle, there could be real issues with lifetime spending caps and him trying to get health insurance as an adult with that type of pre-existing condition.

To paraphrase an old politician, $300,000 here, $300,000 there – pretty soon you’re talking real money! Definitely a dollars issue.

So what’s a libertarian to do? Is there a solution other than “I’m sorry, Mr. Kimmel, there’s nothing we can do?” That’s what you would hear in most of those countries where it’s “free.” Don’t we want to save babies in this country? Wouldn’t it be nice to be able to do that and not go broke? How can we do that today, and still be able for that kid to afford reasonable health care later?

Fortuitously, Dr. William Davis’ new book – “Undoctored” came out just recently, and Tom did a book review.

[Confession time – I don’t read Tom’s book reviews any more. When I see he’s written one, I just save myself the time and buy the damned book.]

Now, if you want a great book on the disastrous macro-economics of our health care system, and policy proposals to address insurance and health system availability at a national level, don’t buy this book. That’s totally not what it’s about.

What it is about is you getting control of your health, which Dr. Davis reiterates throughout is not particularly connected to medical care. In fact, unless you get yourself informed and proactive, medical care can often be inversely related to your health. Although he doesn’t do a deep dive on the economic history of the health care system, he does do a great job illuminating how the money and incentives in the current system don’t line up with attaining real health as an individual. Then you’re off on a terrific primer in how to evaluate, improve, and monitor your health, in conjunction with health care professionals who will work with you and at your direction when needed.

Seriously, buy the book.

Okay, so how’s that tie in with the subject at hand? Well, the idea that the medical industry is more responsive to money than patient outcomes was nothing new to me – or probably any Fat Head, really. “Have a $tatin with that hearthealthywholegrain muffin” vs. “have the bacon and eggs and take a walk,” right? So, I was already on board with the concept.

Right in the introduction to “Undoctored,” Dr. Davis noted that we spend (endlessly pointed out with delight by the single-payer cheerleaders) over $3 trillion dollars a year – 17% of our GDP — on health care. Which I also already knew.  But this time when I read it I’d been thinking about Kimmel’s performance, and my daughter-in-law’s point, and then pretty close in to the beginning of the book Davis points out that:

“The system is ready and willing to commit you to a life of taking drugs and injectable insulin for diabetes, … providing “education” designed by people who put commercial interests first, while no one provides the handful of inexpensive health strategies that have been shown to reduce, even fully reverse, type 2 diabetes.”

Once again, nothing I didn’t already know, but it kind of all came together at that point and I thought, “well, just how the hell much do we spend on all of this crap?!?”

So I looked it up.

I tend to do that. I just stopped reading and went Googling for info on how much money we spend on the various medical substitutes for good habits. I’d like to think it’s due to my insatiable inquisitiveness when I’ve got an intellectual conundrum, but it’s probably just ADD.

I struck gold fairly quickly when I found a JAMA paper from 2016 titled “US Spending on Personal Health Care and Public Health, 1996-2013.” They collected seven years of data from 183 sources and sorted them into 155 conditions. The numbers, which, once again, we’ve probably all heard at different times, are stunning when you look at the whole picture.

The total spending for 2013 – the last year in the study – was $2.1 trillion. The estimate for 2014 was $2.9 trillion, so Dr. Davis’ $3 trillion seems to line up well with the reports info, and it would be safe to assume that the numbers I’ve got increased proportionately.  So, pretty much every number I’ve got has likely gone up by 50%. But here are some of the things we see:

Right off the bat, “diabetes had the highest health care spending in 2013, with an estimated $101.4 billion in spending, including 57.6% spent on pharmaceuticals…”

Keep in mind, that’s more like $150 billion today. One hundred and fifty billion dollars. A year. For a “disease” that’s easily 90% treatable by just stepping away from carbs.

Heart disease – the one that Dr. Davis put himself out of business from treating by getting people to change their lifestyles vs. post factum medical treatment — was $88.1 billion, so I’m calling it $130 billion.  I’m not saying no one would ever have a heart attack if we all stopped cooking with vegetable oil and started taking an evening walk, but it wouldn’t be an industry that by itself would rank in the top quarter of the rest of the world’s GDP’s.

Plus, that $130 billion does NOT include treatment for hyperlipidemia (i.e., statins) which earns itself $52 billion ($75B?) all by itself, or high blood pressure.

Here’s some other big ticket items, almost all of which the case studies of folks in “Undoctored” either completely reversed or substantially improved – often within weeks – of making the simple changes that Dr. Davis promotes:

Blood Pressure:  $84 Billion

Back & neck pain (think largely obesity and sedentary lifestyle related, so I’m counting it): $88 Billion

Depression (think mood disorders and gut biome dysbiosis. Not considered are other “mental” health issues – ADD, bipolar, etc): $70 Billion

Dental (tooth decay, inflammation): $66 Billion

Skin conditions: $55 Billion

Alzheimers and other dementias (i.e., Type III diabetes): $36.7 Billion

The 2013 numbers for all of those come up to about $469 Billion, which scales up to over $700 Billion in today’s spending. Mostly avoidable by straightforward, understandable lifestyle modification.

Like I said, some people will still have heart attacks, or pull a back muscle, or get depressed and need some help so you don’t have a 100% savings on the table; but the largest part of these diseases are self-inflicted and self-treatable.

I also left out other categories (Osteoarthritis – $47.9B; Asthma – $32.5B; Endocrine, metabolic, and immune disorders – $19.6B; and cancers, which were disaggregated into 29 separate conditions); so there’s some pickup available from the same lifestyle changes in areas I’m not counting. The point is that nearly one quarter of our health care spending is going to conditions that we have the capability of exerting a large degree of control over. Quickly.

Preterm birth complications, BTW, ranked 73rd at just under $5 Billion, so it seems like if we could get a handle on our grain and industrial foods habit, Jimmy Kimmel’s son and my grandson shouldn’t cause too much financial discomfort to the system.

After thinking about this, I had an epiphany.

I know Tom and many others, including myself, have compared the various and sundry mandatory coverages — dictated via Obamacare and other legislated and regulatory bodies — to requiring your auto insurance provider to include free oil changes, tire rotation, tune-ups, etc.  in your policy. The point being that these are known conditions that are a routine part of automobile ownership. Inclusion in a policy would only increase overhead and incentivize over-utilization, resulting in inevitable, recurring premium increases.

We completely misrepresented the argument. It’s correct as far as it goes, but it stops so short of reality that I count it as a huge error.

Our entire medical cost reimbursement system, as currently comprised, is like requiring that all auto insurance companies include DUI coverage in your policy.

It was stupid that my health insurance covered the two or three doctor office visits for the ear infections we knew The Sons were each going to get each year when they were toddlers. Same for the bottle of pink stuff we’d pick up at the pharmacy after each visit.

But it’s insane that insurance would pay for insulin for the 90% of people who could avoid the pharmacy if they’d stop blasting their system with sugar in all its forms. Same with all those other diseases of civilization driving a quarter of our spending. We’re making it convenient and cheaper for people to engage in behavior that’s harming them.

Add in the USDA budget with its massive grain subsidies and the SNAP (food stamp) program, and it’s like after adding the DUI coverage, we then pass out free booze to the people with the worst driving records.

So what about this — I say we should remove mandated coverage of all of those lifestyle diseases – Type II diabetes, blood pressure, non-emergency heart disease treatment, etc.

Companies would be free to make them available, but they’d be add-on items to a base policy and they’d also be rateable. I’m not interested in preventing someone from purchasing diabetes “treatment” coverage with their insurance, but I don’t want to be forced to “chip in.”

Rateable means they could adjust the premium, for example, based on a periodic A1C, fasting insulin, or some other marker to account for the risk and behavior of the policy owner. Behavior instantly gets coupled to economic consequences.

So people could pay higher premiums for diabetes treatment coverage, pay out of their own pocket for drugs and medical attention, or eat more veggies and fat and cut back on the sugar. I predict immediate, dramatic changes.

I don’t see why we couldn’t reduce medical spending by half a trillion dollars, plus another $100 billion a year by driving a stake through the USDA’s heart.  Putting money aside for just a moment, can you begin to imagine the quality of life improvements people would get?

Of course, I do see why we can’t. Politics. Money. Bureaucracy. Power. The usual suspects. But that doesn’t mean it’s not technically possible or the right thing to do.

It also doesn’t mean that you can’t get started, or step up your game so that you can limit your interaction with the medical system as much as possible. Just because you have to sacrifice them your money doesn’t mean you have to sacrifice your health, too!

Cheers,

The Older Brother

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Hey Fat Heads! Long time.

Tom’s still off on the Low Carb Cruise, so I get to staff the Big Chair for a bit. Folks on the cruise are going to get to see the almost final cut of the Fat Head Kids DVD. Tom, being Tom, in order to avoid disaster (long time Fat Heads may recall there was an audio issue on one of the first cruises), took a copy on his laptop, a DVD, a backup drive, an extra laptop, and an extra projector. Just in case. He’s also left copies at home, and at the in-laws, just in case the ship sinks and his house burns down at the same time. I asked him if the odds weren’t pretty astronomical on that kind of coincidence, and all he said was

“Three words: President. Donald. Trump.”

That pretty much took care of that argument.

I meant to post last week, but, in addition to a flooded basement (again) and a mouse-infested camper to deal with, I also officially passed into old age last Tuesday. The Big Six-Oh. Doesn’t actually feel any worse than the day before, to tell you the truth. Tom called to rub it in a bit under pretense of “Happy Birthday” wishes, and we agreed that hitting a calendar date really never had much psychological impact.

Over the years, I’ve only had a couple of those “OMG, I’m getting OLD” moments. The first was a couple of months past forty — which I’d pretty much shrugged off – when the friend who’d been cutting my hair for the previous ten years or so was finishing up and nonchalantly went for my face with the scissors, explaining “I’m just going to trim those eyebrows up.” I was thunderstruck – “holy crap, my eyebrows have forgotten which direction to grow!”

The next time was a few years later. The same friend had just finished my hair (okay, and eyebrows) and then — just as casual as can be — shifted to my side and said “let’s get those ear hairs taken care of.” Fortunately for my self esteem, she retired shortly thereafter, and I was able to find a new barber with bad eyesight.

Anyway, on account of the milestone, I thought I’d give myself a present and commandeer the Big Chair and talk a little about health care and piss everyone off.

You were warned.

The source of my most current irritation wasn’t at the health care system, per se, but at some really good news. The good news being the amazing story of Jimmy Kimmel’s son. The boy was born late last month (April), and Kimmel did an emotional monologue on returning to his show on how the baby was rushed into surgery immediately after birth with the deadliest version of a rare heart condition. During the monologue, as he described the procedure he said the surgeon “did some kind of magic I can’t even begin to explain…”

And then kind of turned the whole experience into a morality tale on why we need to keep Obamacare, only bigger.

I don’t have a problem with Kimmel projecting his personal experience onto a larger issue that I’m sure he’s not particularly well-informed on. I do have a problem with how the media instantly elevated Jimmy to the status of Economic Savant, and I find it sadly not surprising that politicians on both (wrong) sides of the issue felt compelled to rush for a camera and pontificate as if this was some new large issue that hadn’t been debated.

As it turns out, I’m actually familiar with the condition and can also explain the “magic” to Mr. Kimmel.  The condition is called a Tetralogy of Fallot with pulmonary atresia, where there’s a blocked valve with a hole in the baby’s heart. It requires immediate surgery, with a couple of more “upgrade” heart surgeries as the child grows, because the replacement valves don’t grow along with the child.

See, the Oldest Grandson — the one we lucked into when the Middle Son got married last year – was born with the exact same thing. He’s nine now, so it turns out that treatment was available before Obamacare. Within a couple of hours of being born, he was whisked via helicopter from Springfield — where we have pretty damned good neonatal hospital departments – to Saint Louis, MO, ninety miles away where they had specialized facilities and pediatric cardiologists.

The actual Magic — the reason Jimmy Kimmel’s son and my grandson are alive – is called “the Market.” You see, if Jimmy and his wife, despite the blessings of wealth his talent and hard work have brought him, had been in Canada (the current darling of the “free” health care advocates) I suspect it would’ve been a much darker monologue.

Not necessarily, of course. They might’ve been lucky enough to have their baby in a city with one of the seven pediatric cardiology units within Canada’s 3.8 million square miles of land mass. There are 122 in the continental U.S., despite having 20% less area (3.1M). Caring, forward-thinking Canada has 81 Pediatric Cardiologists. Here in health care’s evil empire, we’ve got 2087 on tap.

And I do mean in a city. Ninety miles away doesn’t get it in Canada, like it works here. If you don’t believe me, ask Liam Neeson. In case you don’t recall, his wife died because it took over three hours to transport her 77 miles by ambulance as helicopters weren’t available where she was injured. But hey, what are the odds of needing an airlift for emergency medical care at a ski resort, right?

[Another helicopter story – several years ago, my brother-in-law’s niece was critically injured in an early morning slippery roads/tree vs. car accident on her way to school. This was in very rural North Carolina. They got a helicopter shortly after the accident was discovered. She flat-lined three times in the air, but she pulled through.]

It’s not like we don’t have major issues with the health care system in the good old U.S. of A. But the issues are with the availability of dollars, not doctors, and Obamacare makes both worse, not better. And Jimmy Kimmel is a terrific entertainer and wonderful human being and I am truly overjoyed at his good fortune, but he’s not a very good economist. Better than Paul Krugman. But not very good.

I’m going to address those dollars next, and my thoughts on that happen to dovetail nicely with Dr. William Davis’ book that Tom just reviewed. If you haven’t got your own copy yet, you’re missing a really good read that can do more to improve your health than any elected official can possibly do for you.

Cheers,

The Older Brother

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Here’s the short review:

Undoctored, the terrific new book by Dr. William “Wheat Belly” Davis, covers pretty much everything I’ve been saying on this blog about how the Wisdom of Crowds is crowding out conventional (but lousy) health advice, then adds a heckuva lot of good step-by-step advice on how to monitor and improve your own health — partly by leveraging the Wisdom of Crowds.

Now for the longer review:

A couple of years ago, when I was kicking around the idea for the Fat Head Kids book and film, I drove to Wisconsin to interview Dr. Davis on camera.  We ended up conducting the interview in a downstairs reading room because the desk in his upstairs office was piled high with stacks of research.

Over dinner later, he told me the research was for a new book.  But before he described the contents of the book, he told me why he felt compelled to write it:

Dr. Davis grew up as a dirt-poor kid in New Jersey.  After rising from such humble beginnings, working his way through medical school and becoming a cardiologist with a busy practice, he felt a sense of pride in what he’d accomplished.  For most of his adult life, he enjoyed his status as doctor.

But that was then.  Nowadays, Dr. Davis views the health-care system as little more than an industry designed to shuttle people through a series of expensive drugs and procedures.  Actual health isn’t the priority.  The movers and shakers have no interest in, say, preventing or treating type II diabetes with diet, because they view diabetes as the gift that keeps on giving.  Diabetics are paying customers for life.

As a result, he explained, he hesitates to tell people who don’t already know him that he’s a doctor.  He doesn’t like being associated with the modern medical industry.

So the new book (which was untitled at the time) would include two major sections:  The first section would explain to readers why the “health-care” system is more interested in their dollars than their health.  The second section would arm readers with the knowledge and tools to monitor and improve their own health, and thus avoid ending up in the belly of the health-care beast.  With all the bad advice coming from the medical establishment, people need to do their own research and direct their own health instead of relying on doctors to do it for them.

That, of course, led to a long discussion about the Wisdom of Crowds effect.

You can gauge a doctor’s opinion of the general public by his or her attitude towards the explosion of health information available online.  In a post last December, I pointed out that Dr. David Katz – a big-time promoter of arterycloggingsaturatedfat! hysteria whose idiotic NuVal system ranks sugar-laden soy milk as far healthier option than a turkey breast – sees social media as a danger.  An essay Katz wrote for the Huffington Post basically boils down to this:  Dangit!  All those bloggers and podcasters and health discussion groups online are causing the stupid, gullible public to question true experts like me!  This is very, very bad!

Let’s just say Dr. Katz doesn’t believe in the Wisdom of Crowds effect.  He believes we should all bow before the superior expertise of The Anointed – himself included, of course.

Compare his attitude to the attitude expressed by Dr. Davis in the introduction of Undoctored:

I propose that people can manage their own health safely and responsibly and attain results superior to those achieved through conventional healthcare – not less than, not on a par with, but superior.

And later:

Self-directed health is a phenomenon that will stretch far and wide into human health.  It will encompass preventive practices, diagnostic testing, smartphone apps, and therapeutic strategies.  It puts the astounding and unexpected wisdom of crowds to work, providing you with a depth and breadth of collective information and experience that far exceeds that of any one person, no matter how much of an expert.

Just a wee bit different, eh?  Dr. Davis thinks it’s perfectly okay for you to do research online and question your doctor.  In fact, he WANTS you to do research online and question your doctor.  He says so over and over in the book.  That’s because unlike Katz, Dr. Davis believes people have brains and are capable of using them to find the advice that works and ditch the advice that doesn’t.

Undoctored offers plenty of specific advice on how to gather information about your own health and leverage the wisdom of crowds:  sites for exchanging ideas and data with other people, places you can go to order your own lab tests, sites that help you interpret the lab tests, and so on.

But that’s a bit later.  First, Dr. Davis gives the modern medical industry the blistering it deserves.  Here are some choice quotes:

There’s no ham in hamburger, Grape-Nuts don’t have grapes or nuts, and health does not come from healthcare.

There is a continual push to medicalize human life.  Shyness is now “social anxiety disorder” to justify “treatment” with antidepressant medication; binging in the middle of the night is now “sleep-related eating disorder” to justify treatment with seizure medication and antidepressants; obesity, declared a disease by the FDA, justifies insurance payments for gastric bypass and lap-band.   Don’t be surprised if sometime soon, bad dreams, between-meal hunger and excessive love of your cat are labeled diseases warranting treatment.

I was reminded of what Dr. Malcolm Kendrick wrote in Doctoring Data:  normal human conditions are now classified as diseases just in time to be diagnosed and treated with a new wonder drug.

Dr. Davis goes on to describe how Big Food and Big Pharma have corrupted the healthcare system from top to bottom, from the research, to the health advice, to the treatments when the advice doesn’t work.  Your doctor may mean well, but her (ahem) knowledge of what to diagnose and treat often comes from seminars sponsored by Big Pharma.  Prevention, of course, isn’t on the agenda.

Despite the book’s title, Dr. Davis isn’t suggesting people never visit a doctor again.  He lists a number of conditions that absolutely, positively require medical attention.  He wants doctors to treat what they treat well.

But he wants you to take control of your own health by leveraging the wisdom of crowds and the experiences of others.  If you do that, there’s a good chance you’ll become what Dr. Davis calls undoctored … meaning you only need to see a doctor for actual emergencies and perhaps a bit of monitoring, not for conditions you shouldn’t develop in the first place.

Reading that, I was reminded of when I went in recently for a dermatology checkup.  (I had a skin cancer removed from my back 15 years or so ago, so I get called in for occasional checkups.)  Part of the conversation with the nurse went something like this:

“Who’s your primary-care physician?”

“Uh … sorry, I don’t remember his name.”

“You don’t know your doctor’s name?”

“I’ve lived in Tennessee for seven years and I’ve seen the guy once.  That was because I decided to have a checkup when I turned 55.”

A big part of becoming undoctored is, of course, adopting a diet that enhances health instead of breaking it down.  You won’t be surprised that the Wheat Belly doctor prescribes a diet devoid of grains.  And sugar.  And industrial oils.  And almost all processed foods.  To make it easier to adopt the diet, the book lists several weeks’ worth of recipes.

But there’s more to it than diet alone.  Dr. Davis refers to the whole program as Wild, Naked and Unwashed.  No, that’s not the description of a fraternity party.  It’s a reference to the lifestyle of our paleo ancestors.  We don’t have to actually forgo bathing and run naked in the woods to be healthy, but we do need to recognize that our genes were coded for an environment very unlike the modern industrial world.

With that in mind, Dr. Davis spends the next few chapters describing the nutrients that civilized humans rarely ingest in sufficient quantities, including magnesium and vitamin D.  He also gives specific instructions on how to monitor blood levels of essential nutrients (vitamin D included) using direct-to-consumer tests.  He offers similar advice for checking thyroid health.

The book also includes an entire chapter on the importance of bowel flora (a subject he talked about at length when I interviewed him).  He explains how to obtain at-home test kits, and which specific supplements to take if necessary.  He also provides dozens of recipes for prebiotic shakes using ingredients such as green bananas, inulin and bits of raw potato.

I don’t find the “Appendix whatever” sections of most books particularly useful.  Undoctored is an exception.  In fact, I suspect these final pages will become dog-eared.

Appendix A lists several common ailments – from constipation to fatty liver – with a protocol for identifying and correcting the source of the problem.  Appendix B lists hidden sources of wheat and gluten.  Appendix C describes how to ferment your own vegetables.  Appendix D offers a list of sites where you can exchange ideas, do research, order at-home lab tests, etc.  It also lists the brands of supplements Dr. Davis considers high-quality.

Like I said, this is a terrific book.  With all the junk advice being handed down by doctors, government agencies, and organizations like The American Heart Association, it’s also a very necessary book.  Readers of this blog don’t need to be convinced that a huge chunk of what passes for health advice these days is garbage, but plenty of other people do.  And fairly or not, a lot of them will need to hear it from a doctor before they’ll believe it.

Dr. Davis took on the grain industry in Wheat Belly.  He takes on pretty much the entire medical establishment in Undoctored.  I’ve asked him to please stay out of dark alleys and to consider using a stunt double for public appearances.

Kidding, of course.  Well, half-kidding.  We need Dr. Davis to stick around for many more years and continue writing books like this.

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With all the hubbub of reviews and podcasts — not to mention the hours I’m putting in on the film — I nearly forgot to post chapter one of Fat Head Kids.  I’m addressing that oversight now.

Again, I can’t recreate Chareva’s two-page layouts in a blog format, but all the text and most of the graphics are included.


Stuff I wish I knew when I was your age:
Getting Fat Isn’t About Character

Since much of this book is about why kids get fat, I’m probably supposed to stop here and show some charts to prove that childhood obesity is a big problem. I’m not going to do that, and here’s why: I went to school in the 1960s, and yes, things were different then. We had maybe one or two fat kids in each class. And you know what? After I became one of them, I never once got together with the other fat kid in class and said:

It’s no fun being a fat kid, period. If you’ve been getting fat, I know you want to change that. And I’ll bet at least a few people have already told you why you’re fat and what to do about it — like the classmates who explained it to me.

What these helpful young men were telling me is that people get fat because of a flaw in their character: They like to eat, so they eat too much, and then they get fat. So to lose weight, they just need to apply some willpower. Eat a little less, exercise a little more, or both.

Now … let’s suppose these guys grow up and become doctors, or dieticians, or personal trainers — and they learn it’s not polite to make fun of fat people. They’ll probably still give the same advice, especially if they’ve never been fat. Only now that advice will sound almost like science:

It’s kind of strange if you think about it. Fifty years ago, very few Americans were overweight, but almost nobody counted calories. In fact, the calorie labels you see on food now didn’t even exist until the 1990s. Nowadays we have lots of fat people, and everyone seems to be talking about calories. Cut the calories, cut the calories, cut the calories! So what’s a calorie?

To understand calories, let’s forget about food for a minute and talk about something you wouldn’t eat unless you’re a termite: wood.

If you had a nice piece of wood, you could chop it into pieces and build something useful, like a chair. Or you could store the wood for later. Or you could toss it in a fireplace and burn it to produce heat. How much heat? Well, there are different units for measuring heat, but the common ones are BTUs (British Thermal Units), joules, and … calories. So technically, a calorie is a unit of heat.

But heat is also a form of energy, and in our world, energy makes things happen. Back in the Old West, people burned wood to boil water to make steam. The steam could turn an engine big enough to move an entire train. So we could say the energy to move a train came from the calories in wood.

It’s the same with food. To determine the calories in food, scientists burn it in something called a calorimeter and measure the heat. No, they’re not trying to figure out how many pizzas you should burn to keep your house warm. They’re measuring how much energy the food would produce if you burned it all for fuel.

But you don’t burn all your food for fuel. Some of what you eat is broken down into building materials for the rest of your body. Some of it is converted to fat and stored in your fat cells. That way your body can burn fat for fuel between meals. If you couldn’t store calories in your fat cells, you’d have to spend most of your life eating.

Because your body can store calories as fat, a lot of so-called experts (like my helpful classmates) think your body works like a savings account. I call that The Piggy Bank Theory, and it looks like this:

Every time you eat, you deposit calories in your body. Some of the food goes into your body’s Building & Repair Fund, and some goes to pay your daily energy bill — the energy your body burns just to stay alive. But if there’s any extra food left over, those calories are automatically converted to fat and stored in your fat cells — like saving money in the Piggy Bank.

With a real piggy bank, it’s easy to control how much you save. If you deposit $50 every week and withdraw $40, your piggy bank will grow by exactly $10 each week. If you deposit $50 every week and withdraw $60, your piggy bank will shrink by exactly $10 each week. It’s a simple matter of calculating dollars in vs. dollars out.

According to The Piggy Bank Theory, losing weight works by the same simple math. To shrink your fat cells, you just deposit fewer calories by eating less. Or you spend more on the energy bill by exercising. If you do either one, your body has to withdraw calories from the piggy bank, so you lose weight. It’s a simple matter of calculating calories in vs. calories out.

People who believe in The Piggy Bank Theory will do things like drive to a gym, take an elevator to the workout room, then spend an hour on a treadmill walking nowhere. Or they write articles offering simple advice like this:

If you cut just one pat of butter from your daily diet and walk for just 20 minutes every day, you’ll lose 20 pounds of fat in a year!

Well, that sounds easy, doesn’t it? So according to these people, if you’re fat, it’s because you’re not willing to eat just a little less — which means you’re a pig. Or you’re not willing to exercise just a little more — which means you’re a lazy pig.

But does that really make sense? Most fat people hate being fat. They spend billions of dollars on gym memberships, weight-loss clubs and weight-loss drugs. Are we supposed to believe they’d rather be fat than give up one pat of butter per day?

If people get fat because of their character, why are there more overweight babies now than 30 years ago? Did babies in previous generations drink less mother’s milk so they wouldn’t get fat? Did they go to baby-aerobics classes?

If your body works like a bank account, how do we explain naturally thin people, like my wife? They have no idea how many calories they consume and eat whatever they like, but never gain weight. That’s like making lots of deposits and withdrawals at your bank, without ever bothering to add them up … and yet every time you check your balance, it’s exactly 2,000 dollars.

Here’s something else The Piggy Bank Theory can’t explain: We have two big dogs named Misha and Coco. They’re sisters, and we feed them exactly the same meals. Coco is bouncier and more active than Misha, so she ought to burn more calories, right? But Coco is 18 pounds heavier. In human terms, if Misha weighed 180 pounds, Coco would weigh 212 pounds. When we bought them as puppies, the breeder told us Coco would be bigger. She never mentioned calories.

Obviously, there’s something wrong with The Piggy Bank Theory. Plenty of doctors and researchers have known that for years.

In a study from the 1960s, researchers wrote about obese patients who were locked in a hospital and fed just 600 calories each day. That’s about one-fourth as much as most adults eat. And yet the obese patients didn’t lose weight. Is that because of a flaw in their character? Should they only eat 300 calories per day? Or 200?

In an experiment at the Mayo Clinic, researchers had a group of volunteers eat an extra 1,000 calories every day for 56 days. According to The Piggy Bank Theory, those 56,000 extra calories should have made everyone 16 pounds fatter. But some people gained 10 times more body fat than others. The naturally-thin people barely gained any weight at all.

In another experiment, researchers took a group of mice and reduced their daily calories by five percent. That’s the mouse version of cut just one pat of butter per day from your diet. They also used special lab equipment to make sure the mice were just as active as before.

Let’s apply The Piggy Bank Theory and predict what happened:

  1. They were eating less, so they made smaller deposits.
  2. They were just as active, so their daily energy bill should have stayed the same.
  3. Therefore, according to The Piggy Bank Theory, the mice had to withdraw calories from their fat cells to pay part of the energy bill. So their fat cells had to shrink.

But that’s not what happened. When the mice were given less food, their fat cells got bigger, not smaller.

No wonder one scientist wrote this in an article about obesity:

The commonly held belief that obese individuals can ameliorate [improve] their condition by simply deciding to eat less and exercise more is at odds with compelling scientific evidence.

If your goal is to lose weight, let me ask you a question: Would your school hire a football coach who lost 97 percent of his games? Would your parents hire a piano teacher if 97 percent of her students never played any better … and some ended up playing worse?

Of course not. But year after year, millions of people try to lose weight by following The Piggy Bank Theory. And year after year, 97 percent of them fail. In fact, many end up fatter than before.

People who believe in The Piggy Bank Theory argue that it’s based on the Laws of Physics. Matter and energy can’t just disappear or be created out of nothing. So to get bigger, you have to consume more calories than you burn.

That statement is true. But for explaining why people get fat, it’s also meaningless. It’s like saying Donald Trump is rich because he deposited more dollars in the bank than he spent. It’s like saying if your toilet overflows, it’s because more water went into the bowl than went out.

Yes, of course more water went into the bowl than went out. But that only explains HOW the toilet overflowed. It doesn’t tell us WHY the toilet overflowed. The WHY in this case would be a clog in the drain pipe.

To fix a problem, you can’t just describe HOW it happens. You also have to understand WHY it happens. We’ll begin looking at WHY we get fat in the next chapter.

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