The Obesity Epidemic

“The current diet advice is not the cure, it’s the cause...”

Food for thought...

Q1) Do you ever wonder why, when people want to be slim more than they want anything else in the world, they don’t just lose weight?
Q2) Do you ever wonder why, when more people than ever are on a diet (13m people in the UK are ‘permanently on a diet’ – source Mintel), we are fatter than ever as a nation?
Q3) Do you ever wonder why, an estimated 95% of people who lose weight put it back on?
I will answer these questions throughout this note.

The Obesity Epidemic – where we are now...

One quarter of the UK population is now obese (BMI >30) and two thirds is overweight (BMI >25). Levels of obesity have tripled since 1980. If current trends continue, by 2050 60% of men, 50% of women and 25% of children will be obese.
Here are some direct quotes from the Food Standards Agency’s web site:
- “... since the late 1980s we have been consuming less total fat and we’ve also cut down on saturated fat”;
- “Since the 60s we’ve been consuming fewer calories from household food… However, there are an increasing number of people who are overweight or obese. The reasons for this are not clear…”;
- “Following significant changes over the past few years, the British diet is probably as healthy as it’s ever been”;
- “Levels of obesity have tripled since 1980 in England, and there is no sign of the upward trend stopping”;
- “The UK has the fastest rising obesity rates in the developed world”.
So, let me understand this, the UK has been following the diet advice – we are eating less fat, we are eating fewer calories, our diet is probably the best it has ever been, but levels of obesity have tripled since 1980 and we have the fastest rising obesity rate in the world. If this were a scientific experiment, we would stop it immediately and conclude that it isn’t working.

What is the current advice to solve the obesity epidemic?

The Food Standards Agency sets out the precise formula, which is the foundation of the general principle: “Eat less and do more.” The assertion is:
“To lose 1lb of fat per week, you need to either reduce your calorie intake by 3500 a week, or increase your exercise, or do a combination of both.”
What this is effectively telling people to do is to drive from Lands End to John O’Groats, but without putting enough fuel in the car to do so (“Eat less”). Worse than that, people are then being told to ‘flog’ the car even harder, so that it will break down even sooner than it would have done, had it been driven to conserve energy (“Do more”). If a mechanic seriously told us to do this to our cars we would think they were mad and yet millions of people in the ‘developed’ world are deliberately trying to run their bodies on less fuel than they need, every single day.
If only it were as simple as “Eat less and do more”, we wouldn’t have an obesity problem, let alone an epidemic. The body, first and foremost, is a survival machine. It has developed over thousands of years and it has survived and adapted to far more challenging things than calorie counting. The body is far more complex than “Eat less and do more” allows for. Obesity is about: insulin; hormones; the body’s handling of carbohydrates; how the body turns food into energy; nutrients; nutritional combinations; what we eat; when we eat; what we eat with what; and much more.
I firmly believe that the calorie theory will go down as one of the most serious health myths in history. Just as we came to realise how bad smoking is for people’s health, so I believe that we will come to realise that telling people to “eat less and do more” has caused our current obesity crisis.

Why do we tell people to eat less and do more?

Thermodynamics: Following the publication of “Why do you overeat?”, I contacted my local university to see if they would be interested in supporting further research to challenge the calorie theory. The professor literally scoffed at me. She asked ‘did I not know that the calorie theory is founded on the laws of thermodynamics’? I do know that calorie theorists think this and I think that they are wrong and here is why...
Let us, generously, put aside the second law of thermodynamics, about entropy, and pretend that the human body can be viewed as a closed system. The Law of Thermodynamics that the calorie counting fans like to quote is the first law. This law is invariably simplified to: “Energy in (to a ‘closed system’) equals energy out”. However, please can a calorie theorist show me where thermodynamics says, “Put less energy in to a closed system (eat less) and try and get more energy out of that closed system (do more) and the system will use itself up (lose weight).” The literal application of thermodynamics to dieting would be – put less energy in to the human body and you will get less energy out. And this, in fact, is what happens. People eat less, they get tired and hungry and their metabolisms (energy mechanisms) slow down.
If we take the first law of thermodynamics more accurately: “You can change energy from one form to another, but you can’t lose any”, there is another aspect of the laws of physics that has been incorrectly applied to dieting. Diet advisors seem to have overlooked the issue about how useful each form of energy is. If you put a gallon of petrol into a petrol car, which does 40 miles to the gallon, it will go 40 miles. If you put a gallon of diesel into the same engine, the car will not move. I suggest the same applies to the human body. If you feed the body real food and nutrients, it will use that energy effectively. If you use empty calories, like sugar, for fuel, the body will not function.
It is critical that governments, nutritionists and dieticians realise that we have incorrectly applied a fundamental law of the universe to the ‘slimming industry’. Until this is recognised and corrected, millions of people will think eating less will make them lose weight and it will simply make them lose energy.
Newburgh & Johnson: Following the foundation of Thermodynamics, the more particular view that obesity is about calories came from Newburgh & Johnson. In 1930, these two American Doctors published some research that said, “obesity results from a diet too high in calories.” So, the calorie theory was more specifically proposed in their paper and it has received little challenge since. Even the two doctors were alarmed at how literally their research was adopted and applied. They followed up their paper with words of caution, but the bandwagon was already rolling by this time. Despite the fact that their research was quite limited and they themselves had concerns about the widespread adoption of their original findings, their work remains the basis for slimming advice world-wide.
Kekwick & Pawan: Two doctors proved, back in 1956, that a calorie is not a calorie. Whether or not the calorie is a carbohydrate, or a fat, is of crucial importance. The two pioneers were called Professor Kekwick and Dr Pawan. They worked in a London hospital and they used their inpatients for their research, so that they could perform a precise, controlled experiment.
Three groups of dieters were given the same number of calories, 1000 per day, but the groups were given very different proportions of carbohydrate and fat. One diet was 90% carbohydrate, another 90% fat and the final one had a balance of carbohydrate and fat. Those on the high fat diet lost the most weight; those on the high carbohydrate diet lost the least. Some even put weight on with the high carbohydrate diet. In further tests, the group eating mostly fat had their calories increased to almost 3000 per day – but with still hardly any carbohydrate – and this group continued to lose weight. This supported other findings in the USA, around the same time, where it was shown that the greater the amount of fat in the diet the greater the weight loss.
This absolutely critical experiment almost seems to have been dismissed, as it just doesn’t support the simple message that health practitioners want to give. “Eat less and do more” is a great little slogan – so memorable and simple. It is just utterly tragic that we continue to repeat it, when it so clearly doesn’t work.

Is the current advice working?

The simple and obvious answer to the question “does this calorie counting theory work?” is no! We have been pushing this advice increasingly strongly since the 1980’s and the numbers of obese and overweight people are going up, not down. Not only are they going up – they are galloping up at an astonishing rate. Could it be, therefore, that far from making the obesity epidemic better, this advice is actually making it worse? This is my absolute belief. I am totally convinced that the calorie theory is not the cure for the obesity epidemic. It is, instead, the CAUSE.
The UK Food Standard Agency’s own quotes in section (2) above confirm that this horrific experiment with public health should have been stopped long ago, as it clearly isn’t working.
The reason that this advice makes the obesity problem worse, is because of what happens to the human body when we try to “eat less and do more”…

What actually happens when we try to eat less and do more? a) directly and b) indirectly?

Please note that the following is the culmination of twenty years of research. It has been written below, and in the published books, in as simple a way as possible, to reach as many overweight people as possible. I would welcome having the debate, at whatever level is desired, to convince you of the catastrophic consequences of the current obsession with calories.
a) There are three direct things that happen when we try to eat less energy than our body needs:
i) We get hungry;
ii) Our bodies store fat and use up lean muscle;
iii) Our metabolisms slow down, to conserve the limited energy that we have.
(i) increases our desire for calories/fuel. (ii) and (iii) reduce our need for calories/fuel. You can start to see the root of the problem...
Let us look at each of these, for a quick and simple explanation:
i) The first thing that happens, when we try to eat less, is that we get hungry. As soon as we eat less than our body needs, our body sends out signals to try to get us to eat. Our body doesn’t know that we have read a diet book. It thinks we have landed on a desert island and have been forced into a life threatening starvation situation and it tries to keep us alive.
You may be familiar with the signals that your body sends out to try to get you to eat. Physical symptoms include: shaky hands; sweaty palms; feeling light headed; headaches and a rumbly tummy as some of the best examples. Mental/emotional symptoms include: irritability; inability to concentrate; indecisiveness and an unusually high preoccupation with food. It is no coincidence that, as soon as someone starts a calorie-controlled diet, all they can think about is food. This is their body telling them to eat.
The first outcome of eating less – our body making us hungry – is enough to ruin most diets. UK PLC starts a new diet with such good intentions, but every individual is trying to fight their own body from the start and the body will always win. (The only exception to this is Anorexia, where approximately 20% of Anorexics will die from this disease. This is the only circumstance when the person will ‘win’ and the body will ‘lose’).
ii) The second thing that happens, when we try to eat less than we need, is that our body stores fat and uses up lean muscle. This is the exact opposite of what we want to happen. We want to get rid of the fat and keep the lean muscle, but our body won’t do this and here is why. Lean muscle uses up more calories (energy) than fat does. Back to the desert island situation – our body is in survival mode when we try and eat less, so it needs to ‘dump’ the part of us that needs the most energy. This is the lean muscle – so that needs to go first. The body hangs on to the fat a) because it uses up less energy and b) because it is going to be a valuable reserve if we are on the ‘desert island’ for a long time.
This is a ‘double whammy’ a) because we want to lose fat, not nice, toned, lean muscle and b) because the more lean muscle we have, the higher our metabolism is. So, if we lose lean muscle, we reduce the number of calories that we can eat without putting on weight.
iii) The third thing that happens, when we try to eat less than we need, is that our metabolism slows down. The body does this to conserve the limited energy that is now coming in. This then means, as with (ii) above, we will need fewer calories to live on and we will put on weight if we try and eat the number of calories that used to maintain our weight.
b) There are three indirect things that happen when we try to eat less energy than our body needs:
i) We increase the proportion of carbohydrates in our diet. This happens because fat has nine calories per gram while carbohydrate only has four, so calorie counters opt for carbs over fats, at every food choice situation;
ii) We reduce the variety of food eaten. This happens because calorie counters tend to go for the regular favourites that give ‘the biggest bang for the buck’ (the most food for the fewest calories);
iii) We weaken our immune systems, because, by definition, we are not consuming the energy that we need for our body to function.
The completely new and key impact of my research is the next bit. The analysis I have done shows that there are three medical conditions that cause insatiable food cravings. These three conditions are Candida, Food Intolerance and Hypoglycaemia (definitions in Appendix 1). They have been known about and written about for years – over 100 years, in the case of Hypoglycaemia. Doctors and authors who have written about these conditions have talked, almost in passing, about the impact that they have on weight and food cravings (quotes in Appendix 1). They haven’t put all the evidence together and discovered why people can’t stick to a diet. The two unique contributions of my work are, therefore, to show:
- That these three conditions cause insatiable food cravings; and
- That calorie counting is almost guaranteed to cause these conditions.
In short, therefore, if people follow the current diet advice – “eat less and do more” – they will directly (i) get hungry, (ii) store fat and (iii) slow down their metabolisms and indirectly they will (i) increase the proportion of carbohydrate in their diets, (ii) reduce the variety of foods they eat and (iii) weaken their immune systems. The direct and indirect outcomes of eating less make every calorie counter extremely likely to develop three medical conditions that cause food cravings. So, start counting calories and settle down to a life of uncontrollable cravings and food obsession. It really is as scary as that. The calorie myth has turned millions of would-be slim people into food addicts.

Food for thought...
So, here are the answers to the “Food for thought” questions:
Q1) Do you ever wonder why, when people want to be slim more than they want anything else in the world, they don’t just lose weight?
A1) They don’t lose weight because the current weight loss advice doesn’t work. If it did work, they would simply achieve their dreams. The current advice doesn’t work because, directly and indirectly, it is working against the human body and the body then ensures that the dieter will want more fuel and need less fuel. We must educate people to work with their body to lose weight and not have the body doing the opposite of what we want it to (increasing its desire for fuel and reducing its need for fuel).
Q2) Do you ever wonder why, when more people than ever are on a diet (13m people in the UK are ‘permanently on a diet’ – source Mintel), we are fatter than ever as a nation?
A2) We can have a ‘chicken & egg’ debate here. You may think that more people are on a diet than ever because they are fatter than ever. I think that they are fatter than ever because they are on a (calorie-controlled) diet. Because the current advice is the cause of, rather than the cure for, the obesity epidemic, the more people diet, the fatter we will get as nations. We must get UK PLC eating better, not eating less.
Q3) Do you ever wonder why an estimated 95% of people who lose weight put it back on?
A3) The answer to this question has a number of dimensions. When we eat less, our body stores fat, uses up lean muscle and slows our metabolisms. This simultaneously reduces the body’s need for fuel, so that we get to the point where we put on weight consuming the amount of fuel that used to maintain our weight. Another dimension is that our body tries to get us to eat, to reverse the fuel deficit, and we also develop the three medical conditions that cause insatiable food cravings. There are many things acting together to get us to eat more and to slow our metabolisms, so we increase our desire for calories/fuel and reduce our need for calories/fuel. This is why we put weight back on.

What should we do about the Obesity Epidemic?

Professor Sir David King’s proposal to set up a specific taskforce is excellent. Please do this and please make sure that a number of people on this taskforce do not subscribe to the calorie theory. This myth absolutely must not be accepted as the foundation for advice going forward.
Rt Hon Alan Johnson’s consideration of banning trans fats is also excellent – we should do this immediately, following the bold lead of New York City.
My further recommendations are as follows:

1. We must stop telling people to “eat less and do more” – it is the cause of the current obesity epidemic – it will never be the cure. We need to tell people instead to eat better – to eat only real food – nothing processed. People should be advised to eat meat, fish, eggs, vegetables, salads, fruits, dairy products, nuts & seeds, whole grains and pretty much nothing else, for optimal health.
2. To support this advice, we should take tangible measures to make processed food less available and less attractive. (It is critical that all political parties agree to these measures, so that the food manufacturers cannot lobby one party to continue pushing junk food). Three key tools at the government’s disposal are:
3. Banning certain substances – trans fats is a great start. I would also ban sugar – the only substance we ingest with essentially no nutritional value whatsoever. “Tate and Lyle” won’t like this, but do we care about lives, or the profits of the sugar industry? Please read “Pure White & Deadly” by John Yudkin, if you have any doubt about how important this step is.
4. Taxation – Politicians can put substantial taxes on processed foods and use the proceeds to subsidise real food – especially for lower income families. It cannot be allowed to be the case that a family can get a burger & fries cheaper than roast chicken and fresh vegetables. I would recommend making food tax directly proportional to the number of ingredients in each product. Real foods only have one ingredient – meat, fish, egg, milk, brown rice, oats etc. Some processed foods are ‘less bad’ than others. Crisps can contain just potatoes and sunflower oil – two real ingredients. The ingredients in another well known global brand of crisps are: dried potatoes with citric acid, monoglycerides or sodium phosphate; vegetable oil; corn meal; wheat starch; maltodextrin; water; salt; seasoning; spices; flavouring; acetic acid; malic acid; sodium acetate; sodium citrate; mono & diglycerides and dextrose. We need to tax the second product out of consumers’ reach.
5. Education – It has been documented that we see, on average, ten adverts for food per hour and 95% of these are for food high in fat, sugar, salt, or mixtures of these ingredients. No government and responsible media can compete with this to even balance messages about real food, let alone to massively outweigh such messages. As a minimum we need to ban advertising for food containing sugar or trans fats (and I would add artificial sweeteners). Ideally, we would ban not just the advertising, but the actual substances, as advised in (i) above.

We should also increase the number of positive health messages to adults and children about the part they can play in managing their own weight and health. This will require an end to the obsession with calorie counting and more sophisticated education to help people realise how the body uses food and how important good fuel is for us to function. We need to explain what real (good) food is and the benefit of eating it and use ‘shock tactic’ adverts, such as those used by Jamie Oliver, to show people what is actually in processed food and what harm it does to our bodies.

My final recommendation is to retrain dieticians and diet advisors so that they stop pushing the calorie theory and stop designing low calorie, low fat, high carbohydrate diets for people and ensure that they advise people to eat real food instead. Given that obesity is about insulin; the body’s handling of carbohydrates; how the body turns food into energy; nutrients; nutritional combinations; what we eat; when we eat; what we eat with what; and so many inter-related things, we will need to comprehensively retrain dieticians so that they can help people to work with their body to lose weight, not against it. I would love to share all my findings – theoretical and empirical – about how people can lose weight and keep it off.

Please do not go down the route, which has been proposed, of funding slimming clubs to help overweight people. In one form, or another, all of these are expounding the calorie theory and they are trying to get people to eat less to an often dangerous extent. They are perpetuating the mass of hungry food addicts walking around the UK every day.
If you are still reading this, you have my heartfelt thanks. I feel like I am continually trying to tell people that the world is round, when everyone (other than, perhaps, an Atkins’ devotee) maintains that it is flat. If you still believe that “Eat less and do more” is the answer to the obesity epidemic please tell me why and please tell me what is going to make this advice work, when it has clearly failed for decades.
If you are even vaguely aroused to the possibility that we need to try something different and plan to explore this further, please let me know how and please don’t hesitate to ask if I can help in any way.
Someone once said to me that a definition of madness is doing the same thing and expecting a different result. Please don’t be mad: lead the way!

Zoë Harcombe BA MA CANTAB
www.whydoyouovereat.com

www.theharcombediet.com

Appendix 1

Glossary of Terms & Quotes

Calorie: The definition of a calorie is “a unit of heat and energy equal to the amount of heat energy needed to raise the temperature of 1g of water by 1?C from 14.5?C to 15.5?C.”
Candida: Candida is a yeast, which lives in all of us, and is normally kept under control by our immune system and other bacteria in our body. It usually lives in the digestive system. Candida has no useful purpose. If it stays quiet and in balance, it causes no harm. The problem starts if Candida multiplies out of control and then it can create havoc with our health and wellbeing. Candida has been shown to cause insatiable food cravings – particularly for all sugary foods, bread, cakes, biscuits, fruit/fruit juices and vinegary/pickled foods.
“Candida overgrowth brings a craving for most of these forbidden (on the anti-Candida diet) foods – not just a preference but a strong virtually insatiable craving. People report dragging themselves out of bed at 2am to go to the all-night grocery.”
Shirley S Lorenzani “Candida – a Twentieth Century Disease”

Food Intolerance: Food Intolerance means, quite simply, not being able to tolerate a particular food. This is different to Food Allergy – Food Allergy is the really serious, life threatening, condition where people have nut, or strawberry allergies, for example. Food Intolerance develops when you have too much of a food and too often and your body just gets to the point where it can’t cope with that food any longer. Food Intolerance can also make a person feel horribly unwell. The real irony is that Food Intolerance causes people to crave the foods to which they are intolerant. You are most likely to be intolerant to anything you have daily and feel you couldn’t live without.
“He may wake up in the middle of the night and help himself to more food. Sometimes family members will joke that he seems to be addicted to sweets, cheese, steak, or whatever is his favourite treat. If only they knew how right they are!”
Theron Randolph & Ralph Moss “Allergies – Your Hidden Enemy”

Hypoglycaemia: Hypoglycaemia is literally a Greek translation from “hypo” meaning ‘under’, “glykis” meaning ‘sweet’ and “emia” meaning ‘in the blood together’. The three bits all put together mean low blood sugar. Hypoglycaemia describes the state your body is in if your blood sugar levels are too low. When your blood sugar levels are too low, this is potentially life threatening and your body will try to get you to eat. Hypoglycaemia can cause cravings for any carbohydrate – even fruit.
“…the person with hypoglycaemia makes himself worse by eating sugar, and the ironic feature of the disorder is the craving for sweets that accompanies it.”
Carlton Fredericks’ “Low Blood Sugar and You”