Book Review – Rethinking Thin by Gina Kolata

May 23, 2016 by Gretchen Newmark, MA, RDN

Rethinking Thin: The New Science of Weight Loss --and the Myths and Realities of Dieting by Gina Kolata

Rethinking Thin is an engrossing book that summarizes our current scientific knowledge of obesity and weight loss vs. the cultural biases against people who appear overweight (by ever more severe standards.) Ms. Kolata engages the reader by following the stories of four dieters who participate in a study at the weight loss center of the University of Pennsylvania, comparing the then-popular Atkins diet with a conventional low fat/calorie approach. 

In the course of the book, Ms. Kolata summarizes the history of our obsession with body weight, and the various, sometimes ludicrous, means that health professionals and the public have promoted to address it, including the first known incarnation of the Atkins diet, self-published in France 1825 by a gourmet/attorney. She describes as well the history of our scientific understanding, including a concise, compelling description of the discovery of the hormones leptin and ghrelin, and other genetically determined factors that affect appetite, body composition and weight; and how these discoveries may influence future weight loss interventions.

In addition, she illustrates the controversy that exists among health scientists and care providers about the actual risks of obesity. Her conclusion is that the health risks of overweight have been exaggerated by misinterpreting data to fit the current bias that one must be thin to avoid metabolic conditions like heart disease and diabetes, and that all fat people, regardless of their fitness level, are likely to develop them. Without naming it, she provides scientific rationale for “health at any size.” She also includes descriptions of research that proves that overweight people are no more likely to have emotional problems like anxiety and depression than thin people. Current research demonstrates that the belief that people get fat because they overeat, typically for emotional reasons, is false. Many fat people eat no more than their thinner counterparts, are no more or less likely to eat for emotional reasons and are as likely to be psychologically healthy. She reveals motives for the myths that surround our medical/cultural views of weight, from the billions of dollars to be gained annually from exploiting these myths, as well as professional reputations based on perpetuating them.

What emerges in the course of the book is the dirty little secret seldom spoken in medical or nutrition circles: that currently no one knows how to help most people lose more than about 15% of their body weight permanently, despite repeated warnings that they do so. Ms. Kolata is a well-known New York Times science writer who has authored five previous books, including Ultimate Fitness: The Quest for Truth about Exercise and Health. She is thin herself, with no personal reason to be biased in her assessment of the current science and practice of weight loss.

Anyone who is interested in weight loss for any reason would be wise to read this book. If you work with people who are trying to lose weight, you need to read it.