406: The Case for Keto: Rethinking Obesity and Weight Loss With Gary Taubes

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Gary: Well, thank you, Katie, for having me.

Katie: I'm so excited to chat with you. In fact, you were one of the authors I read very early on when I got into the health and wellness world. And your books, Why We Get Fat and Good Calories, Bad Calories, really kind of were a paradigm-shifting for me and changed the way I thought about food and nutrition. And I think it changed the conversation of how many of us in this world think about food and nutrition. I also think that these are extremely timely topics that get more and more so with all of the things going on right now.

And you now have your new book, which is The Case for Keto. And I wanna really go deep on this today, too, because I get so many questions related to this. And I think you might be the most qualified person I know to answer them. But to start off with, talk about why you decided to write this book? Because you have written extensively in the past, your books, I highly recommend all of them. But why did you feel this book was so important, especially right now?

Gary: Well, I think, when I see the discussion Let me backtrack even a little further on. You know, I got into this 20 years ago, as a journalist with no preconceived opinions. And my conclusions in Good Calories, Bad Calories, which was about seven years of work was that, you know, the nutrition, obesity, chronic disease research community, right, had made a lot of mistakes. It's when you talk about the sort of paradigm-shifting aspect of that book for which Thank you for those words, by the way.

What I ended up concluding was that we had made a lot of mistakes and that there had to be a sort of huge fix for individuals to get healthy and for Americans to get healthy, and people around the world to kind of cure these metabolic disorders that have become so common. And as I've continued writing about that, the world has indeed shifted. So these arguments are more and more being taken seriously.

One of the points I make when I lecture on this now is, back in 2000, when I first started writing about them, there might have been a dozen physicians in America, who prescribe these low-carb, high-fat ketogenic diets to their obese and patients with obesity and type 2 diabetes, to try and fix this metabolic problem. And today, my estimate is there are probably a few tens of thousands worldwide. So this is a sort of small proportion of all physicians clearly, but it's a huge absolute increase in the number of doctors who have bought into this way of thinking.

But there's still a lot of misconceptions in the way the media discusses it, and the way a lot of physicians discuss it, and the way that people, in general, think about these problems. And I just thought what we need now is a book that can kind of put all this in context, put it in a historical context, put it in a scientific context, and kind of teach people how to think about these problems. And how to think about eating, if they're among the, you know, half of all Americans who struggle with their weight and struggle with their blood sugar.

So that was sort of the goal is to give advice. Originally, the title of the book was what I wanted it to be called, was, How to think about how to eat? Because I just think that the nutrition and obesity communities have been so misguided over the years that they've embraced a whole host of ways about thinking. From the idea that you have to eat less and exercise more to control your weight, to a line I hear a lot The diet that works is a diet that we can stick with. Without ever actually defining what happens you know, what you would expect from a diet that works other than being able to adhere to it. So all these misconceptions I wanted to try and set straight as much as, you know, I can do it with the soapbox that I've got.

Katie: I love that. And I think there are so many important points in that. And I think this book is such a good follow up to your previous books as well. And right now, we're hearing so much about metabolic health and all these chronic conditions like obesity, and diabetes, because they are relevant to health outcomes. Of course, we're finding out when people get other types of illnesses, which this year especially has become very top of mind for a lot of people.

But I think to go back to some of the points you make in your earlier books for anyone not familiar, like you said, we're told that the obesity epidemic is because we're eating too much and we're not moving enough. And in fact, it seems like people who carry extra weight, it's viewed as a character flaw or a moral failing of some sort, some sort of lack of self-control. And you really explain this, I think, in the most clear and comprehensive way I've ever seen. But walk us through what is the real difference between lean people and obese people? Is it just self-control or what's really going on?

Gary: Okay, so this is one of the points I'm hammering on in this book. And I'm a little embarrassed I didn't hammer on enough in Good Calories, Bad Calories. So the conventional thinking on obesity is that it is a disorder of energy balance. And we hear this all the time, calories in minus calories out. If you get fat, it's because you take in more energy than you expend. And the implication of this is that the difference between those of us who get fat and those of us who stay lean is simply how much we eat.

And you can see this again, in the history, the field going back to the 1930s, where So as soon as researchers decided that obesity was, you know, caused by overeating, taking in more energy than we expend, they completely ignored all the physiological hormonal mechanisms that regulate how much fat we accumulate. So the point I'm making in this book is that, you know, our fat accumulates I've done it in the past as well and I'm making it again stronger here, is that, for instance, if somebody gains 30 years between high school and middle age, 30 pounds between high school and middle age. So 30 pounds in 30 years, that means they're storing about 10 calories of fat in their fat tissue. Their friends who stay lean, 10 calories every day that their friends who stay lean are not storing.

So when people talk about what to do to fix obesity and they say you should eat 500 calories less or whatever, or you're getting fat because you're eating too much. What they're talking about is this very, very, very subtle day to day accumulation of calories in your fat tissue that isn't burned. And the way I describe in the book is, you know, every day if you eat, say 2,500 calories a day, which is actual


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