Synopsis
Everyone knows diet and exercise are key components in the prevention and management of obesity and diabetes. Most people don't know how to best implement the accurate but shop-worn advice to eat less (and better) and move more. And fewer still understand the need to look beyond nutrition and physical training for the causes of and solutions to their weight and/or metabolism problems—the dozens of additional factors, some reparable, others not, impacting success. In THE 37 THINGS THAT MIGHT BE MAKING YOU FAT, a board-certified endocrinologist—and diabetes and thyroid patient himself--seeks out the unexpected and little-known, and sometimes scientifically cutting-edge, contributors to the dual epidemics of obesity and diabetes in the world of the 21st century. Following introductory chapters covering the physiology and pathophysiology of fat tissue, obesity, and human energy balance, and a primer on the clinical assessment of body weight, and the diagnosis, consequences, and epidemiology of obesity as a disease—Dr. Rone spends the middle 2/3 of the book in a systematic exploration of multiple categories of obesity/diabetes-causing factors, and tallying up a final "Obesogen List"--the titular 37 things that might be making you fat. Along the way, Dr. Rone documents his claims with extensive descriptions of the relevant medical literature, covering obesity/diabetes/metabolism peer-reviewed research mostly from the 2015-to-2019 period. This feature will make THE 37 THINGS a valuable reference for healthcare providers, professional nutritionists, and interested laypeople alike. The categories of obesogens spotlighted include counterproductive, yet normal, features of human physiology; lifestyle issues to include sleep disruption, stress, and screen time; eating and drinking habits; prescription-drug issues; obesogenic diseases; ubiquitous environmental toxins; and irreversible personal-history issues, such as childhood experiences, smoking history, and even what year you graduated from high school. Particular targets of Dr. Rone's biting sarcasm are dogmatic but oversimplified notions of what it means to eat "right," and government-driven nutritional guidelines. Should we really be afraid of fat? Might the 1992 Food Guide Pyramid have caused the "diabesity" epidemic? Is it possible to gain weight from zero-calorie diet sodas? The final four chapters summarize and distill what came before into actionable step-by-step advice for tackling a weight and/or blood sugar problem, and tailors that advice for three different types of individuals: (1) those with a normal body weight seeking prevention, (2) those who are overweight or obese, but still metabolically healthy, and (3) those progressing along an insulin-resistance spectrum in which worsening obesity and diabetes, and accumulating comorbid diseases threaten to spiral cripplingly, even fatally out of control, without decisive corrective actions taken at the earliest possible point in the process. At no point does Dr. Rone claim that diet and exercise are unimportant or unnecessary, but they may be insufficient, a source of great frustration to many people hoping and trying to lose weight. Ultimately what this book accomplishes is to improve the implementation of the EAT LESS and MOVE MORE pillars, and adds a third, forming an obesity/diabetes management triumvirate. The third pillar being The Obesogen List of additional factors to address, shorthanded "The Big 37"—the 37 things that might be making you fat.
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