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Fat @ National Geographic Magazine
   
By Cathy NewmanPhotographs by Karen Kasmauski



A love of carbs? A lack of exercise? The real reason one in three Americans is obese is simpler than you think.



Get a taste of what awaits you in print from this compelling excerpt.

In one sense, the obesity crisis is the result of simple math. It's a calories in, calories out calculation. The First Law of Fat says that anything you eat beyond your immediate need for energy, from avocados to ziti, converts to fat. "A calorie is a calorie is a calorie," says Lawrence Cheskin, director of the Johns Hopkins Weight Management Center, whether it comes from fat, protein, or carbohydrate. Cheskin, who is six foot one (185 centimeters) and weighs 160 pounds (70 kilograms), has never had a weight problem himself. "Who said life is fair?" he observes.

The Second Law of Fat: The line between being in and out of energy balance is slight. Suppose you consume a mere 5 percent over a 2,000-calorie-a-day average. "That's just one hundred calories; it's a glass of apple juice," says Rudolph Leibel, head of molecular genetics at Columbia University College of Physicians and Surgeons. "But those few extra calories can mean a huge weight gain." Since one pound of body weight is roughly equivalent to 3,500 calories, that glass of juice adds up to an extra 10 pounds (five kilograms) over a year. Alternatively, you'd gain 10 pounds if, due to a more sedentary lifestyle—driving instead of walking, taking the escalator instead of the stairs—you started burning 100 fewer calories a day.

"We know people get fat by overeating slightly more than they burn, but we don't know why they do it," Leibel says. "I'm convinced our overeating is not willful or the result of a deranged upbringing. It's the genes talking, but it's a very complicated language. Genetics are everything."

In the 1960s James V. Neel, a geneticist at the University of Michigan, listened in on one genetic conversation. In his "thrifty gene" hypothesis, Neel suggested that some of us inherited genes that make us exceptionally efficient in our intake and use of calories. Our bodies are good at converting food into fat and then hanging on to it. This trait may have helped our ancestors survive when calories were few and far between, Neel speculated.

But fast-forward to the 21st century, when calorie supply isn't a problem, and genes that favor gaining weight have outlived their usefulness. Evolution betrays us. We store fat for the famine that never comes. "If we understood the genetics well enough," says Anna Mae Diehl, a professor of medicine at Johns Hopkins School of Medicine, "we could fingerprint people when they are born and say: Ah, good genes. Lucky you. You can eat whatever you want. Or: Uh-oh. Poor kid. Better never have a doughnut."

Get the whole story in the pages of National Geographic magazine.



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More to Explore

In More to Explore the National Geographic magazine team shares some of its best sources and other information. Special thanks to the Research Division.

Did You Know?
With 144,000 bariatric surgeries expected in 2004—up from 16,200 in 1992—the severely obese are increasingly turning to this life-altering measure. Popularly known as stomach stapling, the surgery, using several different techniques, promotes weight loss by closing off parts of the stomach to make it smaller. Celebrities ranging from singer Carnie Wilson to American Idol judge Randy Jackson have helped popularize weight-loss surgery in recent years with their success stories. Most of those who undergo the procedure lose weight quickly and continue to lose for up to two years. And they aren't just dropping pounds—they're also seeing improvements in almost all their obesity-related conditions.
 
But weight-loss surgery isn't without risks. One out of a hundred patients who have gastric bypass, the most common type of bariatric surgery, dies, and 10 to 20 percent of all bariatric surgery patients require follow-up operations to correct complications. Some develop gallstones and almost 30 percent develop nutritional deficiencies, including osteoporosis, anemia, and metabolic bone disease.
 
—Cate Lineberry
Did You Know?

Related Links
Overweight and Obesity
www.cdc.gov/nccdphp/dnpa/obesity
Learn more about the prevalence of obesity, the impact of it on health, and how to prevent weight gain at this Centers for Disease Control and Prevention site.
 
American Dietetic Association
www.eatright.org/Public
Get answers to your nutrition questions and learn more about achieving a healthy lifestyle.
 
Food Guide Pyramid Update
www.usda.gov/cnpp/pyramid-update
Find out more about how the Food Guide Pyramid will be updated in 2005.
 
Physical Activities
prevention.sph.sc.edu/tools/compendium.htm
To help calculate the approximate amount of energy burned for various activities, check out "The Compendium of Physical Activities Tracking Guide," one of the tools at the website of the University of South Carolina Arnold School of Public Health Prevention Research Center. (Original publication: ACSM's Guidelines for Exercise Testing and Prescription, by Lippincott, Williams, and Wilkins, 6th ed., American College of Sports Medicine, Philadelphia, Pennsylvania, 2000.)

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Bibliography
Brownell, Kelly D., and Katherine Battle Horgen. Food Fight : The Inside Story of the Food Industry, America's Obesity Crisis, and What We Can Do About It. McGraw-Hill,  2003.

Cheskin, Lawrence J., and Ron Sauder. New Hope for People With Weight Problems. Prima Publishing, 2002.
 
Nestle, Marion. Food Politics: How the Food Industry Influences Nutrition and Health. University of California Press, 2002.
 
Stearns, Peter N. Fat History: Bodies and Beauty in the Modern West. New York University Press, 2002.
 
Willett, Walter C. Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Eating Healthy. Free Press, 2002.

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NGS Resources
Newton, Carolyn. Making Healthy Choices. National Geographic Books, 2003.
 
Sui, Nat. What Makes Me Healthy? National Geographic Books, 2003.
 
Winkler, Peter. Keeping Fit. National Geographic Books, 2003.
 
Thornton, Jim. "Global Health." National Geographic Adventure (February 2003), 28.
 
Gore, Rick. "What It Takes to Build the Unbeatable Body: Pushing the Limits." National Geographic (September 2000), 2-33.
 
Dunn, Jerry Camarillo, Jr. "Yuckie Yummies." National Geographic World (December 1997), 28-31.
 
Hapgood, Fred. "The Prodigious Soybean." National Geographic (July 1987), 66-91.

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