“Can I borrow that book when you’re done with it?” asked a friend who saw Fat Science on my reading pile. Well, yes, of course. Although this is a book I’d prefer to keep on hand to dip in and out of so that I can continue to think about the issues that Toomath raises.
The title and sub-title get right to the point – diets and exercise don’t work. The book itself explains why not – and what alternatives there may be.
Toomath has helped me to understand what’s going on that makes it so hard for many New Zealanders to get healthy food and enough exercise. Most weight loss diets lead to only short-term success for people living with excess weight, who Toomath describes as being unreasonably optimistic. Our bodies are complicated. There are multiple factors that interact to determine whether and how we lose, maintain, or put on weight. These include genes, hormones, the effects of sedentary work and sleep deprivation, time-pressured cooks, urban design, food pricing strategies, rising inequality, trade and economic policies . . . the list is long. Toomath thoroughly and systematically explores key questions – eg Can drugs or surgery make us thin? Is fatness inherited? – and related topics. She draws on credible and well-referenced local and international research to back up her observations and recommendations. She emphasizes that most of us cannot change our body size – and that efforts to change the amount of exercise that we do are notoriously difficult to sustain.
We likely all know that there’s no simple or single solution to the obesity epidemic – especially given how, where and when fast foods are marketed. Toomath raises our awareness of marketing ploys and urges consideration of how the “cute shapes and attractive colours” of many processed foods, with their combinations of fat, salt and sweetness tweaked to perfection, are peddled relentlessly by an industry with large advertising budgets. No longer restricted to traditional media, ads for fast foods, processed foods and other unhealthy foods are hurled at us (and our children) day and night, with subtle and not so subtle internet marketing on the rise.
The weight loss industry is flourishing, with numerous plans, programmes, shakes, pills and supplements on offer. Governments in New Zealand and other countries have tried a raft of initiatives to help people adopt healthier lifestyles and to support people to lose weight and keep it off. Although the evidence from many trials is discouraging (with poor long-term outcomes reported) there are schemes that work and proposals that are worth pursuing. As a starting point, Toomath points to ideas put forward by an international food policy advisor and her team. Their suggestions include providing an environment that encourages young children to learn to prefer healthy food, overcoming barriers to cost, and encouraging people to think more critically about their choices when they are purchasing food. Toomath explains how these ideas can be actioned – for example, by providing healthy food in schools, reducing sugar content in food intended for children, subsidising healthy food for low-income families, and restricting access to unhealthy food retailers in areas where children gather. One point on which Toomath is very clear: exercise is good for us, but exercise on its own is rarely the only answer.
This is a thought-provoking book, packed with facts and figures and personal insights. Toomath challenges us to consider why there is such a gap between evidence and policy – when governments know what is likely to work, for whom, and under what circumstances, what is preventing the appropriate actions being taken? “Demand an environment”, she urges, “where it is easy to eat and exercise in a way that keeps everyone healthy”. She also makes it clear that policymakers and politicians must invest time to understand which interventions will be acceptable and which will likely meet resistance and fail.
Fat Science has helped me to look more critically and carefully at how individual and collective responses can influence how New Zealanders source, prepare, market and consume healthy food. I’m going to consider which of Toomath’s key messages I should pass on to others, and how. As a start, I will soon lend her book to my friend.
Reviewed by Anne Kerslake Hendricks
Fat Science: Why diets and exercise don’t work – and what does
by Robyn Toomath
Published by Auckland University Press