The Hungry Gene: The Science of Fat and the Future of Thin

www.genomenewsnetwork.org By Ellen Ruppel Shell Reviewed by Teresa G. Gionis January 10, 2003 Book Review

Though they may be familiar, the statistics on obesity are nonetheless shocking. One in three Americans is obese and 60 percent are overweight. Despite some $33 billion spent on diets and exercise programs each year, Americans are fatter than ever and more at risk for heart disease, diabetes, cancer, and hypertension.

The health crisis, at epidemic proportions in the U.S., has spread around the globe. Obesity in China became six times more common during the nineties. Half the adults in Brazil, Chile, England, Finland, and Russia are overweight or obese, and children in many of these countries have weight problems of their own.

How did the world get fat, and what can we do about it? These questions are at the heart of The Hungry Gene, a fascinating and often disturbing new book by science journalist Ellen Ruppel Shell. She takes us into the cutthroat world of obesity research and exposes the machinations of the powerful diet and food industries. She explores the damaging influence of consumer culture on our philosophies about eating and exercise, and offers a glimpse of the tragic and isolated lives of the very obese.

Shell came upon her topic unexpectedly during an interview with a biotechnology executive a few years ago, on Christmas Eve. The topic was genomics, and as the executive rambled on about how genomics would transform biomedical research, she asked which disease he might hope to cure. His answer was not heart disease or cancer, as Shell had expected. It was obesity.

To illustrate just how desperate the health crisis has become, the author opens the book with a rather gruesome play-by-play account of gastric bypass surgery. In the procedure, a tiny part of the stomach is cordoned off, stapled and re-attached to the intestines. The procedure is performed only on the morbidly obese, and it has mixed long-term results. It is also in high-demand: medical centers have waiting lists of persons wanting the procedure.

The account of the surgery is illuminated by some of the author's irreverent yet effective metaphors, such as her description of a surgery patient's exposed flesh, "rippling thickly, like a crème brulee."

About half of the book tells the history of obesity research and the mad race to be the first to discover the elusive "fat gene," which drug companies had hoped would be the silver bullet solution to our weight problems—and their bottom line.

Shell begins the narrative thirty years ago, at a research institute called the Jackson Laboratory in Bar Harbor, Maine. There, scientists developed the first super-obese mice that would be used to discover genes involved in appetite and hunger.

In lively and understandable language, Shell reports on major advances in the highly competitive world of obesity research. She gives the reader a solid understanding of the physiology of fat, and the potential role of genetic science in contributing to solutions.

The story is driven by Shell's compelling profiles of pioneers in the field, including Douglas Coleman of the Jackson Laboratory, and Rudy Liebel and Jeffrey Friedman of Rockefeller University in New York. Like characters in a novel, the scientists appear on the pages as complicated and flawed human beings, who at times are greedy and willing to stab competitors in the back.

Shell nonetheless conveys a deep respect for the challenges they face in trying to discover obesity genes. She notes that locating a gene in mice without knowing which protein it produces is "like finding the home of a reclusive uncle who lists his address as 'Someplace, USA.'"

‘Every major drug company is heavily invested in obesity research.’

Ultimately, their research leads to the isolation of an obesity gene, which is christened "leptin." The gene in mice is critical in regulating appetite, and its discovery demonstrates that the drive to overeat does indeed have deep genetic roots. The role of leptin in humans is unclear, however, and its value in fighting obesity is unproven.

"Although leptin is not a cure for obesity, it is critically important," Shell writes. "It is so promising that every major drug company in the world is now heavily invested in obesity research."

The second half of the book includes a scathing portrait of the diet industry; an eye-opening examination of the social conditioning that has led to our current state; and steps we must take as a society to turn back the tide.

Shell's descriptions of the pharmaceutical and diet industries placing profit above safety concerns are vexing. But her argument begins to feel heavy-handed and muddled as she presents a few too many case studies suggesting how drug companies profiteer.

One example is the debacle of the fen-phen diet pill combination. The combination was wildly successful in 1996, when eighteen million prescriptions for the two drugs were filled. Within a year, however, studies proved that fen-phen was causing serious heart valve damage and other injuries. It was taken off the market. Evidence was presented that the manufacturer knew of these dangerous side effects long before the product was recalled.

The author's exploration of what has led us down this path to obesity takes her to Kosrae, Micronesia, and the story of that island's residents. Due to the recent mass importation of high-fat Western food, and subsequent rise in diabetes and heart disease, the life span in Kosrae has decreased dramatically. These and other telling examples offer evidence of the power of environmental forces in shaping our eating habits.

Toward the end of the book, the author includes an attack on the "unfettered consumerism that drives the obesity pandemic of the 21st century." She assails the American car culture, and TV culture, and the "obstacles to human exertion" that exist in most of our cities. She asserts that "free market capitalism is wonderful for some things, but public health is not among them," and supports the kind of public awareness campaigns and regulations that have been so effective against the tobacco industry.

In the end, the author's conclusions about the origins of the crisis are not exactly surprising. The real culprits in obesity are eating too much and exercising too little.

Teresa Gionis is a freelance writer who lives in Washington, D.C.