Why we eat: the science of obesity - Book Review

Washington Monthly, Oct, 2002 by Stephanie Mencimer

THE HUNGRY GENE: The Science of Fat and the Future of Thin by Ellen Ruppel Shell Atlantic Monthly Press, $25.00

TWO YEARS AGO, A YOUNG ORGAN transplant doctor told me a harrowing story. Recently he had stood by and watched helplessly as a 15-year-old African-American girl died from an enlarged heart. A transplant might have saved her, but high blood pressure, diabetes, and a body mass of more than 400 pounds made surgery impossible. The memory haunted him as he continued to treat more and more children experiencing the deadly effects of chronic obesity. Mostly poor black kids, they marched through his office suffering from high cholesterol, high blood pressure, enlarged hearts, and adult-onset diabetes that promised to fill their future with kidney failure, amputations, blindness, and early heart attacks and strokes.

Despite the staggering numbers of kids like this who were showing up in District doctors' offices, little was being done about it. The public schools had long since sacrificed physical education to budget cuts; understaffed cafeterias served students Domino's pizza to be washed down with 20ounce bottles of Powerade from school vending machines. The American Diabetes Association, headquartered in nearby Alexandria, Va., did not have a single program in the District for adults, much less children. Even as the casualties mounted, no one was sounding the alarm about all these fat kids. Eventually, though, I discovered that one group of people had taken a keen interest in the local obesity epidemic: drug company researchers. D.C. had so many fat kids, most of whom also had fat parents, that it was a veritable gold mine for gene-hunters looking for new drugs to treat Type 2 diabetes and obesity.

I thought about these kids--and the scientists pursuing them--as I read Ellen Ruppel Shell's new book, The Hungry Gene. As the co-director of the science journalism program at Boston University, Shell's specialty is scientists, and her book is largely a story about them. Her characters run the gamut from geneticists to nutritionists studying indigenous people of Micronesia, where a traditional diet of fish and breadfruit has been replaced by, of all things, Spam. The sum of all their tales isn't particularly heartening for those who may be carrying around a few extra pounds.

As Shell explains, humans are hardwired to get fat. Put us within arm's reach of too much junk food, liberate us from manual labor, and very few will avoid gaining a spare tire. "Obesity represents a triumph of instinct over reason, and as such it embarrasses us," writes Shell. "We prefer to think of ourselves as rational beings, in firm control of our destinies or, at the very least, of our bodies. But the deciphering of the genetic underpinnings to weight regulation has ascertained that it is to some degree biological, and that our drive to eat can sometimes eclipse reason."

The difficulty of overcoming genetic imperatives, though, hasn't prevented the nation from devoting its tremendous scientific resources to finding a pharmaceutical cure for excess poundage. While Shell strives for balance, it's clear that she doesn't think too highly of some of the scientists leading the race to find an obesity drug. Some of those who specialize in the study of gluttony also seem to suffer from another deadly sin: greed. Foremost among them, according to Shell, is Jeffrey Friedman, the head of the Laboratory of Molecular Genetics at Rockefeller University, who eventually helped discover--and patent--the first obesity gene, ob, and the protein it expressed, called leptin. Researchers believe that leptin is the body's tool for regulating appetite, alerting the brain when enough food has been consumed, and have entertained high hopes that someday it could be used as an appetite suppressant in humans.

In getting the gene patent, according to Shell, Friedman screwed over the very people who had helped him make the discovery in the first place, including veterans in the field whose preeminence helped secure the funding for his experiments and lab assistants who had devoted their lives to the cause and labored in horrible conditions for years. Shell says Friedman conveniently took over one assistant's nearly finished experiments while she was out of town, just before the big discovery, thus ensuring that he would be the only one credited with finding the gene. Friedman had also ensconced himself on the scientific advisory board of a drug company, anticipating a windfall from any drugs produced as a result of the discovery of leptin.

Among the many people Friedman denied credit for the achievement was Doug Coleman, who had done the pioneering work on obesity in mice in the '70s, and who had advised Friedman on his work. "Science was once about the free exchange of ideas, about collaboration," Coleman told Shell bitterly. "But today it's about intellectual property and confidentiality. It's all about patents, about ownership."

Another of Shell's targets is George Bray, a professor of medicine at Louisiana State University Medical Center, an esteemed scientist, past president of the International Association for the Study of Obesity, and founding editor of both the International Journal of Obesity and Obesity Research. He's also a guy who thinks that obesity is so dangerous that half the country should be taking diet drugs. As a result, his services have been sought out by various drug companies seeking to promote, or to protect from regulation, highly dubious weight-loss products. According to Shell, Bray has pimped fen-phen, Merida, and Metabolife's dietary supplements containing ephedra, an herb that works much like amphetamine and has been linked to the deaths of more than 100 people.