Reading your book. It was fun and fascinating because i think everybody has questions about why do some people get fat and others not get fat. What dont people understand about this. It seems like its been a problem for so long. Why is it still a problem . One of the things i like about your book is that you have a lot of personal stories. Yourself, scientist, people who are struggling with their weight and i was drawn to the book from page one. I think everybody can relate to it. I thought people might like to hear what your book sounds like so i wondered if you could start by reading page one and stop at the end of that anecdote in page two. It was great. This is my personal story about how i got into writing this book. The prologue is called skinny teen. It was a greedy friday evening in the fall in san diego. I was a biochemist, phd student. I had a strong interest in biology since grade school, particularly in how the body malfunctions and how we treat it. The idea that tiny molecules affected are thought and quality of life was fascinating to me. I was excited to be learning so much about the inner workings of the body. Another interest to that me constantly. My weight. Aside from advancing my career, i measured my success at how well i did and staying thin. Keeping my fat in check was never easily. I watched my weight closely. On this day, like every other, i had counted my calories since morning, i ate a combination of grains, protein investable. I strayed from anything fun. No sugar, carb heavy snacks or alcohol. Nothing fun. I iran for 40 minutes and lifted weights. I knew i was on my way to fitness victory. I had stayed steadfast at dinner with my friends. I ordered salad and water and i knew i would go to bed hungry. That was my secret to keeping my 5foot 3inch frame under 110 pounds and capable of fitting into my skinny jeans. If i could maintain this weight i would maintain control and look like every other college student, be asked out on dates and be confident about my future. Instead, something happened that would forever change how i viewed my body. Something profound that confirmed i was not normal. My best friend ordered a beer and burrito and devoured it all. That event changed everything. She was 4foot 11 inches and 95 pounds bridge she never went to the gym. She drank a sugary latte and ate fast food. She worked in the lab all day like me and hunched over a computer in the evening yet somehow this petite woman was able to pack in a large burrito with sour cream, guacamole, with cheddar cheese, all wrapped in a tortilla and down a beer as if it was nothing unusual. She had no luck of guilt or appearance of worry. She didnt make a comment about feeling sick or how she would have to run on the treadmill. It was just a normal everyday occurrence to eat and 800calorie burrito at 8 00 p. M. And her jeans were smaller than mine. So unfair. It seems like its against the laws of physics, doesnt it. We are told that a calorie is a calorie is a calorie and if you just eat a certain amount you will not be fat and if you eat more than you will suffer the consequences. That is an incredible story and that sets you off on a path of trying to figure that out. Thats right. I had so many of those types of stories. That was college. My life didnt get easier after that. I started a career and had children. What was your career. I was a scientist. I started off in research and went to the business side. What kind of research . I was researching alzheimers. I was looking at memory and learning and things like that and most specifically alzheimers. As i started looking for a job, one of my advisor said if you dont have a burning question, dont go into resech because its a lot of sacrifice. They dont get paid for paid well and its long hours. I like looking at the big picture of things so i got my mba and i worked on Development Drugs for various diseases. Later i had this burning question, it just kept happening i noticed there are people who can eat a lot and not exercise much and they are thinner than me. I went on a number of diets. It perplexed me. I could lose weight and then gain it back. I thought im going to figure this out. I was not going to go on one more diet. My fat was different. I gain it easier, its softer than other people. How do you know its softer. You can tell the way they dress. Some have that stout fat. Some is much softer. I noticed everything. Im gaining faster and it looks different. I dont have the same responses to food that other people have. I thought if anyone can figure this out i can. Was going to figure it out. I spent five years researching knowthing there is to about that. Everything i could find. I pulled out about a thousand articles and looked at 50 researchers around the world regarding their cuttingedge research on fat. What i found that was so astounding made me want to write a book and the secret life of fat is that book. Whats the most surprising thing you found out about that. Fat is not just fat. Its not just calories. Its an organism that releases hormones that are body depends on. Amazingly our brain size is linked to fat. There are people who have defective fat and part of their brain is smaller. Our bone strength is linked to fat. Our reproductive system is linked to fat. Its amazing that there are so many systems in our body that are linked to healthy fat, but because of those hormones that fats increase. Because its so important to us nature tries to protect it. It has a direct link to our appetite and metabolism. Fat is almost fighting to come back on to us. We might not value our fat at all. We want it to not come back at all. You have to understand it if youre trying to manage it. You have a story about a girl who didnt have any fat or no fat. That was amazing. I think some people would y thats great. Heres someone who doesnt have anfat. Can you tell us about her life . Theres something that happens if you dont have any fat. This is a story about christina. How did you find christina. I was looking at different facts of not having enough fat or having too much fat. I was looking at the ends of the spectrum to see what happens in those cases. Doctors and researchers all knew about this girl, christina. She was a very normal girl growing up in new jersey and around 12 or early teen she started have a problem in that she was losing fat. First in her face and then the rest of her body as well. At the same time she developed an enormous appetite. She would eat a can of mushrooms or anything she could find. Finally she started getting these blisters on her skin as well. They were painful and became inflamed. They didnt think it was anything unusual that she was hungry and growing but the blisters were concerning. They took her to a dermatologist and her triglyceride level was about 100 times normal level. Her sugar levels were five times normal. He quickly ascertained this was not a dermatologic problem. He center to another doctor and he was treating her for diabetes but she continued to lose weight and her appetite was the same. It didnt help her. He was before though. They finally diagnosed her with the disorder where the person sponneously loses fat tissue. They lose it all over their body. It stays in their hands a little bit, but they really start have almost no fat tissue at all. Because our fat is linked with appetite, we lose some fat and we lose some lipton. She couldnt stop eating. It circulated in his blood endlessly. The nutrients and the blood in the sugar, it had no place to go. The only way to alleviate this is to eat every second of the day which is impossible to do. Her fat was stored in her liver. It was about eight times the size of a normal liver and would protrude into her abdomen. The blisters in her skin were fat filled blisters which made it hard for her to move at time. At first they didnt have a cure for her. They took out her blood and would clean it and the doctor said her blood was creamcolored but it was so sick for of fat and cholesterol. She would have to do this three times a week. Eventually it was discovered that she was able to get the hormone she needed. Then her appetite finally subsided. When her appetite subsided she ate less and was able to resolve some of her diabetes issues because she didnt have these extra nutrients. But she never got the fat. Or fat did not come back. Did she look weird. She looked emaciated. Her cheeks were hollow and she looked older than what she was but e was able to get her health back in order, more or less. These patients have other issues so the never be completely normal and healthy, but they thought she was in for an early death but thanks to the discovery of this and be able to get the injections she need, she is able to go on and she has adopted children and shes married and shes going on. Its a hard life. For anyone who wants to get rid of all their fat, who wishes he could get rid of their fat, i think its a great case study to understand and appreciate what its doing for your body. Its creating hormones and that affects our body as well. That was an amazing story. Did you read write about the girl . Fat is something that sends your brain and tells you you want to eat so if we dont have that what happens . Rather than just sitting there holding our calories its producing leptin and goes into the bloodstream and goes into your brain. Its talking. Its sending out signals and orchestrating. When we dont have enough leptin its a signal we dont have enough fat. We have to start eating. Maybe there fat isnt producing leptin. In any case if it doesnt have it keeps you eating. Before this was discovered this wasnt known. There was a girl in britain and she was four months old and had an enormous drive to eat. Even as a baby. She gained weight and was an obese child. It wasnt a normal drive to eat. She would go through the trash looking for food when her parents restcted it and she was even caught broking into a freezer to eat raw fish. There was something amiss. No one knew the spreadsheet got blamed for it. Her parents got blamed for not controlling their child. At one point they put her to the hospital. They thought they could restrict her calories there and she could lose some weight. What happened, she didnt lose weight. Even on restricted calories she continued to gain weight, just more slowly. It was very perplexing and finally she was sent to the university of cambridge, Steven Oreilly who is an expert in metabolic diseases. Steven oreilly had read a paper on leptin and thought maybe shes actually got this problem, this defective gene. He tested her for it and sure enough she had this defect in her gene that she doesnt make functioning leptin. Once they figured this out they were able to get her leptin like they did for christina. Her appetite diminished. She turned into a normal child. She went from an eating machine to someone who could function normally. She lost weight and within a couple years she looked pretty normal. These kids usually die an early death from complications from obesity. Having this leptin and discovering that fat is not just fat. Its not just a reserve of calories. Its a very important organ that we have in our body. That discovery has helped people like layla and christina because they can get the hormone that fat makes and they can live a pretty normal life after that. So fat is really important as like something that is sending signals to your brain and your body. Its not just something inert. Then that leaves us with the question that you started with, why are some people fatter than others. Why arent we all perfectly uniform in the amount of fat . Why are some people fatter. That was a question that sent me on this long research. I know, thats why i asked it. Now that we know fat is a reserve of calories as well as an organ, the question about why some people have more fat, theres all kinds of reasons. Some people eat too much or dont exercise. What if you eat too much. You just talked about a girl who didnt have any leptin but she couldnt stop eating because she had a signal telling her to eat. What is too much . Your brain is telling you how much to eat. Too much is where youre getting more fat they are not healthy anymore. Thats what i would define as too much fat. There are people who can be fat but fit. I write about that as well. I know we vilify fat. It is associated with some diseases. Not all fat is created equal. It depends where its at. There is fat under our skin and visceral fat which is the more unhealthy fat around our organs. That fat can get inflamed and interfere with signaling. That is tied to diabetes and Heart Disease. I do talk about sumo wrestlers who are fit but fat. They eat 4000 calories a day and easily weigh 400 pounds. Actually they eat up to 7000 calories a day, but they exercise six or seven hours a day. Another trick that fat has is it releases a hormone that helps keep our blood clean of fat. It is fats way of saying please come home to a safer deposit of fat. It keeps us healthy. Because of all the exercise they do, these sumo wrestlers, they have a high level that keeps them healthy. All that fat we have, they dont have as much disease as one might expect. When they come off the diet and the exercise they do. Do they deliberately get that heavy. Yes. You had some stories in your book about people at Rockefeller University and other stories that did the reverse. Some stories were people who were very heavy and lost a lot of weight. They were put in a metabolic ward at a hospital. Other stories were people that agreed to try to lose weight for the experiment or try to gain weight or have a normal weight, and it doesnt look a like its that easy to control your weight. Can you tell us about experiments where people were fat and made to lose weight and people who were normal weight and made to lose or gain weight and what happens when people try to be at a weight that is not what their brain wants him to be. Yes, thats very interesting. That gets back to the leptin story again. When we lose fat we be become almost leptin deficient in a way. Its almost like the case study we discussed. When we lose fat we lose some leptin and then we have a drive to want to eat more to replace the fat. It also binds with our muscles and our thyroid gland. It drives metabolism lower. Our muscles get more efficient when we are low on leptin. That combination of having a higher drive to eat and lower metabolism, it is making the fat come back. There are studies looking at brain activity were people who are shown images of food after they lost a percentage of weight are a bit more aroused or excited by it. At the same time there are areas of their brain diminished. They are having more of a drive to eat and less control. All of that is a recipe to get fat back. It takes an enormous amount of strength and will to maintain not for a long time. People love lost 10 of their weight have to eat 22 fewer calories than someone who have not had the loss of weight. Someone who is 170 pounds and lost 120 pounds will have to eat 20 fewer calories than someone who is naturally at 150 pounds. I think the downside, its not that you want to eat and youre driven to it and its harder, its people dont realize and they give in slowly. You think you can diet for six months and you lose some weight and youre good to go. The thing is youre not good to go. This effect has been observed and its not certain that it goes away for everybody. Whatever diet you pick, you have to stay on it permanently. Your biologically different after youve lost weight. What about people who gained weight in the experience, made themselves that when they went fat to begin with. What happened to them . Its pulling the wrapper band in the direction you wanted to come back. They have the more than someone whos naturally at the weight. Someone whos naturally 150 and someone whos naturally at 130, they have the more calories than the person who is at 150 pounds naturally. You have a set point in your body. Your body wants to stay there. It takes a l of effort to try tohange that. I dont know that its impossible to change and they think it is possible, some people gam gain weight permaneny and some people lose weight, but its harder than what the diet industry leads you to believe. They say just cut out carbs or do these simple steps and if it doesnt work for you youre doing something wrong because this is math, calorie and, calorie out, but theres all sorts of reasons some people get fatter than others. If you yoyo diet, you are going to need fewer calories than somebody else. Any program, jenny craig or something might be too much for you and you have to be aware of that. There are studies in genetics and bacteria and viruses and all Different Things that lead to fatness. Gender, its having 2x chromosomes has something to do with it. Why do women get fatter than men. Thats not fair. Its not fair, watching my husband eat ice cream every night is not fair. I said im gonna figure out why you can do that. I had to go and look for this research. This is very interesting. Girls, even from the time they are born, have more fat than boys. There have been studies where they collect birth data around the world. At any age, girls have more fat than boys. It continues into life. There are a couple reasons. One is nutrient partitioning. For example if you eat 100 calories, women might put 3e putting a little more into fat compared to men. Women interact with their fat differently. We dont use it the same way. If we are fasting or exercising a t, womens body will reach for fat more. We use it. You think this would be so great. Men reach for protein more. But, women store fat more efficiently than men. Were putting more back into fat at a higher rate than men do. In a way its healthy because we are cleaning our blood and its stored in the fat which is a good thing, but it does make us a bit softer compared to men, although women, up to a certain point, they have less metabolic disease than men because of this effect. Women dont react to exercise the same. When we do a really hard bout of exercise like burning 600 calories, we release a hunger hormone that comes from the stomach. We have a 33 increase of that hormone and we will be hungry. Even after we eat it stays elevated to 25 . Men dont have that response. We are driven to get that fat back on us after we exercise really hard. Women have to reproduce and nurse and theres all sorts of evolution rules that could apply. We do get more fat. It is keeping us a little healthier and there is some good to having some of this fact. Wow, that is pretty amazing. So come out i guess its hard to lose weight because your leptin is making you eat more and women are fatter than men because they partition their fat differently and its used differently and they get hungrier faster. Theres a lot of unfairness going on. I have a couple other questions i wanted to ask you. Where are they . Okay. Oh yes, this is a great one. Bacteria and viruses. Do they have anything to do with obesity . You wouldnt expect it, but your book makes you think maybe they do. Yes, there are a lot of different components as to how we get fat. Gender is one but bacteria is another. This is pretty surprising to people. Its been known in animals for quite some time. There are vaccines who have caused fatness in mice and rats. Some people then hear about it happening to humans and become concerned. So if you stay around a fat person you could get fat . Theres all these things. When we talk about gender and genetics and how