Hungry Gene Review

Is obesity genetic? It can't be, since obesity rates have skyrocketed in a few short decades while genetic change takes several generations. Yet we've all observed that annoying colleague who can eat everything in sight without gaining an ounce, when we merely sniff a doughnut and have to loosen our belts. Ellen Ruppell Shell's excellent book The Hungry Gene examines the interplay of genes and environment to convince us of the essential roles both nature and nurture play in the global obesity epidemic.

Shell's overall conclusion is that our weight is determined by "the sum of our genes interacting with a particular environment." Her visit to the Pacific island of Kosrae, where 85 percent of adults are obese, illustrates this well. Kosraeans evolved on a diet of fish and breadfruit in a harsh environment periodically decimated by disease, starvation and typhoons. Only those whose bodies could hoard fat survived, so Kosraeans have what's called "the thrifty gene." Today the population is sedentary and everyone's diet leans heavily to Spam and Coke. The only islanders escaping obesity are those descended in part from nineteenth-century whalers whose genes, developed in a more food-stable environment, had no need to maximize food resources.

Much of The Hungry Gene recounts science's search for the genes, hormones and neuro-circuitry that control appetite. Shell's writing experience shines through especially in these chapters, creating page-turner suspense from what she calls "a sometimes twisted, sometimes wacky tale" of intrigue, human melodrama and intellectual politics. Is a gene mutation responsible for obesity? What roles do leptin and insulin play? What blockbuster drugs can we create, and who will hold the patents? The players are jockeying for credit and cash, and the story—still unfolding today—is riveting.

Yet human pain and illness are always on the edge of the scientific search. Shell opens her book with a patient undergoing risky bariatric surgery in hopes that her new thimble-sized stomach will end years of life-threatening obesity. A later chapter discusses drugs like Meridia, Redux (fen-phen) and Xenical, and the desperate patients who take them even when they're told the expensive drugs will cause only moderate weight loss—and must be taken indefinitely, as the weight will return if they stop taking the drugs. In only a few rare cases is obesity caused by genetic mutation or disease. In most cases, as Shell points out, diet drugs are "designed to interfere with what is essentially a healthy, smoothly-running system." Surely there must be some alternative to diet drugs that, in most cases, tinker with brain chemistry and cause unknown long-term side effects.

Shell devotes one of her best chapters, "An Arm's Reach from Desire," to the impact of processed foods, food advertising and pricing. We learn how and why the McLean burger and other lean choices have failed at fast food outlets—in part because any attempt to highlight healthier foods reminds patrons of the unhealthy effects of everything else. We learn that Asians don't consider burgers or Kentucky Fried a proper meal—so residents of Singapore and Seoul add these foods to their diets as snacks, in addition to multi-dish family meals. We also learn that for many folks worldwide, junk food is a choice dictated by economics. Most fascinating of all, Shell explains how taste buds worldwide are developing a preference for sugary flavors once considered "childish" over the complex tastes more typical of vegetables and adult dishes.

The Hungry Gene concludes with Shell's suggestions for stopping our slide into obesity, many of them based on successes in other lands. Finland cut heart disease 73% in the Karelia region in large part by subsidizing salads and vegetables in schools and company cafeterias. Sweden and Norway ban advertising to kids, and have the lowest child obesity rates in Europe. We should follow suit, while also replacing the USDA's timid, compromised nutrition advice with a meaningful public education campaign run by the CDC or some other party without an inherent conflict of interest. Shell also suggests rezoning our cities and towns to make walking a viable alternative.

I highly recommend The Hungry Gene to anyone who wants to understand the genetic and sociopolitical causes of obesity. The book covers some of the same ground as Fat Land, but in a more cohesive and compelling structure. Though both are good reads, The Hungry Gene has the edge, for its global perspective and its thorough coverage of gene science issues.

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Review © 2003 Cynthia Harriman.
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