Chapter 18  Fattening Diets 

There is no reason to believe that fattening up the constitutionally lean is any easier than inducing leanness in the obese. For successful fattening, the excess calories consumed have to be stored as fat, rather than expended in metabolism or physical activity or stored as muscle. This is not a given, considering these alternative uses for the calories. 

How do Japanese sumo wrestlers fatten up? They consume 5,000+ calories a day of chanko nabe (a pork stew), which is 57-80% carbohydrate, and only 9-16% fat! The higher the carbohydrate composition, the fatter they are and the less muscle they have. 

If we wanted to design a diet capable of inducing pathological obesity in young men in their prime, we might start with just such a very low-fat, high-carbohydrate diet. 

The insistence that fat, not carbs will fatten is why a low-fat, low-calorie diet is recommended. 

This is based on 4 easily challenged pieces of evidence. 

1) The association of heart disease, obesity and diabetes

2) that Lab rats become obese on high-fat diets

3) the density of fat calories "fools" people into eating lots and 
4) the metabolic cost of storing calories

There is the notion to "fill up" on fiber, veggies and water. But experiments indicate that intake is adjusted by calories, not mass. 

The nutrient composition of the diet seems to affect profoundly the desire to consume calories to excess. It's impossible to fatten people on a high-fat, high-protein diet in which the food to be eaten in excess was meat. Volunteers will sit staring at a plate of pork chops a mile high, and refuse to eat even a thousand excess calories. 

Getting people to add 1,000 calories a day of FAT to the diet is very difficult, but it's easy to add 2,000/day of fat plus carbohydrates. 

By perceiving obesity as an eating disorder, a defect of behavior rather than physiology, the investigators concerned with human obesity have managed to dissociate the perception of hunger and satiety from any underlying metabolic conditions. They rarely consider the possibility that hunger, satiety, and level of physical activity might be symptomatic of underlying physiological conditions. Imagine if diabetologists had perceived the ravenous hunger that accompanies uncontrolled diabetes as a behavior disorder, to be treated by years of psychotherapy or behavioral modification rather than injections of insulin! These researchers simply never confronted the possibility that the nutrient composition of the diet might have a fundamental effect on eating behavior and energy expenditure, and thus on the long-term regulation of weight.