A close examination of this extraordinary collection suggests that Americans will do almost anything to lose weight, with the two exceptions of eating less and exercising more. The current American life‐style is unsustainable, both in terms of planetary resources and in terms of the technical limitations of human physiology. This is very worrying, as the American life‐style is extremely contagious. A recent survey (Reilly et al., 2004) found Scottish children from three years old expending insufficient energy in proportion to intake, giving a strong prediction of future obesity.
Practically everything described in this book, from amphetamines to the zone, is nonsense, and some of the practices it mentions are clearly dangerous. I am mildly surprised that the amphetamines rate an entry of their own here while neither heroin nor arsenic do. Both of these will act as appetite suppressers after all, and some practitioners, licensed or unlicensed, have tried to make a quick buck out of marketing pills and potions containing them. Tapeworms also go unmentioned, although there has been at least one case of an entrepreneur marketing packets of tapeworm eggs as “infallible weight reducers”, which, of course, they really are. Even more surprisingly, there is no mention of smoking, though there are well‐authenticated recent cases of teenage girls deliberately taking up smoking as an appetite suppressant.
What the book does give is detailed descriptions of various popular diets, including serious criticisms that have been made of them, and biographies of famous dieticians (Atkins looks awfully fat in his photo). The evidence presented suggests that all special diets work in the short term, mainly by encouraging the loss of lean muscle and water, but that most users yo‐yo back to their original weights fairly shortly afterwards unless they make permanent changes to their lifestyles. It also makes it clear that most drug or surgical treatments for obesity have appalling side effects. As a scrawny vegetarian I would probably go for the cabbage soup diet as described here, but most carnivores would probably prefer the Atkins alternative. Perhaps Christian evangelicals will be buying books like Slim for Him, More of Jesus Less of Me, or What Would Jesus Eat?, while exercising along with the Praise Aerobics video. Actually, now I come to think of it, what Jesus ate probably was fairly healthy – the Mediterranean diet, excluding pasta and tomatoes – wholemeal bread, dates, fruit, olive oil and red wine, with only the occasional relish of fish or meat. If other factors had not intervened He would probably have stood much more of a chance of reaching a healthy old age than those poor little Scottish three year‐olds.
I would like to have seen more mention here of genetic predisposition, which clearly plays a part in obesity, and, most especially, a discussion of very early childhood nutrition and perinatal maternal diets. There is also some research interest in the effect of diet on behaviour rather than just on girth, which is only briefly discussed here under the Feingold diet. (It has been plausibly argued that some of those poor young Scots may grow up with attention disorders as well as obesity to cope with). Any serious reference text on the subject of diet and nutrition would be expected to give much more coverage to the factors contributing to the obesity epidemic as well as just to the attempts that have been made to combat it. This is not, however, a serious medical text. It looks and feels more like the sort of book that is sold in supermarkets, piled up next to the cookery books as a sort of counterweight to their excesses. The eating disorders team in my own institution are much more concerned with the serious mental disorders of anorexia and bulimia nervosa and so are not likely to be interested in most of this book. Many of the nurses seem to spend much of their time talking about diets however, so I suspect that any nursing library or public reference library would find eager readers. Such information as is in the book is presented in such a way as to give a clear indication of the problems and dangers involved, and the nutritional information provided appears to me to be fair and accurate. I cannot see anything in here which will do the sensible reader any harm, and some which may do some good. I am therefore happy to recommend this to public reference librarians.
