Why Women Need Fat (A Book Review of a Diet Book in Which I Rant Momentarily About Birth)

If you're tired of ineffective dieting or you've had trouble losing weight, I'm sure the title of this book caught your attention. Why Women Need Fat: How "Healthy" Food Makes Us Gain Excess Weight and the Surprising Solution to Losing it Forever, by William D. Lassek, M.D. and Steven J.C. Gaulin, PH.D. has a delicious looking bowl of chocolate mousse on the cover. The title and the chocolate are intriguing. I'm sure you're wondering, "do I get to eat that?"

Yes, you do.

No, it's not a chocolate mousse diet.

Let's start with the things I liked and found interesting:

Why Women Need Fat sets out to answer some basic questions, the most obvious of these being, why do women need fat in their diet and on their bodies? How has the average US diet changed in the last forty years? Why are US women fatter than they used to be? What can women do to get back to their "natural" weight without starving themselves or eating crazy diets?

For Lassek and Gaulin, the bottom line seems to be that eating low fat foods, using excessive amounts of vegetable oil, and increasing our intake of processed foods have made women fat. Eating "healthy" unsaturated fat while decreasing saturated fats put our bodies out of whack. Women gain more and more weight in order to reach a balance of good and bad fatty acids. Essentially, we're deficient in good omega-3 fatty acids and we're getting way too much omega-6 fatty acids that aren't as good for us. They explain it better than I do. 

The solution is not surprising. Eat more whole foods and less processed food. Eat good food in moderation. Don't starve yourself by dieting. Butter, chocolate, and sugar are not necessarily bad for you. Eat organic when possible and choose grass-fed meats. By making meals yourself and making more informed choices in the store, Lassek and Gaulin argue that you can re-establish an adequate store of omega-3 fatty acids and decrease your omega-6 intake. This, in time, will return you to your natural weight.

Your natural, healthy weight might not be super skinny. Most people should weigh less than they do now but genetics play a big part in our body composition. Healthy does not equal skinny. 

There's more to it all than that, but you get the general idea. I won't waste anymore time rehashing what they said. You can read the book.

But before you do, let me tell you about the two things I found irritating. These things shouldn't stop you from reading the book but I'd like you to know how I felt about them all the same.

First, I found the title a little misleading but I guess it depends on your definition of "healthy". The primary "healthy" food they talk about is vegetable oil. They argue it makes us fat. But the majority of our vegetable oil intake is from processed and commercially fried foods. Not things I consider healthy, even if they're fried in "healthy" oil. At times it was hard for me to wrap my head around a discussion of "healthy" food making us fat when we were talking about fried chicken strips from a fast food joint.

Finally, in the fourth chapter they discuss from an anthropological/evolutionary standpoint, why women are designed to have smaller waists and larger hips. They argue, smaller waists ensure our babies don't grow too big to be born. They contend that because women in the US are getting bigger, they are having bigger babies and need more cesarean sections.

And this is the part where I start ranting.

I found this section strongly lacking in complete information. They did not discuss any other reasons for high cesarean rates in the US. They barely mention other factors (aside from lack medical care) that influence birth outcomes in less developed countries. They mention Europe having thinner women and lower cesarean rates but they do not discuss that Europe also has lower rates of epidurals and artificial inductions. From what I could tell from the sources, they based their contention that heavier women are more likely to have obstructed labor and need cesareans on a study of women whose labors were induced without clarifying how they controlled for the impact of the inductions on cesarean rates.

The authors have extensive research credentials. I understand they can't fit every detail into one book. I know birth wasn't the main topic. I want to trust what they say but I admit this chapter made me wonder about the rest of their research.

I won't deny they made some valid and interesting points in chapter 4. Medical technology is great and I'm thankful we have it. I know people who have needed and had cesareans. Obstructed labor is real and it's scary. However, having a "big" baby does not mean you cannot have a vaginal birth. "Big" is a relative term and there are a lot of other factors to consider. It's hard to make broad generalizations on this topic. There is undeniable evidence of unnecessary technology used in childbirth in this country. Technology is not always better. Bigger women are not the only reasons US birth outcomes fall behind other industrialized nations.

It is frustrating to read a book that appears to be well researched and full of useful information yet contains a chapter of what came across (in my opinion) as missing critical information. I'd be really interested to hear what Marsden Wagner and Ina May Gaskin have to say about the conclusions drawn by the authors. I want to lend this book to my friends with a disclaimer that they should watch The Business of Being Born after reading chapter 4.

But I'll end my rant there. This was a book about weight loss after all. The authors don't claim to be experts in childbirth and neither do I. No matter how much their repeated mention of big babies grated at my nerves (I kept thinking about the women I know who have birthed really big babies vaginally), it was a small part of the book. 

Ultimately this book appears to be a practical guide to eliminating dieting, eating good food, finding balance, and losing weight with some interesting anthropological stuff thrown in. I'll highlight the parts I found interesting and pass it on to my friends despite the few things I found irritating.

For the record, I was paid to review this book for the BlogHer Book Club. Nonetheless, the opinions it contains are entirely my own. For more discussion and other opinions about this book visit the Why Women Need Fat page at the BlogHer book club.