Lillian Wilson

Fat Chance by Robert Lustig

Find out why sugar is a culprit of obesity and why we consume so much of it with an in-depth obesity exploration in the book 'Fat Chance.'

Fat Chance
“No scientist has done more in the last fifty years to alert Americans to the potential dangers of sugar in the diet than Dr. Robert Lustig.” 
– Gary Taubes, author of 'Good Calories, Bad Calories' and 'Why We Get Fat'

Every story must have a villain. Well, when it comes to excessive weight and obesity, sugar is the baddie.

In the book ‘Fat Chance,’ Dr. Rober Lustig goes deep into the research and explains why we end up consuming way more sugar than we realise. Lustig points out that it’s not just about sugary foods, but also the policies of the government and big food manufacturers that have contributed to the high sugar content in our diets.

Author’s background

Robert H. Lustig, M.D., is a distinguished pediatric endocrinologist with expertise in childhood obesity, sugar’s impact on the central nervous system, metabolism, and disease.

Robert H. Lustig (r)

He serves as the director of the Weight Assessment for Teen and Child Health Program at UCSF Benioff Children’s Hospital and is a respected member of the UCSF Center for Obesity Assessment, Study, and Treatment, along with the Obesity Task Force of the Endocrine Society.

What is the book about?

‘Fat Chance: The Hidden Truth About Sugar, Obesity, and Disease’ presents crucial nutritional insights often overlooked by policymakers, health professionals, and the food industry. The author, Robert H. Lustig highlights how processed foods with added sugar contribute to life-threatening diseases.

‘Fat Chance’ is an eye-opening book that shows the problem of obesity from a completely new perspective. The author highlights how the U.S. government’s emphasis on reducing fat in people’s diets led the food industry to add more sugar for taste and longer shelf life by removing fibre. This unhealthy combination has wreaked havoc on our health, altering our biochemistry, making us feel constantly hungry, losing control of our eating habits, and leading to a sedentary lifestyle. All of the by-products of such policies lead to an arousal of an obesity epidemic, with an estimated 41.9% of US adults being obese.

The book is divided into six parts. The first section challenges commonly accepted theories about calories and culprits of obesity. Parts 2 and 3 delve into the science of obesity, exploring how the body handles energy burning and storage. You do not need to be a biology expert to understand this; the author simplified it to make it engaging and accessible. Part 2 also explains how your brain has evolved to resist dieting attempts and how hormones influence your food cravings.

In Part 4, Dr. Lustig demonstrates how our current environment is toxic, with the ‘American diet’ now a global issue causing harm over time. Part 5 offers guidance on how individuals can protect themselves and their families by changing their personal environment.

Lastly, in Part 6, Lustig argues about the importance of governments worldwide establishing cooperation with the public to combat the obesity pandemic before it leads to dire medical and financial consequences.

Table of contents

  • Title Page
  • Copyright
  • Dedication
  • Introduction: Time to Think Outside the Box
  • Part I. The Greatest Story Ever Sold
  • 1. A Fallacy of Biblical Proportion
  • 2. A Calorie Is a Calorie—or Is It?
  • 3. Personal Responsibility versus the Obese Six-Month-Old
  • Part II. To Eat or Not to Eat? That’s Not the Question
  • 4. Gluttony and Sloth—Behaviors Driven by Hormones
  • 5. Food Addiction—Fact or Fallacy
  • 6. Stress and “Comfort Food”
  • Part III. “Chewing” the Fat
  • 7. The Birth, Care, and Feeding of a Fat Cell
  • 8. The Difference Between “Fat” and “Sick”
  • 9. Metabolic Syndrome: The New Scourge
  • Part IV. The “Real” Toxic Environment
  • 10. The Omnivore’s Curse: Low Fat versus Low Carb
  • 11. Fructose—The “Toxin”
  • 12. Fiber—Half the Antidote
  • 13. Exercise—The Other Half of the Antidote
  • 14. Micronutrients: Home Run or Hyperbole?
  • 15. Environmental “Obesogens”
  • 16. The “Empire” Strikes Back: Response of the Food Industry
  • Part V. The Personal Solution
  • 17. Altering Your Food Environment
  • 18. Altering Your Hormonal Environment
  • 19. Last Resorts: When Altering Your Environment Isn’t Enough
  • Part VI. The Public Health Solution
  • 20. The “Nanny State”: Personal versus Societal Responsibility
  • 21. What Hath Government Wrought?
  • 22. A Call for Global Sugar ReductionEpilogue: Not a Top-Down but a Bottom-Up Movement
  • Notes
  • Glossary
  • Index
  • Acknowledgments
  • About the Author
  • About the Publisher

Key takeaways from ‘Fat Chance’

1The number on the scale does not always tells the truth

‘Not all pounds are created equal.’

The book challenges the trustworthiness of measuring obesity via BMI. While many Americans have a BMI of over 25, which classifies them as overweight, studies show that people with a BMI of 25-30 tend to have the longest lifespans. So being overweight is healthy?

This is where the problem arises. BMI estimates your body composition based on height and weight. In fact, it is abdominal or visceral fat that plays a significant role in life expectancy and quality.

Visceral fat is metabolically active and promotes inflammation, insulin resistance, and various diseases like diabetes, cancer, cardiovascular issues, dementia, and ageing. While people often worry about losing subcutaneous fat (the fat under the skin) for appearance reasons, it is less prone to being lost and rarely shed through diets like caloric restrictions or starvation.

Doctors are concerned about visceral fat since it poses serious health risks and is the first to be lost when weight is reduced. This fat is the real culprit behind health problems, but not your BMI. However, measuring this fat requires specialised imaging techniques like MRI or liver ultrasound.

2Fibre is not a ‘waste product of food’

Despite the existence of an immense number of healthy diets, each targeting specific needs, Lustig argues that high in fibre and low in sugar diet will bring the best results for those willing to reverse obesity.

Fibre is often underestimated micronutrient and most people consider it a ‘waste product of food.’ Even the USDA does not recognise fibre as an essential nutrient.

Interestingly, DNA footprint analyses of stool samples from caves in Texas revealed that our ancestors consumed around 100 grams of fibre daily while modern people eat around 15 grams of fibre a day.

Lustig argues about the importance of fibre and suggests that high in fibre and low in sugar diet will bring the best results for those willing to reverse obesity. Fibre limits overall food consumption. For maximum benefits, it is essential to consume fibre from whole, intact foods, incorporating both soluble and insoluble fibre.

3Obesity is a complex issue caused by various factors

‘Fat Chance’ challenges common misconceptions about overweight and obese individuals, providing a fresh perspective on the underlying causes of obesity. Lustig highlights the significant influence of genetics, metabolic adaptation, and the food environment in this complex issue. He firmly rejects the oversimplified notion that obesity is solely a result of overeating and laziness, asserting that weight loss requires more than just behavioural changes.

The author emphasises the role of leptin resistance, a biological factor, in driving gluttonous and slothful behaviours among obese individuals. When the brain fails to respond to leptin signals, it creates a false sense of starvation, leading to increased energy storage (gluttony) and reduced energy expenditure (sloth). This highlights the need to comprehend the biological foundations of obesity instead of solely attributing blame to personal choices and behaviours.

Overall rating & strengths and weaknesses, according to readers’ reviews

The book has gotten 4.17 ⭐️ on GoodReads.


  • Comprehensive scientific evidence. The book is well-researched and presents extensive scientific evidence, making it a valuable resource for those seeking to understand nutrition and health better.

  • Eye-opening revelations. The book exposes the toxic and addictive nature of sugar, shedding light on its detrimental effects on the body and health.

  • Advocacy for societal change. The book discusses the role of government and the food industry in perpetuating unhealthy dietary practices, calling for policy changes to improve public health.

  • Easy-to-read format. Despite the complex scientific content, the book is presented in a clear and accessible manner, making it suitable for a wide range of readers.


  • Language complexity. The book’s language can be convoluted, making it challenging for readers seeking a light and easy read.

  • Lack of complete and consistent explanation. The book lacks a clear and consistent elucidation of the biological mechanisms of metabolism, which could have been beneficial for readers.

Best quotes from ‘Fat Chance’

"All successful diets share three precepts: low sugar, high fiber, and fat and carbohydrate together in the presence of an offsetting amount of fibre. Anything after that is window dressing"
"First step in eliminating your sugar consumption is to start eliminating all sugared beverages. We were designed to eat our calories not drink them"
“Not all pounds are created equal. The scale lies - you were right all along! – at least in terms of your health and your lifespan. In fact, the majority of Americans now have a BMI of over 25, which puts them in the overweight category. Studies show that, on average, people with a BMI of 25–30 have the longest lifespan. So being overweight is good? Yes, all you Kate Moss wannabees – provided the weight is in the right place.”

Final takeaway

Dr. Robert Lustig’s book ‘Fat Chance: The Hidden Truth About Sugar, Obesity, and Disease’ is a groundbreaking work that sheds light on the dangers of excessive sugar consumption and its significant role in obesity. With extensive research and compelling evidence, Lustig not only exposes the toxic nature of sugar but also unveils how governmental policies and the food industry have contributed to the widespread presence of sugar in our diets.

Whether you are struggling with weight management, seeking to improve your overall health, or interested in understanding the intricate relationship between sugar, obesity, and disease, ‘Fat Chance’ offers valuable knowledge and valuable takeaways that can positively impact your life.

Where to buy

You may purchase ‘Fat Chance’ on Amazon at the best price. It is available in paperback, hardcover, audio and Kindle versions, so you may choose an option that appeals to you the most.

Healthypedia FAQ

While 'Fat Chance' is grounded in scientific research, it also incorporates personal anecdotes and real-life stories. These anecdotes help readers relate to the content and understand the practical implications of the book's findings.

Yes, the book challenges the conventional belief that 'a calorie is a calorie.' Dr. Lustig presents evidence that not all calories have the same impact on our bodies. He explains how different types of calories, particularly those from added sugars, can have harmful effects on metabolism and contribute to weight gain and chronic diseases.

Yes, the book acknowledges the significant role of genetics in obesity. Dr. Lustig highlights that obesity is a complex issue influenced by various factors, including genetic predisposition. While genetics may play a role, he also emphasises the importance of understanding the biological mechanisms involved and how the environment, particularly the food we consume, can influence gene expression and contribute to obesity.

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