Eat Fat – Get Thin – Book Review

Eat Fat – Get Thin – by Dr. Mark Hyman

eat fat

Screen Shot 2016-04-06 at 7.41.35 PM

Executive Summary

Obesity is a rapidly growing concern among healthcare professionals. The effects of obesity are far-ranging both psychological and physical.

Scientists and healthcare practitioners have arrived at the conclusion that obesity is a debilitating disease that wreaks suffering on its population. Tradition medicine still insists that the obese are simply suffering from a lack of discipline and need to eat less and exercise more.

But functional medicine because these doctors have so many patients who can immediately try and test new approaches, can quickly tell us what’s working and generally provide sound theories as to why.

This book is a well-constructed book that is a must if you wish to understand why you’re fat and what people have been doing to successfully conquer the poorly researched beliefs and positions that have led us to this state.

Chapter 1 – The Demonization of Fat

There is no scientific evidence that eating fat makes you fat.

Further there is compelling scientific evidence that eating fat is essential for health and weight loss.

There is compelling scientific evidence that eating carbs and sugar makes you fat and sick.

When our government published it’s food guide pyramid in 1992, carbohydrates were the foundation and the recommendation was to eat carbs in the form of breads, rice, grains, pasta, and more 6-11 times per day.

Carbs turn on insulin and insulin stores fat.

Sugar is sugar – whether it’s organic, high fructose corn syrup, agave cactus nectar, honey, or 257 other kinds of sugar.

  • Dietary fat speeds up your metabolism, reduces your hunger, and stimulates fat burning.
  • Dietary fat helps you to reduce your overall calorie intake.
  • Dietary fat, and saturated fat specifically, does not cause heart disease.
  • Dietary saturated fat raises the good kind of LDL (light, fluffy LDL) and raises HDL (the good cholesterol)
  • Diets higher in fat promote more weight loss than diets higher in carbs.
  • Dietary fat reduces inflammation – ( and as a side-note, this relates directly to dementia and Alzheimers)
  • Dietary fat improves blood vessel health.
  • Dietary fat improves brain function and mood.
  • Diets very low in carbs and high in fat can reverse type 2 diabetes.
  • “Good” vegetable oils such as corn, safflower, sunflower, and soy are harmful and create inflammation and many other very bad effects.
  • Dietary saturated fats such as butter and coconut oil do not raise saturated fats in the blood.
  • Carbohydrates, not saturated fats, turn into saturated fats in your blood, the fats that cause heart disease.
  • Excess carbs stimulate your appetite and belly fat storage and slow your metabolism.
  • Sugar and refined carbs – not fat – are responsible for the obesity epidemic, type 2 diabetes, and heart disease.

Diabesity is the combination of obesity and diabetes and affects 1 out of 2 people in this country. It is largely undiagnosed. People with Diabesity are generally carb intolerant just like some people are gluten intolerant.

Are you carbohydrate intolerant?

For questions 1 to 9, score 1 point for a “yes” response.

For questions 10 to 13, score 2 points for a “yes” response.

  1. Do you have a family history of diabetes, heart disease, or obesity?
  2. Are you of nonwhite ancestry (African, Asian, Native American, Pacific Islander, Hispanic, Indian, Middle Eastern)?
  3. Do you have trouble losing weight on a low-fat diet?
  4. Do you crave sugar and refined carbohydrates?
  5. Are you inactive (less than thirty minutes of exercise four times a week)?
  6. Are you overweight (body mass index, or BMI, over 25)? (Go to to calculate your BMI based on weight and height.)
  7. Do you have heart disease?
  8. Do you have high blood pressure?
  9. Do you suffer from infertility, low sex drive, or sexual dysfunction?
  10. Do you have extra belly fat? Is your waist circumference greater than 35 inches for women or greater than 40 inches for men?
  11. Has your doctor told you that your blood sugar is a little high (greater than 100 mg/dl) or have you actually been diagnosed with insulin resistance, pre-diabetes, or type 2 diabetes?
  12. Do you have high levels of triglycerides (over 100 mg/dl) or low HDL (good cholesterol) (less than 50 mg/dl)?
  13. For women: Have you had gestational diabetes or polycystic ovarian syndrome?

A score of 5 or more is cause for concern.


Chapter 2 – Fleshing Out the Fear of Fat

Dr. Hyman does a good job in this chapter of sorting out all of the conflicting research and presenting the most credible research to support all of these “wild” statements he’s making. As he normally works as a doctor of functional medicine and is the Chairman of the Institute for Functional Medicine, he has a tremendous number of patients and case studies (1000s) to draw from which is very refreshing for the reader.

One of the most pervasive myths is the “Calories In, Calories Out” belief system. I know that I personally don’t want to give up that fundamental idea myself. But the basic flaw in this equation which has been used and believed by doctors and even researchers for hundreds of years is that any food you eat regardless of what it is, gummy bears or kale, will simply affect your body the same way and if you don’t exercise enough to burn the calories you put in, then you get fat. Once you understand that this just isn’t true, you begin to see why eating fat with more calories can help you lose weight.

Not only does fat burn differently in your body, it doesn’t activate insulin and it has a completely different impact on your hormones. While sugar and carbs quickly metabolize and tell you brain you’re hungry again (you must know that’s why so many foods have sugar in them?) while fats tells your brain that you’re full.

We’ve all been told that no matter what we eat, our gut turns it into glucose (sugar) and that’s how our cells are fueled. But carbs weren’t a significant ingredient in our diet until we began growing grains in our fields. So we gradually began shifting to carbs and this accelerated during the mid-1900s as we defined meat as the enemy and carbs as our fundamental dietary source for losing weight. Fat doesn’t turn on insulin and it doesn’t metabolize the same way as sugar and carbs. Our body and in particular our brains were not build/engineered to work off of glucose. All of the research – and that was very scarce at best – used to justify the US migration to carbs was later found to be flawed and biased and worse non-existent.

You only have to look at the numbers of cases of obesity and Alzheimer’s and diabetes to know that this is true.

Tests using a low-fat plant-based diet show better risk on heart failure but at the same time, test subjects gain weight, their triglycerides (blood sugar) increases and their cholesterol goes in the wrong direction. In other words, there are tests that don’t go so well when depriving the human body of fats.


Chapter 3 – Eating Fat Does Not Make You Fat

Your metabolism is not a math problem. You can’t label everything with how many calories it contains and “do the math” to find out what will make you fat and what will keep you healthy. You would be better off labeling everything with how many carbs it has and what the glycemic index is (how fast the carbs will burn in your system).

For reference, the glycemic index for most grains, bread, etc. is higher than the index for white sugar. That means that bread will turn to glucose in your blood stream faster than sugar will. So when eating bread, cereal, or any other grain-based product, you should simply picture that as white sugar so you can adopt the proper perspective about how your body will metabolize and deal with all that sugar. The faster your body sees sugar the faster it activates your pancreas and insulin to deal with it. That’s why a sweat roll is a “double-whams” – right after the flour in the roll metabolizes first, then the sugar metabolizes right after it.

The quality of the food you eat matters much more than the quantity or the calories.

Eating more and exercising less doesn’t make you fat – although we would probably argue to the death that it’s true. Actually it is being fat that makes you eat more and exercise less. When your body is storing every bit of glucose as fat it leaves you ravenously hungry and you eat more. It’s the fact that your body is storing fat that makes you eat.

Therefore, finding out what makes your body store everything as fat in the first place is the real question. If you could change that, then you would be less hungry, your body would burn more of your fat for fuel, and you’d feel a little better every day.

Here’s a clue – your body creates insulin when you eat carbs but it does not when you eat fat.

Eating a low-fat diet makes you crave bad foods.

Everyone gets to the condition of obesity differently and some will need the help of a doctor of functional medicine to analyze what it is that made us fat in the first place. Sometimes diet alone cannot reverse the cause of the obesity. Here is an ebook called “Beyond Food” from Mark Hyman that is free and you can download here.

Download Beyond Food eBook


Chapter 4 – The Skinny on Fats

Saturated fats in your diets do not affect the saturated fat levels in your blood stream. It is carbs and sugar that cause your liver to produce more saturated fats in your bloodstream.

Some saturated fats can improve your cholesterol ratio.

The most damaging fats are refined polyunsaturated omega-6 oils (from seeds, grains, or beans-like corn, soy, or sunflower oils).

“Saturated fats such as lauric acid (from coconut) and conjugated linoleic acid (from butter) strengthen the immune system and help your cells communicate better, thus protecting you against cancer.

They help your lungs work better. Saturated fats in your body produce something called surfactant, which helps air cross over the lung membranes. Children given butter and full-fat milk have much less asthma than children given reduced-fat milk and margarine.

They are required for you to make hormones such as testosterone and estrogen. They are critical for your nerves and nervous system to work properly.

They help suppress inflammation, despite the common view about their causing inflammation. When eaten with a lot of sugar or refined carbs (think bread and butter, or cookies), saturated fats can cause inflammation. Or if you are deficient in omega-3 fats, they also can cause inflammation. The important thing to know here is that saturated fats cause inflammation only when eaten with refined carbs or sugar or when you donst consume omega-3 fats.

Saturated animal fats contain essential fat-soluble vitamins and nutrients that we need to be healthy, including vitamin A, vitamin D, and vitamin K2, the animal form of vitamin K. Compared to those eating the nutrient-poor standard American diet, hunter-gatherer societies, with very nutrient-dense diets, had levels of these nutrients that were ten times that of the average American.”


Here’s the bottom line: MUFAs are good for you. Populations that consume a lot of olive oil and nuts such as the people of Greece and Italy, have the lowest rates of heart disease in the world”

You can find MUFA in whole olives, olive oil, avocados, lard, tallow (beef or sheep fat), certain types of fish, and many nuts, including macadamias, almonds, pecans, and cashews.

Although modern grain-fed cattle don’t have much MUFA, pasture or grass-fed beef contain substantial amounts on a par with other wild animals.

Plenty of MUFA is one of the key features of the Mediterranean Diet. And MUFA improves your cholesterol numbers.

Although high in MUFA, Canola Oil and other modern vegetable oils are processed in such a manner including high heats and solvents, that the MUFA becomes unhealthy or even toxic.


There are two main types of PUFAs: omega-6 and omega-3 fats.

“So, the two essential fatty acids found in food are:

LA-linoleic acid (omega-6): found in commercial seed and vegetable oils and certain nuts and seeds. We do need the LA omega-6 fats in moderation, but only from whole foods like nuts and seeds, or from cold- or expeller-pressed vegetable oils (and only in small amounts).

ALA-alpha linolenic acid (omega-3): found in organ meats, pastured egg yolks, macadamia nuts, walnuts, and flax oil.”

The later is often supplemented because the body is not effective at converting Omega-3 into sufficient DHA and EPA for good health.

“DHA-docosahexaenoic acid (omega-3 that can be made from ALA, but only about 5 to 10 percent of ALA can be converted to DHA): found in fish or algae or wild or pasture-raised animals.

EPA-eicosapentaenoic acid (omega-3 that can also be derived from ALA, and a good anti- inflammatory fat): found in fish or wild or pasture-raised animals.

AA-arachidonic acid (omega-6 fatty acid that can be derived from LA and is good for membrane flexibility and permeability): found in animal foods like fish, poultry, eggs, and meat.

GLA-gamma linolenic acid (omega-6 fatty acid derived from LA): found in evening primrose, borage, or hemp oil.”

While Omega-3 fats tend to be anti-inflammatory, Omega-6 fats cause inflammation. So although some food-sourced Omega-6 is good, the ratio is important and most people get way too much Omega-6 from everything fried – french fries and so on – while our sources of Omega-3 are much less frequent – fish, meat, seeds, nuts. Too much Omega-6 and your blood starts to clot – it gets “sticky” and your risk of heart disease increases.

Here is a list of conditions that Omega-3 can significantly help and chances are great that most people will be deficient because the sources of these in nature are fairly rare in terms of finding their way to your plate – wild caught salmon, cold water seafood, or fatty fish, grass-fed meat and dairy.

High cholesterol

High blood pressure

Heart disease


Rheumatoid arthritis

Osteoporosis Depression

Bipolar disorder



Cognitive decline

Skin disorders such as eczema and psoriasis

Inflammatory bowel disease


Macular degeneration

Menstrual pain

Colon cancer

Breast cancer

Prostate cancer

Trans fats are the bad stuff. They are man-made and deadly in any type of food – also known as hydrogenated fats. You’ll find them in margarine, shortening, baked goods, and much more. Some foods such as Cool Whip, because they have less than .5g of trans fat per serving can say “trans fat free” on their label.

Most dairy and beef contain CLA (conjugated linoleic acid) which is a naturally occurring transfer that is good for you.

All of the most recent studies – many very large and very credible – demonstrate without doubt that people who eat more fat in their diets have lower risk of heart failure. People who deprive themselves of fat have a higher risk. Fat is an essential ingredient in a healthy diet and without it, you risk heart disease, diabetes, obesity, and mental problems such as Alzheimers.

“The conclusion? Avoid most vegetable oils. Eat more butter, fish, chicken, eggs, and meat. And stay away from sugar and carbs.”

A few words about Statins…

If you lower bad cholesterol (LDL) but have a low HDL (good cholesterol) there is no benefit to statins.

If you lower bad cholesterol (LDL) but don’t reduce inflammation (marked by a test called C-reactive protein), there is no benefit to statins.

If you are a healthy woman with high cholesterol, there is no proof that taking statins reduces your risk of heart attack or death.

If you are a man or a woman over sixty-nine years old with high cholesterol, there is no proof that taking statins reduces your risk of heart attack or death.

Aggressive cholesterol treatment with two medications (Zocor and Zetia) lowered cholesterol much more than one drug alone but led to more plaque buildup in the arteries and no fewer heart attacks.

Older patients with lower cholesterol have a higher risk of death than those with higher cholesterol.

Countries with higher average cholesterol than America, such as Switzerland and Spain, have less heart disease.

Recent evidence shows that it is probably the ability of statins to lower inflammation that accounts for the benefits of statins, not their ability to lower cholesterol.

About 20 percent of people who take statins have side effects, including muscle damage and pain, neurologic problems, memory issues, sexual dysfunction, and more.

Statins have been linked to a dramatically higher risk of diabetes. In one study of almost 26,000 healthy people, those taking statins to prevent heart attacks were 87 percent more likely to get type 2 diabetes. In another randomized controlled trial of 153,840 women, those who took statins were 48 percent more likely to get type 2 diabetes. Large reviews of all the studies show about a 10 percent increased risk. But if all the people who are currently advised to take statins did so, that would mean we would have another 4 to 5 million diabetics in the country!

Getting the Right Tests…(the author provides a list and explanation of recommended tests…

Total Cholesterol, HDL (Good Cholesterol), LDL (Bad Cholesterol), and Triglycerides

Your total cholesterol should be under 200 mg/dl (this depends on your overall profile and risk factors)

Your triglycerides should be under 100.

Your HDL should be over 60 mg/dl.

Your LDL should ideally be under 80 mg/dl (although this matters less than the LDL particle number and size; see the following section on NMR and Cardio IQ test). This also depends on your overall profile and risk factors.

Your ratio of total cholesterol to HDL should be less than 3:1.

Your ratio of triglycerides to HDL should be no greater than 1:1 or 2:1; this ratio can indicate insulin resistance if elevated.

NMR Lipid Profile or Cardio IQ Lipoprotein Fractionation (Ion Mobility)

The NMR test (available from Labcorp) looks at your cholesterol under an MRI scan to assess the size of the particles; particle size is the real determinant of your cardiovascular risk. The Cardio IQ uses a different technology and is available from Quest Diagnostics. It is important to track this as you change your diet. These are really the only cholesterol tests you should have. You should have less than 1,000 total LDL particles and no more than 400 small particles (although ideally you shouldn’t have any!).

Glucose and Insulin Tolerance Test

Measurements of fasting and one- and two-hour levels of glucose and insulin after taking a 75-gram load of glucose help identify pre-diabetes and excessively high levels of insulin, and even

diabetes. You can also just do a fasting and thirty-minute test after drinking glucose; this can be almost as good an indicator of diabesity. Your fasting sugar should be between 70 and 80 mg/dl and your one- and two-hour sugars should be less than 120 mg/dl. Your fasting insulin should be less than 5 and one- and two-hour insulin levels should be less than 30. Most doctors just check blood sugar and not insulin, which is the first thing to go up. By the time your blood sugar goes up, the train has left the station. Be sure to ask that your insulin, not just your blood sugar, gets measured.

Hemoglobin A1c

This test measures your average blood sugar level over the previous six weeks. Anything over 5.5 percent is high. Just measuring your fasting blood sugar is not enough to detect early problems.

Cardio or High-Sensitivity C-Reactive Protein

This marker of inflammation in the body is essential to understand in the context of overall risk. Your high-sensitivity C-reactive protein level should be less than 1.0 mg/L, and ideally less than

0.7 mg/L.


Your homocysteine measures your folate status and should be between 6 and 8 micromoles per liter.

Oxidized LDL

This test looks at the amount of oxidized or rancid cholesterol in the blood. This should be within normal limits of the test. It is available through LabCorp.


This test looks at clotting in the blood. It should be less than 300 mg/dl.


This is another factor that can promote the risk of heart disease, especially in men. It is mostly genetically determined. It should be less than 30 mg/dl.

Gluten Antibodies

Testing IgG and IgA anti-gliadin and IgA and IgG tissue transglutaminase antibodies measures immune response to gluten found in wheat, barley, rye, spelt, and oats and can help you identify this hidden cause of inflammation and heart disease (and many, many other health problems). Any level of antibodies indicates you may have a reaction to gluten. Your body should not make autoimmune antibodies to gluten. There really is no “normal” level.

Genes or SNPs

Genetic tests may also be useful in assessing your heart disease risk factors. A number of key genes regulate cholesterol and metabolism:

Apo E genes

Cholesterol ester transfer protein gene MTHFR gene, which regulates homocysteine

High-Speed CT or EBT Scan

This high-speed X-ray of the heart can help determine if you have cardiovascular disease. It may be helpful in assessing overall plaque burden and calcium score and can inform how aggressive

you need to be in terms of prevention. A score higher than 100 is a concern, and a score higher than 400 indicates severe risk of cardiovascular disease.

Carotid Intimal Thickness

This test is done through ultrasound and looks for plaque in the arteries in your neck, which correlates with heart disease and stroke risk.

Chapter 6 – Vegetable Oils – A Slippery Subject

Most vegetable oils come from genetically modified crops (GMOs). A growing volume of studies have shown that GMOs are at best marginally harmful and at worst, a significant health threat to the world population.



6 thoughts on “Eat Fat – Get Thin – Book Review