The Hungry Brain,

By Stephen Guyenet Ph. D. (2017 Flatiron Books 175 Fifth Avenue, New York, N.Y. 10010) is a book I learned about recently from an intriguing Peter Attia MD podcast from June 2022 that I somehow missed along the way.

The "Hungry Brain" is fluent and organized and appealing and straightforward and easy to read. He makes the case that we are victims of our brain's affinity for wonderful, cheap, delicious, safe, buffet food. The evidence of the cases of the Kitavans and !Kung, and Yanamo and Hadza, and the few other people left in the world who live the way humans did for 90% of their existence on earth are irrefutable. Professor Guyenet includes all of the old and classic fat science literature. That makes it a valuable reference. Many points are clinched by simple studies. For example, the "supermarket diet" AKA "cafeteria diet" AKA the "buffet diet" reliably makes mice fat. There is no need to belabor the evidence that stimulating just one or two mice with strategic optogenetic brain impulses to prove it overpowers the mouse's behavior or the reports of individuals with certain specific brain injuries who have corresponding specific strange behaviors, though this evidence is anecdotal. He is also honest about many contradictory findings.

I had never heard the story about how eating all your calories in liquid form through a straw makes you lose big weight without exhorting calorie restriction. This is intriguing. Is it somehow duplicating how hunter-gatherers eat? Isn't it a safe sustainable, though boring, way to lose weight?

This book was compiled 10 minutes before the discovery of the semaglutide family of block buster weight loss drugs. Now we have to scramble to incorporate this new stuff into the menagerie of brain centers that affect size and shape and appetite. (1) Or maybe we should just skip it. Maybe this book is unnecessary and superfluous. He even states on page 150, "At this point, there has been an enormous amount of research on the brain systems that regulate appetite and adiposity - far too much for me to summarize in this book." In the second to last chapter there is a tantalizing prediction of these new weight loss drug discoveries when he discusses how gastric bypass surgery might work.

Finally to include some of my other inevitable gripes by one fat science maven of another:

The highly equivocal chapter on stress made me think, "Why haven't we invented a cortisol-steroid blocker - at least a weak one or one that only blocks the brain feeding centers."

The too abundant footnotes were a slog that could have been incorporated into the main body of the book.

The scattered highlighted capsule translations of the science into practical life tactics for not eating "unhealthy" foods - mostly they say avoid the stimulus of the bad foods to trick ourselves - and the summary 6 steps in the last chapter, seem like they are so simple and doable we shouldn't even have an obesity epidemic. The book seller's subtitle, "Outsmarting the instincts that make us overeat," is belied. Dopamine made me do it. I have a chemical imbalance.

1. Bruning J.C. and Fenselau H. Integrative neurocircuits that control metabolism and food intake. SCIENCE 29 Sep 2023 Vol 381, Issue 6665 DOI: 10.1126/science.abl7398