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Elon Musk Explains Obesity. Will Wonders Never Cease?

That’s Elon Musk on X this past week, asserting that a fundamental truth about energy conservation explains why we get fat. Musk’s comment came at a time when X had already been set afire by the conservative provocateur Matt Walsh, who posted this to his 2.8 million followers:

We’re not outraged. We’re disappointed. We don’t expect Walsh to know better. Musk, with a degree in physics, probably should.

So what’s wrong with these tweets?

Welsh assumes, as he wrote in a comment that may have set off this whole kerfuffle in late March, that “people with obesity can cure themselves” by simply eating less. That’s why “nobody in Ethiopia has it,” he said. “The ‘disease’ of obesity only takes hold in places where people eat a lot of food and don’t get a lot of exercise… the causation is pretty clear.”

Among Walsh’s many misconceptions (including that obesity is absent in Ethiopia) are that people with obesity are cured if they’re starved or semi-starved until they’re thin. In one way, as I’ve written in my books, much of the entire misguided history of obesity research derives from a similar misconception.

The catch: semi-starve anyone, lean or obese, and they’ll lose weight. But a lean person will go back to being lean when the semi-starvation ends, and the obese person will go back to being obese. Semi-starvation doesn’t cure obesity by removing the predisposition to become obese; it merely treats the symptom of excess fat.

What Walsh should be asking is why some people have to semi-starve themselves to become lean while others are lean and can effortlessly remain so?  Here’s where biological analogies come in handy.  When children are semi-starved, as happens in famines, their growth is  inhibited. When tumors are semi-starved – by cutting off their fuel supply– they’ll stop growing and maybe even shrink. In neither case, though, would we assume that the semi-starvation somehow reverses the condition let alone assume that eating too much causes it.

 As researchers studying fat metabolism and storage demonstrated by the 1960s, the storage of fat in fat cells is regulated directly by endocrinological (hormonal) and neurological factors that themselves are only indirectly related to how much people eat and exercise. The implication has always been that fixing obesity required fixing those regulating factors, not starving the fat cells (and so the rest of the body) of fuel.  

As for Musk’s faith in the law of energy conservation, he’s right that energy conservation is a law of physics – hence, “undefeated!” Yet he’s dead wrong in thinking it says anything meaningful about the cause of obesity and why we get fat.

Here, too, analogies come in handy. We can think about energy much as we think about money. Musk, with an undergraduate degree also in economics, would never say that “dollars cause wealth” (or at least I hope not) even as the logic is identical to “calories cause obesity.”

If we’re wealthy, it means we accumulated a lot of money. We made a lot more than we spent. If we’re obese, it means we accumulated a lot of energy (as fat in our fat tissue).

But these statements say nothing about causality -- why someone gets wealthy or why they get fat. Here I’ll defer to the NIH obesity researcher Kevin Hall, who like Musk (and like me) has an undergraduate degree in physics. (I’ll discuss one of Hall’s clinical trials below. Here, I agree with him, perhaps because he’s agreeing with me.)

We’re hoping someday that Musk will learn to embrace a different way of thinking about obesity that does elucidate why we get fat: specifically, that understanding a disorder of excess fat storage (i.e., obesity) requires paying attention to the physiological mechanisms that regulate fat storage. That seems obvious, yet the obesity research community has not been thinking this way for the past century, as I wrote in STATnews in 2021. Maybe Musk can incentivize them. The lighter Tesla-driving Americans become, after all, the further his cars will go between charging. (GT)

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