Why modern life makes it almost impossible for people to lose weight and keep it off.

In a world where charlatans promise to fix the alarming obesity epidemic with a silver-bullet diet or trendy new exercise program, Robyn Toomath, a physician and realist, steps out of the fray to deliver some tough news: it’s really hard to lose weight. Dispelling common myths and telling provocative truths about weight gain—and loss—The Obesity Epidemic is an engaging investigation into the complicated factors that lead to obesity.

While genes certainly play a part, Toomath argues, more people are fat than ever before because most of us consume significantly more calories than we did 30 years ago. But why? The answer, she asserts, is the commodification of food created by junk food advertising coupled with urbanization, globalization, and trade agreements. And while government, advertisers, gyms, and the weight loss industry keep pushing solutions that science shows do not work—from extreme exercise regimens and fad dieting to prohibitively expensive surgeries, pills, and misguided education campaigns—Toomath outlines what just might make a difference in terms of helping people truly control their weight.

Drawing on the latest research and her twenty years of working with overweight patients, Dr. Toomath argues that even strongly determined people who are offered appealing incentives typically cannot lose weight permanently. Instead of demonizing people by treating weight as an issue of personal or even moral responsibility, Dr. Toomath makes it clear that nothing will change until we make it easy, not all but impossible, for people to eat healthily. Raising important questions about obesity, Toomath sidesteps the standard sound bites and puts an end to the myth of personal responsibility for body size by focusing on the environment all around us.

Robyn Toomath, MD, is the clinical director of general medicine at Auckland Hospital, the former president of the New Zealand Society for the Study of Diabetes, and the founder of Fight the Obesity Epidemic.