Dietitian Reviews: The Elephant in the Room – One Fat Man’s Quest to Get Smaller in a Growing America

NEW YEAR’S EVE, 2014

I weigh 460 pounds.

“The government definition of obesity is a body mass index of 30 or more. My BMI is 60.7. My shirts are size XXXXXXL, which the big-and-tall stores shorten to 6X. I’m 6-foot-1, or 73 inches tall. My waist is 60 inches around. I’m nearly a sphere.

…Those are the numbers. This is how it feels.


To empathize with people is to have a human connection with them.

When it comes to food and nutrition, things get even more human. We’re not robots. We don’t simply eat for fuel. Of course, we DO eat for fuel, but we also eat for celebration, tradition, or to socialize. We eat out of habit. We eat with emotion. Sometimes, we eat just because food tastes so damn good. This book talks about it all through a real-life, real-American example.

The Elephant in the Room, written by Tommy Tomlinson, subititled One Fat Man’s Quest to Get Smaller in a Growing America, provides a deeply honest and vulnerable reflection of the authors struggle with weight. Let’s get into it…


Tomlinson admits that he has “won life’s lottery” but has deep negative emotions when it comes to his weight:

“By any reasonable standard, I have won life’s lottery. I grew up with two loving parents in a peaceful house.

I wouldn’t swap with anyone.

Except on those mornings when I wake up and take a long naked look in the mirror…My body is a car wreck.”

This is the first time we see how the author really feels about himself. Given that nearly 70% of Americans live with overweight or obesity, these are not uncommon feelings.

Compassion is necessary for humanity. We express compassion toward our friends, family members, or when we see sad stories on the news. Self-compassion is a different story. I wrote more about Self-Compassion and Weight Management here. In that blog, I discuss why self-compassion is an important tool for weight management and touch on the three elements of self-compassion: mindful awareness, common humanity, and self-kindness.

Towards the end of the prologue, Tomlinson ponders:

“I’ve never really understood why I eat so much and why I’ve never been able to slow down for good…I fight my cravings every day.”

[Perhaps] Unknowingly, he alludes to the answer to that question earlier with:

“I lust after greasy double cheeseburgers and fried chicken legs and Ruffles straight out of the bag…”

“My brain pings with pleasure; my taste buds groan with desire…”

The reason for those enhanced brain and taste bud responses are genetics and biology, full stop. Some of us have much stronger hunger systems than others. Some people can leave a package of Oreos alone in the cupboard and not feel a constant draw to them. For others, the whole package might last two days, max (I’m guilty of the latter).

To understand more about those brain signals, I highly recommend this fantastic video from a leading expert in the field, Dr. David Macklin: The GateKeeper, The GoGetter, and The Sleepy Executive

The right way to make real, sustainable change

I really like this next part.

Tomlinson writes that by the end of the year, he is “going to lose weight and get in shape”. As a dietitian, I’m a big fan of the parameters he set for himself:

“I’m not going to set a number, because every time I’ve done that, I’ve fallen short. My goal is to prove that I can head down the right path and stay on it. I have to show that I won’t quit even when it’s hard, because it’s going to be hard.

Keeping a Food Journal

One of the things that helped Tomlinson change his eating habits, was keeping a food journal. For him, “it’s a daily journal of how much I care about leading a better life.”

The most important thing when keeping a food journal, as I talk about in my blog, 5 Benefits of Keeping a Food Journal and How to Go About It, is approaching it with non-judgemental curiosity. We want to have an honest representation of where we’re starting. Once we know where we are, we can start making changes and moving forward, layering healthy habits one after the other.

A food journal doesn’t have to be complicated. It can simply be a tool used to raise awareness of your current eating habits. As Tomlinson puts it:

“It makes such a difference -at least it does for me- just to write everything down. I’ve often told people that one reason I became a writer is that I don’t really know what I think until I sketch it out on the page.”

Measuring Success

At the end of each chapter, Tomlinson provides a monthly update highlighting the numbers. He even admits, “I hate reducing my life to a number. But right now, this number matters.”

I see this often in my practice. The numbers can take over and blurr our visions of success.

As I mention in my blog, 6 Measures of Weight Management Success That Don’t Show Up on the Scale, “most people approach weight management with a certain number in mind, like a “goal weight”. In reality, weight management is more about health and wellness than it is about the number on the scale.

The Verdict

Honestly, I couldn’t recommend The Elephant in the Room more. Especially if you’re unfamiliar with what life is like as a person living with extra weight.

It’s not even just physically, what life is like. It’s not just that you’re worried if you fit into the seats at the clinic you’re going to, or worried for the other person on the subway if there’s an abrupt stop and you fall onto them. No, not just that. It’s also the feelings of judgment, the self-loathing feelings. Feelings of disgust, both inward at yourself, and at times, very apparent from others.

The main thing I love about books like this, is that they put us into the shoes of another person. We can get just a glimpse of what their life is actually like.

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