The author’s personal health history is used to validate his discoveries as a doctor dealing with diabetic patients unable to further reduce their weight. He explains the Sponge theory as it affects fat cells that remain after major weight loss. Since fat cells only shrink and never die, they develop low leptin levels which trigger the brain of impending starvation. Then the stomach secretes a peptide—ghrelin—to stimulate appetite and causes any diet to become unsustainable. Edwards’ Sponge theory explains why the “reduced obese” plateau at higher and higher weights.

Edwards has successfully used a combination of diabetic and diet medications to stop this yoyo effect. The treatment begins with losing weight by eating a high fat, low carbohydrate diet which can even include alcohol. Next, he suggests substituting medications, such as using Invokana to replace insulin, known to make a patient hungry. He then recommends specific doctor-prescribed and monitored combinations with explanations of why each works best to interrupt the harmful sequence of yoyo dieting.

This book combines a personal health memoir with quotes from a collection of medical articles. Edwards passionately explains the science behind obesity and his recommended solutions. These explanations simplify the medical information contained so that patients can easily discuss treatments with their doctors. While the author tells the number of calories consumed on various high fat, low carb diets, a welcome addition would be to know which foods and vitamins were included. Only dietetic soda, known to cause weight gain, is mentioned. The glossary at the end of this 70-page book should prove useful to the reduced obese or a family member. Photographs helpfully document episodes of the author’s weight gain and loss, from youth through recent days.

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