The primary problem is the insane cost pharma companies are allowed to charge for these drugs. Imagine the benefits to society if they could be rolled out cheaply and widely.
Imagine if medicines and medical procedures would contribute negatively to the GDP rather than positively.
I mean, they are there because something went wrong before, leading to the need for them.
By having them as a cost, the incentives to avoid them are put in place, so suddenly healthier foods and habits become more profitable.
The problem is that medicine should not be an industry, it should be a cost centre, and the more unhealthy something is the heavier it should be taxed in order to pay for that cost.
Imagine cutting up your own stomach instead of admiting to yourself that you have changed your diet incorrectly...sad state of humanity.
Or using drugs...
Weight loss can be done with food only.
"Reducing calories" is NOT a good way to loose weight and KEEP IT off as it's unsustainable due to hunger.
The general dietary patterns that one finds across tribal people/historyical are two:
1) high carb, low fat
2) high fat, low carb.
Pick one and stick to it.
As long as you mix carbs and fats the body goes crazy since due to the Randle cycle the body cannot effectively process both at the same time + it causes blood sugar buildup.
Guess what kind of a diet is the Western diet? The one that MIXES fats and carbs in HIGH AMOUNTS (eg 40% carbs, 40% fat, 20% protein as calories).
Such a diet is cancer.
Also do note that some obese people will NOT see weight loss for the 1st few months at all if they have a chronicaly elevated insulin, which can take months to normalize. And until insulin falls down to a normal level it's IMPOSSIBLE to lose fat since insulin is KEEPING the fat in the fat cells.
Surgery and drugs definitely feel like a Plan C or D. There are subconscious and cultural aspects to food that those don't address.
For one thing, in a lot of cases, the worst food to eat is also the cheapest to buy and the easiest to prepare and the most profitable to market.
I think most people who are overweight or out of shape know it and also know how to start to fix it. But habits and carbs and sugars are a hell of a combo, and it almost requires an "event" (something beyond a simple "diagnosis") to get people motivated. And that doesn't even work universally.
Those patterns will only work if they also reduce calories though. The vast majority of people who are normal weight in the western world will have a mixed diet and their body is not 'going crazy'.
Blaming it on the person if you're in America is mostly wrong. HFCS and sugar is in literally everything. It's super expensive to buy healthy food. You have to drive everywhere so you don't get the exercise.
Can weight loss be done with food only? Sure. Is it affordable or attainable for the average american? Not really.
It's ok to be accountable for what you eat when you do have choices.
America has a food regulation problems that drive a variety of obesity-related problems. America also has a laziness problem that is almost mandated by suburban sprawl and automobile-oriented urban centers.
Most Americans have severely limited food choices. But even those who don't are subject to marketing and sugar-addiction that leads to bad food choices even when better choices are at hand.
Still, it's ok to hold accountable a person for buying and drinking two 20-ounce sugar-coffees for breakfast and then heading to the local strip mall to eat dinner at the restaurant that only serves 2000mg sodium meals--the affordability of vegetables was not the problem.
Fresh veggies are the cheapest thing in a grocery store. And you don't need to buy the organic/exotic ones to "eat healthy" from the perspective of losing weight.
You know what's expensive? Junk food. For the price of a single bag of chips I can buy several pounds of carrots.
It's not just an issue of healthy food being expensive. If you're obese, cutting your food intake in half will save you 50% of your food expense. That's a lot.
Keeping the same budget, you could most probably eat healthier in smaller quantities.
Although cost might be still be an issue for some, the main problem is education and culture, and these are harder to change: even if you can afford healthy food, you're unlikely to seek it if you have no appreciation for it.
Education and culture only goes so far. The school system has been trying to teach children healthy diet and exercise habits for several decades, but it just doesn't seem to stick. Not that we should stop, but it seems like obesity has more to with a lack of willpower to resist overeating rather than ignorance of how to eat healthily and that exercise should be regular.
Anecdotal evidence, but no obese person I’ve ever talked to about this (including me) is unaware that changing their diet would lead to a reduction in their bodyweight. Smokers also know that not smoking would improve their health significantly. Drug addicts know that drugs are extremely dangerous. Nobody is questioning that obesity can be undone through dietary approaches, just as it’s possible to quit harmful relationships with tobacco and drugs cold-turkey. The problem with these approaches is that they just don’t work at the population level. Obesity is massively costly to society and a burden on individuals. Rejecting effective treatments because they’re not natural, or involve invasive surgery, doesn’t make any sense to me if it means adults who would otherwise live their entire adult lives in ill health would have longer, happier lives with much lower medical costs.
People who are obese could switch to a diet of only red meat -- they would never feel hungry again, since such a diet is massively satiating and they would be free to utterly gorge themselves, and they would also not be obese, since a diet of only red meat is perfectly suited to human health and fitness.
I don't think gp's point is that surgery or pills are should never be considered. Just that as a nation we should look into the actual cause of obesity and try to address that instead of trying to find more ways to cope with our lifestyle.
There is to a degree phycological reasons for our obesity issues but I think most of the country is just misinformed about what's healthy. I heard in a company meeting recently that we should avoid saturated fat and use more trans fats in our diet. I still see my mom pursue low fat options in most dairy products which usually means more sugar to compensate for taste. Many people still think that things like large quantities of grains, cereals and fruit juice are healthy and unharmful.
You are making unorthodox claims and are going to need a bit more citation here. I can also point to the Mediterranean diet that is moderately high in fats (olive oil) and carbs, yet was not considered a disaster.
Further, it's making unwarranted value judgements about surgery - it's essentially an appeal to nature.
I was obese for fifty-one years before discovering a simple dietary fix. For most of that time I was morbidly obese. Among yo-yo dieters I may be world class, being on a diet for most of that time, losing and gaining over 100 pound four times.
Two years and a few months ago I tried yet another diet. (I haven't tried _all_ of the others, just almost all.) This time it worked. I've lost 80 pounds and my diabetes is in remission, but that has happened so many times before that it isn't what has me smiling. The difference is that it has controlled my appetite. I don't crave the carbs anymore that used to be my life's breath. I'm not obsessed with food anymore, I just eat two moderate meals a day and move on with my life in between. I feel like my relationship with food has become like the normal, healthy people that I've misunderstood as masters of self control.
Here's the secret: I went on a lately popular but politically incorrect diet, that when mentioned on this site gathers instant opprobrium. But the effect is that I'm consuming a much greater proportion of protein than before, in a more bioavailable and complete form. I attribute my progress to this change to my macros. I'd just never tried it before. But it turns out that it makes a huge change to my satiety, and the rest follows. I don't assert that other obese people are/were obese because of protein deficiency, just me. I do assert that it's mostly an issue of not getting the right nutrients from their food.
No drugs, no surgery, and exercise only now, after great weight loss, for the joy of it.
I eat mainly beef and I don't understand why everyone in the world doesn't eat mainly beef -- it just fixes everything. I'm thinking about doing an only-beef 2023.
youve got it all wrong now. Ever since I read an article about farmhands and astute svelt businessmen who stand at 18th century lecterns conducting traditional old fashioned business I learned our modern diet is causing everything from climate change to the inevitable heat death of the universe itself. Cornkids and Soyboys beware, for what I propose is a radical change in everything youve ever known about putting a thing into your mouth.
For the past 1500 years ive made it a point to eat nothing but the rancid dew-pocked suet in unattended suburban bird feeders for breakfast. My lunch is a simple trip back to those very same bird feeders, and --you guessed it buddy-- dinner is a quick helping of that sweet greasy nectar of the caged brick full of seeds and lawn detritus. Most people say they cannot believe their eyes when they see what i look like, or how I managed to stay so physically fit, or where all their suet keeps going to.
I hope to start a blog soon where i will expound upon the brilliance of giving up old fashioned coffee as well in favour of a modern advancement in nutrition i call, contact cement and model epoxy.
In fact I spent several weeks during 2021 rendering tallow from beef suet and now I use tallow to fry eggs in and to slow-cook roasts in. I've also been thinking of making pemican with it. I have several gallons of tallow in my fridge (along with several ribeye steaks that I'll be eating later).
I buy my beef by the cow and I get the whole thing for less than $4/pound, whether it be ribeye steaks or ground beef or roasts. That price is for the cow bought at auction, slaughtered, butchered, packaged, and frozen. Note that I don't spend money on any other food, since I only eat beef. You save massive amounts of time, since you only go shopping for food once or twice a year, you never deal with vegetables or chopping, pealing, etc, and your food never goes bad. Sometimes I'll go to Wegman's and buy fifty ribeye steaks and then just eat ribeye steaks for a while -- that can run me about $700 since I've been able to find them for $13/pound and they're about 1.1 pounds each. But the crazy thing is the health benefits you experience -- three dozen minor issues are cured.
That's great, and I believe you've experienced positive benefits in many ways. I myself eat a large amount of meat.
But it's a privilege for individuals in high income countries. The economic impossibilities are tied to the resource side: water, energy, land-use.
Again, I'm far from anti-meat but I am a food systems researcher and the world cannot extract enough resources to feed ourselves mostly beef - or meat for that matter. Nor could we do it at cost.
Perhaps there is a scenario where a majority of the population is directly involved in agriculture and we spend >50% of our income on beef. But then you have a massive reduction in total GDP because more human capital is pulled away from other sectors.
> ...the world cannot extract enough resources to feed ourselves mostly beef - or meat for that matter. Nor could we do it at cost.
I wouldn't be so sure: markets find ways to satisfy demand. People made similar statements about photovoltaic panels, but here we are, with solar competitive with coal. I'd prefer to let markets organically allocate scarce inputs to their highest and best use over asserting that this technology or that behavior is unsustainable. If you're right, markets and prices will take care of modulating the demand and there's no need to tell individuals that their habits and preferences are a "privilege".
Do you realize current food prices are already propped up with government subsidies? And we aren't even pricing in the negative externalities associated with our current agri-food system. You're boiling down one of, if not the most, complex industry on earth to simple supply and demand. Econ101 doesn't hold up in this territory.
I went from spending $1600 a month on food to just over $600 by switching the majority of my diet to beef. Turns out I can only eat about 1.5 lbs of food a day when I'm eating primarily beef. When I'm eating an omnivorous diet I eat around 4 - 5 lbs of food per day and eat out several times a week.
When people say expensive, they aren't necessarily talking about just your wallet. Our agri-food system does not fully price in the negative externalities and govt subsidies which artificially brings the consumer cost down.
Nothing wrong with other protein sources - I prefer chicken as it's cheaper and much leaner for shredding and lean gains for example. Every bodybuilder I know is eating primarily chicken breasts & eggs. Why doesn't everyone in the world eat mainly chicken? ;-)
> I eat beef and salt. I haven't gotten much pushback about the salt.
And nothing else? I've done keto a few times for a couple weeks each time, and I cannot imagine only ever eating beef. Does that take a lot of willpower? I can't even really image eating only meat over a long term, much less only one kind of meat. A couple weeks seems to be about my limit.
Is the amount of salt unusual, or just like a normal sprinkle of table salt for flavoring?
Not the one you're replying to but this is my diet as well. (Having breakfast now - beef and butter with salt.). I thought I'd be bored with it quickly at first and decided to keep using spices on my meat but after two days I ditched the spices and haven't been bored yet. Eight weeks tomorrow.
I also eat butter, some eggs, chicken and pork, lamb, buffalo, etc. occasionally. Probably 90% beef. I try to eat more eggs just to keep the cost down.
I remember sitting down to my first meal on this diet, when I intended a month "cleanse". It was about a pound of hamburger patties fried in butter. I'd never been a big meat eater. (I still don't like steak.) Looking at those burgers I got depressed. Is this all I'm going to get to eat for the next month? I might have gone and added a bagle to it if I hadn't tossed them all.
Then I ate it, and it was good, and the sad went away. I don't think I'd had an all-meat meal before on purpose. After a few such meals my reservations about it went away, and at the end of the month I wasn't interested in stopping. And far from having to will-power myself to eat, I am enjoying food at least as much or more than ever. I generally eat ribs for breakfast (yeah, very expensive, especially in comparison to dying young of metabolic disesase). I very much look forward to that same breakfast, with no regrets or boredom.
This is not the typical carnivore story that I've heard. Jordan Peterson talks about how incredibily tedious this diet is. My brother and his daughter have had success with it, but find it hard to keep going long term. Whatever it is that makes it work so well for me is clearly not the same for everyone.
I find people who complain about the PC community far more annoying, tbh. The PC community is just a bunch of young altruists trying to do the right thing (however misguided the attempt is). The anti-PC community has always struck me as childish.
I didn't downvote you. (I don't think you can downvote a direct reply to yourself?)
He's at best incoherent, and at worst an outright hateful bigot. And yeah, you're not going to sucker me into wasting my time arguing with his fans. I already waste enough of my life on this website, but even I know better than to get dragged into the mud with JP adherents.
As if there hasn't already been mountains of ink spilled criticizing Peterson: there's plenty out there if you're actually curious and not just sealioning.
> And yeah, you're not going to sucker me into wasting my time arguing with his fans.
I just think JP says a lot of things that make sense, but I am open to opposite perspective, as long as it's supported by strong reasoning. Most criticisms of JP I've seen are either vague or shallow, I never see anyone actually deconstruct his argument.
If you don't have time, I respect that. But I assure you, if you have good reasoning to disagree with his ideas, I'll be perceptive. I don't care much about JP himself, but I am passionate about intellectual rigor, which JP seems to have, IMHO.
The difference is that alcohol is toxic to the human body whereas human beings evolved on a diet of red meat, which is why red meat is the pinnacle of human nutrition.
Sounds kind you went went Carnivore. I've been doing the Carnivore diet for the past eight weeks tomorrow and I'm down 14 pounds despite not exercising and increasing my daily caloric intake to about 3500 calories. The change is remarkable. It makes so much sense to me now that obesity rates were about 2% a hundred years ago when nobody knew what a calorie was and ate all the butter and meat they liked but as soon as people been limiting fat in the 80s the obesity rate exploded culminating in today's over 40%: eating fat was never what made people fat.
How tall/big are you if you don't mind me asking? I'm 6'0" 180lbs and my caloric intake is about 3500 when I'm in a bulk cycle (I do a lot of cardio/fencing in addition to weightlifting, so my calorie needs are quite high). Was just curious of your composition given your caloric needs are similar to my own.
The sad reality is that diets aren't a one size fits all solution. Different diets work for different folks. And before someone tries to be a smartass, I understand the calorie out > calorie in requirement; the whole point of finding the right diet is finding one that best helps you control your appetite.
I can attest to both the efficacy of a low-carbohydrate diet and the odd skepticism and judgement that follows it. It's as if some people have so strongly internalized "conventional wisdom" that when their own eyes undermine it, they react to the resulting cognitive dissonance with hostility. The evidence against the past 40 years of official nutrition advice now appears to be overwhelming, but there's still an ugly part of our psychology that wants to punish people socially for dissenting from the opinions of credentialed experts. We're in a strange moment in history when it pays to basically do the opposite of what conventionally credentialed people say --- in a variety of areas.
If dieting doesn't work, how come the procedure he's talking about is basically reducing the volume of his stomach? Sort of a "Forced" dieting if you will?
Dieting and exercise ABSOLUTELY work. Calorie deficit will make you lose weight. You can't create/add matter to your body from nothing. Every atom that your body gained in order to gain weight, came from somewhere, namely, food.
99% of the time when people say the diet didn't work, they were doing a half assed diet with "cheat" days every couple days where they down a 2,000 calorie milkshake.
Source: I used to be that guy making excuses and blaming genetics for being overweight.
It's not that dieting doesn't work. It's that telling people to diet, as a medical intervention, doesn't work. The science of dieting is refined. The science of getting people to diet however has not been very fruitful. It's probably one of the least successful interventions in all of modern medicine, so we obviously need to do better.
And even when dieting is done successfully, most people regain the majority of weight lost within 5 years. It takes permanent lifestyle changes to make weight loss persist over time which is not a simple thing to do.
I think our issues with homelessness and obesity are pretty similar -- targeting the late state symptoms is not effective. Dealing with the root causes will yield the actions for improvement. But both are creeping issues -- they've been going the wrong way for a long time and at least in our American society, we haven't seen any significant improvements. Our structural society doesn't value or recognize well-being.
I’ll preface my comment with the acknowledgment that there will always be medical and non-medical cases preventing dieting from working.
I think on the whole it’s a good thing to have psychological and physiological solutions to obesity. But I don’t think that changes anything. Ultimately the medical advice has remained consistent: the best way to lose and maintain weight is a healthy diet and/or physical activity. Calories in must be less than calories out to lose.
Unless someone has a truly impactful psychological or physiological obstacle to implementing that advice, what is gained pursuing any other end?
I agree with you but theoretically isn’t this kind of like “take your medicine” advice? If you don’t take the medicine, you don’t get better. To what end should we invest society’s resources into ever cleverer ways to get people to “take their medicine”?
> Unless someone has a truly impactful psychological or physiological obstacle to implementing that advice
As someone who lost about half their body weight, I feel very much that just about everybody who has a problem with weight loss meets this criteria.
The question is: why is it so easy for so many people to stay a healthy weight without even paying attention to it, and for others it require constant attention and suffering?
Until we can answer and that, weight loss is most definitely not a solved problem.
> why is it so easy for so many people to stay a healthy weight without even paying attention to it, and for others it require constant attention and suffering?
Society and the easy access to indulging high caloric and straight up unhealthy food. You don't see a lot (if any) fat people in certain parts of the world where access to cheap, unhealthy, highly caloric food is not as readily available as it is in the US. The literal problem around here is "I have too much access to food, and I'm unable to stop myself from eating it".
Some people get addicted to cocaine, others to meth, heroine, others to alcohol, and others, to food (Sugar has been found to be MORE addicting than cocaine BTW). So it is an addiction problem, but because it is tabboo to tell someone they should eat that much, it becomes a hard problem to address.
They appeal to emotion, i.e. "I will be hungry, do you know how hard is to go hungry?", yeah, thats your body craving its addiction, you know how hard is to quit alcohol cold turkey? It literally can kill you, so its almost the same with food.
Someone else commented that some people lose a lot of weight, and then they gain it again 5 years down the road. Thats because the adiction won, at that point you gotta treat your food habits like an addiction. At least with alcohol and drugs, you can literally avoid it and not go near it, and still live fine. You cannot live without food so it makes the tempation of overindulging even higher.
> You don't see a lot (if any) fat people in certain parts of the world where access to cheap, unhealthy, highly caloric food is not as readily available as it is in the US
The word "unhealthy" is doing a lot of lifting in that sentence. For instance, there's the Kitvian people, who have no food scarcity whatsoever and a diet that consists of 70% carbohydrates, which a lot of nutrition "science" tells us is bad, yet obesity is completely unknown to them.
Or the Maasai diet, which is about 66% fat, yet they also don't have an obesity problem.
Sugar consumption in Austrailia between 1980 and 2003 dropped 23% but obesity nearly trippled.
The idea that this is merely due to food addiction caused by some "unhealthy" quality of what we're eating is not well supported by the data. Or at least we haven't isolated what exactly the "unhealthy" part of that is yet.
How hard is it to gather self discipline stats for those groups you mentioned? Not all populations put the same pressure on themselves to stay healthy. There is a massive safety net in Australia that doesnt exist in most of the world.
You are correct, this is not purely due to self discipline.
It seems to me that traditional diets with long observed health outcome histories paired with self discipline lead to better results than the constantly reinvented hyper-processed fad food products (aka fiat foods) consumed in large health safety net environments.
This is sort of what I was getting at with my original comment. I also don’t give credence to the idea that this is primarily about will power, although I see how my original comment could be construed that way.
The US is dumpster fire, and I say that as a US citizen. We have so much high-calorie, low quality food, and so many obstacles to healthful food security in some places, that it borders on the intuitive that these would be significant contributing factors.
Why is this "better" than GLP-1 agonists or bariatric surgery or non-surgical procedures? All of these are accepted procedures approved for use by medical board around the world.
But how can we do better? At the end of the day, dieting is just hard. Unhealthy food is delicious, and choosing healthier options and eating less in general requires a good bit of willpower.
But I don't see what else can be done. Ultimately, dieting is an individual effort, because only you control what you eat. You can be given all the advice and meal plans and other information in the world, but the hardest part is choosing a side salad over fries, or not buying the snacks you love but know aren't good for you. If a doctor said "take this medicine because you have condition X" and the patient doesn't do it, is it the doctor's fault?
>But how can we do better? At the end of the day, dieting is just hard. Unhealthy food is delicious, and choosing healthier options and eating less in general requires a good bit of willpower.
Healthy food also tastes delicious. And while changing one's diet - or any habit - requires willpower, if one has healthy standards set early in life it is not that difficult to continue with them or pick them back up.
One commonality between diets as different as a vegan one or all beef one is the emphasis on eating real food rather than processed garbage.
However I think the idea that there is something present environmentally that is causing a systemic issue should not be discounted. People in the 70s did not eat particularly healthy. They liked to watch tv, had Doritos and snack cakes, were just as lazy, and did not have any more willpower, discipline, or education than people do now.
> Unhealthy food is delicious, and choosing healthier options and eating less in general requires a good bit of willpower
Just want to say that, in my experience, this is only if you're in the habit of regularly eating unhealthy food. Once you break that habit and your body adjusts to eating healthier food, eating unhealthy food regularly becomes too rich/heavy/sweet.
For example: I used to eat a ton of Reese's pieces when I was younger. This weekend over Thanksgiving, I had a few pieces and came to find that they were now WAY too sweet. Same goes for soda, once water is your baseline drink soda becomes far too syrupy and sweet.
Treat it like the addiction it is, and you said it yourself.
Here's a copypasta from another comment I made.
Society and the easy access to indulging high caloric and straight up unhealthy food. You don't see a lot (if any) fat people in certain parts of the world where access to cheap, unhealthy, highly caloric food is not as readily available as it is in the US. The literal problem around here is "I have too much access to food, and I'm unable to stop myself from eating it".
Some people get addicted to cocaine, others to meth, heroine, others to alcohol, and others, to food (Sugar has been found to be MORE addicting than cocaine BTW). So it is an addiction problem, but because it is tabboo to tell someone they should eat that much, it becomes a hard problem to address.
They appeal to emotion, i.e. "I will be hungry, do you know how hard is to go hungry?", yeah, thats your body craving its addiction, you know how hard is to quit alcohol cold turkey? It literally can kill you, so its almost the same with food.
Someone else commented that some people lose a lot of weight, and then they gain it again 5 years down the road. Thats because the adiction won, at that point you gotta treat your food habits like an addiction. At least with alcohol and drugs, you can literally avoid it and not go near it, and still live fine. You cannot live without food so it makes the tempation of overindulging even higher.
> If a doctor said "take this medicine because you have condition X" and the patient doesn't do it, is it the doctor's fault?
Think about it from the doctor's perspective.
The doctor prescribes medicine X as a first line intervention and it doesn't work. The patient is unable to tolerate it.
After multiple failed attempts trying medicine X, the doctor opts to recommend that the patient consider medicine Y as a second line intervention, which has a much higher success rate but significant additional risks.
Makes sense, right? Doctor wants to help the patient.
Now swap "medicine X" for "dietary counseling" and "medicine Y" for say "bariatric surgery". That's not really unreasonable.
I've recently wondered if more strict food regulation would help. Maybe heavily tax sugars (a nuance-lacking example, of course). I mean, we effectively regulate tobacco and alcohol to some degree and limit consumption thus. I wonder if regulation that encourages strict whole food consumption is possible. Of course, even the thought excersise is probably wasteful because it will never happen. Too much money in cheesecake and chips
This is similar to condoms -- condoms are nearly 100% effective in preventing pregnancy. But as a method of birth control (that is, as a medical intervention), they are only 80% effective in preventing pregnancy because people don't always comply.
The procedures and drugs the author discusses affect the regulatory mechanisms at the heart of the drive to eat. People on GLP-1 agonists eat less because they don't want to eat. People with bariatric surgery eat less because they don't want to eat. These procedures are effectively diets.
This simplistic model sounds nice but (and he notes this in the article) doesn't pass the test of explaining the dynamics of weight/gain loss in live humans. Lots of people have pet theories ("just eat meat" or whatever) but researchers who work on this stuff don't seem to think it's such a simple or settled question. I'm an unexceptional counterexample: Despite substantial variation in how I eat and exercise over the last 20 years or so, not disciplined at all, my weight has varied by less than 10%. Is there some secret thing I'm doing that protects me? I doubt it, I think there's just a lot of variation in how different people's bodies run that means some people's lives are a lot harder and there's no silver bullet.
>You can't create/add matter to your body from nothing
Sure you can, imagine two scenarios:
1. You eat 100 calories, and you have a 70 calorie deficit in your cells. 70 calories go to your cells to make ADP (this makes you feel full) and the extra 30 goes to fat.
2. You eat 100 calories of HFCS, it spikes your insulin and your body take 90 calories into fat FIRST and 10 calories into your cells to make ADP. You are still hungry because you have a 60 calorie deficit because your cells still lack ADP, you still feel tired and you got fatter.
It is fully possible to eat nothing but trash food that freaks your body out. The problem is for a lot of people we were though the wrong facts about nutrition, like "Fat is bad and (highly processed) carbs are good".
This ultimately does violate physics if your caloric output is the same in both scenarios. Maybe the HFCS makes you more tired/lazy like you said and that causes your output to drop dramatically, but then it's no longer the same comparison.
100% agree, however I do think we have to apply way more empathy cause losing weight is extremely hard and there are bigger factors that make it harder even if your fully educated and have good will power. Like time and money
I went from 250 to 200 then 200 to 170 pounds, first run I could afford the healthy alternative foods the second time I couldn't. It was 10x harder to lose the 30 pounds than the 50, not just cause higher body fat caused it to be easier to lose but cause the food filled me up. I couldn't afford to get the ideal ratio of protien or even really get about 90g of protein a day on my budget. I then had to be making all this food myself in order to have any filling meals, which took up the last bits of my free time as I was struggling to find contract work.
Of course you can make it yourself, but now you have to learn a bunch about nutrition and cooking, then also have the time to cook it. The super high calorie foods are exponentially cheaper, when you factor your time into it. Mcdoubles have a similar macro density if not better than a protein bar and are more filling. Before a price raise I could eat for 5 bucks in 10 minutes or eat for 1.5-2.5 be filled but lose 1-2hours research, gorceries, prep, and cooking. all of which is cheaper than giving up time you could be working or resting to work better.
I think the time and money to put to dieting is a luxury. I do agree we need to cut the BS excuses, but I do think that someone has a choice to be over weight if they only have a few hours to themselves opt to not spend those hours working but for their health and accept the consiquences. I think we need to focus on finding solutions for that person not the person with no drive to figure it out
> If dieting doesn't work, how come the procedure he's talking about is basically reducing the volume of his stomach? Sort of a "Forced" dieting if you will?
It's pretty simple actually. The forced reduction of stomach volume results in a different physiological response to eating moderate amounts.
You are mixing diet effectiveness (physics) and adherence. Let me give you an example.
I just had a giant mound of quinoa with a mix of sauteed vegetables and a little more raw olive oil. It met my calorie requirements, but was slightly low in ideal protein. (I've had the same meal with a chicken breast, with the same effect.) I've hit my calorie limit and I'm still hungry.
Sure, it's as simple of CICO, but if CICO with a high vegetable diet leaves me hungry for 14 hours a day to maintain my current weight, it's going to be incredibly hard to maintain adherence. (Let me tell you, it's awesome to wake up at 3AM and so hungry you can't get back to sleep. I will choose sleep over my calorie deficit every time.)
Diets don't work because they are hard to adhere to, even if you are not eating junk food.
But the sad truth is that obesity is a disaster area full of people promoting quack cures, nutritional pseudoscience sponsored by food companies, and people who are far more interested in shaming others than actually helping them.
I think the largest problem with obesity, honestly, is food labeling.
Every sentence on every piece of packaging for food is a targeted advertisement, and I don't think most people know that. Whole grain, stone ground, low-fat, etc. They all specifically, legally mean something, and have across the board been perverted to the point that an average consumer absolutely cannot understand what is sold that is actually okay to eat and what is not.
Hell, even when just tracking calories - look at the caloric content. Sitting on my desk is a package of pretzels. It says one serving is 28g, or about 17 pretzels.
It's 12 pretzels when actually weighed. That's 70% of what they list. Read that again; the actual weight of 28 grams is 12 pretzels, not 17.
How can we even hope to be able to understand what we're eating, when even basic facts are fucked beyond comprehension?
There may be some very small subset of obese people who religiously count calories and check nutrition labels whose lives would be improved by this advice, but I don't feel like I'm going out on a limb when I say that the overwhelming majority of obese people are well aware that they are eating poorly.
Value Add for food means changing something cheap into something you can sell for a profit. Corn -> Corn Chips; Corn -> Corn Syrup -> (Candy Bar | Sugar Soda).
Value Add for food means making food more tasty (how could that be a bad thing?) and more tempting. It means advertising your food as a solution to a problem.
Value Add for food means making people eat more food.
It means advertising low-nutrition, high calorie food.
Value Add means that high calorie snacks are cheaper than "real food"
----
I know that you can still get good food, but Value Add makes it harder to get good food, and easier to get bad food.
Ah I see. I agree too much of our food is processed into things that are not necessary or good for us.
Could you also argue that value add can preserve food in ways that reduce cost? Thus freeing up income and human capital for other sectors.
How can we find a balance of reducing the insidious forms of value add while also keeping food costs down and allowing people to work in non-agriculture?
> value add can preserve food in ways that reduce cost. Thus, freeing up income
I suppose the small income one is freeing will not buy him even a fraction of the meds he may need when all that junk will get to him.
> How can we find a balance
This is a false balance to start with. Healthy cheap food is simple. The problem is that it is not the most valuable form to corporations, so they will not push for it.
Maybe because "medical breakthroughs" are not needed.
Moderation and self-discipline in diet and exercise are needed.
Psychological issues (or parenting failures for the young) may undermine those - as indicated in the article - but its difficult to see where "medical breakthroughs" add value to more common-sense solutions.
This is the same vibe as people telling me I don't need ADD/anxiety meds, I just need to toughen up and try harder.
If moderation and self-discipline work for you, that's great. They demonstrably aren't working for millions of people. If medicine can help fix this, there's no reason it shouldn't.
I explicitly mentioned that and am very aware of it as an issue; I am criticising the idea of surgical approaches being "medical breakthroughs", not psychiatric/psychological treatments, including medicine. I should have distinguished that in my comment for clarity.
If a surgery were developed that reversed the effects of alcoholism and dramatically reduced a person's desire to consume alcohol, wouldn't we still consider that a medical breakthrough?
I think so, but I suspect it would be neuro or related surgery and, regardless, we need to distinguish between severe "last resort" cases in extreme contexts (which obviously exist in alcohol, eating and other disorders), and more generally aimed surgical "quick fixes" as in the article that are a) not needed and b) detrimental to the individual and society as they undermine those long term solutions, disciple and moderation as discussed.
Okay -- what is your idea for how to get people to practice moderation and self-discipline?
I don't think anyone would disagree that these would be effective if they were accessible, but practically speaking, telling people that they need to do this doesn't work as a medical intervention.
And I would be surprised if there were obese people that were not aware of this already. The solution is "simple but not easy" and so is ineffective for the vast majority of obese individuals.
In the meantime, the article talks about concrete progress being made to reduce obesity along with it's associated health problems. It's all well and good to say that "it's your fault for being weak and undisciplined" but saying "and therefore you deserve to die" seems a bit extreme.
saying "and therefore you deserve to die" seems a bit extreme
I'm pretty sure you are misquoting me in the last sentence. :)
Yes, psychological help including medication should be available and may well be necessary in many cases, but surgical procedures cannot be considered breakthroughs, as it implies positive progress on defeating an issue caused by mental/character/beahavioural weaknesses in the individual or their parents.
what is your idea for how to get people to practice moderation and self-discipline
For a start, making it clear to them that it is down to moderation and self-discipline in the matter of diet and exercise, and not mollycoddling, "fat-positivity" and made-up physiological excuses. Basically, tell the truth and don't lie.
And I would be surprised if there were obese people that were not aware of this already.
I don't share your surprise, but might agree awareness and self-reflection are only the first steps to individual progress.
I acknowledge my hyperbole. My point is just that while you try to convince a patient that they need to improve their willpower, they are suffering from the effects of obesity, which has innumerable other comorbidities. Every day that they spend obese is courting health problems related to obesity.
> I don't share your surprise, but might agree awareness is only the first step to individual progress. I think
I can say with near certainty that awareness is in fact only the first step. The question is what the next steps are. Saying "psychological help" is a dodge -- what specific psychological methodologies have been proven to work in this regard (I'll give a hint here, none of them). So what comes next? If you lecture them about willpower and stop the mollycoddling (which I assure you, no mainstream medical professional has anything but the harshest things to say about diet or fat positivity), and you give them an exam that proves that they understand what it comes down to, but they keep the weight or gain more weight, then what? Lock 'em up? Put them in a more advanced class to teach them?
> surgical procedures cannot be considered breakthroughs
Sure they can be. We have to be very very very cautious about surgical approaches, because our understanding of human physiology is far from perfect, and there might be long-term problems, etc. But if we make a better, less impactful procedure with fewer side effects, then surely that can count as a breakthrough. The transformation from open surgery for gastric bypass to laproscopic procedures (lap bands and later sleeve gastroplasties) was huge because it greatly reduced complications, and the move to endoscopic procedures (which are non-surgical) has dropped the risk of surgical complications to close to zero. Similarly the progress on GLP-1 agonists have shown some impressive improvements over previous generations of drugs (like fen-phen) that were actively dangerous.
Pursuing healthy weight change or trying to address the food chain issues or other problems may present better long-term alternatives to having healthier weight, but in the meantime, these procedures/drugs can significantly reduce the health risks that come organically from excess weight.
Before making a reply, please consider that I know that not all of these points apply to every person. I think most of them apply to most people with chronic obesity.
When I was a teenager, I wondered why smart people could ever be fat. It's so easy to see how to lose weight.
The answer is: Your body is very very good at maintaining energy balance. You are not bad at losing weight, your body is very good at holding on to energy stores.
Diet and exercise do not fix hunger. When you lose weight, your body tries really hard to get it back. Many interventions can show a short term improvement, long term improvement is very very hard.
Book suggestions:
Pontzer "Burn"
Guyenet "Hungry Brain"
Intervention suggestions:
Control your food environment - if it's within reach you'll eat it soon. If it's in your house, you'll eat it eventually.
Learn to enjoy the food you eat - savor the first few bites, eat slowly. You don't need to eat a lot to enjoy what you eat.
You don't have to empty your plate, or you can get a to-go box.
Protein and Fiber are good.
Sugar and salt taste very good and will make you eat more. Do not buy sugary or salty snacks, or limit the amount that you buy.
Sugar is a triple threat (at least): The calories are empty; Blood sugar crash drives hunger; sugar causes both medium and long term metabolic changes.
Hunger can be put into two big buckets: Energy Balance and Food Pleasure. Energy balance is the hunger you get when you haven't eaten for a while, or after exercise. Food Pleasure is the temptation of snacks, and the drive to continue eating tasty food after you are full. You will need to learn to address all of these.
If medically feasible, try fasting for a couple of days, to prove to yourself that you can survive hunger.
Exercise is very good for your body, but it won't do much for losing weight. It is technically possible to outrun your diet (for a week or two, for extremely healthy people), it is impossible to outrun your body's response to calorie deficit.
"Losing weight" is a terrible goal for most obese people. "Reducing body fat mass" is a much better goal. Those sound like exactly the same thing, but consider that a daily fluctuation of even 1% (up to 3% is realistic) will hide the realistic fat loss of 5 ounces. Adding muscle as you begin to exercise will also make the number on the scale bigger.
GLP-1 works, but it can be very unpleasant. It will not fix your food behaviors when you go off the meds, you need to learn to manage hunger and your food environment.
I'm down 40 pounds from my max, and I've maintained for about a year now. I wish you all success.
>You don't have to empty your plate, or you can get a to-go box.
>Protein and Fiber are good.
These are big. I'm from the American South, and you are taught to eat until you are full. We should be taught to eat until we are not hungry. Two different things.
Protein is highly satiating and every gram of protein in lieu of fat is a good thing. 4cal/gram vs 9cal/gram
Fiber is highly underdosed in American diet, leading to all sorts of issues over the long run
Fiber makes you less hungry and is completely antithetical to how the modern food industry operates.
One huge pet peeve of mine recently is when I'm shopping for high fiber foods, these days everything claiming to be high fiber is also loaded with sugar because "zero net carbs".
Oatmeal has good fiber, but it's nearly impossible to find sanely portioned oatmeal that isn't loaded with sugar. Some foods like almonds have a ton of fiber, but they load them up with salt to trick your brain into eating a ton of them.
It seems like you either have to make everything from scratch yourself, which is a huge time suck, and really bad for portion control, or you stick to the over-processed junk food that stores will sell you, and spend all your energy practicing will power not to succumb to the evils of modern food science.
Don't forget habits. Breakfast before leaving for work (even if you aren't hungry), lunch at noon, and dinner when you get home. And the 2:30 pm snacks. And the morning coffee loaded up with cream and sugar.
One thing that I found works for me is to adjust some of these habits. So even though breakfast is still done at the same time, I adjusted it to be only unsweetened steel-cut oatmeal (7 minutes in the electric pressure cooker). That gives me 180 calories, or I can add a cup of frozen fruit which brings it to 230 calories. If I find that it doesn't hold me over till lunch, I'll add a pat of butter (about 70 calories I believe).
For lunch, when at home I switched to having very specific items rotate through, each one chosen for the calorie count and how much it fills me up. If at the office, and if part of a group lunch where I'm not as selective, I may choose those days to skip dinner (or have a very light dinner).
My biggest habit to break was to cut out a snack before going to bed (don't eat anything after 7:00 pm). But instead switch to herbal tea, or if I wanted to munch on something grab some hot peppers (gives my mouth some entertainment without calories) or a carrot or two.
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[ 0.24 ms ] story [ 173 ms ] threadI mean, they are there because something went wrong before, leading to the need for them.
By having them as a cost, the incentives to avoid them are put in place, so suddenly healthier foods and habits become more profitable.
The problem is that medicine should not be an industry, it should be a cost centre, and the more unhealthy something is the heavier it should be taxed in order to pay for that cost.
Or using drugs...
Weight loss can be done with food only.
"Reducing calories" is NOT a good way to loose weight and KEEP IT off as it's unsustainable due to hunger.
The general dietary patterns that one finds across tribal people/historyical are two: 1) high carb, low fat 2) high fat, low carb.
Pick one and stick to it.
As long as you mix carbs and fats the body goes crazy since due to the Randle cycle the body cannot effectively process both at the same time + it causes blood sugar buildup.
Guess what kind of a diet is the Western diet? The one that MIXES fats and carbs in HIGH AMOUNTS (eg 40% carbs, 40% fat, 20% protein as calories).
Such a diet is cancer.
Also do note that some obese people will NOT see weight loss for the 1st few months at all if they have a chronicaly elevated insulin, which can take months to normalize. And until insulin falls down to a normal level it's IMPOSSIBLE to lose fat since insulin is KEEPING the fat in the fat cells.
For one thing, in a lot of cases, the worst food to eat is also the cheapest to buy and the easiest to prepare and the most profitable to market.
I think most people who are overweight or out of shape know it and also know how to start to fix it. But habits and carbs and sugars are a hell of a combo, and it almost requires an "event" (something beyond a simple "diagnosis") to get people motivated. And that doesn't even work universally.
Can weight loss be done with food only? Sure. Is it affordable or attainable for the average american? Not really.
America has a food regulation problems that drive a variety of obesity-related problems. America also has a laziness problem that is almost mandated by suburban sprawl and automobile-oriented urban centers.
Most Americans have severely limited food choices. But even those who don't are subject to marketing and sugar-addiction that leads to bad food choices even when better choices are at hand.
Still, it's ok to hold accountable a person for buying and drinking two 20-ounce sugar-coffees for breakfast and then heading to the local strip mall to eat dinner at the restaurant that only serves 2000mg sodium meals--the affordability of vegetables was not the problem.
Fresh veggies are the cheapest thing in a grocery store. And you don't need to buy the organic/exotic ones to "eat healthy" from the perspective of losing weight.
You know what's expensive? Junk food. For the price of a single bag of chips I can buy several pounds of carrots.
Keeping the same budget, you could most probably eat healthier in smaller quantities.
Although cost might be still be an issue for some, the main problem is education and culture, and these are harder to change: even if you can afford healthy food, you're unlikely to seek it if you have no appreciation for it.
There is to a degree phycological reasons for our obesity issues but I think most of the country is just misinformed about what's healthy. I heard in a company meeting recently that we should avoid saturated fat and use more trans fats in our diet. I still see my mom pursue low fat options in most dairy products which usually means more sugar to compensate for taste. Many people still think that things like large quantities of grains, cereals and fruit juice are healthy and unharmful.
Further, it's making unwarranted value judgements about surgery - it's essentially an appeal to nature.
Two years and a few months ago I tried yet another diet. (I haven't tried _all_ of the others, just almost all.) This time it worked. I've lost 80 pounds and my diabetes is in remission, but that has happened so many times before that it isn't what has me smiling. The difference is that it has controlled my appetite. I don't crave the carbs anymore that used to be my life's breath. I'm not obsessed with food anymore, I just eat two moderate meals a day and move on with my life in between. I feel like my relationship with food has become like the normal, healthy people that I've misunderstood as masters of self control.
Here's the secret: I went on a lately popular but politically incorrect diet, that when mentioned on this site gathers instant opprobrium. But the effect is that I'm consuming a much greater proportion of protein than before, in a more bioavailable and complete form. I attribute my progress to this change to my macros. I'd just never tried it before. But it turns out that it makes a huge change to my satiety, and the rest follows. I don't assert that other obese people are/were obese because of protein deficiency, just me. I do assert that it's mostly an issue of not getting the right nutrients from their food.
No drugs, no surgery, and exercise only now, after great weight loss, for the joy of it.
For the past 1500 years ive made it a point to eat nothing but the rancid dew-pocked suet in unattended suburban bird feeders for breakfast. My lunch is a simple trip back to those very same bird feeders, and --you guessed it buddy-- dinner is a quick helping of that sweet greasy nectar of the caged brick full of seeds and lawn detritus. Most people say they cannot believe their eyes when they see what i look like, or how I managed to stay so physically fit, or where all their suet keeps going to.
I hope to start a blog soon where i will expound upon the brilliance of giving up old fashioned coffee as well in favour of a modern advancement in nutrition i call, contact cement and model epoxy.
But it's a privilege for individuals in high income countries. The economic impossibilities are tied to the resource side: water, energy, land-use.
Again, I'm far from anti-meat but I am a food systems researcher and the world cannot extract enough resources to feed ourselves mostly beef - or meat for that matter. Nor could we do it at cost.
Perhaps there is a scenario where a majority of the population is directly involved in agriculture and we spend >50% of our income on beef. But then you have a massive reduction in total GDP because more human capital is pulled away from other sectors.
I wouldn't be so sure: markets find ways to satisfy demand. People made similar statements about photovoltaic panels, but here we are, with solar competitive with coal. I'd prefer to let markets organically allocate scarce inputs to their highest and best use over asserting that this technology or that behavior is unsustainable. If you're right, markets and prices will take care of modulating the demand and there's no need to tell individuals that their habits and preferences are a "privilege".
How can a diet be "politically incorrect"? Did you go on a Nazi diet or something?
And nothing else? I've done keto a few times for a couple weeks each time, and I cannot imagine only ever eating beef. Does that take a lot of willpower? I can't even really image eating only meat over a long term, much less only one kind of meat. A couple weeks seems to be about my limit.
Is the amount of salt unusual, or just like a normal sprinkle of table salt for flavoring?
I remember sitting down to my first meal on this diet, when I intended a month "cleanse". It was about a pound of hamburger patties fried in butter. I'd never been a big meat eater. (I still don't like steak.) Looking at those burgers I got depressed. Is this all I'm going to get to eat for the next month? I might have gone and added a bagle to it if I hadn't tossed them all.
Then I ate it, and it was good, and the sad went away. I don't think I'd had an all-meat meal before on purpose. After a few such meals my reservations about it went away, and at the end of the month I wasn't interested in stopping. And far from having to will-power myself to eat, I am enjoying food at least as much or more than ever. I generally eat ribs for breakfast (yeah, very expensive, especially in comparison to dying young of metabolic disesase). I very much look forward to that same breakfast, with no regrets or boredom.
This is not the typical carnivore story that I've heard. Jordan Peterson talks about how incredibily tedious this diet is. My brother and his daughter have had success with it, but find it hard to keep going long term. Whatever it is that makes it work so well for me is clearly not the same for everyone.
Ah. Makes sense. Veganism is hip, and all that jazz.
I loathe the PC community more and more by the day.
The road to hell is paved with good intentions. Especially when your attempt to do the right thing relies on telling others how to live their life.
> The anti-PC community has always struck me as childish.
If it's childish to not want my life to be controlled by some wannabe-altruists, then I'm childish as all hell and proud of it.
He's at best incoherent, and at worst an outright hateful bigot. And yeah, you're not going to sucker me into wasting my time arguing with his fans. I already waste enough of my life on this website, but even I know better than to get dragged into the mud with JP adherents.
As if there hasn't already been mountains of ink spilled criticizing Peterson: there's plenty out there if you're actually curious and not just sealioning.
I just think JP says a lot of things that make sense, but I am open to opposite perspective, as long as it's supported by strong reasoning. Most criticisms of JP I've seen are either vague or shallow, I never see anyone actually deconstruct his argument.
If you don't have time, I respect that. But I assure you, if you have good reasoning to disagree with his ideas, I'll be perceptive. I don't care much about JP himself, but I am passionate about intellectual rigor, which JP seems to have, IMHO.
Well, what was it?
How tall/big are you if you don't mind me asking? I'm 6'0" 180lbs and my caloric intake is about 3500 when I'm in a bulk cycle (I do a lot of cardio/fencing in addition to weightlifting, so my calorie needs are quite high). Was just curious of your composition given your caloric needs are similar to my own.
Dieting and exercise ABSOLUTELY work. Calorie deficit will make you lose weight. You can't create/add matter to your body from nothing. Every atom that your body gained in order to gain weight, came from somewhere, namely, food.
99% of the time when people say the diet didn't work, they were doing a half assed diet with "cheat" days every couple days where they down a 2,000 calorie milkshake.
Source: I used to be that guy making excuses and blaming genetics for being overweight.
With food is harder because your addiction is right in your face every day.
I think on the whole it’s a good thing to have psychological and physiological solutions to obesity. But I don’t think that changes anything. Ultimately the medical advice has remained consistent: the best way to lose and maintain weight is a healthy diet and/or physical activity. Calories in must be less than calories out to lose.
Unless someone has a truly impactful psychological or physiological obstacle to implementing that advice, what is gained pursuing any other end?
I agree with you but theoretically isn’t this kind of like “take your medicine” advice? If you don’t take the medicine, you don’t get better. To what end should we invest society’s resources into ever cleverer ways to get people to “take their medicine”?
As someone who lost about half their body weight, I feel very much that just about everybody who has a problem with weight loss meets this criteria.
The question is: why is it so easy for so many people to stay a healthy weight without even paying attention to it, and for others it require constant attention and suffering?
Until we can answer and that, weight loss is most definitely not a solved problem.
Society and the easy access to indulging high caloric and straight up unhealthy food. You don't see a lot (if any) fat people in certain parts of the world where access to cheap, unhealthy, highly caloric food is not as readily available as it is in the US. The literal problem around here is "I have too much access to food, and I'm unable to stop myself from eating it".
Some people get addicted to cocaine, others to meth, heroine, others to alcohol, and others, to food (Sugar has been found to be MORE addicting than cocaine BTW). So it is an addiction problem, but because it is tabboo to tell someone they should eat that much, it becomes a hard problem to address.
They appeal to emotion, i.e. "I will be hungry, do you know how hard is to go hungry?", yeah, thats your body craving its addiction, you know how hard is to quit alcohol cold turkey? It literally can kill you, so its almost the same with food.
Someone else commented that some people lose a lot of weight, and then they gain it again 5 years down the road. Thats because the adiction won, at that point you gotta treat your food habits like an addiction. At least with alcohol and drugs, you can literally avoid it and not go near it, and still live fine. You cannot live without food so it makes the tempation of overindulging even higher.
The word "unhealthy" is doing a lot of lifting in that sentence. For instance, there's the Kitvian people, who have no food scarcity whatsoever and a diet that consists of 70% carbohydrates, which a lot of nutrition "science" tells us is bad, yet obesity is completely unknown to them.
Or the Maasai diet, which is about 66% fat, yet they also don't have an obesity problem.
Sugar consumption in Austrailia between 1980 and 2003 dropped 23% but obesity nearly trippled.
The idea that this is merely due to food addiction caused by some "unhealthy" quality of what we're eating is not well supported by the data. Or at least we haven't isolated what exactly the "unhealthy" part of that is yet.
It seems to me that traditional diets with long observed health outcome histories paired with self discipline lead to better results than the constantly reinvented hyper-processed fad food products (aka fiat foods) consumed in large health safety net environments.
The US is dumpster fire, and I say that as a US citizen. We have so much high-calorie, low quality food, and so many obstacles to healthful food security in some places, that it borders on the intuitive that these would be significant contributing factors.
Why is this "better" than GLP-1 agonists or bariatric surgery or non-surgical procedures? All of these are accepted procedures approved for use by medical board around the world.
But I don't see what else can be done. Ultimately, dieting is an individual effort, because only you control what you eat. You can be given all the advice and meal plans and other information in the world, but the hardest part is choosing a side salad over fries, or not buying the snacks you love but know aren't good for you. If a doctor said "take this medicine because you have condition X" and the patient doesn't do it, is it the doctor's fault?
Healthy food also tastes delicious. And while changing one's diet - or any habit - requires willpower, if one has healthy standards set early in life it is not that difficult to continue with them or pick them back up.
One commonality between diets as different as a vegan one or all beef one is the emphasis on eating real food rather than processed garbage.
However I think the idea that there is something present environmentally that is causing a systemic issue should not be discounted. People in the 70s did not eat particularly healthy. They liked to watch tv, had Doritos and snack cakes, were just as lazy, and did not have any more willpower, discipline, or education than people do now.
Just want to say that, in my experience, this is only if you're in the habit of regularly eating unhealthy food. Once you break that habit and your body adjusts to eating healthier food, eating unhealthy food regularly becomes too rich/heavy/sweet.
For example: I used to eat a ton of Reese's pieces when I was younger. This weekend over Thanksgiving, I had a few pieces and came to find that they were now WAY too sweet. Same goes for soda, once water is your baseline drink soda becomes far too syrupy and sweet.
Definitely.
Here's a copypasta from another comment I made.
Society and the easy access to indulging high caloric and straight up unhealthy food. You don't see a lot (if any) fat people in certain parts of the world where access to cheap, unhealthy, highly caloric food is not as readily available as it is in the US. The literal problem around here is "I have too much access to food, and I'm unable to stop myself from eating it".
Some people get addicted to cocaine, others to meth, heroine, others to alcohol, and others, to food (Sugar has been found to be MORE addicting than cocaine BTW). So it is an addiction problem, but because it is tabboo to tell someone they should eat that much, it becomes a hard problem to address.
They appeal to emotion, i.e. "I will be hungry, do you know how hard is to go hungry?", yeah, thats your body craving its addiction, you know how hard is to quit alcohol cold turkey? It literally can kill you, so its almost the same with food.
Someone else commented that some people lose a lot of weight, and then they gain it again 5 years down the road. Thats because the adiction won, at that point you gotta treat your food habits like an addiction. At least with alcohol and drugs, you can literally avoid it and not go near it, and still live fine. You cannot live without food so it makes the tempation of overindulging even higher.
Think about it from the doctor's perspective.
The doctor prescribes medicine X as a first line intervention and it doesn't work. The patient is unable to tolerate it.
After multiple failed attempts trying medicine X, the doctor opts to recommend that the patient consider medicine Y as a second line intervention, which has a much higher success rate but significant additional risks.
Makes sense, right? Doctor wants to help the patient.
Now swap "medicine X" for "dietary counseling" and "medicine Y" for say "bariatric surgery". That's not really unreasonable.
Sure you can, imagine two scenarios:
1. You eat 100 calories, and you have a 70 calorie deficit in your cells. 70 calories go to your cells to make ADP (this makes you feel full) and the extra 30 goes to fat.
2. You eat 100 calories of HFCS, it spikes your insulin and your body take 90 calories into fat FIRST and 10 calories into your cells to make ADP. You are still hungry because you have a 60 calorie deficit because your cells still lack ADP, you still feel tired and you got fatter.
It is fully possible to eat nothing but trash food that freaks your body out. The problem is for a lot of people we were though the wrong facts about nutrition, like "Fat is bad and (highly processed) carbs are good".
I went from 250 to 200 then 200 to 170 pounds, first run I could afford the healthy alternative foods the second time I couldn't. It was 10x harder to lose the 30 pounds than the 50, not just cause higher body fat caused it to be easier to lose but cause the food filled me up. I couldn't afford to get the ideal ratio of protien or even really get about 90g of protein a day on my budget. I then had to be making all this food myself in order to have any filling meals, which took up the last bits of my free time as I was struggling to find contract work.
Of course you can make it yourself, but now you have to learn a bunch about nutrition and cooking, then also have the time to cook it. The super high calorie foods are exponentially cheaper, when you factor your time into it. Mcdoubles have a similar macro density if not better than a protein bar and are more filling. Before a price raise I could eat for 5 bucks in 10 minutes or eat for 1.5-2.5 be filled but lose 1-2hours research, gorceries, prep, and cooking. all of which is cheaper than giving up time you could be working or resting to work better.
I think the time and money to put to dieting is a luxury. I do agree we need to cut the BS excuses, but I do think that someone has a choice to be over weight if they only have a few hours to themselves opt to not spend those hours working but for their health and accept the consiquences. I think we need to focus on finding solutions for that person not the person with no drive to figure it out
It's pretty simple actually. The forced reduction of stomach volume results in a different physiological response to eating moderate amounts.
I just had a giant mound of quinoa with a mix of sauteed vegetables and a little more raw olive oil. It met my calorie requirements, but was slightly low in ideal protein. (I've had the same meal with a chicken breast, with the same effect.) I've hit my calorie limit and I'm still hungry.
Sure, it's as simple of CICO, but if CICO with a high vegetable diet leaves me hungry for 14 hours a day to maintain my current weight, it's going to be incredibly hard to maintain adherence. (Let me tell you, it's awesome to wake up at 3AM and so hungry you can't get back to sleep. I will choose sleep over my calorie deficit every time.)
Diets don't work because they are hard to adhere to, even if you are not eating junk food.
But the sad truth is that obesity is a disaster area full of people promoting quack cures, nutritional pseudoscience sponsored by food companies, and people who are far more interested in shaming others than actually helping them.
Every sentence on every piece of packaging for food is a targeted advertisement, and I don't think most people know that. Whole grain, stone ground, low-fat, etc. They all specifically, legally mean something, and have across the board been perverted to the point that an average consumer absolutely cannot understand what is sold that is actually okay to eat and what is not.
Hell, even when just tracking calories - look at the caloric content. Sitting on my desk is a package of pretzels. It says one serving is 28g, or about 17 pretzels.
It's 12 pretzels when actually weighed. That's 70% of what they list. Read that again; the actual weight of 28 grams is 12 pretzels, not 17.
How can we even hope to be able to understand what we're eating, when even basic facts are fucked beyond comprehension?
Really ? IMO Here is the real fundamental dead-end debate we are stuck in -> https://news.ycombinator.com/item?id=33765129
It is always the same debate those days : you cure the symptoms, not the disease because it is easier and makes more sense economically.
Value Add for food means making food more tasty (how could that be a bad thing?) and more tempting. It means advertising your food as a solution to a problem.
Value Add for food means making people eat more food.
It means advertising low-nutrition, high calorie food.
Value Add means that high calorie snacks are cheaper than "real food"
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I know that you can still get good food, but Value Add makes it harder to get good food, and easier to get bad food.
Could you also argue that value add can preserve food in ways that reduce cost? Thus freeing up income and human capital for other sectors.
How can we find a balance of reducing the insidious forms of value add while also keeping food costs down and allowing people to work in non-agriculture?
I suppose the small income one is freeing will not buy him even a fraction of the meds he may need when all that junk will get to him.
> How can we find a balance
This is a false balance to start with. Healthy cheap food is simple. The problem is that it is not the most valuable form to corporations, so they will not push for it.
Moderation and self-discipline in diet and exercise are needed.
Psychological issues (or parenting failures for the young) may undermine those - as indicated in the article - but its difficult to see where "medical breakthroughs" add value to more common-sense solutions.
If moderation and self-discipline work for you, that's great. They demonstrably aren't working for millions of people. If medicine can help fix this, there's no reason it shouldn't.
I explicitly mentioned that and am very aware of it as an issue; I am criticising the idea of surgical approaches being "medical breakthroughs", not psychiatric/psychological treatments, including medicine. I should have distinguished that in my comment for clarity.
I don't think anyone would disagree that these would be effective if they were accessible, but practically speaking, telling people that they need to do this doesn't work as a medical intervention.
And I would be surprised if there were obese people that were not aware of this already. The solution is "simple but not easy" and so is ineffective for the vast majority of obese individuals.
In the meantime, the article talks about concrete progress being made to reduce obesity along with it's associated health problems. It's all well and good to say that "it's your fault for being weak and undisciplined" but saying "and therefore you deserve to die" seems a bit extreme.
I'm pretty sure you are misquoting me in the last sentence. :)
Yes, psychological help including medication should be available and may well be necessary in many cases, but surgical procedures cannot be considered breakthroughs, as it implies positive progress on defeating an issue caused by mental/character/beahavioural weaknesses in the individual or their parents.
what is your idea for how to get people to practice moderation and self-discipline
For a start, making it clear to them that it is down to moderation and self-discipline in the matter of diet and exercise, and not mollycoddling, "fat-positivity" and made-up physiological excuses. Basically, tell the truth and don't lie.
And I would be surprised if there were obese people that were not aware of this already.
I don't share your surprise, but might agree awareness and self-reflection are only the first steps to individual progress.
> I don't share your surprise, but might agree awareness is only the first step to individual progress. I think
I can say with near certainty that awareness is in fact only the first step. The question is what the next steps are. Saying "psychological help" is a dodge -- what specific psychological methodologies have been proven to work in this regard (I'll give a hint here, none of them). So what comes next? If you lecture them about willpower and stop the mollycoddling (which I assure you, no mainstream medical professional has anything but the harshest things to say about diet or fat positivity), and you give them an exam that proves that they understand what it comes down to, but they keep the weight or gain more weight, then what? Lock 'em up? Put them in a more advanced class to teach them?
> surgical procedures cannot be considered breakthroughs
Sure they can be. We have to be very very very cautious about surgical approaches, because our understanding of human physiology is far from perfect, and there might be long-term problems, etc. But if we make a better, less impactful procedure with fewer side effects, then surely that can count as a breakthrough. The transformation from open surgery for gastric bypass to laproscopic procedures (lap bands and later sleeve gastroplasties) was huge because it greatly reduced complications, and the move to endoscopic procedures (which are non-surgical) has dropped the risk of surgical complications to close to zero. Similarly the progress on GLP-1 agonists have shown some impressive improvements over previous generations of drugs (like fen-phen) that were actively dangerous.
Pursuing healthy weight change or trying to address the food chain issues or other problems may present better long-term alternatives to having healthier weight, but in the meantime, these procedures/drugs can significantly reduce the health risks that come organically from excess weight.
When I was a teenager, I wondered why smart people could ever be fat. It's so easy to see how to lose weight.
The answer is: Your body is very very good at maintaining energy balance. You are not bad at losing weight, your body is very good at holding on to energy stores.
Diet and exercise do not fix hunger. When you lose weight, your body tries really hard to get it back. Many interventions can show a short term improvement, long term improvement is very very hard.
Book suggestions:
Pontzer "Burn"
Guyenet "Hungry Brain"
Intervention suggestions:
Control your food environment - if it's within reach you'll eat it soon. If it's in your house, you'll eat it eventually.
Learn to enjoy the food you eat - savor the first few bites, eat slowly. You don't need to eat a lot to enjoy what you eat.
You don't have to empty your plate, or you can get a to-go box.
Protein and Fiber are good.
Sugar and salt taste very good and will make you eat more. Do not buy sugary or salty snacks, or limit the amount that you buy.
Sugar is a triple threat (at least): The calories are empty; Blood sugar crash drives hunger; sugar causes both medium and long term metabolic changes.
Hunger can be put into two big buckets: Energy Balance and Food Pleasure. Energy balance is the hunger you get when you haven't eaten for a while, or after exercise. Food Pleasure is the temptation of snacks, and the drive to continue eating tasty food after you are full. You will need to learn to address all of these.
If medically feasible, try fasting for a couple of days, to prove to yourself that you can survive hunger.
Exercise is very good for your body, but it won't do much for losing weight. It is technically possible to outrun your diet (for a week or two, for extremely healthy people), it is impossible to outrun your body's response to calorie deficit.
"Losing weight" is a terrible goal for most obese people. "Reducing body fat mass" is a much better goal. Those sound like exactly the same thing, but consider that a daily fluctuation of even 1% (up to 3% is realistic) will hide the realistic fat loss of 5 ounces. Adding muscle as you begin to exercise will also make the number on the scale bigger.
GLP-1 works, but it can be very unpleasant. It will not fix your food behaviors when you go off the meds, you need to learn to manage hunger and your food environment.
I'm down 40 pounds from my max, and I've maintained for about a year now. I wish you all success.
>Protein and Fiber are good.
These are big. I'm from the American South, and you are taught to eat until you are full. We should be taught to eat until we are not hungry. Two different things.
Protein is highly satiating and every gram of protein in lieu of fat is a good thing. 4cal/gram vs 9cal/gram
Fiber is highly underdosed in American diet, leading to all sorts of issues over the long run
One huge pet peeve of mine recently is when I'm shopping for high fiber foods, these days everything claiming to be high fiber is also loaded with sugar because "zero net carbs".
Oatmeal has good fiber, but it's nearly impossible to find sanely portioned oatmeal that isn't loaded with sugar. Some foods like almonds have a ton of fiber, but they load them up with salt to trick your brain into eating a ton of them.
It seems like you either have to make everything from scratch yourself, which is a huge time suck, and really bad for portion control, or you stick to the over-processed junk food that stores will sell you, and spend all your energy practicing will power not to succumb to the evils of modern food science.
One thing that I found works for me is to adjust some of these habits. So even though breakfast is still done at the same time, I adjusted it to be only unsweetened steel-cut oatmeal (7 minutes in the electric pressure cooker). That gives me 180 calories, or I can add a cup of frozen fruit which brings it to 230 calories. If I find that it doesn't hold me over till lunch, I'll add a pat of butter (about 70 calories I believe).
For lunch, when at home I switched to having very specific items rotate through, each one chosen for the calorie count and how much it fills me up. If at the office, and if part of a group lunch where I'm not as selective, I may choose those days to skip dinner (or have a very light dinner).
My biggest habit to break was to cut out a snack before going to bed (don't eat anything after 7:00 pm). But instead switch to herbal tea, or if I wanted to munch on something grab some hot peppers (gives my mouth some entertainment without calories) or a carrot or two.