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bullshit. The cause of obesity is and always was gluttony. Quit trying to apologize for overeating. I don't care if "you have a low metabolism". Quit listening to the FDA's bullshit on what a "balanced" meal means. You need to figure it out for yourself.
Angry, much? :)
We should all be angry, because a culture of denying accountability is about to saddle us with the biggest paternalistic program of transfer payments ever. We're going to get to pay for Bubba's heart surgery because he couldn't control how many cheeseburgers he ate in one sitting.
We're going to get to pay for Bubba's heart surgery because he couldn't control how many cheeseburgers he ate in one sitting.

No, we're not being made to pay for Bubba's heart surgery because of his overeating. Don't lose sight of who's making us pay for Bubba's surgery; direct your anger, should you feel it, at those who are making and enforcing this, rather than at the bystander whose issues are used as a pawn to justify it.

I'm also against public health care, but the solution isn't to outlaw and punish anyone who does something less than perfectly healthy, but to strike at the root of the problem. In this case, of course, the only way to do that may be to move to a cheaper jurisdiction; I don't think there's any way to stop the expanding juggernaut without collapse. All things considered, I'm staying for at least a while.

While I agree that we shouldn't be paying for it, and that it is the government's fault for making us pay for it, once the "system" is known, shouldn't the overeater be as much to blame? While an individual is still responsible for paying for their own healthcare, then how they abuse themselves is up to him. In a world were others are responsible for his healthcare, he has a social responsibility to not abuse himself, a social responsibility that I am all too sure will be ignored.

This is the fundamental issue with paternalistic programs. If you give the public responsibility over a person's well being, they will also require the means to control that person's activities.

Unfortunately, I think national healthcare is a foregone conclusion, and not just single-payer-health-insurance, I mean full the "doctors are government employees" thing. Too many people have conflated health care with a right.

What an awful article. The salient fact about the obesity epidemic is that it has more than tripled in frequency (in America) since the 1970s. It can't be genetics. It's unlikely to be gluttony.
I have a question (an actual question, not meant to be a nudge towards any conclusion): is there any research that suggests your level of body fat may be set (i.e. almost like an annealing process) by your level of body fat in childhood? I know there has been research that suggests that body fat plays a very large role in your endocrine system -- therefore causing positive feedback -- but does it do the same for any other systems that might affect metabolism?
I personally guarantee that if you eat less, eat higher quality fresh produce, less sugar, less meat, and less processed food you will lose weight and live longer. If this revolutionary new diet does not work, please contact me.
Even simpler: when caloric intake is below energy output, the result is weight loss. When caloric intake exceeds energy output, the result is weight gain.
This is in theory correct, but there's many factors which decides how much your body will uptake, store and burn. It is possible to eat less but gain weight. It is also possible to gain weight and loose fat. I don't know what this obsession with weight comes from as it's generally a very poor measurement of fitness.
It is possible to eat less but gain weight.

No. Unless you cut energy expenditure as well, the energy has to come from somewhere. If you are consuming 1500 Kcal and using 2000 Kcal, you will loose weight. Thermodynamics is not out to get you.

It might be possible to eat less but gain fat, however.

The human body is not 100% efficient. The efficiency of a human body can change. The amount of Kcal in a food item measured in a lab is not necessarily going to be the same amount a human absorbs.
Your body can regulate how efficiently it stores what you are putting into it. If you restrict your diet too much, your body will think that food is scarce, and it will store more.

For example, several years ago I wanted to lose weight so I was trying to eat as little as possible and skipping breakfast. My weight stayed mostly constant. Then I decided to start eating breakfast and lost about 10 pounds very quickly. (I know you might think that by skipping breakfast I was eating a bigger lunch, or something like that, but it wasn't the case. I was in college on a very regular schedule, eating the same thing for lunch from the same food truck every day).

I realize this is just one person's anecdotal evidence, but from what I understand this is very common among people who skip breakfast in trying to restrict their caloric intake.

This is why experts recommend eating many small but healthy meals throughout the day, and never skipping out on breakfast.

You can and do change your energy expenditure, sometimes dramatically. I've lost 1-2 kg over the course of a weekend of being sick before, but that's just an extreme. All of "eat less loose weight" strategies work only if you consider amount eaten and energy expended to be independent. Which, to me, sounds incredibly unlikely considering how fine-tuned we are in every other respect.

When all said and done, my personal weight loss method is still eating less: but eating dramatically less then normal for relatively short periods (4-10 weeks). I'm a bit scared to think about everything my body is shutting down in this time. For starters, it takes about a week for my brain to catch up with the changed diet.

That's true.

However, by far the most common explanation for "I started eating less, counting calories, and I gained weight" is not a tremendous increase in metabolic efficiency, but a combination of:

1) spontaneous fidgeting and unscheduled exercise dropping off (sitting in your chair all day without getting your normal couple trips to the water cooler/bathroom, not shopping today because you're tired) - this is called "NEAT" if you want to Google

2) self-delusion as to the degree of reduced food intake

The latter is the most likely cause of severely failing diets.

What about Lipodystrophy?
The problem with that advice is that the reasons people eat unhealthy foods and fail to exercise often have nothing to do with willpower.

For example, I have a friend with a very limited sense of smell, so she doesn't really get any enjoyment from food unless it is relatively fatty.

I'm personally not overweight, but if I ever do start getting overweight I'll be in trouble because I've had some medical issues that make it difficult to get my RDI of exercise.

Also don't forget the vast majority of the population has extremely limited information about health. For example, only 6% of parents have even HEARD of the recommendation from the AAP that kids under two shouldn't watch any TV. Not that people should treat the AAP as the absolute source of truth, but if you don't even know what they're saying then clearly you aren't doing your job as a parent.

This isn't just because people are stupid. It's because our media is owned and supported by companies who make physical products. Because of this if Nintendo releases a new videogame system they'll sell millions the first day, and yet by age 18 over 80% of girls haven't gotten enough calcium to prevent osteoporosis. We have great systems for spreading the word about new physical products, at least if they're made by big companies, but our processes for spreading the word about new best practices are virtually non-existent.

By placing blame solely on the individual you're also failing to understand the last 60 years of social science research. The lesson of Milgram, Asch, and many others is that by and large the decisions we make are less than 50% the result of any intrinsic quality or character within ourselves, and are mostly the result of the environments we're surrounded by.

Most people may not have the detailed info you have, but they aren't even acting on the info they have.

Like 94% of parents (not that I am a parent), I've never heard of that specific AAP recommendation and I don't even know what AAP stands for. I do, however, know that I shouldn't expose my kids to much TV (I'd stick to an hour a day, tops).

Similarly, I don't know off the top of my head how many calories I should be eating. I do know that fusilli with broccoli == good and ravioli with cream sauce == too much. That fat guy with the potato chips knows they are making him fat (even if he doesn't know the exact amount), but he chooses to consume them anyway.

Most likely he also knows he can use the google to learn more information.

I think you miss the point of the article. The article doesn't say that this won't work. It says that obese people have genes which tell them to eat more than they should. For example: You need 2200 kcal a day. Your genes tell you to be hungry until you've eaten 2300 kcal a day. The consequence is obvious: You will gain weight.

That is the statement of the article, nothing else. It doesn't say "obese people cannot be lean" or "diets won't work on obese people." It simple states that obese people are obese 'cause their genes tell them to eat more than they should eat. And that we shouldn't prejudice people because they have 'bad' genes.

Your genes also tell you you should be getting some exercise equivalent to hunting woolly mammoths and then dragging them home.
And yet somehow we have entire continents full of thin people living outside the McDonalds belt, many of whom must have this same genetic disorder. How are they managing to keep the pounds off?
Quote from the article:

"Our modern lifestyle is thus a necessary, but not a sufficient, condition for the high prevalence of obesity in our population. "

So some people cope better than others with the modern diet, presumably because of their genes. That doesn't imply that there is nothing they could do about obesity. But they presumably have it harder than the people with more favorable obesity-genes.

right. they gotta work harder to lose the fat. it's like slow metabolism vs. a fast metbolism. either way folks gotta take responsibility
It's not pure genetics alone, it's a combination of genetics and gluttony. It's really simple: if you intake more energy than you consume, then you will gain weight. Our energy utilization varies and is regulated by genes, to beat this problem means simply to eat less (intake less energy) or to exercise more (burn more energy).
No it's not really simple. If you eat more energy than you use you may not gain weight, and if you eat less energy than you use you may lose weight but gain fat at the expense of muscle and other tissues.
"If you eat more energy than you use you may not gain weight"

The normal body will convert excessive energy to fat, so if you intake more energy than you use you will gain fat. Care to explain your case?

"if you eat less energy than you use you may lose weight but gain fat at the expense of muscle and other tissues"

I didn't claim a person eating less will only lose fat.

The normal body will convert excessive energy to fat, so if you intake more energy than you use you will gain fat. Care to explain your case?

IANA(Biologist), and I can't remember the details of what I was reading about it, but it's not like filling a bath and if you put too much in the rest goes through the overflow and into your fat cells. Leptin signals fat cells to store energy as fat, and if it doesn't do that then you wont get fatter.

Where else could it go? Maybe you take in more energy and become more active to use it up? Maybe it goes straight through you - is sensed and less is digested, or is taken into the blood stream, then filtered out again. Maybe some of it is used in rebuilding and repair that wouldn't have happened otherwise.

I don't, for instance, binge on 3500 calories extra of junk food in a day and put on 1lb of fat that same day (I don't think).

There are ways the body can burn though extra calories. You can become restless and agitated; it can activate brown fat; etc.
It's both. Some people can eat like garbage and not get fat, others can't. If you can't, don't eat like garbage.
Well, even if you can, eating like garbage will probably catch up with you eventually.
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What really irks me about this article is that the author uses anecdotes and vague references to science to strengthen his stance. Not only is this shoddy reporting, but it commits a much worse crime. It commits the crime of giving the obese an easy out, a way to say, "Hey, it's not really my fault so I shouldn't even bother to try to lose weight." No. Wrong.

I've personally seen dozens of people go from being very overweight to being healthy and fit. How'd they do it? Through lots of very dedicated, smart work in their diets and exercise. Now, maybe those experiences were simply aberrations that somehow converged on my life--but I doubt it.

There's very little easier than selling people on the idea that their problems are not of their doing, but rather come from environmental factors beyond their control. When you're arguing that angle, you don't need things like science or facts.
Those people are definitely aberrations, especially if they have managed to keep the weight off for 5 or more years. Also, isn't the second paragraph of your comment doing the exact thing you were criticizing in the first (using "anecdotes and vague references" to strengthen your stance)?

I don't think the obese are looking for an easy way out. I think they are looking for a way to lose weight. How many obese people do you know that haven't even tried to lose weight?

It is certainly true that it is physically possible for most people to lose weight (I personally took off 110 lbs and kept it off for 2 years now), the fact remains that most people who want to lose weight and try to lose weight fail. This suggests to me that it requires some trait that the average person simply doesn't have enough of.

I view the situation as very similar to drug addiction. Everyone who suffers from one knows what they need to do, and most of them try, but very few are successful. The difference is kids aren't provided drugs like they are crap foods, and you don't need to take drugs every day to stay alive. So in some ways obesity is even thornier (although I think the brain chemistry a dieter is up against isn't as strong as that of a drug addict).

Ultimately it is easy for a non-obese person to say "this is what obese people need to do and they are choosing not to", and maybe that feels good to you, but it accomplishes nothing.

But I'm able to use anecdotes because I'm not a MD/PhD writing an article in a major US publication
would also allow us to collectively focus on what is most important - one's health rather than one's weight

You mean - one's health rather than one's fat, yes?

http://www.sff.net/people/DoyleMacdonald/l_pyecra.htm (Short story - H.G. Wells - The Truth about Pyecraft)

Amusing story.

My girlfriend has two hindu grandmothers. I've always wondered why she didn't just use their recipes to lose that 5lb she always complains about. Now I know.

Another thing about genetics is that it could probably affect appetite. You know how you feel if you haven't eaten for a day, no amount of will power is going to stop you from eating. Now what if your genetics made you feel like that all the time?

So sure you could lose weight if you ate less, but your genetics wouldn't make the motivation equation work out.

Eh, then how come America has become more fat in the last 30 years? Do the genes degenerate that fast? The article is so bad that I suspect the author is trying to score with a fat chick and published this to make her feel better or something;-)
From the article:

"Although our high-calorie, sedentary lifestyle contributes to the approximately 10-pound average weight gain of Americans compared to the recent past, some people are more severely affected by this lifestyle than others. That's because they have inherited genes that increase their predisposition for accumulating body fat. Our modern lifestyle is thus a necessary, but not a sufficient, condition for the high prevalence of obesity in our population."

Which basically gives you the answer to your comment. You've read the article, haven't you?

Interesting to compare this article to the earlier one on Turing.

For the Turing article, the gist was that Gordon Brown forgave the harsh and inhumane treatment of Turing that happened a long time ago. Nobody around today was directly involved and this -- like it or not - is more symbolism than substance.

For this article, the gist is that fat people are fat because of genetics. There are lots of fat people around today. Billions are spent on trying to make fat people thin, and millions die from the results of being fat. It's a current and immanent threat to our fellow citizens.

For the Turing article, most of the comments were along the lines of "way to go!" and "it's about time!" -- very encouraging that something was being done.

For the fatso article, most of the comments (so far) are along the lines of "Those damn fat people, they should just stop eating so much!" -- very discouraging that anything besides blaming behavior (which amounts to blaming the fat person) amounted to much. I believe one commenter said it was "just giving fat people an excuse to stay fat" (it was subsequently deleted)

I'm sure you guys will tell me that my comparison is all wrong, but I find some interesting parallels nonetheless.

The comparison is wrong because the gays didn't want to be "cured". Fat people spend billions to "cure" themselves. If fat people were content to be fat, there wouldn't be so many people saying "well just don't eat so much!".
So these commenters are being helpful?

I don't see where the motives of the people involved as the object of the story come into it. The point I was making was the motives of the people commenting right here on the article. We have two situations: one in the past where nothing can really be done and one in the present where we have this catastrophe. For the thing in the past, commenters are generally very happy and enthused that a symbolic step was taken. For the thing in the present, commenters are angry that fat people have brought this on themselves, and seem immune to any idea that there's anything involved except a morality play in which fat people are the guilty, ie, nothing should be done except shaming the people involved.

To put a fine point on it: people are very moral. Don't let anybody fool you. There are groups which are okay to trash and groups that are not. Distant, symbolic action is preferred over immediate threats. Modern righteousness generally consists of making yourself feel superior to other folks, whether it is tormentors of Turing or the fatso sitting in the cube next to you (and I speak as a fat person, for whatever that's worth)

Now I'm probably smoking crack, but that's my thesis, in case you missed it.

I agree that people are blind to contemporary stupidity and self-congratulatory about past stupidity they have overcome. People love visiting museums that make them appreciate how far we've come in overcoming racism, genocide, and medieval torture (well, scratch that last one, we have to fight the War on Terruh after all).

Nonetheless, I think the Turing spectacle is valuable because public shows of support will influence fence-sitters to emulate us in support of awesome gay people.

There is also the asymmetry. You can gain in one day what you lost in a weak.
Whatever the "real cause" of the recent prevalence of obesity in the US may be, it isn't either gluttony or genetics, because those things don't change that much.
Indeed. You're not fat through any fault of your own. Certainly not because of anything you ate. It's genetic. Now you can feel good about yourself and not have to try.

This is us, several miles down the road we started down in the '70s when we started teaching kids Self Esteem without any correlation to the things they need to do to actually earn that self esteem. You're special just the way you are.

Combine that with the basic American right of "nothing is ever your fault", and here we are. A whole country full of people who refuse to take any responsibility for their own actions.

And we just got done doing this a month ago... http://news.ycombinator.com/item?id=751311

There are two very unreasonable sides to this issue:

One is, as in this article:

> Be nice. There's nothing the obese can do; you're not superior to them in any way other than fortunate genetics.

The other (and more common):

> Low body fat (with optional huge muscles for men) is and should be valued by all, so my modest efforts at staying lean are just too heroic for those weak-willed fatties.

The truth is that the majority of obese Americans could of their own initiative (without fat camp, medication, surgery, involuntary famine) become not-obese. Regardless of a "heritability" statistic shows (it's probably not what you think), people can significantly influence their weight and body fat in a way they never can for height.

The other truth is that it's incredibly more easy for some people to become lean (or muscular) than others; I'd say almost to the same extent as people vary in native intellectual or musical talent.

So, the main point: "be nice; don't assume superiority of moral fiber based on superior physique" is absolutely valid and needs widespread appreciation by smug bastards everywhere.

Noise, even at the level of 10%, in actual calorie content of food compared to nutritional labels, is irrelevant (there are other, more significant sources of variance in your own metabolism and activity in any case).

If, over the course of a week, you haven't lost any weight, decrease your target calorie count by 50. Eventually the odds of predicted vs. actual noise giving you an "over maintenance" intake for a given week fall to epsilon.

Counting calories is not even necessary.