A metabolic master switch underlying human obesity | Hacker News Reader

A metabolic master switch underlying human obesity

news.mit.edu

131 pointsapas151 comments

The phrase that being overweight is "simply calories in vs calories out" is both trivially true and completely unhelpful.

It's similar to thinking we have solved poverty. People living in poverty should spend less and make more. Problem solved.

The much more interesting questions are

1. Why does it take some people more food to reach the same level of satiety as others?

2. Why do some people's bodies burn off excess calories through things like non-exercise activity thermogenesis and other store it as fat?

3. Do different types of food effect long term satiety? By changing what we eat can we effect our weight in the long term?

4. How does the body increase hunger and turn off self-control when there is reduced food intake?

The only known "solutions" we currently have to obesity are dieting and exercise. The problem is the long term efficacy rate of dieting is around 5%. If dieting were a drug it would never pass FDA approval for effectiveness. Exercise has only modest effects and is probably more effective as preventing weight gain than causing weight loss.

We still have so much more to learn. We are just at the beginning of figuring out the causes and solutions to this issue.

> The phrase that being overweight is "simply calories in vs calories out" is both trivially true and completely unhelpful.

Why is it completely unhelpful? The corollary is that if you adjust your intake to X (where X might have to be determined empirically for the individual), and use planning and your conscious brain to know when and what to eat, you _will_ lose weight.

This is a revelation to some people, who, once they realize the simplicity of it and plan around it, are able to completely change their bodies. Many of these same people try various intuitive plans that don't work for them (because they don't have the intuition) or try to manipulate exercise first (which makes some people increase appetite).

If you don't believe me that it works, is useful, and is a revelation, go lurk on the myfitnesspal forums for a while or /progresspics on reddit and read how people succeed.

The reason that it isn't helpful, despite you're peer reviewed, laboratory evidence cited on MyFitnessPal postings, is that the causal mechanism that common sense derives from this is completely incorrect.

People aren't fat because they eat too much. People (and mammals) eat too much because their fat cells are being metabolically triggered by environmental and/or genetic factors to store fat at a higher than normal rate, diverting calories from operational needs, thus stimulating hunger.

Bears don't go into hibernation because they've gotten fat. They get fat because their endocrine system begins gearing up for hibernation, and telling their fat cells to kick into overdrive growing. They will literally burn muscle while simultaneously gaining fat in this stage, like all hibernating mammals. The other side effect of growing fat cells is massive hunger, obviously.

In humans, simple things like not eating sugar can help correct the endocrine factors which, for a lot of people, cause the fat cells to do this. However, genetic factors are going to be a different story.

I say this as somebody who is fit and active, but have had running buddies who are fat. Pitting will-power against metabotically driven hunger ends, in the long-term, with biology winning every time.

Without endocrine/genetic factors taken into account, reduction in calories in simply causes a mammalian body's system to reduce calories out by making the subject less energetic.

If we reduce to core principles, if you know your stuff, there's probably not much to disagree on. There are many factors affecting variables like appetite, subjective energy level, energy used through spontaneous movement, many hormones and so on.

But, if you're an individual trying to decide what works and what doesn't in a field where the popular media is full of misinformation, I have a really hard time seeing the position that counting calories is _completely_ unhelpful.

> "Pitting will-power against metabotically driven hunger ends, in the long-term, with biology winning every time."

Yet, awareness of calories in vs calories out can be a way to plan your strategies, to know from the start whether a given strategy can even work or not, from the point of view of physics. Many people try things that this simple knowledge would rule out. A lifestyle change that does not result in a negative energy balance will not cause someone to lose weight, period.

It's also a framework where you can discover what works for yourself. Does lowering carbs vs lowering fat affect your appetite at the same calorie level? How does burning an extra 500 calories through exercise make you feel vs lowering food intake by that amount? These are valuable things to know, again for an individual on a personal quest, not talking about making public policy or population science.

Some people find an intuitive lifestyle change that successfully allows them to lower their body fat and keep it down. Bravo. Some people also succeed more mechanically with conscious calorie control. I have a hard time seeing the argument that both of these can't be useful and successful.

I don't know the research on this area very well. Does that mean for some people, their bodies will actually store the intake as fat preferentially even if the intake is a minimal amount for survival? You can actually die by eating a minimal amount of food because your body doesn't know to use it for energy and, instead, stores it as fat? Are there any studies on this phenomena?

One thing that would mimic the symptoms you describe would be induced hypoglycemia.

Diabetes medication can cause that. But that's basically a knock-on effect of an already present metabolic issue.

For a healthy adult there shouldn't be any such issue.

I am not sure that genetics & weight have that a big effect on weight but a lot of people use it to justify their weight.

I say this based on my observation and because today I find out I am at risk of obesity (based on this study), yet I slightly overweight.

In my personal circle, I have a lot of overweight friends and like hanging out with them. Some of them are always talking about losing weight, 10K steps, and other diet fads. And some have given up, I guess.

But sometimes it is difficult to eat/hangout with them. Overweight friends who want to lose weight will want to go to healthy restaurant. Then they will get footlong sub with every possible thing at counter. Oh and of course, diet soda and chips. How does it make any sense? I have to bite my lips to stay quiet.

And then other overweight friends/arrogant normal-weight friends, who will only want to eat buffets. And make fun of you if you don't get second refill. Apparently, you have to eat a lot to proof you are a man.

My biggest problem with food is people's obsession with talking about it. I can't help but feel that people make it such a huge deal about how much/little/what people eat that we're creating food issues in children that might otherwise not have it.

> thus stimulating hunger.

Then go hungry every now and then once you know the causal link. It's not like it's an irresistible force to which you have no choice but to succumb.

> Pitting will-power against metabotically driven hunger ends, in the long-term, with biology winning every time.

In my experience [sample size: 1] it's entirely possible to ignore hunger for quite some time.

Additionally there are options such as adding filler ingredients that help with reaching satiety with fewer calories. Carbohydrates with a low glycemic index which get absorbed more slowly, thus avoiding a boom-bust cycle as far as your blood sugar levels are concerned are also something you can adjust. This also helps staving off the next hunger for more hours.

It's certainly not an inevitable "I'm hungry, therefore I must eat and grow fat" link that can't be broken.

There are also plenty of factors which can lead to overeating which are not caused by the hunger response (i.e. craving food based on learned behaviors, peer pressure, desire for a particular taste, boredom, depression, etc).

The grandparent's post seems highly suspect to me. Hunger no doubt plays a role in obesity among some individuals, but the ultimate determinant is how many calories are available to be processed versus how many are expended, regardless of why they have been ingested.

When you take a hypothetical individual and lock them in a room and control their food you can give them a restricted calorie diet and they will lose weight.

No-one credible denies that.

What the people arguing against CICO are saying is that it's fucking stupid pointless advice to give to a population because while true it's not helpful. We know it's not helpful because we've been saying loud and clear it for many years and obesity rates have risen in almost every country every year.

"We could cure cancer if we just kill all the cancer cells" is true but not helpful.

"We could fix world hunger if hungry people just grew food" is true but not helpful.

I'm going to quote the grandparent here:

> People aren't fat because they eat too much. People (and mammals) eat too much because their fat cells are being metabolically triggered by environmental and/or genetic factors to store fat at a higher than normal rate, diverting calories from operational needs, thus stimulating hunger.

Is hunger really the primary cause of overeating for those who suffer from obesity? This seems unlikely to me.

It's true that calin/calout is a simplification, but there are many who outright deny it. They may not be credible to you, but they are still powerful voices across all media and their gospel is happily accepted by many.

> What the people arguing against CICO are saying is that it's fucking stupid pointless advice to give to a population because while true it's not helpful. We know it's not helpful because we've been saying loud and clear it for many years and obesity rates have risen in almost every country every year.

Posts like yours that deride calin/calout as a useless oversimplification miss the mark; of course it's a very basic fact, not a treatment plan. It's crucial that people understand that this is the mechanism at play if they want to succeed at regulating their weight, and despite your assertion that "nobody credible denies it" there are a lot of big names who will sell you all kinds of solutions that ignore it, and focus on specific distractions rather than looking at obesity as a complex disease with many causes that lead to calorie surplus.

Calories in vs calories out is simple thermodynamics, human nutrition is complex biochemistry. The real question is, why should anybody have to count calories? Is there a way of eating that leads to the same level of satiety with fewer calories?

It's not "the" question, but it's "a" question. What I don't understand is why people balk at counting calories as part of a successful plan to change body composition, but plan everything else. Should you only go to the gym intuitively, or is it useful to count sets, weights, plan a certain time of day, maybe measure heart rates, plan rest periods and so on?

Why is food different? We know the human body is adaptable to an incredible variance of conditions, including the fact that we know that if anything, prolonged caloric restriction seems to cause adaptations that _increase_ lifespan. So what's the objection to counting and measuring?

I think that counting calories, while certainly helpful, is not a long term solution. I prefer to eat in a way that triggers certain hormonal responses that lead to me eating fewer calories naturally. (Yeah, that means no carbs)

> Why is it completely unhelpful? The corollary is that if you adjust your intake to X (where X might have to be determined empirically for the individual), and use planning and your conscious brain to know when and what to eat, you _will_ lose weight.

People talk about how hard it is to lose this way, but although I've tried diet after diet, I only recently understood intuitively the reverse: why some people can't understand how difficult it is for some. When I moved to a new area this year and went to a new GP, he wanted to talk about my weight, of course (I'm 42, but everything else about my health was quite good). I explained that I had managed to lose about 50 pounds since my peak in 2012, through various diets like intermittent fasting, keto, and sometimes just counting calories for a bit. He suggested I try an appetite suppressant. I scoffed a bit, saying that my problem wasn't that I was too hungry, since I rarely ate so infrequently as to experience hunger. Instead, I said, my problem was that I ate when I was bored, or when friends were, or ate to improve other experiences like TV or movies, or just because it had been a while and I felt increasingly that I "ought" to eat. He didn't argue with me, but just mildly pointed out that it might well not work, but why not give it a shot for a few weeks and see? So I agreed. That was three months ago, and on the appetite suppressant I've lost another 50 pounds. But that's not my point, exactly.

My worldview around food has changed. Before, I assumed that people who were thin were either heroically couting every calorie they ate, or had some weird biology that meant that they couldn't gain even when they tried. I think both of those sets do exist (since I know people in each), but now I realize that there is a large group of people out there who simply don't care about food that much. I didn't even understand that I had this constant drive to eat until it vanished; I'd never not experienced it, as far back as I can remember. I didn't know what people were talking about when they talked about appetite, because the only thing that ever changed was hunger, until I started taking the suppressant.

"but now I realize that there is a large group of people out there who simply don't care about food that much."

This. I used to be a member of this group. In college and early twenties, I had friends who didn't care about food.

Now most of my friends only focus seems to be food, how to eat it properly, how much to eat, where to eat, what is healthy. It is frustrating sometimes but it is hard to find friends in mid 30s who are into playing sports, bars, pool, and video games as much as me.

Which "appetite suppressant" did you use? I wasn't even aware there's a class of drugs / pills / additives with that title.

Can you also say where you started before losing those 100 pounds?

The drug is phentermine. It has at least three positive effects: appetite suppressant, stimulant, and a separate "weight loss" factor. The "drug facts" include a statement that after accounting for the first two, it is not understood how phentermine causes weight loss. It also has a list of side effects, one of which is that it raises blood pressure, so if someone has blood pressure issues already, this isn't something your doctor is likely to want you to take. Fortunately, I don't have that problem.

A fourth effect that it seems to have is to make exercise stop being terrible, which was a whole other revelation for me separately from the one I talked about, above. I've taken stimulants before, and none of them ever made me eager to go run around and do physical activity; phentermine has. I'm not sure if they classify this under the stimulant effect, though.

In January 2012, I was about 380 pounds. I'd hovered around 335 for years, and the higher figure was shocking enough to me that I immediately went to a ketogenic diet intermittent fasting, and shed about 65 pounds in six months. It then became quite difficult to continue the loss, and I stopped trying so hard. On February 9, 2015, I was 336. I started keto again and lost about 10 pounds through mid-May, which was when I finally had that meeting with my new GP, where I talked about being discouraged because keto wasn't working the way it had three years before. :)

As of this morning, I'm 286.

"Calories in vs calories out" is really just Occam's razor in action an hence helpful. At least it was helpful to me to re-engineer my lifestyle from 10h TV per day and fastfood as a teenager to regular workouts and healthy food.

>The phrase that being overweight is "simply calories in vs calories out" is both trivially true and completely unhelpful.

For the issues most obese Americans face, which is a poor diet high in sugar, it is absolutely helpful. As I understand it, the bulk of the problem of our obesity epidemic is that people eat calorically dense foods with little nutrition, not that 40% of the population suddenly stopped being able to be sated by their food.

Of course people don't respond the same way to food and exercise. But your post is about fixing edge cases before the actual problem is solved. The low hanging fruit is in fact, calories in vs calories out. Once people's diets get back in line, then we can worry about why some people have a harder time losing weight than others.

See my previous comment regarding sugar. It's not the calorie density, but the metabolic effects of sugar that are the issue.

It's not binary. Both of those things can be issues with it.

Absolutely. However, it is important to note that there are a very large number of obese people who don't eat sugar.

So sugar, while deservedly notorious, is far from the only highly significant factor, yet it sometimes receives 100% of the blame.

One of the several problems with that is that, due to popular perception, many will swear off sugar and yet still be unable to drop to a healthy weight.

Although a good percentage of those eat white carbs like bread and potatoes that easily convert to sugar in the body. Those on the salads without bread/chips tend to do quite well weight wise.

Yes, and that's part of my point: too many emphasize the evils of sugar, where it is far more to the point to warn against all high glycemic index foods.

The rest of my point is something like: people too often oversimplify complex subjects, which can be actively harmful.

Changing my habits is hard, can you please prescribe me some medication instead?

> being overweight is "simply calories in vs calories out" is both trivially true and completely unhelpful

I appreciate your overall point, but would argue that the phrase in not necessarily "trivially true" in some cases. Unlike thermodynamics, biology is not simple. A person could potentially die of hunger while also being grossly overweight if they have a problem with certain metabolic genes. If your catabolic enzymes for lipids do not function, you cannot utilize fat or break it down regardless of your overall energy budget.

That being said, I doubt that very many people have mutations in the genes for those enzymes, since those variants will tend to be selected out of the population.

die of hunger while also being grossly overweight

Another fun diets-aren't-thermodynamics argument: rabbit starvation.

Seiji, thanks for the reference.

Wikipedia (https://en.wikipedia.org/wiki/Rabbit_starvation) has details. In summary, rabbit starvation occurs on a high protein, no/very low fat diet.

> Why do some people's bodies burn off excess calories through things like non-exercise activity thermogenesis and other store it as fat?

There is a very limited degree to which this can happen. The way some people eat, if it all burned by thermogenesis, they would die of overheating (hyperthermia).

Fat storage is saving them from cooking in their own juices.

[Citation needed]

You could sweat off the heat from 1000 kcal/day of thermogenesis (or any other bodily exothermic reactions) in just 75 mL/hr of extra sweat. You're sweating about 25 mL/hr even when you don't notice you're sweating at all, and people in tropical climates can sweat as much as 3.5 L/hr. [1] I think that's plenty of budget, not to mention the additional budget available via regular convective and radiative heat transfer.

If a person's metabolism is prone to converting energy to fat, just 120 kcal a day could add 10lbs of fat in a year. [2]

[1] http://hyperphysics.phy-astr.gsu.edu/hbase/thermo/sweat.html

[2] http://www.google.com/search?q=(80%+*+120+kcal/1+day)+*+1+ye...

Edited: 1000 kcal -> 1000 kcal/day

I think modern "foods," of the extracted and refined sugars sort, and artificial colors and flavors sort, definitely play a large role in this.

I find all this searching for bio-chemical processes to blame obesity on pretty silly. A non-trivial portion of society has shown it is possible to not be obese. People have also shown it is possible to go from being obese to not being obese.

There are several inter-playing factors that shoulder most the blame I would say.

One major factor that seems to be missing from most conversations is that there is a huge mental factor in obesity I would surmise. And I think you're overlooking that when you ask why do some people feel satiety when others don't.

I think obesity can rightly be considered a mental illness. Why do some people continue to eat when it does their body no good? Everyone probably does this on occasion, but why do obese people do it routinely?

Most obese people I'm guessing would tell you that a lot of their eating has an emotional component, beyond a feeling of hunger.

When you think about it, present day "food" companies, are just as bad as tobacco companies, arguably worse when you calculate the costs. How many people are suffering from diabetes, or potentially will in coming years, how many from other 'diseases of civilization,' what amount of health and monetary resources are expended on these preventable conditions each year?

These are diseases of a civilization that is structured poorly. Just think about it, a civilization of overworked, overstressed, underslept, mindless-media over-exposed people who emotionally stuff their faces with garbage 'foods.'

The "food" industry and regulation there of no doubt shoulders a lot of blame, just consider for some people, the majority of their food energy intake comes basically from candy.

It appears that 'food' companies are exploitative of the low iq, low income segments of our society, but in the US I think that has a lot to do with agricultural policies that subsidize sugar and corn production and the like. And the people running these "food" companies navigate current market dynamics and govt incentives/subsidies to maximize shareholder returns, and that is producing negative health results for many people.

So with these factors considered, I would say that there are better ways of addressing this issue than the search for obesity immunity conferring pills and the like.

>The problem is the long term efficacy rate of dieting is around 5%. If dieting were a drug it would never pass FDA approval for effectiveness.

If your diet has an "end" you have already failed. There's a huge difference between a fad diet and a lifestyle change.

If we are going to compare it to medicine, let's use this as an example:

You suffer terrible headaches. Your doctor prescribes you a once-daily pill to treat it. After 30 days, you suffer no more headaches. After 60 days, you stop taking the pill. After 70 days, your headaches are back.

The pill didn't fail to fix your headaches, you failed to keep up with your medication.

If you diet for 6 months and lose 40Lbs, congrats! If you "stop dieting" and gain all 40Lbs back in a year, the diet didn't fail, you failed to maintain a healthy diet/lifestyle.

The long term efficacy of dieting is low, and that should be totally unsurprising: the very name implies temporariness. If the overweight wish to lose fat, a diet will work. If they wish to keep it off, they must make permanent diet and behavioral modifications, which is not what a diet is. Fewer calories and less sugar/carbs/highly processed foods does work, but it must be permanent.

People want a pill that you just pop once a day without any changes in behavior. And the vast majority of people complaining they can't lose weight don't prioritize losing weight over their current behaviors: diet composition, sedentary lifestyles, etc.

The paper is: "FTO Obesity Variant Circuitry and Adipocyte Browning in Humans", Claussnitzer et al 2015; fulltext: http://www.nejm.org/doi/full/10.1056/NEJMoa1502214

So I checked my rs1421085 status and luckily I don't have the obesity variant.

I guess the cause of my overweight is my laziness then :)

How did you do this?

Got a 23andme analysis some time ago. Now I can just search for gene SNPs (those IDs that start with rs) in the data set and see what variants I have. It's pretty cool.

For the lazy, if you have 23andme and are signed in: https://www.23andme.com/you/explorer/snp/?snp_name=rs1421085

Thak you - turns out I have two Cs in there. Fascinating!

Another thanks. Probably the most value I've gotten out of 23andme to date

Try out http://geneticgenie.org/methylation-analysis/

It might show you some genetic disorders. As it did for me which I then had confirmed by a doctor. Now I supplement a special form of Folic acid and my homocysteine blood levels are normal (they have been elevated for the last 30 years I guess, wich is not too good).

Thanks! You understand UI design!

Not sure if I should be glad I'm not at risk or sad that I don't have that excuse.

I looked up mine as well. I find it really amazing that we can just look these things up so easily now.

If I read this correctly, and I have genotype CC, then this would mean that I'm at risk, right?

I'm completely unfamiliar with this stuff, but from the article:

"In risk individuals, a thymine (T) is replaced by a cytosine (C) nucleobase, which disrupts repression of the control region and turns on IRX3 and IRX5. This then turns off thermogenesis, leading to lipid accumulation and ultimately obesity... Switching the C to a T in risk individuals turned off IRX3 and IRX5, restored thermogenesis to non-risk levels, and switched off lipid storage genes."

So yes, CC is taken to mean "risk" and CT is likewise "non-risk".

As always, one finding doesn't indicate ultimate truth, so take this all with a grain of salt (or not, depending on what 23andMe has to say about your sodium intake).

So TT is lowest risk? That's what I have. I don't really gain weight...

Damn it, I'm CC.

"Switching the C to a T in risk individuals turned off IRX3 and IRX5, restored thermogenesis to non-risk levels, and switched off lipid storage genes."

Hurry up CRISPR-CAS9. Need this fixed!

Mine is CT... does that entail a lower risk?

It would be interesting if they could find some food that flipped this on... clearly obesity is reaching epidemic proportions and there appears to be some correlation between this and the consumption of processed foods. It would be interesting to figure out if there's something in our food that is flipping the switch to lead down that path. Now that we have some (apparently) credible evidence correlating these switches with obesity, it would be handy to be able to see what to avoid to prevent this switch from being triggered... also if there's something that's not in control of the drug companies that we could eat to flip it back.

I don't know if you need a switch to flip the gene variant on/off when it comes to processed food. I lost 10kg since February by just not eating sugars anymore.

I always assumed I wouldn't eat much sugar because I don't like sweets and I don't drink soda. But once I started counting added sugars in the processed foods I consumed it became clear I was consuming way too much of the stuff.

Nowadays I just watch out to buy products with 0 sugar in it. Now that's of course no silver bullet but a pretty low hanging fruit when it comes to improving your overall health.

I've given up all carbs except what is in nuts and fibrous vegetables. My appetite is greatly reduced and U feel better. (Keto adapted diet)

21 libs down in 7 weeks. Blood pressure down a lot. Swelling down, energy up. Feeling better.

And yes I do exercise. Try to do 5 hours a week. Probably average 4.5 hrs / week.

It is frustrating that processors add sugar to virtually everything.

some food that flipped this on

Stop eating bread (yes, pizza counts as bread. beer counts as bread. stop it). Stop drinking calories unless you're exercising for 2+ hours at once (yes, fruit juice is bad for you. stop it).

The practice of making "processed foods" is essentially just cramming carbs and salt into everything and making it as highly concentrated as possible. Much processed food (read: basically anything pre-packaged in a wrapper) is more like a high calorie MRE food brick instead of something you should be combining with other foodstuffs.

We know how food interacts with human bodies. Water doesn't cause fat growth. Dietary fat doesn't cause fat growth (the chemical 'fat' isn't human fat tissue, so drinking a gallon of olive oil won't increase your fat stores). High glycemic sugars cause fat growth in non-glycogen depleted bags of bones. Turns out we can stop getting obese just by not eating things causing obesity.

I think this is likely the explanation. There isn't a food that "flips it on" it's always been on in some people and in others they are either highly resistant to this process or it is age-dependent. Fortunately the solution is to not eat the foods that this process depends on. I think this an important point because you can either wait for therapies that target these processes or simply stop eating crap and accept that some people are more able to eat crap than you are.

Since I've cut processed food and bread entirely out of my diet I've lost a lot of weight pretty effortlessly. I don't think this experience is unique. I also know people that can eat lots of these foods without weight gain.

You're talking about a different kind of obesity i think.

The only thing even remotely healthy about my diet is the vegan part.. but that makes me rely even more on the carb-heavy foods you attack.

I eat tons of processed wheat-based food every day.. I drink heavy juices by the liter, and I am still seriously underweight.

There is clearly a metabolic component, the control of which the OP was theorizing.

Oh, absolutely. I know people who subsist on nothing but ice cream, pasta, chipotle, and orange juice while not gaining significant weight. They aren't ripped, but they aren't overweight either.

In the aggregate of society, the hyper-ectomorph phenotype isn't what people are fighting against. But, we must not forget about them either. Excessive school lunch programs of calorie restriction aimed towards stopping "fat kids" just pains the skinny kids who need way more calories than the 8 year old borderline diabetics.

We need individual nutrition knowledge balanced against our body type. We can't say "everybody must do X," but we should say "People with A, B, C traits should really do X and Y to not be a health menace to society."

Current research shows a link to the type of gut bacteria we carry around. http://www.bbc.com/news/health-23970219

>there appears to be some correlation between this and the consumption of processed foods.

Really? I would love a source on this, because it seems that the #1 reason is that the average portion size has increased greatly in the past 30 years while people are exercising less and less.

It would be great if we could find a way to "flip a switch" to make weight-loss easier, but it's downright foolish to pretend that we are gaining weight for any other reason than that we are eating too much and exercising too little.

This "processed foods make you fat" nonsense is infuriating because it just validates people's beliefs that their weight problems have nothing to do with their personal habits, instead placing the blame on the quality of the foods they've been eating.

There's a moderate amount of evidence that the type of food plays a significant role in overconsumption of calories. One factor is differing satiation for the same number of calories, i.e. 300 calories of some foods make you feel fuller than 300 calories of other foods. There is also something specifically weird going on with a handful of foods that seem to promote ongoing consumption to degrees seen much less often with other kinds of food. Soda and salty/fat snacks are two where people are observed consuming huge numbers of calories in kind of a chain-consumption binge, which is much less often seen with, say, pork chops or broccoli.

What about the fact that our chemical laden foods feeds into addiction that perpetuates the cycle? We become addicted to the types of food we consume which causes us to want more than we should. This in combination with increasing portion sizes is exacerbating the problem.

Also quite often documentaries shows (or at least claim-suggest) how much the """"food"""" industry loves to put sugar on top of the remains the sell as meals so it doesn't taste like sand.

and corn syrup, monosodium glutamate, BHT, Red dye number whatever it is (Tartrazine) and other chemicals that by all accounts do everything from feed addiction and provoke ADHD and cause cancer, all in the name of profit.

I can't tell if you're being sarcastic or not.

I wasn't, but I've gotta be honest, it doesn't appear to matter in the context of this specific topic. With the amount of information and disinformation out there regarding food and nationwide obesity levels, it's tough to tell what is and isn't true or to what degree. It's somewhat akin to the propaganda campaigns run by tobacco companies in the 50's, 60's and 70's.

I'm not sure what you have in mind; Tartrazine is lemon yellow (although of course often mixed to create other colors)

https://en.wikipedia.org/wiki/Tartrazine

The famously banned "red dye number whatever" I think was red dye number 2, banned in 1976 due to suspected carcinogenicity.

https://en.wikipedia.org/wiki/Amaranth_(dye)

But there are so many dyes that I can't be sure what you meant.

I will say, though, that although many food additives are ultimately a bad idea in one way or another, historically most of the suspected carcinogens are not, because humans are resilient in ways that mice are not (in part due to two million years of cooked food, and in part due to testing using cancer-prone inbred mice for decades).

Thanks for the clarification. I was mixing up E102 as it is labelled int the UK (Tartrazine) which was banned in 2013 due to being linked to aggravating/causing ADHD and Red Dye Number 2 which was banned in North America in 1976 due to being a Carcinogen. [One of the downfalls of being an immigrant is that after a while you can never remember (or perhaps just lose the inclination to care) which news applied in which jurisdiction and not the other and which numbering systems belong where]

>chemical laden foods feeds into addiction

Care to explain what you mean by this?

There are many articles on the internet - with varying levels of credibility. A quick Google for such things as chemical food addiction should yield many of this type of thing:

http://www.alternet.org/5-unhealthy-foods-engineered-be-addi...

Obviously you will be able to discern which are credible and which are not. That was sarcasm/cynicism, because it's really hard to discern what is credible, to what degree and what the motive of the author was. There is much propaganda on both sides of the fence, so at this point, it's pretty tough, beyond a religious debate to have any objective discussion.

>One factor is differing satiation for the same number of calories

>a handful of foods that seem to promote ongoing consumption

>people are observed consuming huge numbers of calories in kind of a chain-consumption binge

As I said: It has absolutely nothing to do with the foods or how they are processed; it has everything to do with how much people eat of these foods.

Fatty/Salty foods can promote overconsumption, but blaming the foods for a person's lack of self-control is, as I said previously, incredibly foolish.

Sure, food trends may have increased the amount of fatty/salty foods on the market in the past 30 years, and this certainly would contribute to the obesity epidemic. However, the burden ultimately rests on the consumer to ensure that they are not only consuming healthy foods, but that they are consuming healthy portions of these foods compared to the amount of exercise they get daily.

I could easily eat 3 Big Macs for lunch, but I am aware that that would be 1600+ calories, so I don't.

> As I said: It has absolutely nothing to do with the foods or how they are processed; it has everything to do with how much people eat of these foods. > Fatty/Salty foods can promote overconsumption, but blaming the foods for a person's lack of self-control is, as I said previously, incredibly foolish.

Not everyone has the same self-control/discipline. Exploitation of this fact by food companies is becoming more visible as time goes on. One that immediately springs to mind are the slogans for products such as Pringles: "Once you pop, you can't stop!"

Certain foods cater to, nay exploit, addiction and human behavioral traits. You can't exploit weaknesses in the human psyche and then say "it's their own fault," without assuming any responsibility or blame.

That's like blaming a drug addict entirely for becoming addicted to crack and not apportioning any of the blame to the dealer... not everything is entirely the fault of the... I'm struggling for a better word than victim, but that's not really the word I mean. Most addicts are at first desensitized, then conditioned and then coerced into trying what they become addicted to long before they become addicted.

Food companies have been slated to add chemicals into their food that have been found to correlate with addiction, to keep people coming back for their product. The media desensitizes, conditions and coerces people into trying their product. Portions are decided not based on what is a scientifically proportionate amount of food, but what is most profitable or will make the "client" keep coming back for more - to feed the addiction - in exactly the same way that dealers cut their drugs with chemicals that feed addiction and keep the addict coming back for more - even though many of them want desperately to quit.

> Food companies have been slated to add chemicals into their food that have been found to correlate with addiction, to keep people coming back for their product.

What does this even mean? Barring the more obvious "correlation != causation" issue here, this seems... logically fuzzy at best, and also reeks a bit of the "chemicals are bad" fad. Do you happen to have examples of such chemicals that "have been found [by whom?] to correlate [how strongly?] with addiction [to themselves? to something else? to what?]"?

> As I said: It has absolutely nothing to do with the foods or how they are processed; it has everything to do with how much people eat of these foods.

Why and how have people changed to have less self-control in the past 30-40 years?

The most obvious answer is the proliferation of food that is extremely calorically dense and designed to promote fast and heavy consumption.

Or you could wave your hands and say "People these days are just irresponsible!"

>The most obvious answer is the proliferation of food that is extremely calorically dense and designed to promote fast and heavy consumption. Or you could wave your hands and say "People these days are just irresponsible!"

Could it not be both? Food may have gotten more unhealthy, but people have also grown more complacent with what and how much they put into their bodies. You can't expect everyone else to coach you on how to eat healthy, you must do it yourself.

> Could it not be both?

Sure! It definitely could be. I'd be interested to see if there has been some documented cultural shift, independent of marketing by food giants. One generation seems like a short time frame for that kind of thing though.

But for now, the most direct and clear link is between the food available and people's weight.

blaming the foods for a person's lack of self-control is, as I said previously, incredibly foolish.

c.f. http://www.nytimes.com/2013/02/24/magazine/the-extraordinary...

burden ultimately rests on the consumer

Rests on the overworked, underpaid, isolated in food deserts, raising kids in the same environment, consumers. The average human isn't researching nutrition science, they just want to be happy. They eat what tastes good, have no time to exercise—they drive 3 hours a day—and then they go back to eating what tastes good.

Humans aren't brain-rational actors, they are gut-rational actors, and the gut is extremely short sighted and happy to offload trillions in future medical expenses onto future members of society (not to mention the national security risk of having 80% of your population rolling around in Jazzy Scooters and individually running up over a million dollars in weight-related medical bills in their lifetime).

> There is also something specifically weird going on with a handful of foods

The food industry specifically targets the "bliss point"[1] when figuring out the formula for snack foods.

[1] https://en.wikipedia.org/wiki/Bliss_point_(food)

> but it's downright foolish to pretend that we are gaining weight for any other reason than that we are eating too much and exercising too little.

Right, that's pretty obvious to most observers, but it's not the end of the road. The interesting question is why this is happening. Is the cause purely social (perhaps we're lazier, or perhaps large portion sizes occur purely by normalisation over time), or are there other changes to our society or what we eat that make over-eating and under-exercising more common?

I wasn't saying this at all... the operative word in my statement was "appears"... perhaps the correlation is entirely coincidental. Many correlations we note when we don't have enough data turns out to be coincidence - we draw incorrect conclusions and hey presto, the next great fad begins.

I agree with your statement: Portion size in North American markets is ridiculous; Our consumption and exercise levels are way out of whack and that surely does need correcting; But there does appear to be a not insignificant number of people where despite diet, exercise and unimaginable will-power and discipline, there is little if any change in body mass.

Some people despite eating ridiculous amounts of junk food their entire lives and doing little if any discernible exercise have a disproportionately low body weight; and some people despite eating little store all the fat their bodies can muster. I watch enough of this around me every day to know that these people aren't lying - if they could flip a switch to make their lives easier, why wouldn't/shouldn't they? I would. I know that even having the tine/discipline to lose 10-20lbs is hard. Imagine those that have 100+lbs to get into a healthy range. That's a struggle many of us will hopefully never have to comprehend.

> but it's downright foolish to pretend that we are gaining weight for any other reason than that we are eating too much and exercising too little.

Right, but the question here is why are we eating too much? (why we're exercising too little is easier to answer: it's harder to exercise when you're overweight, and our lifestyles have changed). It seems that the hunger mechanism is out of whack; either because the types of food have changed, or something changed in our internal reactions to calories/fat/etc

beliefs that their weight problems have nothing to do with their personal habits

Eating garbage food is a personal habit, but the food is also engineered to be not very filling, high in calories, and mildly to strongly addictive (more profit!), so how do we balance personal responsibility in the face of adversaries engineering addiction?

instead placing the blame on the quality of the foods they've been eating.

Except, the food quality/provenance is the problem.

Go to middle america and watch obese people at restaurants. Most of them are ordering more obese-enabling foods. Giant sandwiches, giant cheese fries, giant cokes refilled three times per meal. A lot of people just don't have the training or education to connect what they eat to their physical body—bodies are magical things that "just exist" and "just happen" with no responsibility in any direction.

You can't get an obese person (100+ pounds overweight) down to "normal" just by exercising more and eating less of already addictive bad-for-you foods. You've got to remove all the crap from their diet and essentially de-program them from a lifetime of bad habits. Oh, and we need to do this on a national (even global) scale on the order of hundreds of millions of people.

>> “Obesity has traditionally been seen as the result of an imbalance between the amount of food we eat and how much we exercise, but this view ignores the contribution of genetics to each individual’s metabolism,” says senior author Manolis Kellis, a professor of computer science and a member of MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL) and of the Broad Institute.

The article is pretty clear in stating that this new research is novel because it might depose the firmly held belief that diet and exercise is the sole cause/determinant of one's obesity.

There's no actual moral high ground to exercise and careful eating. Its just an unfortunate fallout of the human condition. Somehow this has turned into a popular victim-blaming culture? Perhaps because its voluntary. But lots of other things are voluntary - I stay out in the sun too long, I burn. Anybody want to shame me? I like to play in the sun. Unfortunatly I'm very pale and prone to burning.

I'd be perfectly content with a switch to flip, and have no guilt nor shame in flipping it.

>Somehow this has turned into a popular victim-blaming culture?

Obesity is directly related to an individual's diet and exercise habits. Gaining/losing weight is easier/harder for different people for different reasons, but ultimately a person's BMI is within their control. To pretend that they are "victims" of some unavoidable outside force misses the point entirely. Obese people do not deserve to be mocked, shamed or blamed for their problems, but one cannot pretend that the power to fight obesity lies anywhere other than with the obese person. People don't "develop" or "catch" obesity, they become obese by allowing body fat to become too large a portion of their body mass. This problem may be harder to tackle for some people than others, which isn't fair, but that's life for you.

>I'd be perfectly content with a switch to flip, and have no guilt nor shame in flipping it.

As an overweight person, I completely agree! It would be great to have a truly reliable method for accelerating weight-loss. However, we can't pretend that this is going to lead to some "eat whatever you want and lose weight" magic diet pill. This research seems like it could lead to promising treatments that one would use alongside lifestyle/dietary changes and exercise.

Yes, yes, missing the point. I'm a victim of sunburn, even though its voluntary, because not everyone has this issue. Likewise, its normally reasonable to eat in moderation and exercise moderately, unless its not for you. So we are a victim of our genes in that way.

The thread is about a genetic switch and treatment that could bring more people a higher quality of life. This is a great idea; and unless I misinterpret the article, yes indeed it is a 'magic bullet' at least for those with unfortunate genetics.

It's not quite a magic bullet... because flipping genetic switches may have unintended consequences. Plus, in my reading of the article, I wasn't clear on whether or not flipping this switch would cause body weight to return to a "normal", all other things remaining the same. i.e. with the same consumption and exercise patterns.

True. But I'm not so worried about unintended consequences. Nature flips bits all the time, randomly. We're in no more danger than average, trying it ourselves. Most bits are there so they can be flipped, and that helps in at least some environments.

Probably this bit will just make you tend to burn fat more often. Which is pretty significant!

>I'm a victim of sunburn, even though its voluntary

I think it's stupid to lie in a tanning bed twice a week to keep tanned. People still do it though, and when they get cancer I don't blame the tanning bed company for it; I blame the idiot who irradiated themselves twice a week.

I had a professor once who specialized in human factors design in cockpit safety. Her view was that it was pointless to blame anything on "pilot error" because if the plane let the pilot screw up it was a flaw in the design of the plane.

That's a good way to view any problem having to do with people. People are the same as they've always been--it's ludicrous to think that they're intrinsically any lazier or have less self-control than people a generation or two ago. If they're a lot fatter than prior generations, then something external must be different. You're never going to fix people, so if you want to solve the problem you have to focus on those external things.

Populations change over time - its called culture. We eat out more; we have better access to sweets and soda, we indulge in exotic fruits and meats. Not possible in the past.

Its all tangles up of course. But fixing people was actually the topic of this thread - with gene therapy. That indeed seems to be possible!

This actually is within the realm of common sense and inductive/deductive reasoning if you know a bit about nutrition.

First I'll agree with you that most people lack self control, and that the increase in portion sizes is a significant factor contributing to the obesity epidemic we're seeing right now.

That said, as someone who's been tangentially involved in product engineering for years, literally everything from the packaging to the chemical composition is designed the re-enforce addictive behavior (which is intrinsic to human psychology). Serving sizes are also often deceptive as they don't clearly indicate the macronutrient content for an entire package (as they do in many other countries). Sure, 7g of sugar per serving seems ok for cookies, until you realize that's every 2 in a box of 20 and you've eaten the whole thing (70g).

Most preservatives and artificial sweeteners are actually fairly inane, despite scary-looking ingredients lists. What you should be worried about are the cheap forms of sugar, refined carbohydrates, hydrolyzed oils/trans fats (which are thankfully declining in popularity), and HFCS/cane-sugar-based drinks which average 32-68g of sugar per bottle.

All of these things cause a condition called insulin resistance, which leads to obesity and eventually if untreated, acquired diabetes. Insulin is the hormone that extracts glucose (energy) from carbohydrates (food), and turns it into a source of energy for your cells. [It is well established scientifically that the aforementioned "watch-list" all spike your insulin levels, and that instability in your insulin levels relative to blood glucose is bad.](http://www.ncbi.nlm.nih.gov/pubmed/2995635)

In layman's terms, these things make your body release disproportionate amounts of insulin compared to the amount of food you've ingested, and this has a few downstream effects; a large spike can make you feel intensely hungry (why people say "empty" foods make you eat more than you would otherwise), and most importantly insulin becomes less effective at transporting glucose. That's the beginning sign of Insulin Resistance Syndrome, and its correlation to obesity is well established.

Ultimately it's because of the composition of processed foods, not any dangerous chemical additive (with a few notable exceptions) that most long-term complications arise.

Looking back 30 years you may be correct, but looking back 500 to pre-industrial diets, you'll notice sugar was less prevalent in the food of most Anthropocenes, and fiber was much more common. The sugar lobby of the 1900's is largely responsible for its GRAS status and current abundance.

These days we mill our grains into cereals, removing any traces of fiber/micronutrients and inject large amounts of liquid sugar into most beverages for 'flavor,' having the compound effect of up-regulating what we perceive to be "sweet." Both of these things make our bodies release far more insulin than is needed to extract their energy, making us hungrier disproportionally to caloric intake and setting the stage for a diabetic future.

To the unconscious consumer, these forces are silent and automatic. For as little self control as people may have, I personally can't place sole blame on the individual when I know the entire chain of supply to be rigged against their nutritional best interests.

There was a video recently that corroborates this, I thought it was TED talks, but apparently I was mistaken:

http://www.upworthy.com/no-one-applauds-this-woman-because-t...

Everything from marketing right down to product chemistry is manipulated to keep us coming back.

> It would be interesting to figure out if there's something in our food that is flipping the switch to lead down that path.

There is, it's called carbohydrates.

There's been a heavy carbohydrates bias in our food for millennia. Bit strange to point at it now.

If anything, there's been a switch away from complex carbohydrates (grains and starches, particularly) as humans have gained easier and easier access to a wider diversity of foods, including - and particularly - simpler carbohydrates like sugars; the prevalence of fruit and added sugar (especially high fructose corn syrup, but even table sugar, agave, and other objectively-healthier sugar sources) in the modern diet could very well be worth examining as such an "environmental factor".

>It would be interesting if they could find some food that flipped this on...

That might be good for the health side of the crisis, but the graphs of obesity correspond with food waste as calculated by the NIH. Only 30% of the excess calories have gone to making us fat, the rest is waste, so solving the health side alone will not fix the economic or environmental sides of the issue. This issue is discussed in depth at the end of this video: https://www.youtube.com/watch?v=hPi1LQHBWBk

Why the downvote? I was pointing out the the issue has many components, and this would only address one of them.

> appears to be some correlation between this and the consumption of processed foods

http://www.slate.com/content/dam/slate/articles/news_and_pol...

There you go. We are eating more. As other nations adopt an American diet, they also eat more and get fatter.

There may be other things as well, but far too many people are looking for the magic pill that lets them eat all they want and not get fat.

Make sure you're eating a healthy diet and getting needed exercise, then you can move on. But god damn, act responsibly first.

A potentially explosive finding from this week says that many other species are also getting obese along with humans.

Some environmental factor could be behind all of it

http://rspb.royalsocietypublishing.org/content/278/1712/1626...

We are the environmental factor.

It is better to think of this as a target of intervention with drugs and other therapies than as a "gene therapy" product.

The article says that the key process is enabling thermogenesis:

"Follow-up experiments showed that IRX3 and IRX5 act as master controllers of a process known as thermogenesis, whereby adipocytes dissipate energy as heat, instead of storing it as fat. Thermogenesis can be triggered by exercise, diet, or exposure to cold, and occurs both in mitochondria-rich brown adipocytes that are developmentally related to muscle, and in beige adipocytes that are instead related to energy-storing white adipocytes."

If you apply all the methods in terms of exercise, diet, and exposure to cold, you are pushing this switch the right way -- some people might need harder pushing than others.

Thought exercise:

Extend a finding like this out to the (il)logical conclusion 5, 10, 15 years out -- we figure out what causes the body to store fat, we develop the wonder drug that everyone's been waiting for that 'flips the switch' (even in otherwise healthy people), and suddenly everyone has 7.5% bodyfat and weighs exactly as much as they want to.

And then....what? Well from a macro scale, I think some things get better -- overall population health goes up, obesity/fat-related diseases go down. But does heart disease? I wonder if it goes up -- if everyone looks like they've wanted by shutting off the body's fat stores, does the motivation to do cardio go down for some people? (Cardio has huge benefits for things way beyond your bodyfat, but that won't stop a big chunk of the population from giving up on it.)

And from a purely superficial angle -- now everyone who wants one has a "ripped" body. But some guys are still bald, or have back hair, or or or. We'll still find a way to feel bad about ourselves, even with six-packs.

Thoughts?

> And then....what? Well from a macro scale, I think some things get better -- overall population health goes up, obesity/fat-related diseases go down. But does heart disease? I wonder if it goes up -- if everyone looks like they've wanted by shutting off the body's fat stores, does the motivation to do cardio go down for some people?

I don't understand the tendency some people have to find a negative in something that is mostly positive. It doesn't make sense to me. Sure, some negatives MIGHT happen, but are you really trying to justify not moving forward with this research because some people might use it as an excuse to be lazy? Really?

What if everyone being the weight they want gives them more self-confidence, which gives them reason to get out more? What if there's less depression? What if there are fewer people with diabetes? There's potential to have some really great effects on the population at large here.

> are you really trying to justify not moving forward with this research because some people might use it as an excuse to be lazy? Really?

No of course not! Hence my mention of 'thought exercise' -- I'm trying to spur discussion, get some other peoples' input, and explore an idea.

My initial instinct was "awesome! health and low body fat for everyone!" I'm a perpetual optimist, but one of the most valuable skills I've learned as I've gotten older is the recognition that there's always _some_ con to the pro, and I think one of the valuable things about a community (and a discussion) is the exercise of looking at all sides of topic.

(Which, btw, you've provided, even if unintentional ;)

Heh, apologies for being reactionary in my comment. Seems like we're on the same page then. :)

"By editing a single nucleotide position using the CRISPR/Cas9 system — a technology that allows researchers to make precise changes to a DNA sequence — the researchers could switch between lean and obese signatures in human pre-adipocytes."

How far off are we from therapy using the CRISPR/Cas9 system? I would imagine that while it's easy to edit the sequence for cells in a petri dish, editting the cells of an entire organism (human) is not likely to happen in our lifetime?

Radiolab had a story on it: http://www.radiolab.org/story/antibodies-part-1-crispr/

As I recall: it works great, is super cheap (~ $80 per application?), and is pretty easy to use, they successfully used it on rats already and it seems like it should work on any type of organism.

> I would imagine that while it's easy to edit the sequence for cells in a petri dish, editting the cells of an entire organism (human) is not likely to happen in our lifetime?

We've been doing it experimentally for decades, though the technique is controversial. Recently, a few gene therapies have been approved for clinical use.

https://en.wikipedia.org/wiki/Gene_therapy

> “Obesity has traditionally been seen as the result of an imbalance between the amount of food we eat and how much we exercise, but this view ignores the contribution of genetics to each individual’s metabolism”

People might misunderstand this to justify laziness. I have an obese co-worker, who likes to eat several hundred grams of chocolate along with soft-drinks daily. He always quotes genetics to counterargument my elaborations on the first law of thermodynamics.

Yep, but knowing that smart researchers are finding more evidence for why people are overweight despite running and cycling regimes, and trying to maintain a relatively strict balance of nutrition sure makes my efforts feel a little less futile ;)

You can't do much about people who are dishonest with themselves anyway.

People who have never struggled with their weight typically talk about obesity as if it is an uncomplicated phenomenon, an equation to follow, and pretend that cause and effect are obvious and easily discernible.

If he is consuming ridiculous quantities and types of food, it probably means he has given up. Spend enough time carefully controlling your diet and producing minimal gains while the people around you don't seem to have to put any effort into maintaining their weights, and you will give up too.

People are complicated and biology is complicated, and yet every thin person in the country thinks they can express The Fundamental Truth About Obesity in a single sentence.

edit: I will reply to several responses here - your experience that 'losing weight is simple' is not a data point, it's an anecdote. Losing weight is simple for quite a few people. It's also astonishingly difficult for quite a few other people. Stop acting like your personal experience is strong scientific evidence for your point of view.

Myself, I've got a choice. Either I'm at a constant weight and I'm stupid due to low blood sugar, or I end up gaining weight. It's incredibly hard for me to find the right balance, I haven't managed it yet.

Have you tried a ketogenic diet (low carb)?

What helped me was a a low-carb diet. After two weeks, cravings for sweets were gone and I felt great.

My body's response to caloric restriction defies the math behind all the weight loss calculators I've seen. I don't even know how it's physically possible. Which sucks, because I find it fairly easy to limit my calorie intake, but have to eat at nearly concentration-camp levels to drop weight, which isn't fun.

However, my body responds very well to exercise, especially strength training. Less convenient (takes time, space, maybe some equipment) but, conversely, works way better for me than any tables/calculators I've seen say it should. You might try that, if you haven't.

Funny that you mention it, because I do have a punch-line that I tell obese people - it goes like this: "Eat little, fuck a lot". This is really just Occam's razor. Most people would feel better, if they would eat thoughtfully and do physically activities that they enjoy.

btw.: I was the fattest, weakest kid in high-school and after a decade of hard workouts and a strict diet, I can probably beat up most other guys and I also look better.

As someone who has been both obese (as a child even), and underweight (as a stupid teenager), and is now what most people would consider "buff".

Fatness is a simple matter of putting in the work. You have to work hard to gain weight. Eating that much isn't easy (to gain fat). And lifting that much isn't easy either (to gain muscle). And you have to work hard to lose weight.

Yes, biology and genetics play into it. But they only affect your slope, not the end result.

If it took you ten years of consistently bad eating to become fat. Why would you expect it to take less than ten years of consistently good eating to lose the fat?

And yes, it is very discouraging when you naturally have a slow slope. It's not meant to be easy. If it were easy we'd all look like Schwarzenegger in his prime.

edit: my girlfriend likes to complain that "this stuff is easy for you", but she forgets the fact that I haven't had a rest day in 5+ years, and haven't had a cheat day in 2+ years.

Comments like this are myopic. This is reflective of your experience. For some people, eating enough to "gain fat" is easy -- in fact, it's effortless. For some people, outputting the energy to make CalsOut > CalsIn true is easy, also almost effortless. Both types of people exist in fitness-ignorant circles, eating the same foods their counterparts eat, usually in similar portions.

I believe it is sufficiently proven that it's not that people don't want to be at healthy weights (barring a handful of online extremists), it's that "the slope", as you refer to it here, is prohibitively difficult for the vast majority of people to overcome. That difficulty has to be broken down (and I personally believe fixing the issues in our food supply is a very important part of that -- it's almost impossible to buy healthy food in the US without going to a specialty grocer, no matter how hard you try). There are many ways to approach the problem, but right now the primary effort seems to be on just yelling at people to try harder. That works in some cases, but not nearly enough to be the only solution we have.

The discord on this topic originates from perspectives like this, where someone takes their personal experience and extrapolates it onto the rest of the population. It's great that you got fit, and it's great to encourage others to get fit too. It's not great to trivialize the complexity of the realities that contribute to the obesity epidemic. "Everyone else is a just a fat, lazy glutton", the crux of the fitness camp's argument, is popular because it's self-flattering and an effective marketing technique, but it's an extremely naive and superficial perspective on a global health epidemic, and it isn't going to motivate a great deal of progress on the issue.

I agree with you completely. The slope is prohibitively difficult for a lot if not most people.

And the food industry definitely needs to change to make it easier for people to affect their slope.

And regardless of all of that, I would rather tell people that this is hard and that it requires a lot of work and effort on their part, than to encourage them to give up after quickfix solutions don't work.

Ultimately it's about patience. If you do something, anything, every day (even going for a 10 minute walk is better than nothing). And if you are even remotely careful about what you eat, you will see results. Maybe not today. Maybe not tomorrow. But if you keep it up for a few years, results will appear out of nowhere. And this stuff gives you compounding returns. The longer you do it, the quicker the returns on any new thing that you try.

When it comes to people you love, would you rather tell them that they are helpless victims, or that they can overcome their problems?

Here's a question for you: if we agree that being good at your career takes daily effort and practice for the majority of life, why does this conviction fall apart when it comes to diet and exercise? Why do we assume someone else should take care of that, not us? That it should somehow come as if by magic? It's a skill. You have to practice it to get better.

The relevant difference here is that we have much more clarity around career-oriented programs and we're able to keep the slope under control. Most people can find and establish a reasonable career for themselves. We use a lot of economic tools to make it so it's possible to break into a trade or career, including university, etc., and these programs have been successful in keeping "the slope" semi-reasonable. This has not happened with obesity. We've allowed the food conglomerates to run roughshod over American health in the name of greater sales.

(There is also the difference that it's a lot harder to justify extreme effort expenditure on the tasks necessary for daily biological maintenance, like eating.)

If something is impossibly hard for most people, the answer isn't to scream until the populace does the hard thing, the answer is to try to figure out a better path. You've surely heard the expression "work smarter, not harder".

Taken to its extreme, your logic disavows practically all tools of human invention. "Why would you expect to be able to dig a hole without weeks of labor, clawing away at the dirt? The ground didn't get there overnight and it's not going to go away overnight." We could use a manual shovel and reduce the effort investment by an order of magnitude, or a construction machine like a front shovel or auger and reduce the effort investment by (at least) another order of magnitude.

"Just try harder" is essentially just telling everyone else to claw at the dirt with their hands. There may be a handful of people with just the right combination of determination and imperviousness to self-harm to do this to get a hole, but the vast majority are going to give up early, and it's the same way with the obesity epidemic. It's not about "getting something else to do the work" (again, I think one of the root problems is our supply chain, something most Americans have little to no control over). It's simply about finding a solution that works for the 80%+ of American adults that don't get "the recommended amount" of daily exercise (to the extent which some of these people are non-obese, it's mostly a biological accident (one that is liable to break as they age)) and buy their food from the normal grocery store.

We need to see it as the macro problem it is instead of making a collective assault on the character of the people who can't do it. That may have been an OK solution for the first few years, but it should now be apparent that it simply doesn't work. The trend keeps getting worse. I understand it's hard to let go of that perspective since part of the appeal of fitness for many is the superiority complex, but it's not doing us any favors. We need to let it go and focus on finding a real solution, whether that's returning to a normal food supply, utilizing pharmaceuticals intelligently, redesigning our working lives to include more requisite and natural calorie-burning activity, or something else, we need to find an answer that works and stop clawing at the dirt.

> if we agree that being good at your career takes daily effort and practice for the majority of life, why does this conviction fall apart when it comes to diet and exercise?

This is how I put diet and exercise into perspective now. If I told someone I wanted to learn how to paint or play guitar and I started complaining in 2-3 weeks about how I'm seeing no progress, they would immediately be able to see how unrealistic I was with my initial expectations. Diet and exercise are no different.

Yep, people vastly oversimplify the issue. There's a meme that people are fat because they inhale 14 candy bars each day, but in reality, some (many) people are fat without doing that. I won't deny that that's sometimes the problem, but it's probably rarer than you think.

Weight gain induced by medical regimens can be really hard to put off, and YES, this is something that happens (it's not ultra-rare as fitness extremists want you to believe). People's bodies react differently to the heavily-processed, specifically-engineered food we have. It is true that most people can regulate their weight with enough effort, but the amount of effort required seems to fluctuate greatly based on hereditary factors.

This doesn't even mention that in America, it's almost impossible to find food that isn't packed with junky addictive substances. It's pretty likely that normal people who are consciously forgoing the "candy" in attempt to stay healthier are getting practically the same amount of junk calories from bastardizations of "healthy" foods, like "natural whole wheat" bread that contains brown sugar or "maple syrup" that is actually just HFCS, water, and dye.

The issue of obesity is much more complicated than a lot of people want the populace to believe. Identifying the motives behind the perpetuation of this confusion is left as an exercise for the reader.

I believe the issue is caused by the technology we have (along several fronts, including but not limited to the sedentary lifestyles promoted by office work, and the way we manufacture foods today, which does not agree with the biological makeup of many in the population) and I believe there is a technological solution to it out there somewhere. Cheers to the MIT team for looking into this and not just sticking their head in the sand.

It's made worse by the fact that when people give up on losing weight (and most people that fail to do so eventually will give up), they tend to give up by giving in to their own stereotype - eating buckets of fried chicken and guzzling soda. They've created a scarcity reaction in themselves by avoiding all the unhealthy crap that is out of proportion to the actual hardship involved - psychology is a messy business.

So then people see them indulging themselves and think "No wonder he's so fat, look what he eats", and confirmation bias gives them a nice hug.

Every thin person in the country? That's a little broad don't you think? We're not talking in absolutes here, but if every obese person in the country ate and worked like their thin counterparts people do we'd have much less of a weight problem. Plus, then we'd find out who the people are with real problems.

It was obvious hyperbole, directed at the poster I was responding to, a fairly typical speech pattern. Did you actually get the impression I was trying to suggest that literally every thin person in the country thinks in the same way?

But you clearly missed my point. Eating is a cause and an effect. If every obese person in the country ate exactly like 'the thin people do' (by which I assume you mean the same foods and quantities) then yeah, most of them wouldn't be obese. That is exactly the kind of 'simple statement' I was talking about.

If all of the stupid people in the country learned the same things the smart people do, we'd be in much better shape educationally too.

Anybody can eat anything (allergies aside). Stupid people can't just learn the same things as smart people.

Largely untrue on one count or the other. You are being vague about the word 'can'.

Someone with a low IQ 'can' learn almost all of the same things as someone with a high IQ, it just takes more effort and time. We are hindered in our discussion because we have no word to describe the analogous 'propensity toward obesity' for which we have significant evidence.

I personally see thin people buying the same stuff obese people buy all the time. I see thin people at fast food places and sit-down restaurants (which are usually not substantially healthier). I've seen families that live off the same food supply and one person is obese while others are thin. You can argue "the thin people must only buy those foods or go to those places sparingly", but we all know that's not really generally true either.

There is so much variation that it's hard to generalize this, but the sentiment you've expressed is a big part of the reason we can't get anywhere. People's bodies react to food differently. Obesity is not always caused by a lack of inhibition. We need to stop detesting obese people before there can be a serious solution that curbs the growing obesity trend. If "diet and exercise" were tenable solutions, we'd be seeing steadily declining obesity rates; instead, the rates continue to skyrocket worldwide (in conjunction with modernization of country's food supply, suggesting that modern processing "contaminates" food with substances that promote obesity). We need a better answer.

There is at least one fundamental truth: obesity is on the rise. Why?

I think it is safe to assume that a rapid change in the human genome is not responsible for skyrocketing obesity rates around the world. From what I have read it seems that dietary shifts towards more processed and simple-carbohydrate rich food are the main culprit. Increasingly sedentary lifestyles are accomplices.

These effects are on a statistical and societal level. Also, they don't imply that and individual can just change their diet and easily loose weight. It is possible once someone gains weight their body irreversibly changes so that losing weight becomes much more difficult (I mean irreversible to imply hysteresis, not impossibility).

That direction of thought has produced quite a few useful insights, and continues to drive significant research. I'd never call it a 'fundamental truth' though - it's a question, and a type of question which allows for many interacting answers, none of which may be fundamental. In particular, it can be extremely difficult to trace the links between societal (non-physical) changes and the mechanisms by which they affect the physical.

We are eating more sugars - is that because more sugars are supplied, because we can afford more sugars, because sugars are snuck into all our foods, or because we like sugars more than we used to?

We are moving around less - is that because we have more sedentary jobs, because we have less physical labor to do at home, because the interesting hobbies that don't involve moving around are expanding, or because some quirk of the childrearing techniques in the 70s had significant impact on our interest in athletics?

You see how complicated these things get when you start talking about 'fundamental' causes and reasons.

The first law of thermodynamics does not imply that every metabolism is the same. The human body and digestive system is not a physically simple system. There are many biological variables which change how food is processed. People like you (and the entire Fat People Hate movement using the same playbook involving the same misunderstanding of the first law of thermodynamics) might misunderstand this to justify spreading hate.

Much as your coworker faces health risks if he overindulges in sugar, it is not your business to try to regulate the weight of your coworker by arguing with him at work, it is not professional, and it is not civil. His health is his problem. If you find fat people disgusting and feel a compulsion to aggress against them, that is your problem. Please don't also make it HN's problem by using HN comments to spread hate.

The naive thermodynamics argument doesn't say much, because:

When you eat "too much" high-energy food such as your co-worker, the excess energy can be excreted rather than digested and stored. The energy that is digested may be burned off in the form of maintaining a higher core temperature (as mentioned in TFA) or making the body more active.

To sum up, thermodynamics alone doesn't tell us where the "excess" energy will go -- storing it as fat is only one of several options.

What if your co-worker requires 2x the willpower to overcome their genetic predispositions to consuming sweet food, but they only come up with 1.5x your willpower (and therefore fail)?

Are they still "lazy" even though they are trying way harder than you are?

While the human body is still ultimately governed by the laws of thermodynamics, it is an overly simplistic viewpoint by which to manage such a complex system.

Even speaking of only thermodynamics, don't forget that there is a second law: http://www.nutritionj.com/content/3/1/9 ... i.e. someone who prefers sugary things can store more energy than someone who prefers protein. Not all thermodynamic processes are created equal when it comes to the 2nd law.

Reminds me of http://i.imgur.com/8gwNV.jpg

Of course some people will use this as an excuse to do nothing to change their lifestyle and expect everyone else to adjust for them, but those people would find some other reason anyway so there is no point worrying about them.

And the best be to counter this, if it is actually possible, is to point out that while he might be genetically predisposed to a slow metabolism that burns less that means he needs less calories not that he has an excuse to be fat. It means he needs to either burn more through exercise or eat less. Genetics is the reason he needs to do that to stay in shape not an excuse not not bother about his health. Not that he'll listen. If he is someone you like enough to make the effort (or you want to win the intellectual discussion) try use other conditions as a comparison to see if you can get through that way. Anaemia, a genetic condition, is the reason some people have trouble with wounds not clotting and healing properly, it isn't something they use as an excuse to bleed everywhere, get infected wounds, and so forth.

I've recently turned my health around (down from more than 17 stone 18-to-24 months ago to just under 10 stone now, and running 5K at least twice a week (sometimes 10+) where I couldn't run 2K in one go in January). It is slightly irritating that some people can eat a shed load more than I can while not putting on weight, but that didn't mean it was impossible for me to get into a reasonable shape and maintain it. The reason I didn't before was just that I didn't care enough to.

"The paper is a tour de force, according to Evan Rosen, a professor of medicine at Harvard Medical School who was not involved in the research."

That's some pretty high praise.

Also, it wasn't entirely clear to me if they're already testing this on humans. They mentioned using the CRISPR/Cas9 to manipulate genes in human cells, is that just donated human tissue?

From the article: "the researchers gathered adipose samples from healthy Europeans"

What I don't like is how the press and often scientists make every paper seem like something was newly identified. With no disrespect to the authors of this particular study, they didn't "unveil a new pathway". Several previous works over the past decade have honed in on this exact "master switch".

E.g.,

Identification of FTO as relevant to obesity (2007): http://www.ncbi.nlm.nih.gov/pubmed/17434869

Connection of FTO and IRX3 (2014): http://www.ncbi.nlm.nih.gov/pubmed/?term=24646999

In this context, this report from 23andMe is interesting....perhaps old news: http://blog.23andme.com/wp-content/uploads/2015/03/5-N8XiOLk...

I found the master switch. It's called self-responsibility.

What if you were a fat kid. Other kids made fun of you and adults told you to "lose weight", but never gave you actual tips just "eat healthy and move more".

How do you go about eating healthy as a 10 year old? You don't. You eat what your parents put on the table and if your parents are also fat there is going to be a lot of fatty foods and few healthy foods and the healthy foods will often taste horrible in comparison.

How do you go about moving more? You could play outside, but who plays outside these days? You just spend your time playing video games and even if other kids are into sports ball you are fat and slow, and most likely to complain, so no one wants to play with you.

Now imagine this goes on for ~20 years. You are now pushing 30, being overweight/obese your whole life. When people talk about weight they just tell you to "lose weight", but again without any solid steps just: "have self control and eat less and move more".

Running is out of the question because of your bad knees, under your weight. Walking is fine as long as you take it slow and don't walk too long. So your gains are very minimal, you don't even sweat (expect from the Sun) since you can't go fast or long before your legs start to hurt. So people tell you it's all about food, so you try to lower your food intake. It's hell for a week, but somehow you manage it. You starve yourself for two months which feels like 5 years.

You manage to lose weight, not that you know how much since no scale is big enough for you, but your pants start to sag. So you do what people around you want to do, you celebrate, because what's one night of having fun going to do, right? You got your new smaller pants and it's time to hit the town. Next thing you realize it's 6 weeks later, you are shoveling cake in your face at alarming rate and your pats are starting to look like skinny jeans. You feel like shit, and since you were a kid what have you been doing when you feel like shit? You grab a soda or a cupcake or something else that's bad for you.

It's not just about having self-control, because you have life time of nagging about your weight on your back. People have always told you that you weren't good enough, that you should lose weight, but no one has taken the time and guide you on the right path. Losing weight is simple in theory, but hard in practice and it takes a lot of time and effort, more than most people are willing to dedicate.

No matter what you are responsible for your body. Period. Full stop. I am not responsible for your body. As an adult your parents are not responsible for your body. The government is not responsible for your body. You and you alone are responsible.

Your body may be more susceptible to holding onto fat than the average person. You may have genetic markers that makes you more likely to over indulge. There are one of a million factors that may make you more likely to be overweight. But literally none of them change the fact that you and you alone are responsible for your body.

It's easy to say that, since it is true after all, but you are not helping in this matter at all. You are not going to get a single fatty to lose a pound of weight by telling them: "hey! it's your fault!". Fatties know that, but that doesn't mean it will in any way make them change what they are doing.

Constantly searching for genetic markers as excuses doesn't help either. It's not your fault! Your genetics cause you to over eat and hold on to all of the fat! And you know what that changes? Nothing. Literally nothing. You can shift blame to genetics or make excuses on how your parents didn't teach you how to eat healthy but it doesn't matter. At the end of day one and only one person holds the keys of responsibility.

I never said anything even remotely about genetics.

And I never blamed my parents, they did what they thought was best, but I dare to suggest that adults constantly telling kids: "you should lose weight" for years doesn't do any good. At worst you start to resent everyone who says that and then you are in deep trouble.

If you have been skinny to normal weight your whole life you have no idea how hard it is to keep up with a diet and how easily it gets out of hand. Kids are the place where we should start treating this epidemic and it doesn't start with nagging them every time they visit a doctor/nurse. It starts with proper school meals which favor salads instead of shit like pasta, rice and potatoes, and removing shit like coke machines from school property. With PE classes where kids actually get exercise and isn't just about playing few rounds of sports ball. And some actual advice with weight problems and proper after school activities (these probably should be sports ball activities) which don't cost a lot.

Maybe I'm way off base here. Maybe I'm just crazy. But I know what my educational system is like and for most part it ain't helping.

Some changes happening. Here in Iowa, our high school has a fitness loft, and PE is about everything you say. Cardio, weights, running, inclusive activities and good sportsmanship all play a part. My boys are lean and mean, in no small part because of their high school experiences!

The article under which this entire discussion exists is about genetics.

>Fatties know that, but that doesn't mean it will in any way make them change what they are doing.

Obese people who do nothing about their health and weight suffer all of the consequences. It's no skin off my teeth of someone dies in their 40's of a heart attack.

Any weight loss solution that says "obesity isn't your fault" fails to address the #1 cause of obesity: Unhealthy habits.

Agreed on the part of not taking responsibility for your own unhealthy habits. Also, there is no doubt that biology realities are immune to political correctness.

However, I find the tone of the first comment (and your too, to a lesser degree) quite disrespectful. You seem to imply that people are full aware of what their unhealthy habits are, and what precise steps they need to take in order to change those for healthier habits. In particular, you seem to subscribe to an early modern model of human behavior that assumes everyone is 100% rational and if they engage in, let's call'em "unproductive", behaviors it must be because the person is wicked. This model of behavior is factually wrong, and to believe otherwise is to dismiss the whole body of knowledge of modern psicology (yes, from Freud on. I am aware he had a thing with sex issues, but at least he understood that, under a thin rational layer, the innards of human mind operate on irrational symbol manipulation and pattern matching).

What other people is trying to tell you is that you are not helping anyone by condemning the fatsos of the world. You gain nothing but to stroke your own ego, and don't seem to mind alienating other human beings in the process.

I found the master switch of why your software is ridden with bugs. It's called lack of attention (since you didn't type it flawless and perfectly complete the first time around).

I also found the master switch of why your project is behind schedule. It's called lack of passion (because you keep choosing those pesky hobbies, social life and family/civic responsibilities over working 100+ hours per week).

I could keep going all day, but I think the point should be clear now. :P

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