Why is it that so many people are completely oblivious to the limits of human psychology? Telling people to eat less doesn't work. We need to try other public health measures.
Modern weight loss plans focus on making sure people feel full, and have tricks to help people feel like nothing is forbidden (you could still eat cheese or chocolate, just controlled small amounts), while helping them make better choices.
There's not much evidence, and the evidence is about as good as all the other dietary stuff (not great) but they do seem to work and be maintainable.
Why is this concept so difficult to get across? There are _constant_ advertisements in every medium for weight loss programs of every sort. We've already explored the entire parameter space of dieting. Tweaking the food mix and saying, "No. This time we have the perfect mix to keep you health and full!" isn't science. It's quackery that belongs on the cover of Cosmo.
You know what works in reality?
* Amphetamines
* Nicotine
* 2,4-Dinitrophenol
* Gastric surgery of various sorts
* Cancer
You know what might actually work?
* Pigovian taxes on high glycemic index food and drink
* A ban on food advertisement
* Portion size regulation
* Weight-based airfare
It's time we stop pretending that yelling at people about diet and exercise is going to make a bit of difference. We might as well yell at the sea and tell it to stop rising.
N=1 sample, not to prove anything but sharing an anecdote: I'm nicotine-taking non-smoker, consuming it in form of nicotine gums. I haven't noticed any effect of it on my weight over the period of last two years. I did respond to ketogenic diet however, but found it hard to maintain over long periods of time - basically it's a big time and cognitive investment to invent new foods that you won't puke on out of a limited set of ingredients. I do think that a lot of diets would work if they were the only thing people have to think about during the day. Alas, the cognitive demands of our fast-moving, competitive world are strong.
http://www.medscape.com/viewarticle/852616?nlid=89075_2052&s...
> Suicide attempts increase substantially in morbidly obese patients in the years following bariatric surgery, when the "honeymoon" period of substantial weight loss comes to an end, new research shows.
I agree that death does have a slimming effect.
> yelling at people about diet and exercise
Nothing in my posts can be seen as advocating for yelling at people. Please don't bring your bickering with other people into your replies to me.
What I'm talking about is an "Every Contact Counts"[1] style approach of supporting people to access a modern weight loss programme[2], for free if they can't afford it. This will be "prescribed" by their GP, paid for by Public Health[3] or perhaps their Clinical Commissioning Group. I've accepted that the evidence is not great, but if you want to find what's wrong with the evidence[2] used by NICE I'd be interested to hear it.
I haven't said anything in this thread about exercise, but I have said in other threads that exercise does not help weight loss. We should be recommending that people do exercise because it has other undeniable health benefits.
[1] http://www.makingeverycontactcount.co.uk/
[2] http://www.nice.org.uk/guidance/ph53
[3] https://www.gov.uk/government/organisations/public-health-en... England's use of generic names is nice, but feels a bit weird sometimes.
A quote from the beginning that captures the gist of the article:
"[L]ecture on ADHD suggested several reasons for the increasing prevalence of the disease. Of these I remember two: the spiritual desert of modern adolescence, and insufficient iron in the diet. And I remember thinking “Man, I hope it’s the iron one, because that seems a lot easier to fix.”"
The same author also wrote an article about when it's better from a practical standpoint to treat something as a disease instead of a failure of character[1].
[0] - http://slatestarcodex.com/2014/09/10/society-is-fixed-biolog...
[1] - http://lesswrong.com/lw/2as/diseased_thinking_dissolving_que...
True. For many people issue lies, I feel, not with changing things, but with knowing what to change and how. Most people - myself included - have pretty streamlined diet: they know what they like, where to buy ingredients for that cheap and how to prepare them. Even starting on a stable, maintainable diet requires you to think through what exactly to change, what new components are needed, where to source them and how to alter your preparation routines. You want to do it in such a way as not to deprive yourself of important nutrients, or else your body will say "fuck it" and force you to break the diet (or if you're particularly strong willed, you'll feel like crap all the time). If you do this, it's easy to keep on diet, but you have to do a big investment up front. I've personally done this once; procrastinated months on it, but after I sit down and made the necessary time investment, my weight reacted to changes pretty much instantly.
But I can see how most people simply don't have time for diet. It's kind of like being poor - you could get a lot more for the same amount of money if you have enough capital available to do bulk purchases. But if you're living paycheck-to-paycheck, you don't have enough money to buy cheap.
Also that's why some people are willing to pay for someone else to figure it out for them. I personally know someone struggling with weight for almost two decades, for whom the solution for instant weight loss was to pay someone else to micromanage their food - she got a list of allowed choices and amounts for all meals a given week and - what I think was a key trick - a protein powder alternative to use if she didn't like a particular meal. It had pretty much no taste, but it was a line of retreat that let you skip something you don't like without breaking the diet.
For most people it doesn't need that much thinking. 1) Stop drinking regular soda and switch to zero calories sodas, or water, or teas and coffee, or sugar-free squash. 2) When using something like cheese don't use 300 g in a sandwich - use 30 g of a stronger flavoured cheese and grate it finely.
These small simple steps are achievable and maintainable - and with diets the lifestyle changes you can stick to are the ones that work. It's a good business model. People need to keep going to the groups once they've reached their target weight; people have the chance to keep buying the books and magazines and snack products.
http://www.nature.com/tp/journal/v4/n10/full/tp201498a.html
Also, it's a mental illness so it's not a fucking choice.
Look, my point is that it's possible to eat fewer calories, but it's not necessarily easy to do it in a way that doesn't harm you. It's not suppressing appetite that is really complicated, it's reducing calories and staying on top in terms of nutrition.