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Comment by randlet | Hacker News Reader

It's tough to hear but no matter what your genetics or internal flora are, being overweight is still your fault. It may not be "fair" that someone puts on less weight than someone else eating the same diet, but ultimately you're the one responsible for maintaining your own weight (by controlling what you put in your mouth) no matter what the state of your gut microbes.

edit: not picking on you Onion2k...I end up commenting a lot on these stories because it really irks me when so many articles and people are looking for something external to blame for their weight problem. You may or may not be able to change your metabolism but you absolutely can change the number of calories you're consuming.

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>...being overweight is still your fault

Citation needed.

The ability of human beings to control their biology through willpower is limited (if you don't believe me, try holding your breath for 30 minutes, or not drinking anything for a few days). Willpower itself is limited, and motivation is itself influenced by mental health. And diseases like Prader-Willi and Emery-Dreifuss demonstrate situations in which motivation and willpower are irrelevant.

And that's only what we know.

Sometimes when I have dinner with friends, I'll observe a situation where two of them will order the same thing, the bigger one will wolf down the dinner and the thinner one will pick at it and eat maybe half. I don't see two people equally tempted, where one gives it to his cravings and other is morally strong. I see two people with two different drives.

Why do different people respond so differently the same meal? What is it our society that leads so many people to consume a calorie surplus? It's disappointing the number of people that don't even want to investigate the biological and psychological origins of such phenomenon, instead claiming (without evidence) that it's all about moral failure.

In the 19th century, when painkillers first started becoming available, physicians would refuse to give them to woman in childbirth, because the Bible says childbirth is supposed to be painful. Women had sinned, therefore they must suffer. That's nonsense, of course, but people really wanted to hold onto their moral judgements, even at the expense of biology, good medicine, and relief of suffering. I think we should be suspicious of any impulse to use moral judgement to avoid investigation into the causes of medical conditions. Like obesity.

> In the 19th century, when painkillers first started becoming available, physicians would refuse to give them to woman in childbirth, because the Bible says childbirth is supposed to be painful. Women had sinned, therefore they must suffer.

This is a great analogy. "It's your fault" is not a public health policy, it's a cop-out. And it doesn't even make sense. Obesity is rising dramatically in developed countries. Is the current generation just morally inferior to the ones that came before?

Obesity is peoples' fault in the same way car accidents are. That doesn't mean the proper response is to simply blame people, instead of using science to devise solutions.

>Obesity is peoples' fault in the same way car accidents are. That doesn't mean the proper response is to simply blame people, instead of using science to devise solutions. //

But if obesity is primarily the fault of the person who is obese lacking will power then shouldn't we start by doing things directly addressing this.

For example, I snack late at night - except when there are no snacks in the house. Sometimes I'll still make food, but mainly I'll just wander around feeling tetchy and eventually get distracted enough to not think about it. For me it absolutely is lack of willpower (which is much better recently probably due to antidepressant meds) to avoid eating things I know aren't healthy for me; or indeed just to eat less in general.

If we're looking to prime cause then for me willpower seemingly fits the bill, as you say that revelation may not help to fix things for me - if I can do outdoor pursuits for a week then I can lose weight no problems! - but healthcare workers looking to help me should perhaps seek ways to enforce diet that don't rely on my willpower so much rather than just ignore willpower deficiency altogether?

> But if obesity is primarily the fault of the person who is obese lacking will power then shouldn't we start by doing things directly addressing this.

Yes, we should. The average weight has gone up far faster than humans can change genetically, so people start looking for things like gut flora or epigenetics. Occam's razor would point to the average supermarket and restaurant selection of today versus a few generations ago to explain the obesity epidemic. Cheaper, faster, tastier food (capitalism optimizes for these three qualities in food), and more riveting, less active indoor pursuits can easily explain it. That's not to say the research is worthless, but gut biome most likely influences subconscious cravings, not BMR, and epigenetics is still young enough that many biologists think that pulling conclusions from research into it is premature at best.

> This is a great analogy. "It's your fault" is not a public health policy, it's a cop-out.

A cop-out from what, exactly? Does society have a responsibility to make everyone thin?

Even if you say it does, how would you propose it goes about doing that? There's no scalable, organizable effort you can take that will make fat people thin.

If you say we have to throw more money at research, I say, sure, we should! Along with every other worthy cause. Where we're going to get the money, I've no idea. If you do, that's a completely different kind of argument.

We managed to decrease smoking rates by 50%. It seems reasonable to assume that reducing obesity rates is a fairly similar problem.

It's intriguing how morale is again on the stage; we went from "obesity is caused by lack of will" to "it's not deserving we pay for that research".

Isn't that likely, though, that this research pays for itself?

How does research pay for itself? Naturally the results of the research could well be worth the time and money invested, even many times over if you're lucky, but that doesn't mean that it paid for itself. Somebody still has to pony up the dough to pay the scientists, lab assistants, equipment, time for them to figure out what they're doing, etc. None of it is free.

Society does have a reponsibility to not provide those substances that cause serious physical harm to many people more readily and cheaply than those more suited to good life.

Yet we don't tax sugar, processed food is the cheapest and non-processed are the most expensive.

The entire food industry is designed to sell more of 'their' product, and the addictiveness is developed more than the health value. Lobbyists ensure the governments keep the status quo.

You can surely make people fat, or lead-poisoned, or stuffed full of sugar and diabetic, or more full of meat, etc. through government decisions.

While the libertarians might have a point that most such decisions turn out to be deleterious, it's certainly not the case that policy can't make you fat, and so can presumably avoid making you fatter.

Did you just compare holding your breath for 30m to not eating?

Fail.

http://news.discovery.com/animals/fat-pets-obesity-weight.ht...

- Mammals that live near or with humans, from lab rats to pet pooches, have gotten fatter over recent decades.

- Fatter lab animals are the hardest to explain, since their diet is tightly controlled and well documented.

- Endocrine disruptors, pathogens or temperature changes might play a role and could also factor into human obesity

http://www.bbc.com/news/health-23970219

A study showed that transplanting gut bacteria from obese people into mice led to the animals gaining weight, while bacteria from lean people kept them slim. The findings were published in Science. Researchers at the Washington University School of Medicine, Missouri, took gut bacteria from pairs of twins - one obese, one thin.

The bacteria were then put into mice which had grown up in completely sterile environments and had no gut bacteria of their own. Mice with the obese twin's bacteria became heavier and put on more fat than mice given bacteria from a lean twin - and it was not down to the amount of food being eaten.

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Ok, so you may need 1300 calories a day to maintain an "ideal" bodyweight but The Minnesota Starvation Experiment shows that amount of food intake causes severe emotional stress and depression. So yeah

Where did the 1300 calories a day number come from? How big is the person that number is for? What is their activity level?

I made it up completely as an example.

I used to exercise 3-4 days a week. Lifting weights, cardio, and yoga. I wasn't losing weight. I started gradually counting and cutting calories and when it didn't help I cut more. The only way I was at a good weight was on 1400 calories/day. This made me completely miserable and anti social (I wouldn't eat outside my house). This may be sustainable for some, but it wasn't for me, eventually I just had to eat more. I kept it up for a couple years though. I didn't have a body image problem either, my weight was a couple pounds below "overweight" BMI.

On the other hand a decade before that I ate junk food every single day and was very thin. Something seems to have changed in my body, but I don't know what. When I was thin my diet was truly horrible!

Even when I was a kid - Every single Halloween I would eat an entire pillow case worth of candy over the course of around 3 weeks, but I never gained a pound.

There is SO MUCH we don't know on this topic!

Yes, one can cut back on food, but willpower and the ability to control are limited to some degree.

Very similar experience here! 4K+ calorie daily average mostly of junk food from ages ~15-21, maybe 30 minutes/day average of weightlifting, rarely some cardio, visible upper ab muscles, call it a "4 pack", full on six-pack abs if I happened to be slightly more active in a week (a few hours of casual swimming, for instance).

Then I decided I wanted to cut down to the six-pack bodyfat level and stay there, so for the initial "cut" phase of that plan I dieted at ~1400 calories a day, every single day (no cheating) for ~2-3 months, and started doing way more cardio. Only lost a couple pounds, little or no visible difference, so, confused and frustrated, I gave up. Makes no damn sense according to any "weight loss calculator" I've ever seen (which all claim that my BMR should sit in the low 2000s), but that's what happened.

Packed on fat immediately when I went back to my usual eating patterns, took me years to get that under control. To this day I seem to easily hit a plateau a bit over what I'd call my healthy range when dieting at any reasonable (not near or under starvation level) caloric intake.

OTOH I've found that strength training's more effective for me than it "ought" to be but requires time, which sucks. I'd love to be able to diet my way to a trim waist, since maintaining an intake under what weight loss tables/calculators say should work for me is something I find easy to do. Too bad it doesn't.

Don't know what the explanation is, but something weirder than the "calories in/calories out, and calories out is fairly easy to guesstimate with useful accurately" orthodoxy is going on.

The laws of thermodynamics still apply. If someone does not lose weight on 1300 calories a day then either their body is a marvel of science and should be studied for its amazing efficiency... or they are completely sedentary.

"Thermodynamics"? There are 120 calories in a tablespoon of olive oil. If I pay you $50 to drink a whole bottle of olive oil, do you think you'll gain several pounds of fat?

To elaborate upon this point, let's say I gave you 10,000 calories of sawdust to eat every day for a week. Would you gain weight or lose weight, ignoring the other health consequences?

Similar - I saw an episode of Superfat vs Superskinny where the superskinny guy ate almost nothing but chocolate. His calorie intake was probably 4000 calories a day or more yet he was unhealthy skinny. Do you think he was lying?

I did not watch this show so I have are some questions.

  1. Was the skinny individual monitored the entire time? He could have regurgitated his food. 

  2. Was the skinny person's poop analyzed for complete digestion of the 4000 calories?

No, its not some sort of science experiment, its mindless entertainment. 4000 calories was a wild gestimation of something I saw probably 5 years ago.

The premise of the show is they bring in two people - one superfat and one superskinny. They weight them and each person tells what a typical day's food intake is for them. Then they switch diets for a couple weeks and are weighed again at the end.

Yes, its possible he lied about eating all that chocolate. Yes, he could be throwing up every day. This isn't a controlled experiment, its a TV show. It seems odd someone would do that though.

> Do you think he was lying?

Yes. If there's anything reading diet studies has taught me, it's that people lie, to themselves even, and people are very bad at estimating calories. Things like MyFitnessPal have been a boon to countless people trying to lose weight because they can actually get a handle on what their intake really is. Bonus, they can compare across food choices to see what will fit in their caloric budget but still be filling or satisfying.

I'll issue you a counter-challenge: watch "Secret Eaters".

Yes, they typically under report their calorie intake, not over report it. Its not really socially acceptable to eat like 10 chocolate bars a day and hardly anything else so why say you do when you really don't?

The question is moot; sawdust is basically pure undigestible fiber (poor mans Metamucil), so since the caloric content of it is virtually nil, it would be impossible to consume 10,000 calories of it.

The caloric content of olive oil is not virtually nil, and you can in fact consume a whole bottle of olive oil. Does "thermodynamics" dictate that you'll gain several pounds of fat after you do that?

Your answer, of course, is "no". So just to move the conversation forwards: do you think if 3 random people consumed a bottle of olive oil, they would necessarily gain an equivalent amount of weight? Why or why not?

This question is facetious, almost as facetious as the "10,000 calories of sawdust". Almost. The human body can only process so much fat at once based on bile production. On top of all that, I would say no, I wouldn't gain several pounds of fat after consuming a whole bottle of olive oil because it wouldn't be 3500 calories (12floz = 24 tablespoons * 119 calories = 2856 calories), even assuming I don't poop most of it out (as can be seen on Youtube videos). That doesn't change the fact that a tablespoon of olive oil contains 119 calories and up to a certain volume the human digestive tract will extract energy from it.

Second, I don't think three random people would gain the equivalent amount of weight; that's one of my points I've made elsewhere. TDEE for different people is different, based on height, weight (heavier people have higher TDEEs, which is ironic because it makes it easier for them to lose weight), and activity level. If you're talking three people of the same height, weight, strictly controlled activity level and strictly controlled intake, then I would expect their weight gain to be as close to identical as to make no difference. There's always some variance (within 200-300 Kcal: http://examine.com/faq/does-metabolism-vary-between-two-peop...)

Since we're cherry picking completely unrealistic intakes, I'll pose back to you: if three random people consumed 3500 calories worth of refined sugar, and that exceeded their TDEE by 3500 calories, then yes, each and every one of them would gain 1lb of adipose tissue. Seeing that many in the US easily approach an intake of this much refined sugar in the form of soda, the results (of the population, 2/3 is overweight, and 1/3 is obese) should not be surprising.

It's not my argument that the environment plays no role in obesity. It clearly does. I too think liquid calories are a major culprit.

I just think the "thermodynamics" argument oversimplifies immensely. Even the variance in resting metabolic rate is unlikely to capture the whole difference between multiple subjects consuming 3500 calories of oil (or, for that matter, bacon or butter), because resting metabolic rate captures the variance you'd see between people consuming refined sugar, and there are more variables involved in metabolizing fat.

Later, because this is bugging me a bit

And that's all before we get into satiety, which is a hormonal response. I had some cheese and rillettes for lunch. I'm not going to be hungry for the rest of the day. If I'd had the equivalent calories in carbohydrates, I'd be hungry in an hour. Upthread, the term "willpower" is being bandied about as if people can simply will themselves to eat a fixed number of calories. That's true only if you eat carefully, and if you don't have any hormonal dysfunction; it's as true as saying I could will myself into coding for 48 hours straight, if I just focussed my "will" on it.

I didn't say they weren't losing weight on 1300 calories a day.

The Minnesota Starvation Experiment was such a poorly designed diet that it's not really relevant to the modern discussion of prevent obesity among a relatively prosperous population. According to Wikipedia (https://en.wikipedia.org/wiki/Minnesota_Starvation_Experimen...), the diet was based on "foods that were expected to typify the diets of people in Europe during the latter stages of the war: potatoes, rutabagas, turnips, bread and macaroni." In other words, almost entirely carbs, with practically no fat or protein. Almost every reasonable diet I know of (coming from the modern fitness community at least) focuses first on maintaining adequate protein intake as the top priority, usually followed by at least a reasonable amount of fat. While it may have been useful to understanding starvation in a population with food scarcity, it just doesn't apply when looking at obesity in modern America.

> ...no matter what the state of your gut microbes.

Or your mental state. Or working hours. Or illness and injury. Or depression. Or lifetime habits, possibly due to choices your parents made.

Yes, it is all our own faults. That doesn't mean it is easy to change. Nor does it make somebody a lesser person for having made poor choices.

BTW, It is also your own fault for everything else that is wrong in your life. Ever answered a question wrong, made a mistake, messed up a project, gotten a speeding ticket, injured yourself, or hurt anybody in any way? All your fault.

Perhaps throwing blame at problems just isn't a good approach to making things better?

I certainly did not mean to imply that it was easy. Simple yes, easy? Hell no. (I lost 45lbs last year, not fun). Nor did I imply that someone was a lesser person for being overweight. However, I do believe if you want to change your weight you need to take responsibility for the things you can control.

Having been 330 lbs at one point and now being less than 220 you're both right and wrong at the same time.

Your statement is the equivalent of saying its a heroin junkies own fault: Technically true but useless. It also has many parallels in the way you grew up, differing genetics, etc.

If it were just a matter of willpower or simply eating less then I would already be my ideal weight. It isn't that simple. You can't detox off food and quit eating. At least a drug addict doesn't have to take just the /right/ amount of the drug every day to stay healthy!

The drive to eat is one of the most basic instincts. Evolution has created signals and feedback mechanisms far more powerful than our puny frontal lobes. The problem of too much food has simply never existed before. Fruit eventually falls to the ground and rots. During winter food becomes scarce. Excess food is consumed by other animals. For our entire evolutionary history the correct long-term survival move was to eat while the eatin' was good because there was definitely going to be some kind of lean time ahead.

The only simple or easy part of losing weight was cutting out sugared soda. That dropped 30 lbs. The rest was a slog and using various techniques to trick my body (like eating a large meal before going to the grocery store so I wouldn't buy anything outside my meal plan). It also involved lots of extremely strong urges to eat more and hunger pains. I have to think about what I eat every day and no matter what I do I will never be my ideal weight. Internal or external, this is a battle a lot of people just never face. They just eat when they are hungry and stop when they feel full. Of course their myopic view says it's just "calories in, calories out" (which the research has already proven is false... Some people gain more weight on the same calories).

> At least a drug addict doesn't have to take just the /right/ amount of the drug every day to stay healthy!

spoken like someone with no experience with drug addiction. ever heard of a maintenance program?

That's an option, not a necessity. It also tends to involve restricted access.

But with food is it impossible to go to rehab and stop eating over a period of a couple weeks.

If lifelong drug maintenance programs were the only option to quit abusing, there would be a lot more relapses.

the relapse rate for methadone is around 90%, that's why I object to wording it as 'at least'

For the rest of your life? What crazy drug did you get yourself into?

Methadone is the most popular maintenance drug for opiate abuse and the relapse rate is around 90%. Many people on methadone/buprenorphine maintenance prefer to just stay on the program rather than come off.

Based on all this discussion I regret using the phrase "it's your fault" which sounds too aggressive. Instead I wish I just emphasized that regardless of biological and societal pressures everyone of us does possess the ability to control your weight. Specifically by accurately counting calories (with a food scale) and tracking your weight you can adjust your caloric intake to lose, gain or maintain weight.

>everyone of us does possess the ability to control your weight.

Yes, buy only to a degree.

It's just not the simple. The body fights back with a caloric reduction either through drowsiness, reduced thyroid, and hunger pains. The body wants to maintain.

It's easy to posit so that some people's responses may be more intense than others.

It is that simple; it's just not easy. Having been there, yes, it was hard. But it was also worth it, and I didn't have to change my gut biome or epigenetics to do it.

Again, that was you. And your level of difficulty may not be equivalent to someone else's. Our responses can be different, some more intense than others.

It's not really worth it, though. If I eat much less than I do now I just suffer, and the weight loss quickly plateaus at a point that doesn't have any aesthetic value and isn't likely to improve my health.

So I can weigh a little less by becoming obsessed with what I eat and always being in a bad mood. And I get no credit from the smug thin people who still see me as a lazy obese person.

And to add to your point, you also can absolutely change the number of calories you're burning. Exercise (especially at high intensity) can make a huge difference.

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