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Comment by foobears42 | Hacker News Reader

Or you could just choose to eat good foods at the proper amount. All this study, science, drugs, surgery, etc. Just to achieve nothing more than than eating normally would achieve.

But an appetite drug sounds like a better option than having parts of the stomach and intestines surgically removed.

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Obesity is vastly more complex than people “just” making bad choices. Tell someone who is addicted to cigarettes to quit smoking while everyone around them smokes all day and there are cigarettes cheaply or freely available everywhere.

Oh, and modify the scenario slightly: you have to smoke a little to live. And while smoking is making one person sick with cancer, other people have different genes and can smoke as much as they want with no side effects.

That is what it’s like trying to “just make good food choices” today, especially if you are genetically insulin resistant, in which case you not only need to eat “good food,” you need to eat less of it than other people or you’ll still gain weight. Oh and don’t get me started on stress and cortisol.

“Just eat healthy,” is the ignorant remark of someone blessed with good genetics.

> Obesity is vastly more complex than people “just” making bad choices. Tell someone who is addicted to cigarettes to quit smoking while everyone around them smokes all day and there are cigarettes cheaply or freely available everywhere.

> Oh, and modify the scenario slightly: you have to smoke a little to live. And while smoking is making one person sick with cancer, other people have different genes and can smoke as much as they want with no side effects.

> That is what it’s like trying to “just make good food choices” today, especially if you are genetically insulin resistant, in which case you not only need to eat “good food,” you need to eat less of it than other people or you’ll still gain weight. Oh and don’t get me started on stress and cortisol.

> “Just eat healthy,” is the ignorant remark of someone blessed with good genetics.

Yeah it's like the mentally healthy telling the depressed to cheer up. It's not that simple.

Do you really think people are choosing to be extremely obese?

Unless they're being force-fed, then yes, they are choosing it. It can be hard to lose weight, especially if raised with poor dietary habits, but it's not like people can't lose weight unless a magic diet pill is invented for them.

Sure, it's obviously possible. Just like it's possible to quit smoking without assistance, or quit heroin cold-turkey. So you're arguing that because it's possible, we shouldn't try to make it easier?

Do you think cigarette smokers are choosing to have tar in their lungs? Its the same argument - albeit there is a lack of common knowledge about what harms food can do to your body. Thats why we should promote eating healthy instead of taking drugs

We use medication to deal with a desire to smoke. There are tons of drugs for managing this.

Except change your metaphor such that you have to smoke a little bit to live.

You're right, that's a good point. Its harder to make these decisions every day, but I still know that education of nutrition and diet can give people the power to make the better choices when it comes to food; rather than giving them a pill.

They don't want the consequences of overeating. But yes, I do believe they choose to eat the amounts they do.

Here’s an interesting fact: if you’re insulin resistant (more than half the population is), then you could have a “healthy” meal like a bowl of oatmeal for breakfast, and the body’s poor insulin response actually forces all the carbs you just ate into your fat cells while denying your body fuel, thus making you hungrier. To overcome this you have to eat enough carb to still have fuel available even after your fat metabolism is satisfied. So the heavier you are the more you have to eat before you have fuel available to your body.

It’s very, very difficult to overcome genetics.

In those cases, is there medication or treatment available to help deal with the insulin response? I know hyper / hypothyroidism is a thing as well (although research has shown -thyroidism may not influence weight significantly: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711558/)

How much did human genetics change in the last 100 years? I'm very much convinced that genetics plays a role, but surely it cannot be the cause of the obesity epidemic?

I think what changed significantly in the last 100 years is the abundance and composition of our diet. In particular the quantity of sugar added to everything, and the abundance of simple starches in our diets (in particular in the US where the "food pyramid" suggests that grain is the main thing people should be eating).

"good food" is a weasel word; What do you mean? Low calorie food? Also a very broad and unspecific term.

It's not as easy as "this food is good" or "that food is bad", you need to educate yourself first; calories in and out, then macronutrients, then micronutrients, in that order.

All the diets, diet trends, and things labeled "good" and "bad" food are handwavey things, and research has shown that the common factor they all have is calorie intake reduction.

"If people could just choose X" has been a losing strategy on everything from drug addiction to climate change to boycotts of products with child labour.

If people could just choose to give me a ton of money, I'd fix all their problems.

Appetite is not a choice though and it's not easy to just ignore and do the right thing. It's not a thing you can change just like that.

While it's not a choice, there are things that influence appetite; for example, going for high calorie but poorly filling food and drink (e.g. soda), or the (I'm handwaving here) "moreish" foods.

It isn't. But change like that is exactly what you need to do. If it's good or bad to change it via a drug instead of mental discipline is another question.

But you could change your food and eat tons of it. I am a pretty slim person and i eat a lot compared to my friends. I also don't do much sport and as a developer is sit a huge part of the day. So for me it comes down to WHAT i eat and it's serving me pretty well. You don't need to fight your appetite, you can serve it and still loose weight.

> You don't need to fight your appetite, you can serve it and still loose weight.

I've lost over 150lbs and kept most of it off for the better part of a decade, so I will tell you from experience that you are full of shit.

In my experience, bodyweight functions like a closed loop control system that uses hunger signals to address the error signal. The error signal is basically (greatest weight attained) - (current weight) where the greatest weight attained value is severely lag filtered, say 2 years or more. The system seems to be very strong in response to rate changes in the error. The integral of the error seems to be pretty strong over a period of say 5-7 days.

Congratulations on your weight loss, does your experience compare to what I've described?

I agree completely. People aren't going to be able to eat all the junk they want just to take a pill and be healthy. No - you have to earn your health. You wouldn't put diesel in a gasoline engine because that will ruin the engine. So why do you put endless amounts of sugar and bread in you? It's just going to do the same.

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