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As an adult, over about 15 years, I've gone from around 140 lbs (nearly clinically underweight) to almost 200 (slightly overweight), but in my case it's a well known side effect of medication I take. So is diabetes.

I hate reading about this topic. I ask (rhetorically) how can it be that people pretend that normal weight is normally achieved through conscious choice?

I like to think even if I had stayed the same weight my own life, I would have insight enough, but in my position, it's really clear to me. I have a thermostat, and ingesting chemicals changed the set point. People who keep on gaining weight until they die must have a broken thermostat set on "high". It can't be psychological.

I feel like there's an awful conspiracy to gaslight people who are obese, because they can't be sure when someone says it's a matter of willpower, if they've always been that way. What to compare to?

But everyone who has spent much or all of their life at a normal weight, should know it doesn't take supreme effort or fanatical accounting. It doesn't require not eating when you feel like you're starving. Empathy should come from properly understanding yourself, even if you can't be philosophically certain what it's like in others' shoes.

People have free will, but you wouldn't tell a person who had a congenital inability to feel pain that they are responsible for injuring themselves, would you? You wouldn't construct a model of them as a person, as someone that enjoyed hurting themselves, right? Because conscious thought is not a replacement for automatic regulation.

I’m formerly obese, controlling my weight at will with healthy food is relatively easy, with junk food it’s very hard. Sugar, salted and fried foods are basically hacks, your brain and body has no idea which quantity is enough so they can be eaten without limit. Whereas with a plate of vegetable, a protein and no added sugar or fat you naturally can’t eat more calorie than you need. In fact I must usually add olive oil to eat enough calories and not lose weight if I eat too healthy. So it’s not willpower in a vacuum, the kind of food is key.

> you wouldn't tell a person who had a congenital inability to feel pain that they are responsible for injuring themselves, would you?

I know people who absolutely do that. The logic is those people don’t have enough faith or care enough to be healed.

People will go a very long way to blame a person who is suffering because it absolves them of responsibility.

> I have a thermostat, and ingesting chemicals changed the set point. People who keep on gaining weight until they die must have a broken thermostat set on "high". It can't be psychological.

This misses something important. If your weight is the thermostat's setpoint, then your BMR is the A/C unit, and your calorie intake is the ambient outdoor temperature. If your A/C unit is out of whack, then you'll need to move to a cooler climate (lower calorie intake) in order to get to a comfortable temperature. For example, women have a lower BMR than men and must eat less to maintain a healthy weight.

> But everyone who has spent much or all of their life at a normal weight, should know it doesn't take supreme effort or fanatical accounting. It doesn't require not eating when you feel like you're starving.

Only it does sometimes. You can't see how someone can slowly adapt unhealthy eating patterns over time? Or, as perhaps in your case, they need medication which changes their BMR? Once your ghrelin production/cycle no longer matches your BMR + physical activity, you may feel like you're starving even though you've already met you're calorie intake needs. Fortunately, we can change how hungry we feel in the long run just as we can change how much we eat, and there are plenty of examples of that. I don't think it's a gaslighting conspiracy to say that much.

What's BMR?

Basal metabolic rate

I don't think it really matters how it's normally achieved. The point is that it can be achieved through conscious choice.

I used to be slightly underweight when I was younger, and could eat endlessly with no consequence. These days I have to consciously watch my calories. It was a bit difficult at first, but I've gotten used to it. Conscious thought is not a replacement for automatic regulation in itself, but you can consciously work to form new habits.

Believe it or not, fat people receive this kind of anecdotal lecture unprompted throughout their lives.

It is precisely these attitudes that the article addresses directly. If you assume the problem is simple and easy to solve, then anyone who hasn't solved it has a character defect. Needless to say, receiving this kind of pep-talk is annoying and unpleasant.

I'd encourage you to read the article or study directly and perhaps ponder what it might feel like to not have been able to eat endlessly from the moment you were born before telling someone else how best to handle a medication actively dis-regulating their metabolism.

You seem to be reading a lot into what I wrote. I never said anything about a "character defect", or that the problem is easy to solve. I'm saying that easy or hard, we do have agency. In particular, I disagree with these two statements from GP:

> People who keep on gaining weight until they die must have a broken thermostat set on "high". It can't be psychological.

> Because conscious thought is not a replacement for automatic regulation.

I skimmed the article, but only because I've already read an entire book on the topic. I understand that there are hormonal effects on weight. That's no reason to throw your hands up and declare that you have no agency in the matter.

Are all people obese due to medication? The article from beginning tries to say it's not due to difference in total calorie taken and used. Is it really not the case? People always chose sugary food over fruits, veg and meat whenever they are hungry.

edit: Want to add that people also eat way too frequently, which makes us feel hungry (falsely) whenever not eating in that schedule. This can be averted by practice of eating less frequently few days. It does not mean starving, we just deviated from the normal and trying to go back.

There are things that have fundamentally changed in our bodies as a whole to make us have a different relationship with food and hunger. This change really started in the mid 19th and 20th century.

Food security can't be the only explanation for this because there were dozens of periods in human civilization where food security was just as good or better.

Not investigating this is causing lives lost and mental anguish. It's like we don't want to admit that fat people might have actually been fat because of other reasons other than being a failure.

> The point is that it can be achieved through conscious choice.

"It's normal and trivial for me; therefore, anyone who doesn't do it right must be lazy/greedy/insufficiently determined!"

There are so many ways that different people's bodies and brains are different, it is patently clear that the idea that it is realistically possible for every human to achieve and maintain what our current society says is an "ideal weight" over the course of years, no matter their physical, psychological, or financial situation is just another way for certain people to see themselves as more worthy and morally upright than others.

Most people are capable of running the marathon after some training but most don’t. The fact, that, theoretically, it is possible to loose weight by conscious choice (I have), does not mean it is reasonable to expect everyone to do it. I know very well how hard it is. Thus, “it is possible” and “you should have done it” are not equivalent statements

You're focusing on the overweight side of the ledger, causing your character judgement to kick into gear. Controlling your weight can be difficult without moral failure. When I was 14 I was desperate to gain weight (5'10" 128lbs) so I was eating nearly 3,000+ calories per day. I was lifting weights a few times per week for maybe 20-30 minutes but not much other exercise. Over the course of 5 years I gained a grand total of 19lbs. Weight gain is definitely not a simple calorie intake vs calories burned formula.

> not a simple calorie intake vs calories burned formula

People have lost weight that way. At 14 your body was in growing phase. Clearly fat does not come from air. I gained weight last year and I know how it happened. What kind of food you eat (sugary packaged vs fruit veg meat) and lifestyle matters.

Surely the experience of it becoming harder can be extrapolated? If it's a little harder for you, then it could be much harder for some people?

Giving up alcohol is way easier for some people than others. Lots of people have written about what alcoholism is like; have you ever read Lawrence Block's Matthew Scudder novels?

I think what the article is trying to say is, yes, there is a behavioural (psychological) component. But there is also a metabolism (physical) component too that is not getting enough attention. (Your own example highlights this well - when you were younger, you could eat more, and / or perhaps lose weight faster too, but now your body's metabolism has changed and you put on weight more easily). For e.g. thyroid imbalances can cause someone to put on weight, and can be addressed medically. The author believes there may be many other similar factors at play behind someone's obesity.

I partly agree with the author. But there is another factor - we also know that processed and / or junk foods definitely contributes to obesity. Yet, many obese people refuse to change their diet. If obese feel that they can't do without 1000 calories in their diet, why can't they eat 1000 calories of vegetables instead of 1000 calories of processed food? If gut bacteria plays a huge role in the kind of food we like to eat, then the author has a solid case ...

This is actually a great analogy. I believe what the article is (more or less succesfully) explaining is that the problem is with your thermostat, which drives you to eat too much, and that over-eating carbs screws up said thermostat.

I'll reuse this.

There are two basic mechanism groups defining the weight of a person: one, that adjusts calorie input based on the weight and one that adjusts output based on weight. Some of these mechanisms are physiological (stress eating), some physical (it is harder to walk for a overweight person). System dynamics basically tells us being over-, or underweight comes from these mechanims being unbalanced. For some reason the automated adjustments do not kick in on time and at sufficient volume.

> The article draws up comparison to defining "wealthy" as "People get rich because they take in more money than they spend." But that's actually a perfectly fine definition of wealthy which explains what it is.

In that analogy, I believe, the article's point is that a definition has been masquerading as an explanation.

Imagine you explained to people in the nineteenth century: the way you do heavier than air flight is to deliver sufficient thrust to overcome gravity and drag. Well, yes, that’s quite true. But how to get that done reliably is the ‘rest of the owl’.

How can people reliably eat a balanced diet despite feeling compelled to smash calories, now that calories are very cheap? The thermodynamic explanation has nothing to say on this.

Yes, but the huge effort to deny the thermodynamic explanation is straight up harmful.

I'd really like to be pointed to someone seriously denying the thermodynamic explanation. I've heard that argument time and time over, it's a strawman.

I've definitely met people, not even fat people, who deny it. They either think they just don't burn many calories because their body is a "different type" or that their body absorbs more calories.

I guess it doesn't deny the physic principle of thermodynamics, but they deny using thermodynamics is a reliable way to predict if you're gonna gain or lose fat.

Well, if their body chemistry is predilected to create fat over healthy muscle or ramping up their metabolism to burn the excess, then there may be a grain of truth to the claim.

Per the article: Carbs + high circulating Insulin + Low Ghrelin+ a certain amount of fat already on the body = body chemistry that prefers to create fat over using the energy for literally anything else.

If that is the case, then that's a hell of a dilemma. If you eat more than your body will burn by the time the food has processed, the excess will go to fat.

Eat one meal a day but have 1,200 calories in a meal (since most dieticians say that no one should eat less than 1,200 calories a day), well, your body can only process so many calories in a certain amount of time, so everything else goes to fat.

True, if your BMR is higher than 1,200 (which it should be if you're not dead) then you will turn around and burn that back away if you stick rigidly to your diet.

But a normal person not afflicted like this might have a body temperature increase as their body ramped up to process the excess calories instead...

A body temperature increase... as in a fever? If eating food gives you a fever, you have bigger issues than losing weight.

The problem with saying everything goes to fat if you eat 1200 calories in 1 shot is that if that happens, you'll actually burn the fat during the day when you need it, and you'll lose energy during the conversion, meaning your body will be overall less efficient than using it straight away and you'll lose even more weight. I don't know how inefficient that really is, all I remember from my biology classes is this is a lot more efficient than burning muscle, but it sure doesn't increase the total amount of energy in your system. That would be breaking thermodynamics laws.

i.e. Just because you store fat, doesn't mean you need any less calories per day. Your body won't just starve itself to death while leaving your fat alone.

See Gary Taubes, i.e. the article we are discussing.

Taubes isn’t denying it, merely saying it’s not explanatory. If you prefer: necessary but not sufficient.

It is an explanation. The article does not propose an alternative to the imbalance explanation rather alternative focus of action to achieve said intake balance. It doesn't even say the existing method of action of enough flat intake reduction as an answer to the imbalance explanation (this action is what the article actually finds flawed not the explanation) won't work just that it is ineffective for the same amount of effort.

I believe the point is that the answer begs another question of "why".

In their drinking example, alcoholism literally is overdrinking, but we accept that there is an underlying mechanism of physical and psychological dependency that exists outside of "they just consciously choose to drink all of the time and other people don't". At this point we generally recognize it as a disease with more nuance than "overdrinking". We recognize that there is a significant neurological component that is, at the point that they are an alcoholic, not under their total conscious control. Their subsconscious is pushing them to do things that the subconsciouses of people without the disease do not push for.

Similarly, you could ask the question, why do some people eat significantly more than they burn? And it then seems not implausible that the problem could be similar to that of alcoholism, that some neurological system is calling for the body to ingest more food, whereas other people's appetites are fundamentally more accurately calibrated at a subconscious level.

Much more speculative, but this would even seem to make sense from a wider lens. Almost our entire evolutionary lineage existed in a world of food scarcity, not overabundance. The selection pressure necessary to evolve a reliable safeguard against overeating would seem plausibly to not be old enough for that mechanism to have evolved to be as reliable and widespread as the one to prevent us from allowing ourselves to starve to death.

The health problems of the 20th and 21st century are still incredibly new from the perspective of the mechanisms that created our instinctual impulses.

Agreed, I'm not sure how any of this disagrees with:

"It is an explanation. The article does not propose an alternative to the imbalance explanation rather alternative focus of action to achieve said intake balance."

I understand the article wishes to point out we should focus on a different action but it spends its time attacking the current definition not because it has a problem with the definition but because it has a problem with the currently popular action associated with the definition.

The popular definition is fine, it's the popular "soluttion" to the definition they attack. The paper is much more clear on this.

There are issues with the imbalance explanation. w.r.t obesity, the least wrong (and most explanatory) equation will relate calories going into adipose tissue, and calories being taken out of adipose tissue.

Then another less wrong equation can relate calories absorbed by the digestive system and the calories burnt by the whole body.

These are not the same equations as calories eaten vs calories burnt. And the quantities are not easily measured.

Depending on exercise, and other potentially unknown environmental or genetic or other conditions, the body will put energy into tissue other than adipose tissue.

Not all energy eaten will be absorbed. There was a recent study which showed how eating fructose expands the gut lining to be able to absorb much more nutrition. We do not know all the regulatory mechanisms that control absorption. Nor all mechanisms that control hunger.

We're far from understanding all aspects of nutrition. The imbalance equations needs to be refined, if people are looking up to laws of physics to explain this matter.

I feel like you might have just skimmed the article, as the points you make here were addressed directly, yet you don't take the points made head on.

Quoting: 'Similarly "[Obesity] is an energy imbalance between calories consumed and calories expended" is a fantastic definition of obesity.'

It isn't though: 'Obesity is a complex disease involving an excessive amount of /body fat/.' is how the Mayo cilic puts it.

Not all energy imbalances in either direction result in a loss or gain of /fat/, which is the point the article is trying to make.

I'll quote from the article: "Although researchers have rarely thought to control for energy intake in their experiments, when they did, testing whether their animals get fatter than lean controls even when eating as little or less food, they almost invariably report that they do. “These mice will make fat out of their food under the most unlikely circumstances, even when /half-starved/ [my italics],” as Jean Mayer wrote about obese mice he studied in the 1950s. This fundamental observation directly challenges the notion that obesity is caused by poorly regulated eating behavior."

Quoting again: "as if that means alcoholism isn't an intake problem"

Explaining why curing alcoholism isn't as simple 'stopping overdrinking' is just as tiresome as explaining why losing weight on a nationwide scale isn't as simple as 'eating less', as the article spills much ink to make clear.

The problem with this theory is that in clinically controlled lab studies, where both food and exertion are measured carefully, the weight gain (or loss) is almost 100% predictable based on the inputs of food, exercise, and Basal Metabolic Rate (BMR). Unless your hypothesis is that the weight gain/loss is going into something else other than /fat/?

I'm guessing the reason nobody runs these studies is that it's solved science?

Not true, for example:

https://www.sciencedaily.com/releases/2012/09/120912125114.h...

Also

>Basal Metabolic Rate (BMR)

What increases or decreases BMR?

E.g. https://www.scientificamerican.com/article/6-years-after-the...

Why are there very slim people who struggle to gain weight regardless of how much they try to eat more?

What causes hunger pangs for people when they have half a million calories strapped to their waist?

>I'm guessing the reason nobody runs these studies is that it's solved science?

Exactly this type of thinking has stymied research into very interesting questions.

"I'm guessing the reason nobody runs these studies is that it's solved science?"

One of the article's main points is that the obsession with the calorie-only model (with the assumption that it's solved) has stymied even asking these fat-metabolism questions in the first place (outside of veterinary science, where they actively trying to make animals that get fat very quickly).

But yes, your body is free to store/burn mass and energy in muscles, tissue, glycogen and whatnot if it chooses to store the excess at all.

Of course if you force an environment of extreme depletion (like bootcamp as mentioned elsewhere), you body will get to its adipose tissue, but that's not going to solve the obesity epidemic. Most veterans get just as fat as the rest of the population after they leave the service.

I personally can feel when my glycogen has been depleted when working out. Once it's gone I look a bit anemic and /pushing/ beyond certain limits becomes impossible. Normally it's a precursor to me entering ketosis, which pretty much guarantees I'll be burning fat or muscle only from then out.

Now if only Taubes had written this essay with the same clarity and conciseness that your analysis of it just did, it would have gotten a lot more traction with me. I mean, he can at times be a great writer - "Why we get Fat" was a book that I and a lot of friend bought and debated at length - it was revolutionary (to us).

You might prefer the study itself. https://academic.oup.com/ajcn/advance-article/doi/10.1093/aj... Judging from the reactions here, he meandered too much and made his point badly with the majority of the commenting cohort, but there's a fair bit of selection bias to account for.

What I took away from the article is that the standard diet is unhealthy, and that in some people it will cause their insulin production to spike, causing them to create more fat than a person who is not similarly affected.

This then causes a snowball effect as their body craves food, energy, and nutrients that their body fat is effectively hijacking and preventing from getting where it needs to go, so the body sends more hunger signals so that enough food to satisfy you is consumed.

As the fat increases, so too does the hunger, as fat cells also require maintenance calories.

If this is true, (and it seems somewhat more plausible to me than just, "fat people are gut-stuffing pigs with no self control") then the solution to both the obesity crisis and the issue of over-eating is to find systems that shut down that cycle by either chemically manipulating the brain to not respond to the starvation signals caused by the fat cells, (probably effective but not healthy) or to modulate the diet so that the fat cells become the cells that have to beg for calories as the healthy cells get fed first somehow.

Low-carb diets might be a first step to that second path as without carbohydrates to trigger insulin the fat cells will have a harder time taking in sugar. Mayhaps in the future we will learn more about the process and find a pill to make the insulin-carb-fat pathway from working as well as it does.

Don't let the article put you off, the paper, no paywall, is much better and much more concrete:

https://academic.oup.com/ajcn/advance-article/doi/10.1093/aj...

Thanks, agreed the paper is miles better than the article! And to be honest an easier read... I almost wish it were the post instead.

> but the best way to fight the intake problem may not be saying "drink less" and that's the type of idea actually being proposed in the research

Somewhat comically, drinking more water is a great (as in easy / painless) way to combat both alcoholism and obesity. As well as a bunch of other health issues. I have no idea why we -- as humans -- don't just naturally drink the right amount of water.

Because we do? Most people are not chronically dehydrated, despite what a vocal minority would have you believe.

> not chronically dehydrated

Good job. Taking something to an extreme, just to straw-man it.

I like the negative connotation on vocal minorities too. A+

I grew up in a town with chronically terrible water; we used to joke about the many colors of the water in the school water fountains.

So, I grew up drinking anything but water, and that's a habit that's stuck with me for my entire life.