Is losing weight an important health goal? | Hacker News Reader

Is losing weight an important health goal?

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Being fit can have a huge impact on individuals life. Like it or not the way you look affects how you are perceived by others. There are studies which showed good looks can help boost career.

Being fit, not steroid fit can be great for your joints and overall health. It doesn't mean you won't get cancer. It just means that if you exercise and have muscle, your joints have better support. Your lungs will probably have better function than someone who doesn't exercise. Plus, it lowers your risks.

Having good fitness really is amazing. If a pill or supplement gave one the benefits of exercise I wouldn't believe it: it would come across as a "too good to be true" scam. It really does improve cardiac health, mood, energy, the immune system, etc.

But "being fit" does not mean being skinny (unless we're using the british slang definition of "fit"). There are people heavier than me that are more athletic, and there are skinny people who are wasting away.

This article rubbed me the wrong way. I gained a lot of bad weight over COVID. Most of this was because I wasn’t moving and I was eating a lot of food that made me feel good but my body stored as fat.

Now I’m being a lot more deliberate about my choices in food, exercise, etc. the weight is slowly, but consistently disappearing.

I’m finally feeling like myself again. My overall mood is better and I’m not compensating with food that I don’t need.

The title asks an interesting question:

> Is losing weight an important health goal?

I would argue having that as a goal sets you up for failure. You can lose weight a bunch of different ways, most of them probably aren’t in service to your actual goal.

Instead, keep asking yourself “why” do you have a specific goal to get at the root cause. This is sometimes called the “5 whys”

eg:

- why do I want to lose weight? To be physically attractive

- why do I want to be physically attractive? So others find me attractive

- why do I want others to find me attractive? Because I want to have more physical relationships

You could go another way:

- why do I want to lose weight? To feel good about myself.

- why don’t you feel good about yourself? Because, uhh, maybe it’s not about the weight?

- why don’t you know why you feel bad? I don’t know! Let me find out.

“Losing weight” is a catch-all for solving some underlying issue most of the time. Figure that out and work toward a solution.

I think your argument is best summed up as goodharts law. Weight is a good metric for measuring health, but when one targets weight instead of targeting health, it stops being a good measure of health.

This is great, thank you!

For reference (and for other great laws): https://github.com/dwmkerr/hacker-laws#goodharts-law

Such an important subject and they touch on important topics within that subject, but ultimately end up confusing things more and ultimately probably making things even harder for those who would be in service of advice on how to manage their weight (most of us nowadays).

Losing fat when overweight, provides very clear health benefits, we don't need to look at observational studies for this, the fact that gastric bypass operations have such positive impact on health is enough to show this.

It's true, that dietary advice rarely can make any lasting dent in population level body composition, however, this should not be confused to mean that a motivated individual can't. A very simple and robust method is to count calories and drop the amount until the desired level of weight loss is achieved, then simply revert back to a comfortable level when the goal is reached. It's just that this takes a level of motivation that most people don't have. This is not surprising as many of the negative effects of being overweight are rather subtle and takes time to appear.

This means that many people will have to live with their overweight and ideally not feel severe anxiety from it, which is the constructive point the article is making. The problem is when they try to cloud the evidence to achieve this goal.

This makes people believe that staying at a healthy weight or losing fat when overweight is not meaningful at all and you can be just as healthy while being obese as long as you take some walks and eat your greens. Which in turn means that we don't get motivation to do the things we need to keep our weight in check.

Now, this doesn't, of course mean that keeping a healthy weight is the ONLY thing that matters. But it's a pretty important one, in particular for those who are obese.

Would love to see what HN thinks about this. I recently picked up a book called Anti-Diet on this subject, at the suggestion of my physician, and I don't know what I think yet. It seems almost dangerous, yet the arguments are very intuitive and apparently backed by overwhelming evidence.

Specifically, that weight loss in the long term is not only practically impossible but also actively harmful.

But what if I want to be more muscular? Is that impossible as well? Not sure.

People likely overstate how dangerous being overweight and even to some extent obesity is. Excess weight usually comes with a whole raft of comorbidities, many of which can't be accounted for and which can play the actual causal role in bad health outcomes. I'll take my actuarial chances on a fat person who has good mental health, has a rich social circle, regularly exercises, and eats "healthy" (however you define it) foods any day over a depressive skinny person who sits on their couch all day eating potato chips.

That said, many interventions for the obese would help all of those other things, even if hypothetically you could vary them independently. And those comorbidities are often the things making those anti-obesity interventions so ineffective.

Muscle wise, lifting weights and eating a surplus is usually good enough to see significant gains for an untrained individual. There are "hard gainers," but their issue is having difficulty eating enough; that's not an issue for people who are overweight.

It’s a sad load of nonsense. Being fat sucks and the best thing that can happen to a fat guy is to lose weight. You can’t even sleep properly if you’re fat. You can’t keep up mentally.

> But what if I want to be more muscular? Is that impossible as well? Not sure.

That is impossible. There is no way to build muscle — gyms are scams. Read “The Muscle Myth” and “The Protein Delusion” by Ivana Tinkle.

Is that the same Ivana Tinkle who sometimes writes under the pseudonym I. P. Freely?

Anecdata here but I’ve built ~30lbs of muscle from when I was a skinny kid back in school.

I’m curious what the core argument is from these books. Could you tell me more?

Sorry, I made them up. Of course it’s possible to get more muscular. The author name was supposed to be the tell. A Simpsons reference.

Hahaha, wow that went right over my head.

The idea is that either long-term fat loss or muscle gain are impossible is clearly ridiculous. There are simple existence proofs. How does the world have athletes? Go look at the master's division of a natural bodybuilding or tested powerlifting competition. Or the master's division in some 5k or 10k road race. Are the lifters bigger and stronger than they were 30 years ago? Of course they are. Are the runners fat? Of course not.

What research shows, unfortunately, is that taking a bunch of people in some kind of shape they don't like, applying a point-in-time intervention that changes it, and then going back five years later usually results in finding they went back to how they were before.

That doesn't mean changing your physical condition for the long-run is impossible. It means there is no such thing as a point-in-time intervention with permanent effects. You need to make a permanent lifestyle change to see a permanent effect. The overwhelming majority of people will never do that, but it absolutely does not mean you can't do it.

> Specifically, that weight loss in the long term is not only practically impossible but also actively harmful.

Depends what you mean by “long-term” but now at 30 I am both lighter and more muscular than I was at 18. Based on the results of a recent physical exam I don’t see any harm having been done.

There is a theory that repeated weight loss is harmful, because dying or shrinking fat cells release toxins that they’d been holding. That the obese are mainly harmed by having their fat cells cycle more as they gain and lose fat, voluntarily or not.

a more persuasive theory imo is that yo-yo dieters that don't do serrious resistance training, have repeated cycles of sarcopenia and osteopenia -- i.e. lose 'good stuff' along with fat on the diet phase and gain back disproportionately fat after. The negative effects compound over time with each cycle.

That sounds plausible to me.

The article first states that the science is pretty much unambiguous, but doesn't seem to like that conclusion, so then picks out experts who at first also admit that the evidence is overwhelming, but then quickly segway into speculation like "restricting your calories or cutting out certain foods may not be healthy overall if it negatively impacts your mental health" without offering any sort of evidence that that's an actual issue (the only evidence offered there is a study showing that diets have high relapse rates, without discussing any relationship to mental health).

One reason why the BMI doesn't work well at the individual level is that the square exponent for height is wrong for 3D beings like us. The article completely glosses over this well-known issue. I can empathize with the agenda behind this selective reporting, but I also find it questionable in a time when obesity has become an epidemic to the point of being among the most important preventable risk factors [0].

Fyi, we also don't scale linearly (which would imply an exponent of 3), the actual exponent is sth like 2.5. So to align with the established scale, Prof. Nick Trefethen of Oxford University suggests using the formula 1.3 * weight/height^2.5 for metric units [1]

History fun fact: the 2.5 exponent was already known to the inventor of the BMI, but apparently that wasn't considered practical to compute in the 19th century (source: also [1]).

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790820/

[1] https://people.maths.ox.ac.uk/trefethen/bmi.html

While I do believe a generally healthy, active lifestyle is important, all this focus on just weight has over-simplified health to almost be detrimental. Your body can change it's mass and viable bulk for a wide range of reason other than body fat. Muscles add weight and bulk. Water from proper hydration adds weight and bulk. Winter adds weight and bulk (albeit the bad kind). Hell, I'd even imagine someone going hard on milk is some percentage heavier than average from their denser bones. BMI tries to compensate but still ends up doing a horrible job of correlating what ratio of your weight is actual dead weight, versus the weight of just more going on, and makes some skinny fat coach potato starving themselves on hot pockets look healthier than an Alaskan lumberjack who has to eat 5 meals a day to sustain the energy needed to throw 200 Ib logs around in the freezing cold.

Based on my experience looking at people, and what they are eating and doing on a day to day basis, conclusions from population wide BMI statistics are not affected by people who are too muscular or have high bone density.

The Alaskan lumberjack is not representative of the data. What is representative are people who do not sleep right, eat right, or exercise right for the purposes of preventing and delaying health issues.

I agree from a population wide standpoint even a simple glance at your local [crowded event] is enough to tell you the population at large trends toward unhealthy. My point though is that it's inadequate from an individual standpoint, which is the most important for said individual interested in maintaining their own health.

It's also interesting that you mention sleep, as that's a very important health factor that would barely present itself in any type of measurement based on weight.

The thing is BMI is intended to be a population level measurement and never meant for single individuals — the variations are just too much for it to be useful when applied to the general population individually.

It is useful for individuals. People don’t realize they’re overweight anymore, because everybody else is. BMI tells them an objective opinion that doesn’t change with the times. It is useful because its inaccuracy is small compared to how overweight people are.

Of course the article hits on correlation vs causation and gets comments from a body image coach but the author does not talk to anyone doing research on the role of adipokines in diseases of chronic low grade inflammation which are ubiquitous in the US.

Typical mass media fare I guess.

I think the conclusion is good but it was a bit wooly how they got there:

> What do we focus on if we want to get healthy if it's not losing weight? Focus on health promoting behaviors like quitting smoking, moving more, sleeping better, stressing less and eating the foods your body is telling you that you need, Larmie said.

Was expecting a bit more about how building (or losing) muscle can be seen as the opposite of progress if you measure only weight.

As if Americans need another excuse to stay fat

Personally, my health goal is to not die from a total health failure at the ripe age of 33

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