Man, food is so addictive and not like you can just stop eating it like you can quit drinking booze or quit smoking!
If you have a healthy relationship with food then you're fine, otherwise every day you're faced with willpower checks that you might struggle to consistently pass.
>Among these patients, lean mass accounted for approximately 39% of total weight loss – substantially higher than ideal. In a substudy of 178 patients from the SUSTAIN 8 trial on semaglutide as a diabetes treatment, the average proportion of lean mass loss was nearly identical at 40%, despite lower doses and less total weight loss than in the STEP 1 trial. [...]
Or in other words, 60% of the weight loss was in fat. The article paints this as concerning, but doesn't provide justification why. Sure, it'd be better to have 0% lean body mass loss, but how does 40% stack compared to calorie deficit diets? The mechanism of action behind the drugs is to cause you to eat less, and if the side effects are consistent with eating less, I don't see why people should be extra concerned.
The justification is provided: this is nearly double the lean body mass loss usually seen in drastic weight loss. Yes, 0% is impossible, but this is worryingly high. It might be OK in younger individuals who have a ton of fat mass to lose, and they might gain any lean body mass back. But in older individuals that are already having a hard time exercising, it's unlikely that lean body mass will ever come back.
Makes me think these drugs should probably be a measure of last resort. Unless more studies defuse this.
For the rest of us there's discipline and sheer willpower, as well as smart energy management.
Train too hard? My appetite goes nuts. Train not enough? The weight loss is muscle. It kind of never stops.
(Speaking as someone fast approaching the big five oh, on the very upper end of the normal BMI and not enough muscle to sugar coat all the excess gut fat which somehow disappears when clothed thanks to an above average height yet is still very much a risk factor.)
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To emphasize: the real point is the meta-framework of experiments. Formulate a hypothesis, design a 30-day experiment, test it. I’ve probably done dozens of these over the years.
Here are some examples from the last few years:
30 days of cold showers
90 days of no online news (I thought stress might contribute)
90 days of the carnivore diet
30 days of eating only at In’n’out burger
Doing Starting Strength, a beginner’s powerlifting program
Doing Simple & Sinister, a kettlebell training program
30 days of a low-fiber diet
30 days of a low-protein diet
30 days of a potato diet
30 days of drinking only distilled water (including for coffee)
Eating only pemmican, a raw meat paste invented by Native Americans
But I had that "willpower" for decades and didn't lose much weight. Certainly "pushing harder" didn't change anything.
And then flicking one little switch made it super easy with no willpower involved. So I just don't see how the willpower is related to losing fat.
Do have to add - it's impressive that you went through all these documented efforts. In the name of science and all that.
2) I didn't lose the weight on keto. I did keto for 7 years and managed to gain 100lbs back while on keto. This fat loss is very recent, and while it's still a ketogenic diet, it really is some magic little switch that I've flicked - I just don't know (yet) which one :)
It's far easier for me to just do caloric restriction. Granted I wouldn't lose weight as quickly.
That might have been your experience but millions of other people claim otherwise. Either a million people are wrong, or you're an anomaly. I think the latter is more likely.
Of course you should change how you eat if how you ate caused you health problems. But I'm advocating for making a conscious change that will then enable you to eat without having to use willpower.
That's why "just eat less" is terrible advice and works for practically nobody.
It's like finances. "Just save more" is terrible advice. Getting a degree or finding a high paying job or setting up automatic 401k contributions doesn't require willpower day-to-day, and has a much higher chance of success.
Not buying the bag of chips is an obvious example, as is buying a used car vs. leasing a new one.
Picking a diet that doesn't make you overeat is another one, and I'm in the process of figuring out what that means for me :)
Saying "willpower doesn't work" is just as bad.
I actually agree with what you are trying to say, but you're arguing it very poorly.
When I reduce carbs below 30g/day, my appetite is naturally suppressed (or avoids over-stimulation). Food feels much less addictive. It's easier not to snack in the face of stress. Keto probably added 10+ years on to my life expectancy.
YMMV.
No guarantee that it'll work (I haven't tried myself) but seems like a thing that could help you.
But traumas do accumulate. 10 km a day becomes impossible. Joints, spine, heart - everything has limits.
Counting calories isn't that hard and it works by the very definition of energy.
It doesn't "work" unless your definition of "work" is "lost a few pounds of water weight over a few weeks." Certainly does not work when going from obese to normal weight.
> Besides, if people can really accurately count their calorie intakes and won’t overeat what they use up, then it is thermodynamically impossible not to lose weight.
This is false. The body is a self-regulating system. You eat less, the body can just burn less. You eat more, the body can burn more. What you eat and what you do also plays a huge role.
And it doesn’t hurt your last point in anyway, both statements can be true.
I've lost "post-covid" 15 kg (93kg to 78kg, 180cm height) in about 3 months with counting calories and ensuring a reasonable deficit. MyFitnessPal did help here.
I was just getting about 1800-2000 calories daily (which is not too bad), walking about 10k-15k steps a day (a morning walk, lunch-time walk and an evening one) and doing some very lightweight kettlebell exercises. There are details on how you might want to track weekly averages instead of daily weight values.
Certainly, i was never obese just slightly overweight. Obesity can mean certain serious food-related disorders but most of the time it's just a bad diet together with not moving a lot.
It's very easy. Your calories in depends on your calories out, and your calories out on your calories in.
The body regulates both intake and expenditure dynamically, so if you mess with one of them and don't change anything else, it's most likely just going to adjust the other one.
This has been mainstream science for a generation or longer, read The Hungry Brain by Guyenet for a good introduction.
> Certainly, i was never obese just slightly overweight.
Then it works, of course. Your metabolism was not "broken." This is like buffing out a bump in your car door. Won't work to fix a full-on collision. It's just not the same problem.