The biggest losers: Metabolic damage or constrained energy?
physiqonomics.com
physiqonomics.com
https://www.geneticlifehacks.com/weight-loss-genetics-obesit...
"Interestingly, animal studies show that the gain in fat mass is not due to eating more or moving less… Animals ate the same amount of chow, but those infected with adenovirus 36 increased fat tissue by 60-80%."
https://pubmed.ncbi.nlm.nih.gov/17135605/
"A 2004 twin study showed that the Ad-36 antibody-positive twins were “significantly heavier and fatter as compared with their antibody-negative counterparts”. This was a groundbreaking study indicating that the Ad-36 virus was likely causing obesity."
I highlight this because obesity is increasingly being reestablished as a hormonal problem. See my post and replies for more information about this change: https://news.ycombinator.com/item?id=38942521
Great comment! Interestingly, depleted cortisol levels from chronic stress may be associated with the development of long covid. [2] I wonder if down the road we will see that people who have had long covid are at increased risk of developing or exacerbating obesity.
"Adenovirus infection statistically increases the risk of obesity quite a bit more than eating sugar, refined carbs, not exercising, or eating too much omega-6 fat. However, stacking all of those reasons together likely adds up to quite a bit of weight gain as well. There is no simple answer, but rather is a complex picture of multiple reasons for weight gain."
"If the adenovirus infections are playing a role in our obesity epidemic, this would need to be due to infections rising, starting around the early 1980s, when obesity levels started steadily increasing.
I mentioned above that obesity has doubled since 1980 — and that adenovirus seropositivity had doubled by the mid-2000s (Swedish study).
Here’s the CDC graph again – looking at the green lines (dashed green is women and solid green is men)
One piece of the puzzle as to why this could be happening is the increase in kids in daycare, which has been rising since the 80s. A study looking at overweight kids (9-12) found that Ad-36 increased the risk of obesity by 3-fold and that kids who were in daycare before age 24 months were also at an almost 3-fold risk of obesity.[ref]
Another interesting puzzle piece is that Ad36 was first isolated in 1978 in Germany.[ref] (This may not mean that it first existed in 1978, though, just that it wasn’t well-known before then. Other adenoviruses were identified in the 1930s.)"
Travelers from all around the world tend to remark that once they arrive to Viet Nam, they start losing weight effortlessly. Upon arrival to the US, the very opposite tends to happen.
Adenovirus/population genetics must be a minor influence compared to cuisine.
"Adenovirus infection statistically increases the risk of obesity quite a bit more than eating sugar, refined carbs, not exercising, or eating too much omega-6 fat. However, stacking all of those reasons together likely adds up to quite a bit of weight gain as well. There is no simple answer, but rather is a complex picture of multiple reasons for weight gain."
I lost weight in Thailand and later in Australia, and it was mostly because of the heat, sweating a lot, and generally smaller meals. No magic secret here.
Plus the inevitable "Bali belly" that travelers get the first couple days there.
In my opinion, it's mostly the excess carbohydrates now compared to what we ate 100 years ago. Occam's razor and all that.
"The obvious reason for obesity is eating too much sugar and refined carbohydrates. But statistically how much does this add to the risk of obesity?
A 2019 meta-analysis of different food intake studies and weight gain showed that consumption of refined grains increased the relative risk of obesity by 5% and the consumption of sugar-sweetened beverages increased the relative risk of obesity by 10%. Eating more legumes, fruit, and fish all tilted the scales in the other direction, reducing the risk of obesity by 5-15%. The study concluded, “The dose-response meta-analytical findings provided very low to low quality of evidence that certain food groups have an impact on different measurements of adiposity risk.”"
Food Groups and Risk of Overweight, Obesity, and Weight Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies
From what I can gather, infection with adenovirus-36 basically improves glycemic control... ostensibly a good thing? I couldn't find whether adenovirus-36 was a persistent infection, or whether it only affected patients for a short time, but then they failed to lose weight after the infection had cleared.
This author states that the reason for obesity is eating too much sugar and refined carbohydrates. Why is there a distinction between refined and unrefined carbohydrates? There's no explanation for this, it's treated as given. It's the same chemical makeup, all that changes is the glycemic index. In other words, it's the same poison, it just takes longer to absorb.
The linked study backs this up, but makes no sense from a glycemic load point of view. I notice that vegetables are lumped in one category. Potatoes are not the same as celery. As are fruits, yet blueberries and mangoes have a vastly different sugar content. To add insult to injury, this is a meta-analysis of observational studies, which are notoriously unreliable.
Let me back all this up with a different meta-analysis of interventional trials which treats all carbohydrates the same.
Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9408028/
Thanks for the discussion :)
"In the reviewed studies, there was a high prevalence of Adv36 in all age groups, which exceeded 64% among adults and 73% among children and adolescents with obesity and/or metabolic disorders. The vast majority of the reviewed studies have shown a statistically significant association between Adv36 and obesity, adiposity, and related alterations, whereas only a few studies presented divergent results."
Adenovirus 36 prevalence and association with human obesity: a systematic review
Viruses all passed around globally so you have to assume all developed countries are getting pretty much the same level of population infection.
Maybe it's because if certain viruses do play a role in obesity, it sounds like an evolved adaptation in humans. Ie, if you're sick, you respond by burning less energy and storing more of it as fat.
Like all evolved adaptations, they don't affect all populations equally. I'm guessing if ad36 contributes to obesity, you must first be genetically predisposed to it happening.
I struggled through my 20s to keep my weight under 200 lbs at 6ft tall. Then I went vegan 4 years ago, and started running during the pandemic. Nothing crazy, just 5-8 km once or twice per week when it's nice out, and lots of beans and tofu in place of meat and dairy. I haven't weighed in over 185 since, and that's without fasting or counting calories.
I'm sure that viruses and environmental toxins and whatever else contribute some amount at the margin, but I'm convinced that it's diet and exercise, in that order, that are primarily to blame.
I‘m also vegan, but I would say cutting back on sugar and highly processed wheat products helped me the most to stay at a healthy weight.
"Protein-deficient vegans" is a joke among omnivores, who assume that anyone not eating meat must be malnourished, and among vegans, who find ignorance of that magnitude hilarious.
The same probably goes for climbers. Some of the climbers I know are inredibly lean and their BMI is certainly not in the "normal weight" range. Yet they are able to push their bodies to incredible feats.
All that is to say, I suppose BMI stops to be useful at some point while, at the same time, it may be a good instrument to measure your progress during weight loss. It can be both useful and not, depending on who you apply it to.
People who win running competitions are quite tightly grouped BMI-wise.
And for running I guess that makes sense, a kg of muscle weights as much as a kg of fat. Even if that kg of muscle is a lot healthier than the kg of fat.
The people who DO fall outside of the model are not that common though, especially if you're white. And these days the model accounts for more minorities, so even though it has issues, it's still worth listening to as it can highlight potential problems before they actually become problems.
B12 is the big obvious one, but you should also check out vitamins K2 and A (beta-carotene is only converted by about 70% of people), as well as carnitine, zinc, iron and iodine.
No evidence of this, but I also suspect that vegans care more about their health in other weights too (e.g. exercising, not smoking, etc). If they can keep up with a vegan diet, they likely also have the discipline to keep up with exercise regimes and keeping good habits.
Many of my vegan friends can barely find something to eat when we're going out. As an omnivore you can eat anywhere, as a vegetarian, you can eat almost anywhere. As a vegan, at least in Germany, it's still somewhat restrictive.
If you're consistently refraining from eating, then you're likely to just consume a lot less calories.
Another factor here is that most restaurants cook for attractiveness, not for health. Adding copious amounts of butter, oil and sugar can make a lot of food taste better at the expense of a much higher caloric intake.
I have an overweight vegan friend. He eats fries everywhere. Fat and carbs makes vegans fat, too.
I'd argue it's basically entirely this. The modern food environment is incredible (over)-stimulating. Food is ubiquitous and abundant, with a dizzying array of novel variations. Food cues enticing you to eat are ever present.
Being vegan has the accidental side effect of counteracting much of this. A lot of the built-up food infrastructure suddenly becomes non-existent.
Imagine. You're walking into a busy mall in a foreign country. On your left, there's a café advertising a variety of tempting pastries. Your sister told you about that cafe. She loves their cream cheese cake. To your right, the sizzling flames from a steakhouse grab your attention. Moving to another level, you spot an ice cream parlor showcasing a new flavor: Strawberry Daifuku. But all this has to wait, because you're heading straight for the ramen shop you've heard so much about. They're known for their amazing pork bone broth. It's why your foodie friends have chosen to meet up here.
Now if you were vegan, all of that is just ... gone. Possibly the foodie friends as well ;)
Non-vegans don't think about this but they recognize it subconsciously -- most non-vegans would balk at having to go vegan even for a short time, just due to the inconvenience alone.
Some of the aspects of the modern food environment come back when you figure out where to look of course, but even the even a savvy vegan consumer won't encounter the same level of choice, variety and catering and let's not forget cost-competitiveness that a modern omnivore experiences.
The restaurant scene seems to be a lot better in Canada. Most restaurants have vegan options. My work's Christmas lunch was at a steakhouse of all places, and I still had several options to choose from.
Most of what I refrain from eating is the junk food that seems to suffuse work and social life: donuts, cookies, and cake leftover from one meeting or another, and buttery/cheesy/eggy snacks at social gathering.
I didn't claim anything counter to that. I can cook plenty of tasty vegan food. But if I go out there's not much left in my country to eat. You have to go to a handful of specialized vegan restaurants in the city to have even somewhat a choice. Otherwise it's fries or noodles with tomato sauce, which personally I wouldn't consider a meal.
That it's better in Canada? Great. I believe you, but I've travelled a lot, and I haven't seen many places that have such a variety of vegan food as USA and Canada.
Most of Europe is very meat heavy, vegetarian is still easy, vegan is picky eating. In East Asia there are vegan options, but often tasteless, because they're meant for Buddhist monks. Otherwise even vegetarian is somewhat difficult.
In India vegetarian is easier than meat, especially considering food safety. Had 0 gastric issues with vegetarian food, while one bad piece of meat almost ended the trip for a friend of mine. But a lot of dishes have butter and milk, so vegan again is difficult.
I'm really not saying it's difficult to cook great vegan food, just that it limits your ability to eat outside in most of the world, which probably influences average BMI more than the diet itself.
It's also likely that they simply eat less because vegan food just isn't very good.
I think this is mainly as a response to people using plant based fats for deep frying. Traditionally they were fried in beef tallow, no need for any flavour enhancers if you fry them in beef fat.
Also, fries need mayo, which is made with eggs.
Most people would think these foods boring, but that's because they've only ever had the shitty, mass-produced versions.
Add some fried bacon bits and tell me it's not infinitely better for it.
> fresh rustic sourdough bread
Which is great on its own, but much better with some butter and ham.
> vegetables roasted until they caramelize
Which is a great side dish next to a good steak.
Nothing wrong with vegetables, but none of these things are as satisfying as they would be combined with some animal products.
Prepare to be debated to death. Any solution to the problem of obesity involving personal effort is downvoted in favor of taking medicines.
It's hard to believe that this isn't a psychological and behavioral issue: >A 30 percent reduction in caloric intake results in a 30 percent decrease in caloric expenditure.
Often times I find it difficult to run or exercise, a lot of times I don't feel like I have the energy. Especially when fasting. I've fasted 7 days and run 3+ miles every day until I had no glucose left in my body. I've never met anybody doing prolonged fasting, distance running and a 100% commitment who couldn't transform their bodies. There may be some rare cases out there of individuals with severe disease/diagnosed health disorders, that's between someone and their doctor. For the rest, are they 100% committed? If you feel like this is you, please reach out, would love to talk and connect with you.
In poor health, willpower often fails long before physical performance, and there are many different possible barriers, like struggle to eat properly, poor nasal breathing, general fatigue, poor posture and running form, etc.
Personally, I can run for a longer time, but between having to push through mental fatigue and very poor nasal breathing, it's an extremely unpleasant, aversive experience. Even when I can do it, it's really harsh on me.
As an example of how this looks a bit different to a physicist, most people go to an online calculator to get their TDEE or RMR, some measure of how much energy per day passes out of their body. If you're a physicist, you can't help but measure this at two different weights, current and target. So that gives you a slope, a delta: kilocalories per day per kilogram of fat lost. Except there is also a rough measure of how many kilocalories to lose to lose a kg of fat, so in dimensional analysis terms, this is really just a time constant. I forget the exact amount but it works out to something like nine months or a year or so.
And then you realize that that's a half life. You choose a lifestyle, you start living as if your weight were W, then after a year you will get halfway there, after another year you'll get halfway closer, and so on, and so on.
But that's not how anybody thinks on a diet. They are thinking, I'm going to intervene, get my life under control, then I can return to the lifestyle I had before but without the weight. But what you are describing is a severe lifestyle shift, “I became a marathon runner and my friends are all marathon runners and that is our new lifestyle.” Polar opposite of intervention.
But it's also, there's a selection bias. If the actual cause is depression related, and marathoning worked because it gave a new sense of purpose and self, how would you notice? You spend all this time on caloric output, that's trying to treat it like a linear system. When the circuit has transistors and op amps, that's not how you analyze it.
Ten years after starting to run in this group he was set to run a marathon under 2:50. Unfortunately a cramp around the 30 km mark made it impossible to continue and actually achieve it. But his grit certainly motivated everyone around him, marathoners and short-distance runners alike.
I would love to share his eating habits but I do not remember them in detail and I do not know enough about nutrition to confidently share any presumptions on this part. Your first paragraph simply reminded me of this great individual.
A while back I had a massive immune reaction in my skin, which brought with it the constant urge to scratch. A lot of people idly comment that the solution is to just not scratch, but it turned out that I had a skin infection, and under those circumstances the instinct to scratch is incredibly strong; you do it as soon as your mental attention is turned elsewhere. Once the skin infection was cured, and a bit of steroid cream applied the urge to scratch went away.
Now imagine how strong is the instinct to eat. Eating is essential for life, the instinct to eat when hungry has been reinforced by evolution constantly since the nervous system developed. Have you read a description of what it's like to starve? The brain can think of nothing but eating, peoples behaviour becomes quite extreme. Some people do overcome it - those who starve themselves to try to save their children, for example. But that's an enormous external motivation.
There's a bit of cognitive dissonance in seeing a hugely fat person and trying to imagine that their nervous system is for some reason acting like they are starving. It's a lot easier to imagine that they just don't have the willpower to resist that extra snack, which is a situation a lot more familiar to most of us. But it seems likely that the further is more correct.
yes, 100% this. Your analogy with scratching the itch is spot on. And you know that the itch that you can't scratch will continue forever until the end of your life. How depressing is that? It's not like running a marathon - with a marathon, it's long and hard, but there is a finish and you can rest after that. With being hungry all the time, there is never a finish. You just gotta keep on running. And running's kinda hard - and if you stop resisting and eat a few big meals, you offset weeks of weight-loss. Losing 100 calories a day for 20 days is hard, but gaining 2000 calories a day is real damn easy, and also feels great!
About 10 years ago I weighed 113kg. I decided to really tackle it hard and not give up. Threw out all the sugar at home and went on a weightwatchers diet.
Over a period of 1.5 years I got my weight down to 97kg. It was very hard. It was a constant battle with hunger and feeling like crap. But I made it! I reached my goal and it was awesome!
So I crossed the finish line, right? No more hunger?
Guess again. I was back to 110kg a few years later. Still hungry.
So yes, please do tell me about how the urges will go away.
No, they do not.
It's a chemical reaction somewhere that in my body is happening with different amounts of components than some other people's body's. It's not a thing that I can wish really hard to change.
I am not giving you or anyone else advice. But the electro-chemical reaction is also happening in your mind and the software you choose to run there.
There is no finish line. Life is suffering.
further evidence refuting your claims
I am inclined to believe that the root cause for the obesity epidemic is our satiety signals being out of whack. In which case "just eat less" is about as useful piece of advice as "just breathe less". In both cases you would be struggling against enormously strong, primordial bodily mechanisms.
Have you ever tried meditating? Is it easy to just sit?
TikTok users have a strong urge to watch more TikTok. Should they just give into their urge for a short term dopamine rush? Will it feel difficult to not listen to this urge? Can they overcome it or are they trapped forever?
"Now imagine how strong is the instinct to eat." Fasting is a methodology to reset your metabolism. Dopamine fasting is a way to reset your urge to doom scroll. Meditation is a way to clear your mind.
Metabolically fasting dramatically increases insulin sensitivity, has profound benefits and helps one to become a master of their urges. It is a practice, like dopamine fasting, meditation, anything else...
But, I was also always hungry. Mostly not starving, but just hungry. I could eat a big meal, that made my stomach feel physically full, even painfully so and still have the feeling of hunger.
Of course, I also understood that on pure physics terms it really is calories out vs calories in that makes the difference. So I did try to eat less.
Also, you read and see people eating a salad and at the end saying, "oh, I feel so full". I always tyhought they were lying, because that never happened to me, so I kind of dismissed it as bragging or something.
Now, could I eat less food? Yes, of course, but it's always a struggle. Every day, all day. And if you fail once, that's that week's gains gone. Imagine there's a fly that's buzzing around your face 24/7 and you can't swat it away, you just have to live with it and if you have a bad day and swat it away for just a bit, you get fat.
Some time ago I took ozempic for the first time and that's when I realized that yes, in fact, it is possible to eat a salad and feel satisified and full after that. Even after more than a year on semaglutide I'm still amazed at how little food I actually need. It kind of feels like I should have died by now due to lack of input calories. But I'm feeling great and almost to normal weight now!
For me the change of how I felt was really something I could not even have imagined before, that you could actually not think about food all the time and kindof ignore it and not really get hungry. And eat just a little and feel full. Amazing. But two years ago I could not have imagined that this is possible, as it had never been before.
This of course led to the realization that the opposite is true for some people, who have better regulation of whatever chemical makes you hungry. Apparently there are lots of people for whom feeling hungry after eating a large meal seems impossible. And since this is something they have never experienced, it's not really reasonable to expect them to understand or be able to imagine it. I wasn't able to imagine the reverse!
So yes, it is possible for everyone to lose weight just by commiting. But it is much harder to commit in a specific area for some people than others. Commiting to a lifetime of always being hungry is very very hard over the long term.
I don't know, I found the idea of "what if I was hungry, but too much instead of too little" pretty easy to wrap my head around I think. I also wouldn't call feeling full necessarily as being the same thing as being well regulated, anorexics can feel full but they're hardly well regulated.
I once knew this fairly average weight bodybuilder that hated fat people with a passion and practiced a strict diet. During one of his many anti fat people rants, he started ranting about how fat people have no discipline, I sort of snapped back at him and pointed out my many struggles with eating and asked him "why it is that you complain that fat people are undisciplined but don't criticise me in the same way when you know I don't have a good diet and struggle to put on weight?" He didn't have a response to that and the conversation awkwardly ended.
For me, it was pretty easy to come to essentially the same conclusion you did from the opposite starting point. That it's possible for everybody to change their weight by committing, but for some people like this bodybuilder they're going to be able to maintain a healthy weight without struggling, and for others it's going to be a slog.
It's those who seemed to control their weight at will I couldn't empathise with, fat people were relatively relatable.
Usually in debates around weight, people focus on the message of counting calories and metabolism, but the psychological aspects are not usually discussed and based on how I felt and what you said, it is a super imprtant important aspect of the puzzle. After all, the feeling of hunger only exists in your head, not in the cells of your stomach.
I am currently taking semaglutide, and it's exactly the same.
Previously I suffered a lot with little effect. And everyone was giving me advice how I simply need to stop being lazy. Now I am losing almost 1 kg a week with zero suffering. The difference is not that I suddenly have more willpower; the difference is that I no longer have to spend all of it on fighting my hunger.
(By the way, it is also possible to have an opposite problem. I know a guy who is thin and wants to gain a little more weight, but he can't, because after he eats a little he feels so full that he is unable to eat more.)
As someone who was an ultra endurance rider (IE audax rides of 200/300/400/600/1200 km, where you stop only to sleep for the shortest sustainable time on the longer events), you are very much wrong. Your statements around .
There are plenty who complete these events who are skinny, and plenty who complete these events who are fat. The training load to maintain this level of fitness/endurance is high. The mental commitment is high. The sheer amount of energy required both during the event and to repair muscle damage after is huge. The next level down is the physical discomfort (I don't like the taste of water but I know I need it); the hallucinations, fear or depression that can kick in... But you still have 25% of event to go. Let's not forget those who get injured or have equipment failure and either wisely decide to DNF or drag themselves over the line.
Pray tell me how your jogging for what, two hours a day? Makes you more committed and enlightened.
Exercised - Daniel E Lieberman
https://www.npr.org/2021/01/05/953249677/exercised-explains-...
Burn - Herman Pontzer (who I believe was a student of Lieberman's)
https://www.scientificamerican.com/article/new-human-metabol...
Both a fairly dry and academic, but do get into the weeds if that's your thing.
A third book that's related but is an easier more entertaining read is "The Comfort Crisis" but Michael Easter.
https://eastermichael.com/book/
Easter actually interviews / quotes Lieberman.
The gist of all three...from an evolutionary perspective, the human body is designed for lean caloric times. When there is more calories than there is activity to burn it, those calories will be stored as fat (in preparation for leaner times). There's no ceiling on that so you'll keep adding weight.
In modern times, our evolutionary advantages become disadvantages. The best way to lose weight, is to not gain it in the first place.
Speaking of the brain, I've often wondered if less focus and thinking is also contributing to weight gain. The brain is responsible for ~20% of resting metabolic rate. If the brain consumes just a bit less calories per day, that's also going to add up.
"There have been some experiments to show that abstract problem solving does raise the brain’s metabolic requirements, and the higher your IQ, the more extra energy you can expend in this way. But it’s unlikely to amount to more than five calories an hour, either way. So you can’t Sudoku yourself slim"
5 kcals x 15 hrs = 75 kcals.
Actually, this is significant in the sense that if you over kcal by 100 kcals per day that'll add up. 75 is 75% of 100.
It looks small but in the context of weight, 75 kcals per day is enough to make a difference.
The body didn't evolve to carry so much extra weight. You're on the wrong side of history.
In any case, thousands of years of evolution, boom and bust cycles of metabolism, show that having excess fat stores is very, very useful when you have to go months without regular sustenance. Those are the people we're descended from, not the ones who have "fast" metabolisms. It leads to problems later in life, sure, but not before one reproduces!
Why? How we came to be impacts how we deal with today. This is one of the problems...denial. That is, denial that where we came from has little to do with where we are.
> "when you have to go months without regular sustenance"
And this happens how often in modern times? Most people can't skip a meal, let alone go a couple of days or more without eating.
What is leptin? Discovered in 1994, leptin is a hormone that signals the availability of energy reserves in the body. "High leptin levels are interpreted by the brain that energy reserves are high, whereas low leptin levels indicate that energy reserves are low", the latter causing the body to enter a resource-minimizing starvation mode [1]. More recently, leptin has also been shown to regulate "neuroendocrine and immune function and [play] a role in development" [2].
Why is leptin so important to obesity? "Most obesity occurs in the presence of increased leptin levels", which suggests a form of "leptin resistance" in obese individuals [2].
Leptin changes our understanding of body fat, also called adipose tissue. We generally think of body fat as simply stored energy reserves, so fat can be burned by decreasing our caloric intake (diet) and increasing our energy usage (exercise), forcing our body to dip into its reserves. This approach is generally referred to the calorie-in/calorie-out (CICO) model. While true to an extent, this perspective is too simplistic, given one key fact: leptin is primarily produced in adipose tissue [1]. This fact means body fat is actually an endocrine system organ.
Consider this: an obese individual has elevated leptin levels. A decrease in adipose tissue causes a decrease in their leptin production. Due to leptin resistance, low leptin levels causes the body to enter starvation mode, and hardcore dieting causes leptin levels to drop further, which makes weight loss even more difficult. What they mean by "metabolic adaptation" may be understood as "leptin adaptation", though I'm just speculating there.
It's strange that so many articles talk about weight loss and "metabolism adaptation" without mentioning the hormone signalling energy availability. With leptin, we clearly see the body has an energy availability feedback loop, and fighting the intrinsic dynamics of a feedback loop rarely leads to good outcomes.
On this vein, I want to highlight slothtrap's comments:
>The more frequent the dieting and steeper the caloric deficit, the worse metabolic adaptation gets, and the longer it takes to return to normal.
>I wonder if those who sustained higher levels of exercise were actually in a steeper caloric deficit.
>perhaps it's fair to say that if you're going to exercise, you best sustain it.
These comments align with present understanding of leptin dynamics. A steep caloric deficit pushes the obese body into starvation mode, so net energy expenditure from high levels of exercise will be decreased. Weight loss will be maintained once the body adjusts its leptin production and usage, which, as of now, can only be accomplished with habit.
It's also worth mentioning here the hormone ghrelin, which was identified in 1999 and is nicknamed the "hunger hormone" [3].
[1] https://en.wikipedia.org/wiki/Leptin
[2] DOI: 10.1146/annurev.physiol.62.1.413
What about fasting? Dr Jason Fung wrote a book about fasting that IIRC says that it does not cause starvation mode.
Lots of arguments about what diets maintain the most muscle (e.g. fasting people say they keep the most muscle, and as much as I love fasting, plenty of studies say that is probably not true.)
The dramatic weight loss induced by GLP-1's demonstrates that.
We're seeing a disproportionate amount of lean muscle mass loss.
Dr. Fung says obesity is a basically a hormonal issue, not a caloric issue. He discusses a "causality test": "If we inject this hormone into people, they must gain weight". According to Dr. Fung, leptin and ghrelin don't pass this test, but insulin and cortisol do. Still, leptin and insulin appear to have a close relationship. "Insulin promotes fat storage. Leptin reduces fat storage. High levels of insulin should naturally act as an antagonist to leptin. However, the precise mechanisms by which insulin inhibits leptin are yet unknown." He also says that "too much insulin causes obesity" and that "obesity is a state of leptin resistance." (Sorry for that mini book review; I needed to understand what he was saying.)
On the fasting point, he's explicitly supportive not of regular fasting but intermittent fasting: "Diets must be intermittent, not steady...we cannot fast all the time. It won't work."
Based on my fast read of his work and my own understanding, intermittent fasting keeps leptin levels high enough that the body doesn't kick into calorie restricting mode. One approach which seems to accomplish this is eating close-to-zero carbs five days/week (say, during the week) and then eating lots of carbs two days/week (say, on the weekend). The burst of carbs will cause leptin levels to spike since the body now has tons of available energy. Over the week, the leptin levels will remain elevated, but since you're minimizing carbs, the body will draw energy from adipose tissue.
As far as I understand, people with type 2 diabetes (insulin resistance) have excess glucose in their bloodstream, which becomes easily stored as body fat. Type 2 diabetes seems particularly caused by eating excessive amounts of carbs over a long period of time.
In both cases, excessive carbs leads to obesity. The type of calories matters more for obese people trying to lose weight than for healthy people maintaining their weight.
[1] https://www.dbl-diabetes.com/all-about-diabetes/food/type-1-...
People with type 1 diabetes need to be conscious of what they are eating in a way the rest of us don't. I'm not sure you can draw much inference from them.
This part I think needs more explanation. The reason calories-in/calories-out model is too simplistic (I would call it almost useless if not completely wrong) is because of mitochondrial uncoupling proteins [1] that control how much energy in the protein gradient gets converted to ATP and how much is lost to waste heat. These uncoupling proteins are upregulated by leptin so when your leptin levels fall, your body literally changes how efficient its metabolism is to do more work with fewer calories. Body fat isn't just an endocrine organ, it might be the primary metabolic controller with a nasty catch 22 feedback loop - which would help explain why a certain minimum percentage of body fat is required or else a person enter organ failure.
That's why there are some people who don't seem to gain much weight despite eating a lot of food: their bodies are naturally less efficient and lose a lot more energy to thermogenesis. Without taking that metabolic adaptation into account, CICO is nothing but harmful dogma that needs to die. Otherwise people are fighting what might be one of the most important biological adaptations humans have.
But for a single individual, working to establish your base metabolic rate by counting every calorie and weighing yourself regularly, you can always find a way to be successful with the CICO model. If you establish a baseline that your metabolic rate is (say) 2000 calories a day, then eating 1600 calories a day will cause you to lose roughly a half-pound to a pound per week. It does not mean that every individual’s baseline metabolic rate is the same.
As you also outline, your base metabolic rate also changes as your weight does, so re-baselining by continually measuring caloric intake and your weight to recalibrate is always going to be necessary.
Given the above CICO almost seems tautological: Measure the weight loss you actually observe at a given calorie level, and that tells you… how much weight you will lose at that given calorie level. So it is almost useless as you describe.
BUT, the main reason I’m still a proponent of CICO is that it simplifies dieting away from thinking about what you eat, and instead focuses on how much you eat. If I establish that I need to eat 1800 calories a day, I can still have a Big Mac meal and drink some beers. But I may not be able to eat much else that day. That alone makes it useful for me. What isn’t useful to me, are diets that essentially limit the type of food you eat and tell you to just go nuts and eat however much you want: I will often find myself hating the foods I’m restricted to, and the quantity I eat may end up being such that I gain weight anyway.
To me, CICO is simply a technique that says “actually measure how much you’re eating”, no more and no less. That is what makes it a useful tool.
The bottom line is: you're welcome to eat your Big Mac and beers, just only two days out of the week.
Also, stress has an important role to play on weight loss. Stress causes your adrenal glands to release cortisol. Cortisol increases glucose levels through gluconeogenesis by making glucose from non-carbohydrate sources, such as proteins from muscles.
The key to CICO is that you’re actually measuring not just the calories you eat, but the weight you gain/lose, and are continually calibrating. If my diet jacks up my leptin levels such that I don’t lose weight, that will show up on the scale, and I have to adjust my calories down to compensate. With this system I am guaranteed to lose weight so long as I don’t cheat. This is trivially true: the calibration could technically push you all the way to zero calories per day (which will never happen in practice, obviously.)
Case in point, I lost 50 lbs with this approach, eating McDonald’s nearly every single day. I kept it off for roughly 8 years. (I since became a dad and have let myself go tremendously, gaining ~30lbs back, but I will cross that bridge soon.)
>With this system I am guaranteed to lose weight so long as I don’t cheat.
Unfortunately, that's just not true. Here's some great quotes from the book "The Obesity Code" (which I've just recently found and find an excellent book):
>The abrupt increase in obesity began exactly with the officially sanctioned move toward a low-fat, high-carbohydrate diet.
>A 30 percent reduction in caloric intake results in a 30 percent decrease in caloric expenditure.
>Total energy expenditure is the sum of basal metabolic rate, thermogenic effect of food, nonexercise activity thermogenesis, excess post-exercise oxygen consumption and exercise.
>Since hormones control both Calories In and Calories Out, obesity is a hormonal, not a caloric, disorder.
>If hormones regulate fat growth, then obesity is a hormonal, not a caloric disorder.
>Sugar will increase the blood glucose level and provoke an insulin response from the pancreas. Olive oil will not...[cause] significant increase in blood glucose or insulin. The two different foods evoke vastly different metabolic and hormonal responses."
All of this is to say that it's not enough to simply adjust calories. Yes, calories matter to a point, and everyone knows that starvation (e.g., 0 calories for an extended period of time) is effective in the long-term, but starvation will also harm your body, and no reasonably-minded person can suggest it as a viable approach to weight loss.
The best available scientific evidence shows that continuing to decrease caloric intake can make weight loss more difficult for an obese person.
That was the sound of you zooming right past my argument and pretending I was saying something I wasn’t.
I’m not saying CICO is a good idea. I’m not saying it’s healthy. I’m not saying it’s easy. I’m not saying it will have a high chance of success vis a vis people actually being able to stick with it. I’m merely saying IF you do it right, THEN you will lose weight. This is trivially and tautologically true (to the point of CICO being useless to most people!), but it’s extremely tiring having to explain it over and over that it still works despite all of this.
To put it another way: there are two operative definitions of “works” for a diet:
1. Will it work if you do it exactly as directed?
2. Is a typical dieter likely to have success by attempting this diet?
CICO fails miserably at 2. It passes with flying colors at 1. Its best not to conflate the two definitions in the middle of an argument because you end up talking right past one another.
CICO is, especially at the population level, terrible dieting advice. We have decades of experience and oodles of research showing that, as advice it does not work.
However, it is, as you point out, basically tautologically true/correct. For CICO to _not_ be correct would essentially be breaking physics and generating mass/energy from nothing.
Yes, your body can change it's energy expenditure in response to dieting, but this is accounted for in the CO part of CICO. If you consume fewer calories than your body expends (in all the myriad of ways that your body can/does expend calories), then you _must_ lose weight.
The fact that CICO is true does not make it good advice but the fact that it's bad advice doesn't make it false.
E.g. if your input is 1200 calories and you work out, but you aren't losing weight? Maybe your NEAT is way down (or you have a thyroid issue). You are super active but can't lose weight? Maybe you aren't tracking food calories accurately, or you need to eat more satiating foods.
CICO isn't a strategy, it's part of the landscape and your diet is a strategy to navigate that landscape.
But no matter what your particular strategy, it is always going to involve eating less hyper-pallitable foods and getting more activity. That may not be all, but you cannot go from obesity to a healthy weight without those things.
Pay attention to what I eat and how often I exercise.
I rarely actually count, but I do lower calories when I look at a label and say OMG. Like, who knew a shake was 2000 calories? Hmm, fries only 500. I just switch and cut my calories by 1500. I’m so good, I deserve these fries! Yum.
The main problem with CICO is that it is confusing the description of a process with an intervention designed to modify said process. Both things a very different.
> I’m merely saying IF you do it right, THEN you will lose weight... > that it still works despite all of this...
That's the first part, the "works" include the IF... You mixing efficacy and effectiveness is here.
> 1. Will it work if you do it exactly as directed?
Try to apply CICO to water and hydration level : You can modulate your hydration level by driking more or less. BUT, you can go above a certain level or below a certain level independent of how much you drink.
The problem with CICO's is you fail to realize that CI and CO are not the control variables and you might be getting the causality wrong.
Much in the same way that you can change the temperature of a room by changing the value on a thermometer... You can't change the body set point and fat disposition by "just" changing CI/CO.
You may want to read my first post again. I spend nearly the entire post agreeing about the problems with CICO. But in my last paragraph I explain that I still like it and that it works for me, and explain why. YMMV.
> That's the first part, the "works" include the IF... You mixing efficacy and effectiveness is here.
Right, that’s called propositional logic. It’s perfectly valid to make “CICO works” predicated upon whether you follow it correctly. This isn’t as trivial it sounds: there are diets for which this is not true!. I can totally stick to a low carb diet to the letter and still gain weight, because if you don’t include a calorie limit, you can still go way over your calorie expenditure even with low carbs. As trivial as my “definition 1” is for “works”, it’s still a bar that many diets don’t pass.
> Right, that’s called propositional logic. It’s perfectly valid to make “CICO works” predicated upon whether you follow it correctly.
Well no. And that really the core of the issue. I see that you didn't answer to the example i gave you.
But if we want to be pedantic :
1 - There is no definition of "works" in propositional logic.
2 - Here what i understand from your logic deductions :
A - CICO can be rephrase as : For a given individual , for every time duration t : delta_weight(t) = CI(t) - CO(t)
B - What you are saying is : for a given individual , for every time duration t : delta_weight(t) = CI(t) - CO(t), THEREFORE, for every delta_weight, there is a time duration T, and CI(t) and CO(t) such that delta_weight = CI(t) and CO(t);
My argument boils down to the following:
For every individual, at any given time, there is a metabolic rate M for which, if their calorie intake was larger than that, they’d gain weight, and if their calorie intake was smaller, they’d lose weight. Crucially, M changes over time.
But going CICO properly means using the scale to measure M, every day, by diffing your expected value of your weight loss given how much you’re eaten, with the actual value on the scale. You now have an updated value for M to use in calorie counting.
Since M is determined by empirical observations of your weight loss/gain in response to the calories you have consumed, you will by definition lose weight if you consume less than M calories. This is the argument that CICO must work by definition. It’s a logical contradiction for it not to work.
Just to clarify B is not cico, it's the inference that you seems to make from CICO.
> For every individual, at any given time, there is a metabolic rate M for which, if their calorie intake was larger than that, they’d gain weight, and if their calorie intake was smaller, they’d lose weight. Crucially, M changes over time
This is "not" the definition of CICO, and again does not follow from CICO. CICO is fundamentally a thermodynamic statement about the observed state of a system. You are making predictive statement about a possible future state of the system.
Again, if you want to believe that statement that's fine. The point i am making is just it's does not follow from cico, no have i seen anything empirically that validate that statement.
> Since M is determined by empirical observations of your weight loss/gain in response to the calories you have consumed, you will by definition lose weight if you consume less than M calories.
sure this derived from your "definition" of CICO... but your definition is not thermodynamically derived...
> This is the argument that CICO must work by definition
the premise (the definition of the argument) is flawed.
> It’s a logical contradiction for it not to work.
Not really, CICO not working (as in this case) can be just the result of sound logic based on bad premises.
Are you saying only carbs matter with respect to leptin?
We first need to choose which of the following macronutrients contribute most to weight gain: protein, fat, or carbohydrates. Proteins (or, rather, amino acids) are not known for contributing to body fat in any significant manner. Fat was once thought to be the main contributor when calories--not carbohydrates--became accepted as fattening. However, modern science shows fat has little significant contribution to body fat and that the real contributor to body fat are carbohydrates. The discovery of leptin about 30 years ago finally shows why.
Carbs are sugars. Sugars, such as glucose, are the main source of fuel in the body, as they are eventually synthesized into ATP. Blood glucose levels are regulated by the hormone insulin. Elevated blood glucose levels increases insulin production, whereas low blood glucose decreases insulin production (with glucagon helping stabilize blood glucose levels). High insulin levels promotes anabolism, whereas low insulin levels promotes catabolism. Creating body fat is an anabolic process, whereas burning body fat is a catabolic process. Putting it all together, eating carbs inhibits the essential catabolic processes for burning fat.
While entirely cutting out carbs should be the answer, it's not. Many obese people report failure to lose weight on ketogenic diets. Why? The hormone leptin. See, leptin levels increase with insulin levels. Leptin signals the availability of energy reserves in the body. Adipose tissue (that is, body fat) is the primary producer of leptin. Importantly, leptin levels vary exponentially with body fat. The obese individual's body is so oversaturated with leptin, the body becomes resistant to leptin.
Decreased leptin levels will cause body fat to be burned. On a ketogenic diet, catabolic processes initially cause a reduction in body fat, which then decreases leptin production. Because the obese body has leptin resistance, the leptin production decrease is interpreted by the brain as a severe drop in available energy reserves, causing total energy expenditure to be immediately reduced and placing the body in "starvation mode." At this point, eliminating body fat actually becomes more difficult, as excess carbs become anabolized into body fat due to decreased energy expenditures.
So, to finally get to your question, how do carbs matter with respect to leptin? To lose weight over months and years, an obese person needs to eat carbs to (1) keep their leptin levels stable over the course of each week to prevent the body from entering starvation mode while (2) maximizing the efficacy of catabolic processes. As the body gradually recovers from its leptin resistance (which will likely take time), the body will shed fat without triggering the energy-minimization mode.
In this paradigm, your total energy expenditure determines how fast fat will be burned. According to the book "The Obesity Code", "total energy expenditure is the sum of basal metabolic rate, thermogenic effect of food, nonexercise activity thermogenesis, excess post-exercise oxygen consumption [(EPOC),] and exercise". Of these five factors, EPOC is mostly likely underutilized. A simple 10-minute HIIT routine every other day will regularly drive EPOC, which causes ATP synthesis. When an person isn't eating carbs, the body dips into fat stores to acquire the necessary glucose for ATP synthesis. Note that with this approach, exercise isn't strictly necessary but becomes extremely beneficial to maximize the efficacy of catabolic processes.
Intermittent fasting should work as long as the specific protocol doesn't decrease leptin levels such that the obese body enters starvation mode. In my opinion, the most workable approach for people is to try their best to completely eliminate carbs Monday-Friday, eat all the carbs they want on the weekends, and do the bare minimum of a 10-minutes HIIT routine every other day.
This is just calorie cycling with extra steps.
It doesn't honestly matter if it is 5 days on, 2 days off, or 2 months on, 2 weeks off. It is up to a person's individual biology. When the scale stops moving, up calorie intake to the extent that the scale doesn't move up more than a smidge, wait a bit, then drop calories again.
TKD, CKD, intermittent fasting, dirty keto, keto with a once a month weekend pizza binge, whatever, almost any combo of "eat less for awhile, then eat normal for little bit, then eat less again".
That's almost right, but it's carb cycling, not calorie cycling. The difference does matter.
>TKD, CKD, intermittent fasting, dirty keto, keto with a once a month weekend pizza binge, whatever, almost any combo of "eat less for awhile, then eat normal for little bit, then eat less again".
I believe that the best approaches, for a given period, will be 2/3 of the time on minimal-to-no carbs, then 1/3 on carbs (which, for seven days, rounds to 5-off / 2-on). The leptin information also suggests that an obese person shouldn't be off carbs for long periods of time, and one week is a nice time frame for people (go low-carb during the work week, have carbs on the weekend).
I hate to post the same video in the same thread twice, but this video dives into carb cycling, and explains that actually it is calorie cycling that makes the difference. https://www.youtube.com/watch?v=QwZfryrVddY
FWIW, and I'm a big keto proponent, the goal should be whatever works. Keto is super effective for some people, and completely useless for others. Research has started to figure out why some people respond to keto better than others, but low carb fails really hard for a certain % of the population, works obscenely well for another % of the population, and works as well as any other dieting system for the majority of the population.
As someone for whom keto works really well (I was on keto for 5 years, training 12hrs+ a week in the gym!), I totally spent time promoting low carb to everyone, until I tried to help some people for whom it just didn't work at all.
> If you establish a baseline that your metabolic rate is (say) 2000 calories a day, then eating 1600 calories a day will cause you to lose roughly a half-pound to a pound per week.
At this point it's pretty safe to say that's likely untrue at the population level. This is a cutting edge area of research but the UCP1 adaptations seems to happen really fast, for some people on the order of weeks. On the order of months for the vast majority of the population. It doesn't take long for the basal rate to fall to whatever your intake is because the system evolved to naturally have a lot of room to spare. The human body always adapts and if I were a gambling man, I'd say this is largely why most people fail at dieting: after a month or two the results stop and they have to further decrease their intake which interferes with other pathways and tanks motivation.
If it works for you, that's great! You're one of the lucky ones, maybe because you've hit your floor for uncoupling proteins. But given just how hard dieting is for most people and how bad the obesity epidemic has gotten, it's probably not useful for the majority of people. A far more holistic approach that tackles macro- and micronutrient deficiency, motivation, lifestyle, and not just net calories is required.
All this is accounted for in this sentence of my post:
> your base metabolic rate also changes as your weight does, so re-baselining by continually measuring caloric intake and your weight to recalibrate is always going to be necessary
If you’re actually measuring yourself at the scale to get the ground truth of your actual metabolic rate, and you’re doing this every single day, then there isn’t a single thing that can change this: UCP1 adaptations, fat viruses, leptin changes, hormones, stress… all of this is covered by the actual weight on the scale. If I ate X calories and gained Y lbs, I need to adjust my calories by Z, no matter the reason I gained those pounds.
You can argue that such a diet is too hard, and that for some people the adjustment to your calories is going to leave you essentially starving, but it doesn’t change the truth of the matter that it will work if you do it right. Now, whether it’s worth it for people, and whether the process is going to leave you utterly miserable or even extremely unhealthy as a result, I’m making no claim on.
(For my part, CICO worked amazingly well for me, and I was able to follow it without much trouble. But that’s just me.)
Feeling hungry or being unhappy with such a diet is more common, but it's generally also fixable, and it doesn't defeat the point either.
then CICO is not practical for weight loss. the "CO" becomes so small that you're screwed
What normal human reduces its CO so that you wont lose weight? Are you talking about someone in a coma?
- many people can cut from a diet of 2200 calories per day to 1800 calories per day and pretty quickly and sustainably lose weight. This kind of calorie reduction is very manageable, and anyone who has lost weight this way starts saying “it’s just CICO man, so easy, just do it”
- meanwhile, in order to lose weight, some (probably not huge but very real) amount of people who maintain at 2200 calories need to drop to 1000 calories per day, or even lower, consistently, for months, in order to lose weight at a 0.5 lb/wk. This is miserable, not sustainable, and probably a net negative on your life (damage not worth the weight loss) unless you are morbidly obese.
The people in category 1 yell “you’re just coping, it’s not hard, just CICO” at group 2. Meanwhile they have never had to reduce calories in that way and have no idea how unsustainable it is. They are so sure their experience is universal, that they usually utterly deny the other groups existence, and smugly go about the world assuming people struggling with weight are just weak.
Which is stupid.
If you want to loose weight and maintain a reasonable BMI during the long run you need 2 things.
1) A healthy diet, if you are in America this requires a bit of planning, if you live in Europe its easier. Limit the portion size (and if you are fat you don't know what a normal portion size is, look to you skinnier friends for inspiration).
2) Get your heart rate up a couple of times a week. If you are fat this might be the _walk_ to the store. If you are just weak weight training is great. And for 99% you most likely should aim to increase the amount of condition training, brisk walks, joggins, biking, chopping wood whatever.
By focusing exclusively on CICO, one dismisses the fact that people dislike feeling hungry. To say it's simply an issue of willpower dismisses the importance role of hormones in driving behavior. When it comes to weight loss, some people are dominated by their hormonal responses, while others have more regulated responses.
I think I've found a good analogy: advocating CICO as primary strategy to lose weight is like saying all you need to do to complete a road track is to drive forward and stay on the track. The track shape analogizes to the unique dynamics of a person's hormonal feedback loops. Completing the race analogizes to hitting a weight loss goal, while going for fastest lap time is like a doing a 30-day weight loss challenge.
There's roughly 8 billion unique tracks in the world. Some tracks may be a drag strip, others may be Nurburgring-style circuits, and an unlucky few get the Baja 1000. Virtually everyone rides a normal car with gas, brakes, and a steering wheel, though performance characteristics do vary. At all times, you are the only driver on the track. Completing a drag strip track is trivial: just drive straight. Some tracks (like a NASCAR circuit) have banked turns which allow for high speeds with minimal focus on turning or braking. Many tracks, however, require different strategies. As an example, you MUST brake at turns on the Nurburgring because failure to break WILL cause you to leave the track, potentially causing a spinout or even a crash. If a racer aims for a specific lap time, they'll need to maintain a minimum average speed across the lap, which requires learning optimal driving, turning, and braking strategies specific to that course.
I think you can mine this analogy for more insight, but the primary point is: CICO is in all weight loss strategies, but because of personal hormone dynamics, not all weight loss strategies can be CICO.
The tl;dr is follow your body (e.g. not sleeping well, exhausted all the time, eat more for a bit), but try starting out around 2:1 for eating a fair bit under vs slightly above maintenance. (e.g. diet 6 days, eat a bit extra for 3 days, repeat).
In another video he also mentions that after weight loss, that it is a good idea to slowly increase calories until the scale doesn't move, and then eat at that level for a few weeks to reset the body's hunger signaling. (I am dramatically simplifying there).
> The human body always adapts and if I were a gambling man, I'd say this is largely why most people fail at dieting: after a month or two the results stop and they have to further decrease their intake which interferes with other pathways and tanks motivation.
This is why "cheat days" or even "cheat weeks" work. People are on a strict diet, weight loss stalls, they go on vacation and eat at a surplus for a bit, and then they find that after vacation they are able to resume losing weight.
Likewise a big thing in Keto awhile back (not sure now) was cycling off Keto for the weekend, which unless a person is very careful, ends up with people eating at least a little bit to "excess".
Plenty of people do "lazy keto" and eat a big Sunday family meal and so long as the excess calories on Sunday don't exceed the sum total of deficits from the other 6 days, they'll be A-OK, and now it turns out they may actually be better off.
Basically their view is that refeeding (aka cycling) probably doesn't do much physiologically speaking, but there may be advantages to adherence when people use diet breaks (typically longer than a cycle or refeed).
The problems I am seeing with all these studies is that the participates in the control groups (just regular dieting) are still losing weight throughout the study.
Instead, do a study where you have a bunch of people who are calorie restricted, and when the scale stops moving, have half the participants do a re-feed before trying to cut again, and the other half keep soldiering on as is.
Or to put it another way, we all know people plateau with diets. Running a study that where participants do not hit a plateau, and instead having science just go "oh well! Sorry can't help you!" aren't of much use.
(It is funny because the author of that article starts out talking about plateaus, and then runs a bunch of studies that.... don't encounter plateaus.)
I've met people, who are grossly obese, who after going from 400lb to 300lb, find that they aren't losing weight at even 2500 kcals a day. So they drop it to 2000kcal. 25 pounds later the scale stops, and they try 1500kcal, feel like shit, and they give up. Math says at 250lb they should be shedding tons of weight at 1500kcal, but they aren't.
I want to see a study that investigates that, instead of "oh someone lost 10kg, woohoo!"
10-15kg is a lot of weight to lose, but almost any dietary intervention will pull of a 10-15kg weight loss (which is what all the studies looked at show!)
> Theoretically, reverse dieting should be most effective in scenarios where metabolic adaptation is most extreme, and to my knowledge, the Minnesota Starvation Experiment reports some of the most dramatic metabolic adaptation ever observed in the scientific literature.
Except it was taking people at healthy weights and having them drop to an unhealthy low weight, and then having them regain weight.
The situation we are faced with now is people at unhealthy high weights, with all the hormonal problems that entails, losing a bunch of weight, and messing up their hormones in a different way, and now the goal is to stabilize their body at that new lower weight.
> As previously discussed, the available research hints at a number of subjective and behavioral improvements related to hunger, satiety, diet adherence, mood, and perceived energy level, in addition to improved performance
All of those "subjective" feelings have basis on the body's physiological systems. With better measurements, the underlying cause of those "subjective feelings" can be found.
Edit: FWIW I think the extreme weights we are seeing in developed societies have multiple underlying causes, and that pure dietary interventions are not the solution for everyone. From gut microbiome to environmental pollutants, to the # of ads for fast food on TV, IMHO the problem is multi-causal.
Yes this is it. People with shit genes simply do not burn enough calories , so these people need to diet to absurdly low levels of calories to merely not be overweight, way lower than predicted by formulas/tables. Which is not sustainable , hence regain.
Many Pacific Island nations also saw massive obesity rates. The reason was carbs, not calories. Soda contributes to obesity because of sugar, not the calories.
Amazingly, some people are different. Who knew. We shouldn’t gaslight them into thinking they aren’t different because they aren’t like the aggregate, and we get to feel so morally superior if every individual is like the aggregate.
Imagine two individuals who both both need 2,500 calories/day to feel satiated, but the second individual stores anything above 1,500/day as fat, and a second individual stores anything above 3,000 as fat. The first person will constantly be fighting his body to not overeat and will feel hungry constantly. The second individual can eat to fullness and not gain weight.
Some men , particularly the formerly obese, have such slow metabolisms that anything stored above 1,200-1,700/day is stored as fat despite weighing 170 pounds or so, from reading personal accounts here and on Reddit. This is also why bariatric surgery patients regain weight and become obese again despite only eating around 1,200-1,500 calories/day. These people basically got short-changed when it comes to metabolism genes. If there is a famine, they will outlive everyone. But in abundance they become fat very easily. This does not answer why there are more obese people today compared to in the past, but there is still probably a genetic component nonetheless.
And on the other extreme are people who can be very slim despite eating a normal amount of calories or only slightly less than 2,000. These people are much rarer, as it's disadvantageous from an evolutionary perspective to have an inefficient metabolism, but they exist in the same way very tall or short people exist by virtue of phenotypic variance.
It was a relatively easy metric to track, and using it alone meant that I could still eat all the things I wanted, though I needed to balance what I wanted to eat with portion size.
CICO also meant I started out slow, making small cuts. So it wasn't bad in the beginning. Over time I had to find ways to adapt so I wouldn't go feeling hungry (mostly increase protein and fiber ratio significantly), but I never needed big changes.
On the flip side CICO also meant that if I messed up one day it wasn't so bad. It just moved the goal post one day or two further away. So it prevented me from feeling like there was no point and giving up, instead getting back into it the next day.
By following CICO I had a very linear weight loss, which didn't feel like a restriction or such. I estimated my CO and aimed for roughly 0.5kg per week and that's almost exactly what I managed.
Not being "prevented" from certain foods due to diet X was a big factor in making this bearable.
1. The scale lies. Liar liar pants on fire it lies. (We could go into this in detail, my wife never seems convinced, but it is to my mind a basic fact of the physics of the system that the scale lies in multiple orthogonal ways.)
2. So you want multiple different probes into the same phenomenon so that you get a better insight into what is going on.
3. So, track calories as a second piece of data to try and check whether the scale is lying to you or not.
4. As part of that, they give you greater insight into the choices that you make. For instance you realize that it is functionally impossible to jog off a Krispy Kreme donut but very easy to replace half a meal with it. Or you discover that you can cut fruit juice for water with no dissatisfaction.
Regrettably this is not peoples’ usual relationship with food and the scale, which is exemplified by the Cheat Day phenomenon. The calories are viewed not as a separate data stream but as a morality judgment, which is then turned off for brief periods because constant judgment is hard on us, and these periods contain a lot of very relevant data such that if you turn the metric off selectively for them, the metric is no longer useful.
https://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor...
> His body mass index went from 28.8, considered overweight, to 24.9, which is normal. He now weighs 174 pounds.
> But you might expect other indicators of health would have suffered. Not so.
> Haub's "bad" cholesterol, or LDL, dropped 20 percent and his "good" cholesterol, or HDL, increased by 20 percent. He reduced the level of triglycerides, which are a form of fat, by 39 percent.
So yeah, in a vacuum, with a perfectly spherical cow, it's not that far off.
Anecdote: I did this over the past year and a half, weighing myself weekly and tracking all calories, including a period of weight loss and gain to get some good data points, and starting around 6-8 months in the linear regression stabilized: I found I burn on average 2200 calories per day even though I'm in my 30s and mostly sedentary. I've since found it to be pretty accurate.
However, as a practical matter for people who want to lose adipose tissue there are likely more effective approaches than CICO.
I realized I've been doing this over the past month. I weighed myself yesterday. Same weight.
Clearly something is different about my body, at least when it comes to sugar calories. It just doesn't seem to readily convert it to fat.
Is it really that hard to believe that some people's bodies actually behave a little more rationally than most?
That said, there are limits to what the human digestive system can absorb from a single meal. Binge eaters do sometimes exceed that limit and just poop out the excess without storing it as fat.
I got the taste for raspberry ripple ice cream in my mid-20s, and ate 10 litres a week - that's 2000+ kcal a day just in dessert.
That's not binging. I put that on top of 500g dry weight of pasta with cheese and sauce, and kept it up for months. Plus breakfast, lunch, and several beers. And packets of chocolate biscuits. I was covering 10km a week or less, no marathons. No tapeworms, either.
You may be right that I was shitting a lot of it out; the horrible shits are what turned me off the ice cream habit. Nonetheless, I ate well over 4000 kcal every day, for years, and never put on weight. 6000 was typical. And most of that was potatoes and wheat, which are very bio-available carbs. I've always been a black hole for food.
I suspect I radiate it as heat. Exes have told me I'm hot - in a caloric sense. I feel the cold more, now that I eat less.
To the overweight, if it helps at all, know that I have other struggles.
Here is a profile of him, among other individuals who are part of his dieting cult/group https://nymag.com/news/features/23169/
Michael’s regimen of 1,913 calories a day is exactly that: 1,913 calories every single day, 30 percent of them derived from fat, 30 percent from protein, and 40 percent from carbohydrates. Cooking for him is the same elaborate exercise in dietary Sudoku it is for all CR die-hards, only more so.
There is no evolutionary justification to have such an wasteful metabolism (for all of history until now it's a a disadvantage), so people like him are rare, but they exist.
Another is Roy Walford who got to a similar weight during Biosphere2 on a similar 1900/day diet when the artificial habitat began running out of food.
The key is that very small changes in calorie intake, over a long time, have a large impact on equilibrium weight, and that height factors a lot more into BMR than people think.
It's possible that for some people at such extremes commonly available models would break down, but clearly for this person, they haven't. And while BMIs of 16 are relatively rare, so are 6 foot tall males that eat an average of 1900 calories for years.
Ultimately if you're trying to use this case to show that the models are inaccurate, that's not what this case does, it's actually remarkably close to what is predicted and if anything would be better used as evidence in their favour.
https://www.webmd.com/diet/features/restrict-calories-revive...
"I eat the same thing twice a day, seven days a week, 365 days a year," says Pomerleau, of his diet of 1,200 calories a day. "It's a lot of veggies with olive oil-based salad dressing, a lot of mixed fruits, almonds and hazelnuts, and flaxseed oil for omega-3 fatty acids."
https://archive.is/e345S#selection-4235.216-4239.443
.Bob Cavanaugh, a 54-year-old landscaper from Morehead, N.C., has trimmed his intake to two meals a day, totaling 1,500 calories. Breakfast consists of one cup of quick oats, two tablespoons of toasted wheat germ, one cup of skim milk and blueberries. For dinner, he eats vegetables, fruit and a small portion of fish. "I'm hoping to see my great, great grandchildren," he says. Mr. Cavanaugh's diet may sound extreme, particularly since at 5-feet 9-inches tall and 158 pounds, he isn't overweight. But over the next several years, if the monkey results hold up, they could represent a major shift in how we view food and nutrition. The U.S. Department of Agriculture says the average sedentary woman should eat 1,600 calories a day and the average man 2,200 -- benchmarks already significantly overshot by most Americans.
and a third guy https://pbs.twimg.com/media/EW8oScgXsAAVqeg.jpg
A bmi of 21, nowhere close to 16 despite eating fewer calories (1700)
Your first example. Pomerlau, weighed only 121 pounds - that's a BMI of 18 - and lost 5kg/year, which means that if he did eat 1200 calories, he almost certainly wasn't at equilibrium yet, either - it would take a few more years.
None of those examples really are outliers.
Note that there is no reliable evidence that caloric restriction to the point of having an underweight BMI will actually extend human lifespans. The experiments have all been done on smaller lab animals living in safe little cages where they are protected from injuries and infectious diseases. Under nourished humans are at severe risk of sarcopenia as they age.
If someone is sitting at a 35+ BMI, then their caloric intake is so out of whack, that CICO helps ground them. Similarly, an anorexic who starves gets a clear directive for increasing weight by increasing calories.
CICO also promotes calorie general calorie comparison. It helps you understand that a milkshake has the same weight impact as an average Mediterranean lunch bowl.
Now the absolute impact on both foods will vary from person to person. But comparatively, it helps ground the unhealthiness of foods like sugar rich shakes and icecream.
How do people who constantly repeat the mantra of thermodynamics in such threads explain this? How is the body burning the same calories with increased physical activity? Not to mention that people can extract more or less calories from the exact same food and quantity consumed.
Or you can find out for yourself. Touch your stomach during a run on a hot day. Its cold. Digestion is slowed and blood pulled away from the gut.
N of 1. But I do not eat much more on the days I run 15 miles on the trail vs days off. I do not need to due to these adaptations.
And then there's healing, and saliva generation, and digestion, etc. I'm sure there's a lot of room for energy savings.
You're improving your fuel economy.
Your body needs to burn less to maintain / manage the fat you are or rather were carrying around.
Your body may be engaged in various processes that it turns down. It's possible, for example, that it may be engaged in various anti-cancer activities that aren't necessary as your body fat decreases (higher body fat is correlated with some cancers, though I don't believe a a direct causal link has been established...but this comment is all speculation anyway). Or the excess calories could signal your body to do other "discretionary" processes that it dispenses with in time of calorie deprivation. It's even possible that such discretionary processes could be statistically bad for you in our current environment, which might be a reason why calorie deprivation may extend lifespan, at least in modern humans.
Your gut could expend less effort to extract certain nutrients or vitamins from your food in a low calorie regime ("bah, opportunistically grabbing that extra Vitamin E is not worth the effort right now").
Just some off the top ideation, not meant to imply that these ideas are necessarily what happens but are ideas why simple thermodynamics is inadequate on its own to explain the phenomenon. The body is more than a simple calorimeter.
As someone that took three semesters of thermo. I don't understand thermo in a deep way and they have a Randall Munroe School of Science understanding.
As someone who runs marathons, the answer to “how does the body burn the same calories with increased activity” is: It doesn’t. You will feel a marathon metabolically no matter what. And if you don’t eat like an absolute monster that day, you’re literally going to feel insatiable hunger for multiple days until you get those calories back.
Feeling hungry when your stomach is so full that you can’t take another bite is quite an experience I’ll tell you that.
And yes, your grocery bill does get higher when training for a marathon. It's very noticeable.
This is just to say: cellular metabolism is stupidly complicated. There is so much we either do not understand yet, or have difficulty piecing together in a consistent way.
It is always realistic to achieve a thermodynamic deficit, that there is some buffer or hysterisis to the curve (i.e non linearity) is not a big deal. The key insight is that the variability in the effeciency of your metabolism is not the bounding factor. A standard deviation of a few hundred calories in the natural variability of metabolism will meaningfully increase the difficulty of weight loss, but this simply means modulating the duration of your activity taking into account the diminishing returns of increased exercise and natural variability in metabolism. Now if this is psychologically or practically easy is an entirely different question.
My maximum effort in a day was an 8 hour off road bike ride. I burned 3500kCal just from the riding, as measured by a power meter. The body can’t even absorb enough carbs to replace that in the same time.
There is some difference in efficiency between people for muscular exercise - between 20% and 25% of energy burned actually gets converted to work.
And no people cannot extract more or less. They can absorb more or less in total for carbs - between 80 to 120 g/hr balanced between glucose and fructose is the limit for most people.
The interesting thing in this link was the impact of change in exercise regimen. We know that exercise in itself can mitigate metabolic adaptation and leads to better outcomes, so maybe that should not be surprising (when they quit). The outsized impact is interesting. I wonder if those who sustained higher levels of exercise were actually in a steeper caloric deficit.
It's possible to lose weight sustainably even without exercise, so perhaps it's fair to say that if you're going to exercise, you best sustain it.
"damaged metabolism" was always kind of a semantic misnomer.
In other studies (alluded to here as those where participants don't undergo anything so extreme), exercise is both a strong predictor of long-term weight-loss success, and can dampen metabolic adaptation (since more muscle and good cardiovascular shape boosts metabolism, usually).
I'm not sure what the lesson is yet, but I would hazard that, in the long-term, it's more important to sustain tracking energy balance (sustainability of your diet is #1). Moderate exercise can probably help, but perhaps it should also be sustainable, and in that capacity there are rapidly diminishing returns to intensity of exercise (and perhaps going hard and then quitting is a risk factor for weight regain).
Yes, but as I read it, they all lastingly changed the level of exercise they were getting, and the extent of the "bad" metabolic adaptation seemed to correlate strongly with how big of a lasting change they made in exercise.
> In other studies (alluded to here as those where participants don't undergo anything so extreme), exercise is both a strong predictor of long-term weight-loss success, and can dampen metabolic adaptation (since more muscle and good cardiovascular shape boosts metabolism, usually).
Yes, trading fat for muscle increases your baseline caloric consumption, but that's not the same as long-term weight-loss.
I'm curious about what studies you've seen, because I've seen several other studies that suggest the opposite: that diet is a stronger predictor than exercise of long-term weight-loss success, and this analysis suggests that the more exercise the more likely it is that it will feed in to metabolic adaptation.
> I'm not sure what the lesson is yet, but I would hazard that, in the long-term, it's more important to sustain tracking energy balance (sustainability of your diet is #1). Moderate exercise can probably help, but perhaps it should also be sustainable, and in that capacity there are rapidly diminishing returns to intensity of exercise (and perhaps going hard and then quitting is a risk factor for weight regain).
My speculation is that the lesson is that in general there are diminishing returns from having a caloric deficit, regardless of the means to achieve it. Which fits with the idea that it is easier succeed with small, lasting changes than to create a more significant deficit for a shorter period of time. It would explain the insane failure rate of the weight loss industry, which for obvious reasons needs to show significant short-term results.
This doesn't contradict me.
> I've seen several other studies that suggest the opposite: that diet is a stronger predictor than exercise of long-term weight-loss success
That is not the opposite. I am not claiming that exercise is a stronger predictor than energy balance. I am claiming that it is a strong predictor.
I am not going to dig them up. Go check google scholar and check out Layne Norton's book Fat Loss Forever.
> there are diminishing returns from having a caloric deficit
The evidence seems to suggest that it's better to lose weight slowly to mitigate metabolic adaptation. If that's what you mean, it appears to be correct.
I would reiterate that I think the impact of exercise might be different with a small/modest caloric deficit.
Exercise is for muscle gain and general health, not for weight loss. You have to exercise a truly absurd about to burn enough calories to lose any meaningful amount of weight. You'd have to run from SF to LA to lose 10lbs, and that's assuming you eat nothing else to compensate which humans are notorious for doing. Your body has a very strong homeostatic drive, and will absolutely push you to eat more and to be more sedentary outside of work-out time to compensate for any additional exercise you do.
There's no studies or evidence whatsoever that shows it has a meaningful impact on weight loss. Weight loss comes from what you put in (or rather don't).
This write-up from 2016 references 60 studies and meta-analysis which all show the same. [1]
tl;dr: you should exercise for health and for muscle gain, not for weight loss.
[edit] Note that metabolic adaptation results from caloric restriction dieting too, which is why 95% of diets fail. Basically only GLP-1s and gastric bypass have been clinically shown to result in meaningful, sustained, long-term weight loss. Obesity is a dysfunction of the gabaergic central nervous system. That's why everyone's so excited about GLP-1s.
[1] https://www.vox.com/2016/4/28/11518804/weight-loss-exercise-...
> There's no studies or evidence whatsoever that shows it has a meaningful impact on weight loss.
Absolutely not true.
> Weight loss comes from what you put in (or rather don't).
It's energy balance. But just as increasing satiety helps (through food choices), exercise is a strong predictor of long-term WL success.
> This write-up from 2016 references 60 studies and meta-analysis which all show the same.
You're quoting a vox article, and it's making the aforementioned erroneous conflation about calories burned during exercise.
Please cite a study that shows that exercise results in long-term sustained, clinically meaningful (>5%) weight loss. I have looked extensively and found none. And that's not for a lack of extant studies.
> It's energy balance. But just as increasing satiety helps (through food choices), exercise is a strong predictor of long-term WL success.
As far as I can see, there aren't any successful long-term (>2y) weight loss studies that don't involve GLP-1s or bariatric surgery, so maybe that's where the issue lies.
> You're quoting a vox article, and it's making the aforementioned erroneous conflation about calories burned during exercise.
I don't think it is, I looked over the studies they link to, but I'm open to being wrong. I don't really have a horse in this race.
Those are not the words I used. Please engage in good faith. More accurately: exercise in addition to energy balance (and with a modest caloric deficit) is a strong predictor of WL success.
Check google scholar for meta reviews, I don't have this bookmarked and I'm not doing homework for you. If you don't want to believe me then don't.
I recommend Layne Norton's book Fat Loss Forever and his yt channel, he cites studies there.
I mean, kinda, sorta?
I can go to the gym and burn 1000 kcals, as measured by a chest strap.
I used to do this 3x a week. That is nearly 1lb of fat burned through just exercise.
In the context of someone who needs to lose 50 pounds, 1 pound seems small, but in reality 1-2lb of weight loss a week through diet is considered "healthy", adding another 1lb of weight loss via exercise is absurdly impactful.
Now, do most people, especially beginners, have the willpower to burn 1000 calories at the gym? Hell no. A 1000 calorie workout sucks.
> There's no studies or evidence whatsoever that shows it has a meaningful impact on weight loss.
The obvious counter example is any endurance sporting event, where by the end of the event athletes weight a lot less than when they started.
30 minute workout 3x a week? Of course no weight will be lost.
Now, instead go train boxing or MMA for 3 hours a day 5 days a week. If you track calories and don't increase your intake, I promise you'll lose some weight.
People doing those bike races lose tons of weight, both muscle and fat.
That is the flip side of going balls to the way hard, it is easy to start eating into muscle, which is fine now and then for an event, but as part of a regular training regime it isn't the best idea.
All of these factors are why the advice "you cannot outrun a fork" is true for the general population, but it scientific fact that no amount of exercise leads to weight loss.
A truer statement might be "at the level of efforts an untrained individual is able to maintain, and for the length of training sessions that are available to an average person with a job and a family, exercise does not contribute meaningfully to near term fat loss."
But people who've been lifting weights for 5 or 6 years hard core may very well have increased their BMR by 500 or so calories, at which point they can eat a, reasonably sized, cookie each day.
Yeah, you use about 100kcal running a mile, so 26mi gets you around 2/3 of a pound of fat.
This is why I said to lose 10lbs you'd have to run from SF to LA, which is about 400mi. Without eating more than baseline.
The problem isn't the micro. Yes, if you exercise a ton without compensatory eating and in excess of the expected drop in BMR that produces, you will lose weight in the near-term. The problem is your homeostatic mechanisms kick in and work against you making it extremely hard to maintain. Your body has a weight set point like it has a temperature set point. The follow-up study on the Biggest Loser showed basically every single one of them put on all the weight they lost. In some cases more. Here's the PubMed link. [1]
The evidence seems to point to the opposite of your conclusion - a lot of exercise reduces your BMR, it doesn't increase it. Makes sense doesn't it? A lower BMR means you're more efficient. While your TEE might be higher, your BMR is probably lower.
> Your body has a weight set point like it has a temperature set point.
And more recent studies have shown how to change it.
Eat at a moderate deficit for 4 months, then take up to 2 more months carefully eating at maintenance. Rinse and repeat to keep losing weight. This avoids the problems you are talking about.
But if someone has 100 lb to lose they don't want to hear "lose 1 lb a week for 4 months, then don't lose any weight for 2 months, repeat for a few years." Adherence to such a plan will be terrible, but it'd work.
Calorie cycling, as described in the video I linked to twice in this thread, also avoids the problems, and Dr. Mike explains how calorie cycling prevents the problems with hormone levels that a long term deficit can create.
Also
> Yeah, you use about 100kcal running a mile, so 26mi gets you around 2/3 of a pound of fat.
This is why I'm not a fan of running. I have recorded workouts (HR chest strap) of me burning 500 calories / hour.
Then again when I'm in shape (currently recovering from a rib injury....) I spend an hour with my heart rate in the 150s to low 160s on a 3-1 interval cycle.
Also it won't be 2/3 a lb of fat, it'll be carbs at first, some fat, and at those calorie burn numbers, some muscle mass as well.
(This is where the keto people jump in, but sadly research studies on high level athletes who are long term keto adapted doing intense stuff are hard to come by)
If you have a link I'd love to read it.
Of course they regain the weight.
These people didn’t magically create mass from nothing. They ate too much for their activity. Done. Stop doing that if you don’t want to gain weight. Obviously easier said than done. But I’m sick of the idea that these poor souls are visited at night by globs of mass that force their way inside.
All these magic drugs are going to do is incentive bad food and bad habits. This isn’t good news.
Not true.
https://www.scientificamerican.com/article/science-reveals-w...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082693/
> discovered that certain Russian populations had large intestines that were about 57 centimeters longer on average than those of certain Polish populations. Because the final stages of nutrient absorption occur in the large intestine, a Russian eating the same amount of food as a Pole is likely to get more calories from it. People also vary in the particular enzymes they produce. By some measures, most adults do not produce the enzyme lactase, which is necessary to break down lactose sugars in milk. As a result, one man's high-calorie latte is another's low-calorie case of the runs.
> Call out: Germ-free mice can eat more and gain less weight than conventional mice
Yes, of course. There are always outliers. But 50+% of the American population doesn't fall into this bucket, do they? Nor did they suddenly become that after they were born (i.e., obesity is a relatively new problem and not so much driven by DNA else why didn't it exist so much even just 50 yrs ago?).
We keep looking for all kinds of "answers" to obesity but we already have the one that works for most people most of the time:
Take in more calories than you burn, and those extra calories will become added weight.
That's it. It is *that* simple.
But people refuse to change their diet and/or lifestyle. In fact they're being told it's not their fault, as if someone else is responsible for what goes in their mouth and their sedentary lifestyles.
Is this not something that actually happens?
It seems like a spiral of doom. Eat less, so now I have even less energy for activity and thus now I am burning less energy, so I need to eat even less...
The ultimate solution is prevention. But bring that up and you're accessed of being insensitive, fat shaming, etc. We've normalized the abnormal, and too few what to see that reversed.
The more basic "Why has there been a rise in obesity?" keeps being asked, and that's already answered.
The idea that people are falling asleep next to a pod and waking up with too much weight for some mysterious reason is a false narrative. It's not making anyone any more aware or any healthier.
to my knowledge, it has not. Researchers are still trying to understand why.
Why are people eating so many calories?
Why aren't people getting off the sofa and moving?
The actual "mechanic" of weight gain are well known. That's not up for debate. But for some reason, it is. And the gains keep on coming.
The things you linked are completely irrelevant. First link: The calorie counts of food are wrong? Sure. Absolutely. No shock there. Treat them as rough estimates.
Second link: different people are different? Whoa. Wow. Oh man, mind blown.
What you naively describe as "not true", the universe itself would describe as bedrock reality.
Despite the bad scientism (i.e. coping) everyone hides behind, nothing changes the fact that if you burn more calories than you consume, you'll loose weight.
If you aren't loosing weight AND counting all of your calories, guess what: you've counted wrong. Dial them back more. Keep dialing back until results are achieved. The gym bros have truly found This One Weird Trick that works 100% of the time.
stimulants
It's so easy, just stop eating so much. As if fat people haven't heard that one a bilion times over. As if fat people havent tried time and time again.
Personal responsibility! you put that stuff in your mouth, rah! rah!
Personally I'm actually sick of people having no eye for the bigger picture, for many systemic reasons and larger society, and just blame stuff like this on individuals.
How are statements about reality fat shaming?
That being said, there is some issues with the prevelance of hyperprocessed unhealthy foods.
The fact that the most unhealthy options also tend to be the cheapest and easies, really do not help.
Permanent weight loss of more than ten pounds is nearly impossible from a scientific standpoint. The success rate after 5 years of weight loss is somewhere around 0.1%. You'd think that if it was as easy as everyone claims, more people would succeed. Heck, many people who have had gastric bypass surgery regain a significant amount of weight, even if their stomachs have been reduced to the size of a ping pong ball.
Physically, weight-loss is utterly trivial. Literally everything that people say works, does. Eat less calories, eat less sugar, cut out snacking, cut out liquid calories, cut out processed food, reduce carbs, literally any and all of those work, choose whichever is most appealing to the individual.
The challenge to weight and diet in America is mental and cultural. Obese people remain obese because they have unhealthy relationships with food and eat addictively or emotionally, using food to soothe anxiety, depression, loneliness, disappointment, etc and because cultural norms and advertising have normalized obesity-causing diets.
Eat food. Not too much. Mostly plants.
The science of body metabolism is hard. But the rules for weight loss are simple: move more, eat less. For some people it's just "Move more, eat the same".
"Eat less" means "less calories", volume can be the same - really helps.
PS chips are a crime against humanity
Changing when you eat is a factor too.
I noticed that carbs such as bread or pasta really help with food satisfaction, unlike fat-intence or protein foods.
Remove sugar in secondary things: tea, coffee, soda. Understand the calorie count in carbs such as chips. East to the mild calorie deficit. Compensate with moderate excercise. And so on, setup new dietary habits one by one.
It doesn't have to be painful!
Agreed; but it is work. And for a great many people, that is an issue.
My journey to effective body weight control was 10 years long. Misinformation is everywhere these days...
But... it doesn't have to be hard. For me gamification of the calorie couting game and step counting worked surprisingly well.
You can't say this on HN, where weight loss is a myth and the only way out is to take a crazy life-altering medicine. Exercise? PFFT. I walked a flight of stairs once, and did not lose a single gram.
It doesn't take more than restricted calorie intake and moderate excercise (walking, gym, etc). After a few cycles of gain/loss it becomes easier food consumption habits change
https://www.sciencedirect.com/science/article/abs/pii/030646...
https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1098-1...
https://www.tandfonline.com/doi/abs/10.1080/07315724.1999.10...
Your initial statement is completely misleading and shockingly you have provided hard evidence against it.
A 5% weight loss for a 200-pound person equals 10 pounds. Anyone can achieve this by following a fad diet for a week or two.
> Permanent weight loss of more than ten pounds is nearly impossible from a scientific standpoint. The success rate after 5 years of weight loss is somewhere around 0.1%.
Your sources indicate that your initial statement was wrong by a factor of ~100 at least.
The majority of these studies consider a weight loss of 10 pounds over two years to be successful. If you start with 100 pounds or more, that is almost nothing.
Many of them consider anyone who starts at 300, loses 100, and gains 80 back in five years to be a huge success. Is it really?
In healthcare, an obese person is typically considered successful if they lose more than 30% of their body weight permanently. This is extremely unlikely to happen without surgery or medication.
A good diet and exercise routine can have wonderful results, even in the long-term. The percentage of success in losing significant weight with those methods is far, far above 0.1%, and I think people should be aware of that.
https://www.hubermanlab.com/episode/david-goggins-how-to-bui...
Fewer options for an appealing 'proper meal', more temptation to eat sugar-laden junk.
The sentiment still stands though, all the cogs in play seem to spin to make real food inaccessible and expensive.
(by real I mean animal products and good produce) (raw milk is straight up illegal in Australia, most of the world would laugh at that)
====
Side note: Judging health questions off a game show is ridiculous
I think you're vastly overestimating how much of this (particularly "calories out") is under voluntary control. We're discussing an article that showed that extra active calories burned tend to lead to a compensatory reduction in resting metabolism.
And there are some very strong psychological/physiological drives that influence "calories in" (read up on the Minnesota Starvation Experiment for examples).
So much science out here to disprove this kind of statement, yet you still make it.
Apparently for this crowd taking medicines is better than stopping stuffing yourself, because you know, if you take a medicine you can keep stuffing yourself.
Oh, and also "it's more complicated than that" is always a nice escape from the harsh reality of thermodynamics.
If your body has the wrong idea of how much fat it should store, it'll do its best to force you to eat more to get that fat, even if it makes you unhealthily overweight. Medication can fix the body's idea of how much fat it should have.
Taking that medication doesn't mean you can keep stuffing yourself, it means you can finally _stop_ stuffing yourself, without your body incorrectly reporting that it's starving. The point of the medication is to make it possible to do the right thing.
That’s not at all how these new medicines work. You can’t (well, don’t) keep stuffing yourself on Wegovy (Ozempic) and Zepbound (Mounjaro), because you no longer spend all your time wanting to. These drugs work by switching off your desire to stuff yourself, not by allowing you to stuff yourself without weight gain. When you eat a big meal on these medicines, you feel satisfied and over-full, rather than like an addict who just got a partial hit and wants to ride it.
I take an immensely helpful SSRI for GAD, that no amount of mindfulness, therapy, or healthy living seemed to touch. I take a GLP-1 agonist for a food compulsion I’ve had for 25 years and couldn’t shake. I never got properly fat, but fighting a desire to EAT ALL THE FOOD no longer occupies 50% of my mental energy.
Have you ever come off nicotine? If so, you’ll know the little voice in your head that is continually telling you that you should have a cigarette for the first few days. You can’t shut it up. Hey, have a cigarette. You know what’s be good right now? A cigarette. Oh you just woke up? Have a cigarette. It fades eventually for nicotine. In my experience, and, in that of many/most fat people, you have that constantly for food, that food noise. GLP-1 agonists turn the food noise off.
You and almost the rest of HN. I’m uninterested in users of a drug that alters your thinking telling me about other new drugs.
No offense of of course. My point is you are already conditioned that “pills solve problems”.
it's also a very poor point because it's presented as a solution without addressing the fact that it's really, really, really hard for people to eat less.
We all know it’s easier to eat garbage than to exercise and eat healthy. We all know it’s more expensive. We all know it takes some degree of knowledge of what and when to eat.
That isn’t the point. It’s that HARD and UNKNOWN is not faultless.
> Six years after the competition, median weight loss in 14 of "The Biggest Loser" participants was 13%...
That means at least 7 of them lost 13%. That's pretty significant. On Ozempic, average weight loss is 11% after six months.
The show worked for the majority, and the difference between the people who it worked for and the people for whom it did not work is Physical Activity not Energy Intake. This is covered in the OP link and also in https://pubmed.ncbi.nlm.nih.gov/29086499/
But yes, 13% is significant.
[1] https://diet.mayoclinic.org/us/blog/2024/how-does-ozempic-af...
Fat, muscle, and activity burn calories.
If you lose weight you’re probably burning fewer calories unless you replace it with muscle.
Activity levels also vary over our lives. We tend to be more active when we’re younger.
But my point is, if someone loses a bunch of fat their bmr is going to take a hit. Could be pretty significant on the order of hundreds of calories a day.
Read that again. Six kilograms, per year. Every year.
Given a person consuming near their total daily energy expenditure, that’s the difference between losing almost 20 kg since the start of COVID, and gaining 20 kg.
Small changes over time compound in unintuitive ways, which is all the more reason not to dismiss them so flippantly.
You might need to put on some fat to gain muscle EFFICIENTLY, but it's not a requirement for putting muscle on at all.
It's sad to see what nonsense (like "metabolic damage") people will invent to justify failing at weight loss (or worse, never even attempting weight loss).
Edit: 5/30 less than 12 hours old, 16/30 more than 20 hours old.
If you guys suggest (or submit!) some good submissions and let me know what they are, I can put them in the second-chance pool, which will accelerate the refreshing of the front page.
That story was on the top by far yesterday and then it suspiciously disappeared, after the comments took a very decidedly (and very deservingly, in my opinion) anti-Muskian bent.
Since then there has been no story about the bitcoin ETF on the front page of HN even though it is a very important time for bitcoin (the deadline for bitcoin etf inclusion is today) and HN loves talking about bitcoin.
So there is your answer.
(Btw HN has plenty of "anti-Muskian bent". A glut in fact! So I'm a bit mystified how that, of all things, would trigger suspicion)