We should keep looking for better options, we can and should always keep an eye on potential consequences down the line — and we can always elongate that line — but the very real, proven consequences of being overweight/having high blood pressure can be calculated like those that are attached to burning coal and they are worth tackling without prejudice, within the guidelines of what good science deems safe.
Anything we can do to help with cardiovascular issues needs to be explored. Doing otherwise would simply be immoral and irresponsible. We have tried eating salads and going for quick walks. It's always great when that's enough to change one person for the better. When it's not, we should help with empathy. Currently, there simply is no clearer, quicker path to doing more than these drugs, on a societal level.
To me, that suggests that maybe that simplistic (and frequently repeated) mental model is inaccurate or insufficient in some way.
My working theory is that most Americans’ gut microbiome is massively screwed up due to some combination of genetic, dietary, and environmental factors, and it changes what they crave, and how their body reacts to the food they eat. But I’m very much a layman on this topic.
People putting it down to eating less are parroting the food equivalent of abstinence-based sex education, and we’ve been drumming on that for like the last 30 years. We have to find what’s making people want to eat to excess, not just tell people to eat less and exercise more. That obviously doesn’t work.
If you think that there's something else going on, then let's see some hard data.
Personally, my "satiated" level is very low. When trying to gain weight while weightlifting, it was difficult to eat the amount of calories needed. I know others who can easily eat twice as much as me in a sitting and not feel full. Something different in happening in our bodies to signal "stop".
Eating less and exercising more does work. Talk to dedicated lifters about their cutting/bulking, where they want to be, and talk to them about it again in six months if you want to see how effective it is. It doesn't work for a lot of people because in the short, medium, and arguably even long term, it doesn't make you feel good.
There are a handful of people that can struggle to gain or lose weight on a diet appropriate for the amount of exercise they do. You may be one of them. If you are one of those people, asking why other people struggle with it is like being a 6'6" basketball player and wondering why somebody who is 5'9" struggles to dunk like you can.
There is a massive difference between being at a calorie deficit and starving yourself. I don't even know what to say -- this horse has been beaten to death by countless thousands of people and it's wild that anecdotal evidence with a sample size of you is enough to justify theorizing an alternative to an incredibly simple idea that until a few generations ago, there was absolutely no evolutionary pressure to not want to eat everything you can.
I suppose you'd say that some areas experienced more evolutionary pressure to eat as much as possible than others due to differences in food security?
But being hungry/unsatiated is distracting and can decrease your performance on every other task you do, so I don't really agree that there's no counterpressure. And I doubt that people in even those less food secure regions are just hungry all the time, like some obese people here describe being. It really seems like something just gets messed up in the signalling, which makes it seem more like a health problem/malfunction than some built-in evolutionary drive that doesn't fit the modern world.
At the very base this is mostly true but it's like saying the reason people die is because they stop living. Framing it as people behaving "in this self-destructive way" also isn't helpful because being obese isn't a moral failing.
The true answer is more complex. At least in the US, consumers have been fighting deceptive marketing/branding for things that have been claimed to be healthy choices but are full of sugar and unrealistic serving sizes. Combine that with unhealthy foods generally being cheaper and/or easier to cook and now more accessible/easier healthy eating also has class issues. Exercise does too as most of the places where obesity is most concentrated in the US (the Southeast) doesn't have walkable cities or sidewalks at all.
This has been a common comment left on HN of "it's just move more, eat less" and yeah, at a fundamental level, sure, but really doesn't take into account how difficult it can be for a person that's in that situation.
> Snack companies take advantage.
I'm uncomfortable with these new drugs but they seem to be a net positive so this is a good thing. But we should also look into legislating junk food companies that hijack people's appetite for a quick buck.
Chile banned sugary food TV advertising to children and saw a roughly 10% drop in purchases high in sugar. An unleashed free market in food has been shown to be harmful and the drugs alone are insufficient. Regulation is necessary.
https://healthpolicy-watch.news/chiles-comprehensive-food-po...
Incorrect.
You patch that by altering the environment OR the body OR or the impulses.
To fix that you need to alter all 3
We have tons of evidence to the contrary in multiple disciplines. Like, have you never made a conscious dietary change?
In any case, yes I have, but the only time it has worked was when I changed my environment (stopped slouching at home bored with a full pantry) and my impulses (filled my days with activities so that boredom hunger wouldn't strike). Only changing one would make me last a couple of weeks max
Different people struggle with different impulses. I don’t have much trouble permanently modifying my diet. I struggle, on the other hand, with keeping a normal sleep schedule.
Which isn't to say that the overall idea of trying to find other ways to make obesity less common is bad, it just isn't a coherent argument for that.
It's "masking" the issue as much as chemotherapy is "masking" the issue. People are dying. We have tried appeals to salads and quick walks.
Unless you got anything up your sleeve, I recommend we stick to the ol' "keep more people alive with the best stuff we currently got" plan, until information pops up, that makes this look like the morally worse option.
But in that regard preventing death is fairly hard to beat as a baseline.
This bit made me laugh, as if public health initiatives have been taken remotely seriously by the past few decades. It seems quite a jump to go from "maybe try a a salad?" to putting millions of people on medication.
Did that happen with tobacco? Alcohol?
It's a hyperbole, meaning to say: The problem is so frustratingly silly and solution is so obvious and simple — just eat a little less, move a little more — that I understand how hard it is to accept that it might just be the completely wrong approach.
What makes it fairly obvious to me is that despite clear and long standing conflicting beauty ideals, the massive societal advantages beauty affords, and an industry build around weight loss (not even drugs, stuff like Weight Watchers), people still struggle.
If you have good insight into why informing about tobacco worked to the degree it did (although lung cancer is still the leading cause of cancer death) other than claiming vague un-seriousness, I am all ears. Otherwise I have a hard time understanding this as an information problem.
My point here was that we seemed to approach tobacco/alcohol a bit more methodically - taxes (i.e., increasing costs for cigarettes), regulations (i.e., where alcohol can be sold), education (i.e., scary cigarette packaging) - whereas we seem to be saying, "Well, we did very little and got no results, so let's go nuclear!" when it comes to obesity
It seems to me that, if obesity is so harmful to society, places like McDonalds and other (provably) unhealthy food shouldn't be as cheap or as easy to get as it is.
> The problem is so frustratingly silly and solution is so obvious and simple — just eat a little less, move a little more — that I understand how hard it is to accept that it might just be the completely wrong approach.
It certainly is frustrating, and I feel that more than I probably should. Probably something to reflect on.
For example, many people around me gained weight after they became parents. Especially women after birth. It is just insanely difficult to work hard in an office job, take care of young kids and exercise etc all at the same time. As you age things get very difficult as well. I eat significantly less than what I used to just few years ago but still have 5-10lbs extra.
And like the majority of people who lost weight, I gained it back.
Why? I don’t know. My body just wants to eat more. I have to be constantly vigilant or else I’ll fall into my old habits of what my body demands that I eat. I’ll eat dinner and then still be hungry.
I think you’re getting this backwards. I already have an eating disorder.
Of course you’re still hungry - you have a pantry of delicious food right at your fingertips. One Oreo couldn’t hurt, right?
That’s not somehow unique to fat people, though I know some other skinny people will pop in and say “I’m basically never hungry!” Humans didn’t evolve to have delicious food constantly available, and to need to do no exercise to get it.
I wouldn’t say those that are overweight have an eating disorder. They’re (obviously, going by statistics) “normal.” Then there’s those of us that have the will power or specific motivation to not stuff food down our throat. The few that are left are probably the real ones with something biologically unique.
I'd take the odds that you eat too fast. Slow down and carefully chew every single bite. Put the cutlery down in-between bites.
All the people who have never been fat have the best advice that us fatties totally appreciate and want to hear even when we never asked for it. In fact, it’s extra awesome when people bring up obvious advice when we don’t ask for it because fat people like me are actually less smart than you! So it’s really helpful to have a helping hand and I thank you for it.
Thank you for downplaying a disease that almost half of the population has and for blaming it on me as an individual. Because obviously if half the country has the exact same ailment as me, it’s really a sign of the dangerous virality of the fast paced chewing lifestyle.
Since most people who lost weight gain it back at some point statistically, it really makes logical sense that it’s all about how fast we are all chewing our food. All the celebrities and pundits on TV and in social media talk about how we need to chew our food faster, so it’s hard to escape that perverse influence.
If you're interested, I do have a recommendation for you. For my money, Joel Greene is the best scientific thinker on the topic of diet and health, and his recent book "The Way" does a lot to replace frustration and confusion on the topic with sense and helpful advice. I recommend it if you've had success with a diet, and then regained the weight, and now nothing works - that's the exact problem he's focused on. Above and beyond whether you like his suggested solution, he does a lot to uncover mechanisms and explain the complexity of the problem.
For what it's worth, I think your experience is completely normal. Nearly universal, even.
I. Am. Not. Looking. For. Advice.
Especailly not some stupid fucking self help book from a quack selling $100+ supplements.
If you'd rather see the bibliography without the boomer, here's what's directly relevant to what you were writing about - one of the (several) mechanisms for weight regain and why losing weight is so much more difficult the second time around: https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(... (TLDR: Control of hunger by the hypothalmus responds to dieting by becoming more aggressive, and it stays that way after the diet stops.)
It's not in your head and it's not a character flaw. Purely physiologically speaking, naive, restrictive dieting really does become much harder, if not impossible, the more you do it.
Obviously meds don’t work for everyone, but the aim is to have population level effects.
It’s about effective interventions. Obviously major interventions are needed as there is a huge amount of obese and overweight in the US and many other methods have been attempted.
It’s not about theoretically possible (ie, a bodybuilder can do it) but effective population interventions that result in people successfully losing weight.
Think about people going to medical school and becoming a doctor. It’s obviously possible but if you said the solution to income inequality was for everyone to go to medical school and be doctors that would not be a very effective intervention.
Not being obese is not being wealthy. It’s simple what to do, but difficult to stick to a successful plan.
Etc etc
Life is full of things that are supposedly easy, but yet people don’t do them. I think it’s reductive to just stick with ineffectual interventions that aren’t being used because they seem simple and people should just adjust.
Saying “Japan (4.5%) can do it so Germany (19%) should stop being so fat” isn’t very helpful. [0]
The goal is to reduce obesity. It’s not like we can’t also attempt systemic changes while also using ozempic.
If you’re saying we shouldn’t use ozempic because other methods should work (but haven’t in many countries), then that’s a pretty simplistic argument. And one that will likely result in greater obesity and societal harm.
[0] https://en.wikipedia.org/wiki/List_of_countries_by_obesity_r...
One of the reasons I referenced other countries was because it provides very strong evidence that culture is a factor. In America, we presently have a culture of telling ourselves that it's really hard to keep excessive amounts of weight off. We betray ourselves every time we tell that lie.