The Obesity Era
aeonmagazine.com
aeonmagazine.com
Obese women consuming a hypocaloric diet with 71% of their daily energy as carbohydrate and 43% of it as sucrose had no trouble losing fat. "Results showed that a high sucrose content in a hypoenergetic, low-fat diet did not adversely affect weight loss, metabolism, plasma lipids, or emotional affect."
Moreover, all carbohydrates, as well as protein, stimulate insulin release, and insulin is not in itself problematic: http://weightology.net/weightologyweekly/?page_id=319
Reducing carbohydrate intake can be an effective weight loss method, but that doesn't mean that carbohydrates intake is uniquely responsible for obesity to begin with. http://wholehealthsource.blogspot.com/2011/08/carbohydrate-h...
All of the world's longest-lived populations consume carbohydrate as their primary macronutrient.
All the other variables and laws of physics still apply.
All the fad diets that cut out a certain type of food all really just work because of calorie restriction. Look at the "cookie diet" for an example.
For me, I'm 6'2, I went from 210 to 175 over 10 months (while adding significant muscle mass, suggesting fat loss of 40+ lbs). I did this by changing my diet: I eat nothing for breakfast. One cup of coffee with cream. For lunch, I eat only fruit. Seasonal. Always an apple, sometimes two, berries and grapes, that sort of thing. Sure they're good for you in a non-processed-foods sense but they also are very high in sugar.
I eat a very large dinner.
I always, always eat dessert. Always.
I work out 3 mornings a week, those days I eat half my "lunch" right after my work-out.
Obviously I'm sharing an anecdote but I mention it just because it echo's the research I mentioned and as a testimonial that it works for me. I eat an absurd amount of sugars and carbs but my total calories are restricted and I'm in fantastic shape.
I eat some junk on the weekends myself, that's how I get perspective on drastic changes in my energy levels.
Or, instead you can switch into fat-burning mode and have a constant blood sugar and not feel hungry nor have to skip meals. Lots of good stuff too, eggs, spinach, olive oil, flax, etc. Doc says my bloodtest numbers some of the best he's seen.
Fad diets are suspect, but this isn't one of them. When was the last time in the wild you saw a chimpanzee or early human eating a loaf of bread, pasta, or cookies? Never, because they are man-made creations. The fad diet is the empty-carb diet pushed by the modern world, the results of which are obvious.
Humans have evolved over millions of years eating veggies, fruit, nuts, meat, etc.
I'm forming an idea, that there is nothing wrong with these two approaches. Rather there is a choice. Perhaps some of us prefer trading off in favor of tasty sweets, while some of us prefer stable blood sugar. You can live much longer than our poor ancestors with either approach. So, let's not bash the A- students on the other side because they're not perfect.
This is 100% bullshit.
(Yes! It's multivariate integral calculus, back from your youth to haunt you!)
Anyway, the second problem is that blood sugar in healthy individuals is very well regulated anyway. The blood sugar pathologies you see in obese individuals are usually pathologies of obesity, not the other way around.
The third problem is that carbohydrates, even simple ones, don't have a monopoly on short-term blood sugar effects. Insulin is usually identified as the primary regulator of blood sugar, but insulin is affected very strongly by protein as well as by carbohydrates. This is because insulin actually has a whole bunch of functions, only one of which is blood sugar regulation.
Biology is really complicated. It's the worst spaghetti code ever. It works, but there's no modularity, no information hiding, no clean APIs, everything is a global variable and there's not even the most basic concurrency controls. It's very hard to reason about.
But because it is so robust, it is easy to do thing A, get result B and attribute the results to factually incorrect theory Z9-gamma-pink-battleship.
Not to mention elegant in the way the human body runs perfectly on early-human food.
I'm not obese, and when eating sugar/starch I end up sleepy at times and starving a few hours later. Everyone knows it... moms have been telling us for decades if not centuries, not to give sugar to children.
Proteins/fats must be converted, meaning their glycemic index will be much lower. As such, a day or two after I substituted green-veggies & nuts for grains the difference was palpable.
I have not been stuffed or starving for over a month, lost my spare tire, and am loving it. Fits perfectly with everything I learned in chem, bio, and nutrition at uni. long before this became a movement. I don't think of this as FSM, rather differential equations such as these: http://17calculus.com/calc08-app-ccfluids.php
There are benefits to keeping blood sugar levels stable whether people want to believe it or not.
Effects of an oral and intravenous fat load on adipose tissue and forearm lipid metabolism. http://www.ncbi.nlm.nih.gov/pubmed/9950782
"Six subjects were fasted overnight and were then given 40 g of triacylglycerol either orally or as an intravenous infusion over 4 h. Intracellular lipolysis (hormone-sensitive lipase action; HSL) was suppressed after both oral and intravenous fat loads (P < 0.001). Insulin, a major regulator of HSL activity, showed little change after either oral or intravenous fat load, suggesting that suppression of HSL action occurred independently of insulin."
The implication being, of course, that this isn't the whole story, and we are doing ourselves a disservice by chalking up everything to diet.
(I don't mean to say you are wrong about this fact by any means - I'm not any kind of expert, and you sound very convincing.)
I wouldn't be surprised if laboratory food was centralized around corporations just like human food. Meaning, I bet cheaper ingredients (more wheat/corn) have made their way into it over time. I can't imagine such peripheral industries not being affected.
But also, if you have a look at my abstract, it does point to another potential cause of obesity and type 2 diabetes in humans (but naturally not the lab animals) - food addiction. The patients in this study were also successful (presumably) because they were actively involved in a 12 step program for food addiction.
On a personal note, I lost 30 lbs over 6 months by pretty much eliminating sucrose from my diet and also consuming a lower amount of carbohydrates (120 - 180 grams per day).
The "fat virus" theory would perfectly explain it. If some of our co-evolved viruses and bacteria have been making us more prone to accumulate fat and it's contagious, the lab animals caught it too. So their metabolism slows down to allow them to accumulate weight on the same diet that used to be merely sufficient for sustenance.
On a personal note: I also lost 30 pounds over 6 months once. I did it by simply counting calories (hacker's diet). And I kept the weight off for about a year. But then I gained it all back and then some within the next few years. Most people can lose weight on most diets in the short term; the real trick is losing a significant amount of weight and keeping it off in the long term. Although some people manage to do it, it's not many. How to reliably lose weight and keep it off is still basically an unsolved problem.
It's also worth noting that people who have gained a bunch of weight and lost it have a slower metabolism than people who stayed at the same weight. The Hacker's Diet - being based on calories in/calories out - did not account for this factor. The claim it made was that you could lose weight by keeping a calorie deficit for a while, then once you've lost enough weight you could stop the deficit, go back to basically eating at the level you did before and still stay at the new weight. Which doesn't work.
Dieting seems to work because your body takes a long while to adapt to new conditions. Eventually you get hungrier and less active; progress tends to stop and reverse whether or not you keep "trying".
Temporarily losing weight is "a solved problem". But losing weight without reducing metabolism and thereby making yourself more likely to gain weight in the future, is not.
No, it is. Getting people to do it and stick to it is unsolved.
Lifestyle change, to reduce calories and restructure meals to include correct balance of proteins, carbohydrates and fats, and to raise awareness of when food is eaten and how many calories are being eaten, is tricky. But if people do it it works.
12 years ago, I lost 55 pounds in six months. All I had to do was carefully monitor everything I ate and burn 1000+ calories exercising six days a week.
Thing is, that was a solution that worked very well for me when I was self-employed 30-year-old single man. It has not worked at all for me as a 42-year-old married man with a child. I don't have the time for 90 minutes of exercise every day. There is always loads of food around I shouldn't be eating. I have vastly more stress in my life than I had then. And my body very definitely reacts differently to food than it used to.
What I'm trying to say is, I found a great hack for losing weight quickly back in the day. I did not find a solution to keep my weight down in the long term.
The parent said he lost 30 pounds over 6 months. This is not a "test case." He implemented the solution effectively. What he ended up doing however was to change the input variables (literally) by increasing the amount he was eating. Therefore the solution he implemented failed, and he gained the weight right back.
(Also, the system I was following (hacker's diet) incorrectly claimed after losing the weight you wouldn't gain it back from simply returning to prior eating habits. Because it didn't account for the now well-known metabolism-lowering effect of dieting.)
...Other than that whatever the formulas are, they seem to make long-term loss nearly impossible for most people.
Can you post a link to this study?
>We don't actually know how TDEE reacts to weight loss in general
I don't think this is something "we don't actually know." Lots of weight loss studies have been done in which energy expenditure has been carefully measured, so there's plenty of data on this.
http://fampra.oxfordjournals.org/content/16/2/196.full
Quote: "...the majority of the studies point to a reduction in short-term resting metabolic rates that is greater than can be explained by the loss of body mass or fat-free mass over the same time period. Unfortunately, there has been very little work done over the last few years regarding the duration of this phenomenon.
[...]
This is relevant for motivated patients who adhere to severe hypocaloric diets to achieve rather large weight losses. When they get to goal weight their metabolic rate is severely depressed, and they can experience almost immediate weight gain if they resume their prior higher calorie intakes. Recent studies have not continued to measure changes in resting metabolic rate for extended periods to determine whether the reductions are self-limiting. "
There's also the "rebound effect", which the Minnesota Starvation Experiment gives us insight into.
People stop dieting and then resume ad libitum eating. They gain fat faster than lean tissue, because gaining fat is easier than gaining lean tissue. Net effect: BF% worsens compared to baseline.
The key is not that "diets don't work, look, they make you fatter"; rather, it's that people see diets as something you do once and then stop. What's actually necessary is ongoing control of food intake.
No, it really isn't.
"Eat less calories than you burn". It's that simple. Even if we include various viruses and bacteria that help us lose weight or help us gain weight, and we include various disorders that help us lose weight or gain weight, the answer is still "Eat less calories".
Unless of course you're saying that getting people to change behaviour, for ever, is tricky. In which case I agree with you.
One thing I noticed while on keto is that it reduced my appetite a bit.
Just for kicks I decided to try Steve Gibson's recommendation to remove sugar and starch from the diet. (https://www.grc.com/health/lowcarb.htm)
No knee-jerk here please, this isn't one of those butter-bacon-cheeseburger things. Nope, I eat tons of fresh veggies, lean meats, all smothered in olive-oil, nuts/flax, etc. I do actually allow myself some treats on the weekends for sustainability.
Still, one month later, for the first time in 20 years I no longer have a spare-tire. It makes perfect sense now that I think about it. As long as you fill yourself with sugar/starch you prevent the body from being able to go into fat-burning mode. Eat too much (as is common) and you go into fat-storage mode.
Bread may have built civilization, but now it builds waistlines.
Meanwhile after an example lunch of fish, veggies, and olive oil I feel full and satisfied almost all day (with the same range of calories).
I feel like most of us seriously underestimate how delicious and engaging carbs are. Even adults will sometimes go overboard and fill up on bread before a real meal.
I'm overweight, and I've changed my life and my diet to try and fix it. When I took note of where I was, I was drinking between 4 and 8 mountain dews a day. I ate candy in prodigious amounts, and constantly ate until I was full.
Since then, I altered my diet and eating habits to where I drink no pop, and rarely have any kind of sugary treat. I eat only until I'm satiated, and in usually get out to exercise daily.
The end result? I'm the same weight as I was before. My weight has not changed in over 9 years now.
I sure I could go on a starvation diet (< 1,000 calories a day) and exercise for hours on end - it's worked to a limited degree in the past - but that's not willpower, that's torturing myself. The last time I tried, I was constantly tired and sickly, and after coming down with a nasty bout of the flu and recovering from it, all of my progress had been lost.
I've come to terms with my weight. I'm eating healthy, I'm exercising regularly, and I'm thinking of getting into a gym and working on my strength a bit more. I have accepted that getting to a "normal" weight again is not within my reach, unless something outside of my control changes.
[EDIT] Before critiquing my story with the usual tropes of "you're still eating too much and exercising too little", please read the entire article and realize that it may not be the perfect answer you think it is.
There might also be medical conditions that prevent you from losing weight.
I gained maybe a pound a month during 2010 and 2011. Finally 12/2011 I had enough. I didn't like how I felt. What worked for me is this:
1. No depravation. I ate dessert every day. Period.
2. A large dinner (followed by that dessert) every day. Large as in, feeling totally full but not like so-full-it-hurts full.
3. Three 90 minute visits to the Gym every week.
4. A dramatic reduction in what I eat during the day. Dramatic. I went from free startup catered lunch every day (which is essentially like eating 2 dinners a day) to eating only raw during the day. That was my commitment: Nothing processed or cooked until dinner. But gorge myself at dinner if I wanted.
I started this 12/2011 and eat like this to this very day. It's easy now. In fact I hate it when I have to eat a big lunch. Today my lunch is 1 large apple, grapes, 5 strawberries, 1 small "Babybel Light" cheese and 3 water crackers. (I only added the cheese and crackers once I got down to under 170 and needed to eat more to stabilize my weight). I ate more fruit and veg the first 6+ months after I started this, I've just acclimated now to the smaller intake.
I cannot stress how important the big dinner was to me. Because I tried dieting before. Deprevation is very very hard to make work I think. And most importantly, what I've done was change my diet, not go on a diet. I can literally eat like this for the rest of my life. But a more conventional "diet" diet? No way. I'd hit some goal, then drop that misery like a bad habit, and probably slowly go back to the gaining 1 pound a month.
For me, at the gym, I was 28 but I'd never really done much time in the Gym. All i did for the first 8-10 months was cardio. The Elliptical. I'd just get on there for a full hour. The computer attached (as unreliable as it is) would usually indicate 800+ calories burnt. I had a handfull of 1000+. In one hour at the gym.
i morphed that later to 35 mins cardio, the rest alternating between isolating muscles (the machines) and free weights.
I mention all this not because I think I've discovered "the way." But your comments reminded me of how I felt before I did this. And now I'm so so happy I did. And here's what I really would hope, if I could pick the best outcome of my spending this 10 mins writing this:
People would read this and realize that they can innovate their own solution, borrowing a little from one diet, a little from another, weaving together a solution that works for them. What I do -- no breakfast, small lunch, huge dinner -- is basically 180* from what the conventional wisdom is. But it works for me. I iterated and found what works for me. To hell with the "experts." What I learned reading Pollan, etc, is that the science of nutrition is hardly a science at all and is full of contradictions and confusions.
A measurement like BMI, which is a great way of looking at a population, is a terrible way of understanding an individual, and the use of weight and BMI as a stand-in for health is infuriatingly wrongheaded.
The prevalence of quantified self & self-tracking is starting to change this & when you're able to measure & track inputs better, you're better able to correlate the results with them as well.
Based on your sibling comments (which as of this moment consist of "you're still eating too much food and not exercising enough"), I agree.
The new info about sugars and starches is that the starches have the same effect on our bodies, they just work a bit more slowly. What does that mean? Well, we knew in the 90's that starches could rot our teeth just like sugar. But today we also know that grains (wheat, corn, rice, potatoes, oats, other empty carbs) raise blood sugar and are only a bit slower than actual sugar. They are chains of sugar.
In other words, if you don't get rid of the bread, pasta, and crackers too, removing sugar will have only limited effects.
Yes, but what do you eat?
You can eat a whole bunch of processed carbs and starches until you're satiated, or you can eat chicken and broccoli until you're satiated. The results will be tremendously different.
Avoiding sugar is good, but by itself it is not sufficient - especially if you are still consuming copious amounts of carbs.
you also didn't mention what kind of exercise you are doing. if you aren't doing deadlift, squat, overhead press, bench press, you're probably doing something way too ineffective to burn fat (hint: you need to build MUSCLE, as a man)
you have a general casual attitude about your descriptions, which is probably why you aren't seeing results.
People trying to lose weight tend to overdo it and eat less than (or the wrong type of food) than is necessary to maintain their muscles. Building any more of them, as unlikely as it is to happen if you eat under your daily consumption, will not help with reaching their goal.
A SMALL PLATE.
That simple. Go out and buy a really individual side-plate, and make that what you always eat off. If you need seconds, OK - but after a few days you'll find that you can actually get by quite happily with one helping.
I'm sure we do eat too much sugar (way too much), but we eat too much everything. I started putting on weight when I was 40, and this is the thing that stopped it. It would be fascinating to measure our grandparent's plates, and what size meals they consumed. Despite a more active lifestyle, I bet they ate far less.
A late bloomer, huh... did you stay active your whole youth and then stopped for some reason? Or did you have an I-can-eat-anything-I-want metabolism in your youth which then petered out a little? I do wonder...
Also, sizes in the US are pretty much all over the map. Pants sizes in the US are measured in inches, and they can easily be 4 inches different than what a tailor will measure with a tape measure.
I regularly see things in Japan like dressed-up women in high-heels, elderly people, and other non-particularly-athletic-looking types, sprinting up long staircases to make the train. In the U.S. I would be quite surprised to see anyone sprinting in public...
Portions also often seem to be smaller. While of course it's easy enough to order large portions in Japan ("oomori kudasai!"), there's far less of the feeling of hard-to-avoid excessively large portions I often seem to get in the U.S. In Japan, "small" always seems to be on the menu, and is often the default; in the U.S., not so much...
I think it's important that such things are not unusual and "intentional" actions that you have to remember to do (and can easily shirk), but rather are a side-effect of the environment, and so happen all the time, even when you're tired, even when you're busy, even when you're out with friends to play, etc.
That said, the issue as a whole is not rocket science, and should not be treated as such. While it is very interesting to examine and discuss how the human body treats various types of calories, at the end of the day the closed system that is the human body is still governed by calories in minus calories out. It is impossible for someone to continue to gain weight if they are eating less calories than they are consuming. Literally. Impossible.
The problem is one of human psychology, both at the calorie consumption side and calorie burning side.
On the consumption side, there are two main causes. First, for overweight and obese people, the act of putting food in their mouths and drinking high-calorie drinks has become so second nature that their minds simply stop registering it after a while. This is why in scientific studies and surveys that examine the topic, overweight and obese participants massively under-report what they ate throughout the study while those who have trouble putting on weight (the so-called "hardgainers") over-report it. The mind underplays the importance of events and situations it is familiar with (such as eating) and vice versa.
The second reason is that even when people do pay attention to how much they are eating and count the calories at that moment, they are terrible at estimating their daily or weekly intake. They try to do "mental accounting," the most common example being "I ate a salad at lunch today, so it's OK for me to order some fries at dinner." For obvious reasons, this approach fails hard.
There's also the calorie burning side. Just like most people are terrible at estimating how much they are eating, they are also terrible at estimating how much they are burning. For example, walking counts as exercise for a surprisingly large number of people, yet walking for an hour straight at moderate pace burns only about as many calories as in a slice of bread. And yet the mental accounting comes into play afterward during dinner and they justify their bad habits by telling themselves they exercised that day.
There are other issues, such as the way food companies manufacture their products in very specific ways so as to maximize their consumption, or the way they market to children. But in my opinion these are at the periphery. Ultimately the matter is about the individual. It's about how much they individual eats. Not what they say they eat, but what they actually eat.
I do not lose weight on low calorie diets, period. I get hungry and sick and cold for weeks on end, and my weight does not budge. My most successful periods of weight loss have been on high fat, zero carb, very high calorie diets. I know what I was eating - I measured everything correctly, regardless of all the patronizing "fat people are unaware of how much they really eat" talk.
http://idealbodyweights.blogspot.com/2009/08/vermont-prison-...
"The rapid weight loss these prisoners experienced is the mirror image of what happens when overweight people try to lose weight. If your set point is too high and you try to lose weight quickly, your body will fight to defend that weight and slow down your metabolism. But if your set point is within a normal range, your metabolism will speed up when you gain weight quickly."
In other words, if you have been fat for a while, then drastically reducing calories will cause your body to fight the changes, which will make you feel sick and cold for a while. That said, adjustment is inevitable.
Low carb and zero carb diets are great for losing weight reliably though, because without carbs the pancreas does not secrete insulin, which means your body cannot store the excess calories in adipose tissue. So it either has to burn it or excrete it.
Low-carb diets work by reducing total dietary calories; a secondary contributing cause is satiety from an increase in protein.
In the complete absence of insulin, maybe, which is almost never the case in normal dietary conditions, since both protein and carbohydrate stimulate insulin secretion. But dietary fat is nonetheless the primary source of body fat; direct conversion of dietary carbohydrate to body fat is not a quantitatively significant process in humans except for in extreme conditions. See De novo lipogenesis in humans: metabolic and regulatory aspects. http://www.ncbi.nlm.nih.gov/pubmed/10365981
"Only when CHO energy intake exceeds TEE does DNL in liver or adipose tissue contribute significantly to the whole-body energy economy."
http://examine.com/faq/what-should-i-eat-for-weight-loss.htm...
Given the choice between "astonishing phenomenon never before detected in history" and "record-keeping errors", I know which horse Occam is telling me to bet on. And it's not that HFCS has more Higgs bosons.
For example, this 2009 study used the following ratios to conclude "low-carb" diets aren't better than regular reduced-calorie diets:
20%—15%—65%
20%—25%—55%
40%—15%—45%
40%—25%—35%
http://www.ncbi.nlm.nih.gov/pubmed/19246357
None of these are actually low-carb. The recommended ketogenic ratio is:
60%—35%—5%
Try Peter Attia's Eating Academy for some highly informative reading:
Review articles come to the same conclusion:
I don't think this citation supports your point of view.
Put another way: ketogenesis isn't a magic escape hatch from physics. If you eat foods rich in protein, you are satieted sooner and total calories consumed falls.
Total calories consumed falls.
That's what causes the weight loss. Not a particular hormonal-metabolic configuration.
As for the "calorie is a calorie" point of view, I recommend reading the following:
Myself personally, I like to eat substantial food and I train hard, so high protein, high carbohydrates suits me to a T.
Are you saying that chickens and monkeys got fatter over time due to "record-keeping errors"? Are you claiming the "fat virus" effect - that if you give chickens or monkeys or rats or mice a certain human cold viruse, they get fatter - is due to "record-keeping errors"?
Have you read anything of Gary Taubes? He argues that the phenomenon of some local culture getting unusually fat in spite of the usual suspects not being present, is something that has been seen a great many times in history...but has been ignored or misinterpreted until recently.
> The preponderance of evidence is that net caloric balance predicts weight.
An equally valid way to put that is "the preponderance of evidence is that weight predicts net caloric balance." You can't derive the direction of causality from that relationship.
Depending on the margin of error, yes.
> Are you claiming the "fat virus" effect - that if you give chickens or monkeys or rats or mice a certain human cold viruse, they get fatter - is due to "record-keeping errors"?
I'm claiming that getting fatter is completely explained by net caloric balance. Insofar as a virus depresses metabolism, it is still explained by net caloric balance. Insofar as a virus increase appetite, it is still explained by net caloric balance. Insofar as measurement fails to be adjusted for either scenario, it's a record-keeping error.
> He argues that the phenomenon of some local culture getting unusually fat in spite of the usual suspects not being present, is something that has been seen a great many times in history...but has been ignored or misinterpreted until recently.
Anthropology is not a substitute for metabolic ward studies and controlled-diet studies and medical fasting studies and twin studies. All of these find that caloric balance has predictive power, modulo noise and measurement error.
If energy or matter is being destroyed by viruses, there would be detectable evidence.
Lethal amounts of radiation, for example.
> You can't derive the direction of causality from that relationship.
Given that changing caloric balance temporally precedes changes in body mass and body fat, and that the outcomes can be predicted to within a few percent in controlled conditions, and that the mechanisms of lipogenesis and lipolysis are well studied, yes. I believe that I can deduce just such a causal system.
> If energy or matter is being destroyed by viruses
The viruses don't need to destroy or create energy, they just need modify the set point. (Which could be done by increasing hunger, decreasing satiety, or decreasing metabolism.) "net caloric balance" is true by definition yet is utterly useless as an explanation of why people gain or lose fat or have trouble doing so. What needs to be explained is why for some people their metabolic rate and hunger demands make them stable at a LOW set point and for others their metabolic rate and hunger demands give them a HIGH and/or INCREASING set point. There are lots and lots of environmental factors that COULD explain some of this. For instance, obesity in the US has increased as smoking has decreased; people who quit smoking tend to gain weight.
I've met these people myself. They call themselves "women".
> The viruses don't need to destroy or create energy, they just need modify the set point.
"Set points" assumes that we are dealing with an automatic system. This is true only if people do not pay attention to what they are eating.
Given that the first and indeed only step in dieting is to observe and control your eating ...
We are dealing with an automatic system. If we weren't, people would starve or become morbidly obese whenever they moved or changed jobs such that they were walking a different amount. Or when the restaurant down the street closed and they switched to a different one. Most people's weight stays remarkably consistent over the years despite significant changes in calorie consumption and energy expenditure. The reason that happens is (a) your resting metabolism speeds up if you eat more or slows down if you eat less, (b) your subjective sense of "being hungry" - your inclination to eat - adapts to your metabolic needs, (c) your inclination to be active adapts too.
People who are obese tend to be in the situation that their automatic system wants to keep them that way. Whether they "pay attention" or not, fighting that system is HARD. It's hard enough that we don't have reliable advice on how to do it. We have crappy advice that mostly doesn't work. People can lose some weight for a limited period of time, but they generally can't lose all the weight they want to (ever) or keep off the weight they do lose for as long as three years.
Most weight-loss studies don't follow people for long enough - 6-month studies tend to show just about every diet "working". But the studies that run long enough do see the weight come back. Almost everyone gets the weight back, from every diet.
Remember the "thin" version of Oprah Winfrey? Oprah is worth 2.8 billion dollars. She was hugely motivated to lose weight. She has a dedicated staff - a personal trainer, a private chef, access to every type of medical advice and equipment and treatment imaginable. If SHE can't keep weight off for more than 6 months at a time, what chance do ordinary shmucks have?
> People who are obese tend to be that way because their automatic system wants to keep them that way.
As a nitpick, people frequently read homeostasis backwards. While the body's systems can be characterised as a control system with some central governor pulling levers to keep it within certain boundaries, that's not really what happens. This appearance is actually an emergent phenomenon of interacting feedback loops. X goes down, so Y goes up. Y goes up, Z goes up. Z goes up, X goes up. X goes up, Y goes down ... and so on. Equilibrium is maintained in the long run by the summative effect of counter-acting reactions and feedback loops.
Set point theory is basically a way of saying that different folks have different appetites. When they eat ad libitum, some people eat more, some less. Their weight converges to the asymptote of TDEE that balances their diet and the increased BMR from additional weight.
This not news. The point though is that consciousness and self-awareness allows us to examine our actions and modify them. But first you must internalise the locus of control. You either accept that you are the only person who can control your weight, or you don't. Oprah is a perfect example, because by hiring trainers and cooks and so on, she can externalise control. It stops working when she gets bored and fires them. Or when she reaches her "goal weight" and, not realising that it needs to be a permanent change in behaviour, fires them.
The final problem with set-point theory is that it doesn't explain why there has been a sudden burst in overweight and obesity in the past few years in rich countries only. Calories consumed per capita does; so does the steady deflation of the rate calories-per-dollar exchange. People's appetites haven't changed. People probably always wanted the salty, fatty, sugary things. It's just that now is the first time in history that it has been massively abundant and cheap in wealthy societies.
> But the studies that run long enough do see the weight come back. Almost everyone gets the weight back, from every diet.
It's a common truism to say that "the weight comes back", and yet actually, that claim is not really supported either. The literature on long-term compliance is sparse and I suspect the waters muddied because when you perform a medically supervised diet, again the locus of control is external. HAES advocates rely on a single study performed in 1959. A single study.
1) Obesity isn't a disease of the rich. So the "cheapness" doesn't seem to be an obvious factor. This is in contrast to the 1600s and 1700s when obesity and gout were diseases of the rich in Europe.
2) In poor areas, especially the third world, we are starting to see a pattern obese mothers and malnourished children. This is bizarre. The usual pattern is to see malnourished mothers and malnourished children.
3) We can simulate the syndrome with insulin injections, which seems to suggest at least one hormonal pathway driving overeating (rather than simple psychology).
4) Women get fat after menopause (hence the estrogen supplementation industry, which turned out to be giving them cancer). Everybody starts to put on pounds at middle age. Kids seem to start eating a lot at puberty, but generally grow up rather than around. It seems like the whole system is much more complicated than "cheap, tasty food."
In the absence of cheap, tasty food, obesity is rare.
When cheap, tasty food is abundant, so too are overweight and obesity.
On a population level it looks very much like cheap, tasty food is both necessary and sufficient. Without an increase in per-capita calories, there can't be an increase in population BMI.
The reason we call all these other phenomena strange is because we've never had tens of millions of overweight and obese subjects before. Sample sizes of tens of millions throw up new and interesting outliers. It's only going to get weirder.
ha, what a jerk.