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Comment by chez17 | Hacker News Reader

>To treat ongoing CDI-related diarrhea problems, the woman received a fecal transplant from her overweight but healthy daughter, via colonoscopy.

One possible situation is that she was eating poorly but didn't gain weight due to diarrhea and when she had healthy stool she gained the weight. Also, 'fatty has no-self control' is a way to stifle opposition to your opinion. Ther is no need for that. The laws of physics apply to all people. Burn more calories than you take in, you lose weight. Clearly there will be factors that determine how many calories you burn (perhaps someone burns them much slower than the average person), but as far as I've read magic isn't real yet. The laws of the universe still apply to everyone. I've yet to see anyone eat well and exercise and not maintain a healthy weight. Ever. Not once.

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> The laws of physics apply to all people.

Yes they do. Ever consider this possibility?

Your body is immensely complex, can rid itself of toxins, pathogens, and other invaders ... but is not able to discard excess calories it doesn't need? To the point of making you sick and immobile?

That makes sense to you? That our body doesn't have a regulation mechanism?

Or perhaps it's more likely that it works in some people and is broken in others. Yes, starving yourself will always work. So will increasing exertion. But so will fixing that regulation mechanism. Just because we don't know how is hardly enough reason to discard the possibility.

> Your body is immensely complex, can rid itself of toxins, pathogens, and other invaders ... but is not able to discard excess calories it doesn't need? To the point of making you sick and immobile? That makes sense to you? That our body doesn't have a regulation mechanism?

Umm.... You are aware that this state of a ton of food being very easy to procure is a recent development right? For a vast majority of the body's evolution food as very rare which resulted in being able to conserve energy optimally being ideal. Evolution is a sum of the entire species past, why are you thinking it makes sense for the body to self regulate its self to a six pack?

Of course the body has a regulation mechanism related to energy intake and usage. However, that doesn't mean that mechanism can't be overwhelmed or made to work in non-optimal ways.

Yes, your body can purge itself of toxins. But despite this, intake toxins faster than your body can purge itself of them, those toxins will still cause damage. Why should this not apply to the body's energy regulation mechanisms as well?

Yes, I completely agree.

It is entirely possible that by consuming poor quality food (rotten, junk, infested with parasites/chemicals/etc.) the regulation mechanism is overwhelmed or broken.

It is also possible it's through a genetic defect. An environmental toxin. A virus or bacteria. A bazillion other alternatives that our level science cannot detect or explain.

My point is that when you see an obese person, the response shouldn't be lazy/stupid/eat less/diet/exercise more. It should be sick/needs research/treatment.

Simple over-eating should be 100% regulated by our bodies and the excess material discarded. It should NOT be a problem. But it IS. Something is poisoning us. Rather than blaming the sick, we should find out WHAT that is.

>Your body is immensely complex, can rid itself of toxins, pathogens, and other invaders ... but is not able to discard excess calories it doesn't need? To the point of making you sick and immobile?

>That makes sense to you? That our body doesn't have a regulation mechanism?

It's so new of a concept, that evolution hasn't had to select for it for more than a few generations, while 99.9999999% of your evolution has favored gathering as many calories as possible.

I realize it's fashionable to believe all of our ancestors were starving all the time, but there isn't exactly any evidence to back this up.

We're a social species with status playing a substantial role. It's far more likely some were starving and others were extremely well fed. Same as today. That would mean there was plenty of selective pressure over millions of years. Look at other primates for evidence.

It also has a lot to do with population size.

We have never been more than some tens of millions until relatively now. So, there was more than plenty of food for all of us.

In fact, if there's one thing where we have had no time for any evolutive adaptation, is our current population size.

> I've yet to see anyone eat well and exercise and not maintain a healthy weight. Ever. Not once.

I too had never, ever met an overweight person who ate well and exercised. Not even once! Until I did meet one. Your anecdotal absence of proof is not proof of absence. The vast majority of overweight people may eat poorly and not exercise, but that doesn't exclude other possibilities.

In my case, I eat junk food and lead a sedentary lifestyle, and yet I'm lean and muscular. Care to explain?

This may be the case, but it's the exception to the rule and shouldn't be used by every person overweight who just give up on discipline because they think it's useless.

You met a person who burned more calories than they consumed, and yet didn't lose weight?

> You met a person who burned more calories than they consumed, and yet didn't lose weight?

No, as I said, I met an overweight person who consistently ate well and exercised (a college roommate). I have no idea how many calories they burned.

By comparison, I ate much more and exercised much less and had very low body fat. Again, I have no idea how many calories I burned.

And that's exactly point. That is to say, given the tremendous variation in almost every aspect of human physiology, is it plausible that there exist outliers whose bodies burn calories at markedly different rates? I don't know, but without more evidence, I'm hesitant to declare it impossible.

> No, as I said, I met an overweight person who consistently ate well and exercised (a college roommate). I have no idea how many calories they burned. By comparison, I ate much more and exercised much less and had very low body fat. Again, I have no idea how many calories I burned.

Typically when I'm told this either by people wanting to lose or people wanting to gain I just ask them to write down everything they eat for week. Guess what we learn at the end of the week? They really had no clue what they were eating. The skinny people were barely crossing 1500 cals and the overweight people were 2500-3000 and had zero idea. The other fun fact here is that food wise both of those are not very far away. A couple sweets or sugary sodas each day and you can easily cross over.

While there are likely exceptions and extremes (thyroid issues), the vast majority have zero clue about how much they really eat. This is why things like Weight Watchers work so well for many people. You get X points/day. Foods are worth differing amounts of points and when you hit zero stop. People quickly learn what foods are 'free' (veggies, most fruit) and load up on those and then plan the non-free foods to maximize taste/fullness/whatever.

Look at my original comment. Clearly there will be people who can get away with doing little and maintain weight while others will have to work much harder. I would guess you're pretty young as well, most young people stay relatively fit without doing much.

The hypothesis is that the bacteria in your gut are able to affect your hunger. If you have this bacteria you are always hungry and eat the wrong kind of food.

> Burn more calories than you take in, you lose weight.

Wrong. Exercise burns calories, but also promotes muscle formation. Forming muscle, pound per pound, takes less calories than burning fat produces. So you can have a calorie deficit while gaining more weight in muscle than is lost in fat.

Depending on exercise patterns, precise nutrition, and other factors, a calorie deficit can result in:

Weight loss and decrease in body fat % (net weight loss disproportionately from fat), Weight loss with no change in body fat %, Weight loss and increase in body fat % (weight loss from disproportionately from muscle), Weight gain and decrease in body fat % (weight loss from fat offset by greater weight gain in muscle.)

(I don't think there is any way for a calorie deficit to result in weight gain and increase in body fat % simultaneously, but I may be overlooking something.)

Additionally, changes in absorption, metabolic efficiency, and other factors can make what is assumed to be a calorie surplus based on food/exercise logs into a deficit or vice versa; both the "in" and "out" side of calories in vs. calories out are, absent a lot of detailed measurement most people aren't undergoing even in inpatient medical settings, a lot more approximate and have a lot more bundled assumptions than people tend to think.

You are just vastly oversimplifying a complex issue. It's like telling a drug addict to stop after 2 beers. Or teliing black kids to study more for school. How about telling people to stop having kids out of wedlock. Simple, just don't to it! SOLVED!Debt issues? Just make more than you spend.

Just eat less, conservation of energy man. Science YO! argument is essentially the abstinence solution for STDs.

Normal people aren't a healthy weight because they sit there and resist hunger all day. Their body keeps it in check.

Finding out why obese people don't keep their diet in check would be a huge help in fighting obesity.

Don't get me wrong, I'm sure for a lot people poor impulse control is part of it, but it clearly isn't the whole story.

And it's important to note that while she wasn't considered obese previously, her BMI was 26, which is considered overweight.

Back when I was going through cancer, my weight dropped to around 130 pounds on a 6'4", large build frame. Obviously, I looked like Death himself and I was seriously underweight. However, even when I got back up to my normal 210 pounds and I still looked a bit too skinny, the chart showed me as being "overweight" at a BMI of 26.

So I'd take that "overweight" indicator with a grain of salt. If this woman is on the tall side or has broad shoulders and hips, that BMI of 26 could mean she appears athletic or even skinny, and she can certainly be healthy with that misleading number.

My ex husband was career military. When he was on recruiting duty, every single year they had some annual conference. Every single year, there were insurance reps there or something. Everyone in the office would get told they were "overweight" according to the (civilian) insurance reps height and weight charts. All of these people had to a) pass their PT test and b) meet weight. In the military, if your weight is too high for the chart, they tape-test you to check if you are actually fat or not. Bodybuilders in the military often cannot meet the weight requirement, but they pass the tape-test with flying colors.

tldr: have an upvote for agreement.

BMI isn't perfect, but it takes height into account. You can actually work back words with her weight and BMI to calculate that her height is less than 5'1".

BMI is pretty accurate most of the time unless you're an athlete. Women putting on far less muscle on average than men, it's far more likely that she was actually overweight...

BMI is pretty accurate for heights that were common in 19th century Belgium. It assumes that people's weights ought to go up as the square of their height but as Galileo pointed out back in the day you would expect a person's weight to go up as the cube of their height.

This means that tall people will tend to have higher BMIs all things being equal and short people lower BMIs. Which actually suggests that the woman might have been overweight if she was only 5'1" despite what her BMI said.

> BMI is pretty accurate for heights that were common in 19th century Belgium. It assumes that people's weights ought to go up as the square of their height but as Galileo pointed out back in the day you would expect a person's weight to go up as the cube of their height.

My understanding is that BMI doesn't "assume" anything about what weight "should" do, its instead a measure which has been empirically shown to have a useful (though rather loose) correlation to risks related to various health conditions, particularly cardiovascular conditions. (Mostly, AIUI, it serves as a proxy for a host of other measures, which together are more accurate but more involved to gather.)

The cube-of-height scaling you refer to is what you would expect if taller people were exactly like smaller people but linearly scaled equally in all dimensions -- but that's neither empirically what taller people are built like nor are taller people whose weight relates to that of shorter people that way on average as healthy in the areas BMI is used a risk measure for as the shorter people.

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