Whatever your political views, the ellipses in the quote are deeply misleading, and in fact make his quote seem to say something Joel emphatically did not say.
Here is the full quote:
>It’s impossible not to see the parallel: the only way to build a successful world today is to allow the contributions of everyone. Carving up the world into us vs. them, building walls, and demonizing religions, nations, and refugees is both morally repugnant and counterproductive, and it goes so much against the spirit of Stack Overflow that as a community we must speak out.
> "there aren't doctors out there recommending cutting out fats and subsisting on sugar"
That's true as far as it goes, but the internal fight inside the medical research community was whether it was fat or sugar that was the culprit in a host of physical problems. Fat won in a slam dunk, even though it turns out to be wrong. Doctors are largely not researchers, and they are taught what was the conventional wisdom. There is no suggestion of malice, just bad (or at least overturned, but it was actually bad in this case) research that has been promulgated in the medical community. A lot of doctors think fat is bad and pay less attention to sugar.
> "Fat people just need to eat less, and the issue basically comes down to compliance.:
On oversimplification, but the crux of the issue. The astronomical failure rate is because of compliance. The prescription you seem to be suggest is "comply more! comply better!" but the biology of this is exactly why it fails so often. The type of food you eat is what sets you up for sustainable long-term success or its opposite. What you wave away with a wash of the hand--compliance--is the reason people fail and more willpower is not the issue and not a solution. It's a dysfunction of the hormones brought on by high insulin resistance brought on by excessive sugar and flour, which becomes a hunger trap, unless you add fat to your diet, which is exactly what people are told not to do. So, I do think hunger tends to differ when you suffer from fatty liver disease and insulin resistance. People can endure calorie restriction and lose weight for a while doing low-fat but they do not stay on it. Saying that people should just comply more is like telling someone with sleep apnea to sleep better. They need a different intervention.
edit--A failure rate of 80-90% is not an anomaly, it's a colossal failure. It's not something to be overcome, it's an indication of wrongness. By asking for more compliance you are asking people to fight their biology and they will lose this fight. Instead the intervention should be to employ their biology as their ally, and lose weight more easily and without much hunger and that's possible. It's just not helpful to tell people to eat less. We've been telling them that for forty years.
(Side note. The 4% bodyfat in the UofM study you mention is an assumption of yours, and not the starting weight of the people in the study. I think you're unfairly dismissing the study and presenting it as if it's a binary condition between starving/not starving, and that may be a thing, but it's not certain that it is. I'm merely cautiously using it as evidence that calorie restriction is difficult (actually more than difficult) to maintain, which anyway we all know from experience. It would be good to explore other studies on the topic). Intermittent fasting, for example, is vastly easier than consistent calorie restriction, and you're consuming the same number of calories as calorie restriction (if you design it right). That's not a matter of willpower, that's a different intervention).
Unfortunately I don't have time to continue the conversation, but take the time to explore some of the links I posted (there are tons more)--they go into way, way more detail and make the argument better than I have.
> "No dude, you are ignoring the fact that these people did not have ample fat stores."
I don't think I am ignoring it. You seem to be asserting that their issues with calorie restriction were lack of body fat. There is no evidence for that I am aware of. A simple rejoinder based on anyone's experience, do fat people get hungry? If they do, why? They have all that energy available. But I don't need to rely on arguments like that, since in the vast corpus of research on this at this point, it's pretty well established that calorie restriction by itself (even with exercise) does not work long-term. The failure rate is astronomical and it is in part due to what plain old calorie restriction as we've been told to do it does to metabolic energy and also due to the psychology of hunger. Also, and this is very important, a full fast does not have these effects according to the evidence. People can totally abstain from food for very long periods of time (depending on body fat), with very little hunger. It is smaller scale calorie reductions, without breaks (like the breaks intermittent fasting provides) and without much dietary fat since fat is highly satiating, that cause these reactions to calorie restriction.
> "This is basically unrelated to your statements about insulin though, so don't conflate the two."
Again, I'm not. I was responding to the request for a source on the idea of energy output reduction in response to lower calories. I'm not claiming there is a link between energy output reduction and insulin.
Fat people can get energy from fat stores, just not in the way we are typically told. If it was impossible to get energy from fat no one would ever lose weight, which is trivially and obviously not true.
On the starvation study it's merely one example that highlights how calorie restriction affects people. Yes, it's an extreme version, but it is different only in degree from any other calorie restriction, and when people try to reduce by X calories, it's probably a linear effect; more restriction, more of these effects. Oddly though, fasting tends not to have these effects, it's only in sustained calorie restriction, so fasting in various forms is one of the tools people can use to lose weight.
As for the lowered energy output Jason Fung wrote (pg. 53 of the Obesity Code, "One major problem is that the basal metabolic rate does not stay stable. Decreased caloric intake can decrease basal metabolic rate by up to 40 percent. We shall see that increased caloric intake can increase it by 50%."
It's actually a fairly complicated and can be quite difficult for people to break out of, even people who desperately want to change. When people follow the standard guidelines (which are beginning, slowly, to change) to avoid fat and reduce calories, they end up feeling hungry all the time, and have to white knuckle their way through. This is not a state that people can maintain long-term.
Starvation studies from the University of Minnesota have been described this way: "During the semi-starvation phase the changes were dramatic. Beyond the gaunt appearance of the men, there were significant decreases in their strength and stamina, body temperature, heart rate and sex drive. The psychological effects were significant as well. Hunger made the men obsessed with food. They would dream and fantasize about food, read and talk about food and savor the two meals a day they were given. They reported fatigue, irritability, depression and apathy. Interestingly, the men also reported decreases in mental ability, although mental testing of the men did not support this belief."
In addition, there is evidence that the body begins to reduce energy output in response to reduced energy input, thus making the advice every overweight person hears from nearly every source to "eat less and move more" a load of nonsense. That can work short-term, but the combination of reduced energy output and constant hunger make that recipe very ineffective long-term.
There is even more to complicate the story (e.g. it is common for overweight people to feel hungry even with massive amounts of energy stored in fat due to some of the effects of what's now being called variously, metabolic syndrome, syndrome X and diabesity).
In short, when people become overweight, which is a progressive condition of insulin resistance that grows slowly over time, or in other words and emergent hormonal dysfunction because of diet, they cannot "eat less and move more." To that extent it is not self-inflicted especially since millions of Americans are doing exactly that as told by their doctors and it is having no effect.
The only way to really change body composition long-term, is to change diet in a way that is at odds with what doctors learned twenty years ago in the two days they studied nutrition in medical school, which, as it turns out, is wrong.
Here is the full quote:
>It’s impossible not to see the parallel: the only way to build a successful world today is to allow the contributions of everyone. Carving up the world into us vs. them, building walls, and demonizing religions, nations, and refugees is both morally repugnant and counterproductive, and it goes so much against the spirit of Stack Overflow that as a community we must speak out.