Excess weight, obesity more deadly than previously believed(colorado.edu)
colorado.edu
Excess weight, obesity more deadly than previously believed
https://www.colorado.edu/today/2023/02/23/excess-weight-obesity-more-deadly-previously-believed
150 comments
Reminds of the parachute study that was shared here recently:
https://healthjournalism.org/blog/2019/02/breakthrough-resea...
https://healthjournalism.org/blog/2019/02/breakthrough-resea...
I love the meta irony of this article, taking the (somewhat satirical) journal article and playing along as an example of overblown science journalism with the headline "Breakthrough research reveals parachutes don’t prevent death when jumping from a plane".
It's beautiful....
It's beautiful....
“We think that everyone might benefit if the most radical protagonists of evidence-based medicine organized and participated in a double-blind, randomized, placebo-controlled, crossover trial of the parachute.”
I'm still crying. :)
I'm still crying. :)
Did they even use a control group?! And was it double blinded?
[deleted]
> He discovered that a full 20% of the sample characterized as “healthy” weight had been in the overweight or obese category in the decade prior. When set apart, this group had a substantially worse health profile than those in the category whose weight had been stable.
There are a few odd things about this approach.
First, 20% of people in a healthy weight being previously overweight/obese? This seems high? Could there be reporting bias or other things here? I'm still trying to understand the full study, but it is odd that more people lost weight than gained weight, according to the numbers I'm seeing in it. Although that may be partially explained by the fact that it was limited to people 45 - 85 years old.
Second, the methodology of taking anyone who was previously overweight/obese and is now healthy (weight-wise) into their own group and then attributing increases in mortality purely to weight seem suspect? There are a lot of things that can cause you to lose weight and lead to increased mortality that aren't related to weight, and those would be captured in here.
The conclusions definitely make sense and "feel" right, at least directionally, I'm just a little confused about some of the methodology to get there.
There are a few odd things about this approach.
First, 20% of people in a healthy weight being previously overweight/obese? This seems high? Could there be reporting bias or other things here? I'm still trying to understand the full study, but it is odd that more people lost weight than gained weight, according to the numbers I'm seeing in it. Although that may be partially explained by the fact that it was limited to people 45 - 85 years old.
Second, the methodology of taking anyone who was previously overweight/obese and is now healthy (weight-wise) into their own group and then attributing increases in mortality purely to weight seem suspect? There are a lot of things that can cause you to lose weight and lead to increased mortality that aren't related to weight, and those would be captured in here.
The conclusions definitely make sense and "feel" right, at least directionally, I'm just a little confused about some of the methodology to get there.
> I'm still trying to understand the full study, but it is odd that more people lost weight than gained weight, according to the numbers I'm seeing in it. Although that may be partially explained by the fact that it was limited to people 45 - 85 years old.
Don't people typically gain weight in that age range, the opposite of what would explain that?
Don't people typically gain weight in that age range, the opposite of what would explain that?
Once you reach 65+ people tend to lose weight until they die.
A lot of it is explained by muscle loss.
A lot of it is explained by muscle loss.
The topic of obesity somewhat reminds me of a joke I once heard from a stand-up comedian whom I cannot remember the name of, but it went something along the lines of, "People always ask you why you quit drinking, but you know... People never ask you why you drank in the first place."
I do not believe that there is a significant portion of the human population that wakes up each day and decides to actively diminish their long-term health by overeating sheerly because he or she lacks the willpower/motivation to improve themselves. I feel that the minor, medium, and major stressors in life are what subconsciously steer one down this path. It's not like people who abuse substances[1] are completely oblivious or ignorant to the negative consequences of the substance.
I think most people understand living an active lifestyle and eating a healthy diet is beneficial, but it's just not plausible for many. Be it time, money, or energy -- I do not think the average person has enough of all three at the end of any given day.
Educating people on how to better take care of themselves is not enough. Obesity is a symptom not a disease in my eyes. I am starting to believe onus of responsibility is less on the individual than we might think for when many of the rats in this rat race are dropping like flies, then perhaps the issue the with the race and not the rats?
[1] I consider food, especially junk food, to be a substance which can be abused.
I do not believe that there is a significant portion of the human population that wakes up each day and decides to actively diminish their long-term health by overeating sheerly because he or she lacks the willpower/motivation to improve themselves. I feel that the minor, medium, and major stressors in life are what subconsciously steer one down this path. It's not like people who abuse substances[1] are completely oblivious or ignorant to the negative consequences of the substance.
I think most people understand living an active lifestyle and eating a healthy diet is beneficial, but it's just not plausible for many. Be it time, money, or energy -- I do not think the average person has enough of all three at the end of any given day.
Educating people on how to better take care of themselves is not enough. Obesity is a symptom not a disease in my eyes. I am starting to believe onus of responsibility is less on the individual than we might think for when many of the rats in this rat race are dropping like flies, then perhaps the issue the with the race and not the rats?
[1] I consider food, especially junk food, to be a substance which can be abused.
Or Big Sugar not actively lobbying and promoting their propaganda would help greatly — it really is unbelievable that due to having loads of corn, the US decided to slowly kill their populace by forcing them onto an over-sweetened diet, purely for profit. For foreigners, plenty of food is simply not edible they are so sweet, like who puts sugar into bread?! And it being the way people grew up with, it is exceedingly hard to change. And it does show up very well on statistics between different first world countries.
Wonderful contribution that didn't even cross my mind, but I completely agree.
Again, this still is not the fault of an individual which was I the point I was trying to make. Thank you for this bit, I will try to add this to my opinions next time I have a discussion about obesity.
Again, this still is not the fault of an individual which was I the point I was trying to make. Thank you for this bit, I will try to add this to my opinions next time I have a discussion about obesity.
This seems to try and give people a way out which is the exact opposite of what is needed to deal with this. There has to be a commitment and a no-way-out approach. It quite literally can be life or death. If individuals are not responsible for their own health then who is? How hard is it to eat chicken/tofu + veggies for one meal a day and cut out pizza/pasta/rice/wheat?
> If individuals are not responsible for their own health then who is?
I view the issue much like burnout. Who's fault is it for burnout? The employee or the employer? To be honest, just like obesity, it's probably a bit of both (not claiming employers are causing obesity).
> How hard is it to eat chicken/tofu + veggies for one meal a day and cut out pizza/pasta/rice/wheat?
It depends on how much one earns. It's a lot easier for someone making a HS salary than minimum wage which in my state, is still $7.25/hr.
I am not saying individuals are not responsible, but I do not agree that individuals are solely responsible. There are other factors at play.
I think we have a societal issue -- people are overworked and overstressed on average. Hell, depending on the source of information, around 20%-25% of Americans are prescribed psychiatric medication. That signals we are facing systemic issue within our society. Why are people so depressed, anxious, and or flying off the rails?
Another issue is that our society has become more sedentary as a whole -- especially in the work place. I imagine there were much less sitting/standing at a desk all day in 1923 than there is in 2023 on average. I think a lot of people were able to fulfill their minimum exercise needs without much effort -- be it factory work, more walkable cities, etc.. Is the increase in sedentary jobs, lack of walkable cities, etc.. an individual's fault or society's?
Maybe I am just talking out of my ass, but I would like to see any kind of research, if it even exists, on if there is a correlation between hours worked in a sedentary job and obesity.
I view the issue much like burnout. Who's fault is it for burnout? The employee or the employer? To be honest, just like obesity, it's probably a bit of both (not claiming employers are causing obesity).
> How hard is it to eat chicken/tofu + veggies for one meal a day and cut out pizza/pasta/rice/wheat?
It depends on how much one earns. It's a lot easier for someone making a HS salary than minimum wage which in my state, is still $7.25/hr.
I am not saying individuals are not responsible, but I do not agree that individuals are solely responsible. There are other factors at play.
I think we have a societal issue -- people are overworked and overstressed on average. Hell, depending on the source of information, around 20%-25% of Americans are prescribed psychiatric medication. That signals we are facing systemic issue within our society. Why are people so depressed, anxious, and or flying off the rails?
Another issue is that our society has become more sedentary as a whole -- especially in the work place. I imagine there were much less sitting/standing at a desk all day in 1923 than there is in 2023 on average. I think a lot of people were able to fulfill their minimum exercise needs without much effort -- be it factory work, more walkable cities, etc.. Is the increase in sedentary jobs, lack of walkable cities, etc.. an individual's fault or society's?
Maybe I am just talking out of my ass, but I would like to see any kind of research, if it even exists, on if there is a correlation between hours worked in a sedentary job and obesity.
For those struggling, controlling your diet is the single most effective thing you can do to make progress on obesity.
Much easier to say no to a 300 cal donut than to run 30 minutes.
Cutting out the daily donut for two weeks is about a pound of fat.
Maybe we need a “just say no” to junk food campaign like we had in the 90s.
Lean meat, tofu, tempeh, seitan, veggies, low calorie sauces, limited fruits, protein smoothies (watching the sugar/fat)
Do a few pushups, a light run, increase slowly.
Make it sustainable, not a flash crash.
Much easier to say no to a 300 cal donut than to run 30 minutes.
Cutting out the daily donut for two weeks is about a pound of fat.
Maybe we need a “just say no” to junk food campaign like we had in the 90s.
Lean meat, tofu, tempeh, seitan, veggies, low calorie sauces, limited fruits, protein smoothies (watching the sugar/fat)
Do a few pushups, a light run, increase slowly.
Make it sustainable, not a flash crash.
True, but don't feel like you have to run for 30 minutes. Walking for that long will go a long way for a lot of folks. Really, walking should probably be looked at far more closely for many folks.
Walking for 30 minutes will go a long way to promote general health, but it's not a lot of calories burned.
This is an area where calories is scary misleading. The 30 minutes walking is indeed low in the direct impact. For some reason, it punches well above expectations, though. Probably something about base metabolism and such, but whatever it is, you will lose more weight from walking than you'd expect.
Similarly, people probably walk way way less than you would expect. It is kind of scary to see how few steps I can get on a standard day.
Similarly, people probably walk way way less than you would expect. It is kind of scary to see how few steps I can get on a standard day.
Yea, I suspect it has a pretty low effect in terms of calories, but it helps immediately bring your blood sugar back under control within <5 minutes of walking or so. At least that's what my experience is wearing a CGM for a few weeks now.
That's maybe the magic of "walkable neighborhoods." You just walk over to the store/the cafe/the restaurant real quick, and then you walk back. It was only maybe a few hundreds steps, but that's enough to put away a ton of the glucose you just dumped into your bloodstream.
It is shocking how little walking is necessary to have a massive impact on glucose. 500 steps or so is easily enough for me.
That's maybe the magic of "walkable neighborhoods." You just walk over to the store/the cafe/the restaurant real quick, and then you walk back. It was only maybe a few hundreds steps, but that's enough to put away a ton of the glucose you just dumped into your bloodstream.
It is shocking how little walking is necessary to have a massive impact on glucose. 500 steps or so is easily enough for me.
I started walking on my way to work and back (London, UK). It's about 5k + 5k steps. Plus a 4k step walk after lunch. Together with a limited calorie intake (2k cal a day) it made wonders. It was crazy to watch the first 5kg just vaporize in 2 weeks.
I went down to 1800 calories and the remaining 10kg were gone in 6 weeks.
I went down to 1800 calories and the remaining 10kg were gone in 6 weeks.
You mind sharing your before/after weight and roughly how lean you were? If your metabolism is already dialed in (i.e. you were not obese) this might totally work and be very effective for fat loss.
93kg to 78kg, 180 cm. Did not look fat, but my face got round and belly was forming. Haven't seen my abs for years and years by then. Surprisingly, 80 kg was like no abs at all and 77.8kg was a 4-pack already.
I wrote earlier that reforming my diet to protein-centric, 1800-2000cal a day + 15k steps walking + some lightweight kettlebell work was enough to get things going. I used myfitnespal, really useful.
It wasn't too hard, to be honest, as I am relatively used to training. For some ppl even walking 10k a day is a challenge.
I wrote earlier that reforming my diet to protein-centric, 1800-2000cal a day + 15k steps walking + some lightweight kettlebell work was enough to get things going. I used myfitnespal, really useful.
It wasn't too hard, to be honest, as I am relatively used to training. For some ppl even walking 10k a day is a challenge.
Especially for people who are very obese :)
For comparison, I recently went from 132kg (290lbs) to 111kg (245lbs) in the last 5 months without counting calories, on a very-low-protein, ultra-high-fat diet.
Re. the abs, I've never had them but my impression is they're hidden by basically the last 5lbs of fat you'll lose. So nothing and then they're suddenly there makes sense. Congrats!
For comparison, I recently went from 132kg (290lbs) to 111kg (245lbs) in the last 5 months without counting calories, on a very-low-protein, ultra-high-fat diet.
Re. the abs, I've never had them but my impression is they're hidden by basically the last 5lbs of fat you'll lose. So nothing and then they're suddenly there makes sense. Congrats!
Congrats! That's huge! I know it's a very liberating feeling, both physically and psychologically.
My collegue went from 115kg to 85kg some time ago. I know it's a different kind of game. Took a year for him. He was younger, in his late 20s, so running was still an option for him. I am In my late 30s, and traumas accumulated so i had to accept that calorie counting was the only remaining option.
Also, I'd suggest still working from a high-protein approach. You get to keep you muscle, especially if you do some reasonable amount of training.
My collegue went from 115kg to 85kg some time ago. I know it's a different kind of game. Took a year for him. He was younger, in his late 20s, so running was still an option for him. I am In my late 30s, and traumas accumulated so i had to accept that calorie counting was the only remaining option.
Also, I'd suggest still working from a high-protein approach. You get to keep you muscle, especially if you do some reasonable amount of training.
My entire hypothesis this time around is that protein is making/keeping me fat, and I went super low protein on purpose :) Of course it could also be something else. Everybody freaks out about the low protein though haha.
And yes, abs are not the most important thing. Depends on genetics, max weight, fat distribution. Doesn't really matter In practice.
Back when i doing boxing in early 20s I was as low as 69kg, and still didn't see the full 6-pack. Go figure....
Back when i doing boxing in early 20s I was as low as 69kg, and still didn't see the full 6-pack. Go figure....
In my experiments wearing a glucose monitor, even 5 minutes of walking has a massive effect on blood sugar. Might not make you slim, but might prevent your diabetes if you're borderline.
I counted the steps. Under 600 steps. Not even around the block, and a ~20mg/dL reduction in blood glucose.
I counted the steps. Under 600 steps. Not even around the block, and a ~20mg/dL reduction in blood glucose.
On a day to day basis it usually isn't a lot of excess calories eaten either, but over a year or 10 those small discrepencies can add up.
Studies don't really support that. They show that rapid weight loss is more effective, but slightly worse for body composition. And slower weight loss is of course the opposite.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702468/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702468/
+1 for the rapid fat loss. It's just that we don't even really know how to do one or the other reliably :)
Haha that's true.
> Cutting out the daily donut for two weeks is about a pound of fat.
For many people, no it's not. Becuse their metabolism just decreases by the exact same amount they cut calories. They cut out the daily donut, and they find themselves fidgeting less and wearing a sweater because they're suddenly a little chilly a lot of the day. And the scale doesn't budge.
For many people, losing weight is a whole lot more complex than reducing by x calories per day. Getting your body to burn fat rather than slow its metabolism can be maddeningly difficult.
For many people, no it's not. Becuse their metabolism just decreases by the exact same amount they cut calories. They cut out the daily donut, and they find themselves fidgeting less and wearing a sweater because they're suddenly a little chilly a lot of the day. And the scale doesn't budge.
For many people, losing weight is a whole lot more complex than reducing by x calories per day. Getting your body to burn fat rather than slow its metabolism can be maddeningly difficult.
Metabolism does slow down, but there is a lower limit. The exact numbers and rate will change, but the fact is that sufficient caloric restriction will cause weight loss.
That said, as someone who struggles with weight loss, it's still hard. There are both physioloical and psychological issues that make it challenging.
As an aside, keto is the only thing thats worked reliably for me so far - largely because of the caloric restriction it inherently forces. I stopped following it because people kept telling me they were concerned it was unhealthy, but I'm sure the weight is worse than anything else.
That said, as someone who struggles with weight loss, it's still hard. There are both physioloical and psychological issues that make it challenging.
As an aside, keto is the only thing thats worked reliably for me so far - largely because of the caloric restriction it inherently forces. I stopped following it because people kept telling me they were concerned it was unhealthy, but I'm sure the weight is worse than anything else.
Metabolism changes is something like going down from 2100 maintenance calories to 1900 calories. A donut is /at least/ 300+ calories. Age-related metabolism changes are also not that serious.
I've seen people losing 40kg (120kg to 80kg) by just walking and counting calories. It's the last 5-6 kg that are harder than the first 20kg is almost trivial to lose - one all the right habits are in place.
And habits are the hardest part. It's not the body, not laws of thermodynamics, it's just your habits (most of the time).
I've seen people losing 40kg (120kg to 80kg) by just walking and counting calories. It's the last 5-6 kg that are harder than the first 20kg is almost trivial to lose - one all the right habits are in place.
And habits are the hardest part. It's not the body, not laws of thermodynamics, it's just your habits (most of the time).
No, it's more like going from ~2500 maintenance to ~1400 cal/day before your body finally decides to start burning fat instead of lowering its metabolism further. At least for me.
Obviously different people are different.
And it has utterly nothing to do with habits, you can see my other comment. It's about the whether you can even manage the other health consequences you suffer from your metabolism being so low.
Obviously different people are different.
And it has utterly nothing to do with habits, you can see my other comment. It's about the whether you can even manage the other health consequences you suffer from your metabolism being so low.
1400 a day? For an immobilised hospital patient- maybe. It's like not moving at all! How would your body compensate for it?
Given lightweight excercise (walking,kettlebells, etc) that's almost impossible!
Given lightweight excercise (walking,kettlebells, etc) that's almost impossible!
> but the fact is that sufficient caloric restriction will cause weight loss.
Yes, but at the cost of your immune system severely degrading so you suddenly get colds all the time. At the cost of extreme fatigue and brain fog. At least that's what's made weight loss difficult for me at times.
Because for some people (like me), your body drops its metabolism to well below what's healthy before it even thinks about burning fat. It's not any question at all of willpower or psychology, it's purely physiological.
Yes, but at the cost of your immune system severely degrading so you suddenly get colds all the time. At the cost of extreme fatigue and brain fog. At least that's what's made weight loss difficult for me at times.
Because for some people (like me), your body drops its metabolism to well below what's healthy before it even thinks about burning fat. It's not any question at all of willpower or psychology, it's purely physiological.
Keto was the only thing that worked for me too. I found it a lot easier to just pick some days and say "I'm not eating anything on these days" than it was to constantly track and procure a perfect diet day after day without lapses.
Not sure who told you it was bad for you, I've predominantly heard it being touted as beneficial and longevity-increasing.
Not sure who told you it was bad for you, I've predominantly heard it being touted as beneficial and longevity-increasing.
I think “for many people” is more like “for a minority of people.”
For a few people losing weight is complex. For most people, it’s simple.
Eat less. Move more.
Saying otherwise is a cop out.
For a few people losing weight is complex. For most people, it’s simple.
Eat less. Move more.
Saying otherwise is a cop out.
Yes! Cannot stress it enough. Move. It doesn't even have to be intense! Running can be traumatic. But calories don't care if it's a walk you're doing or a run.
Unless you have some fundamental food-related disorders it's not that hard. Our bodies were meant to gain weight weight quickly - and lose it if necessary. For most people losing 10-20 kg is a question of 3-4 months, or even less.
Unless you have some fundamental food-related disorders it's not that hard. Our bodies were meant to gain weight weight quickly - and lose it if necessary. For most people losing 10-20 kg is a question of 3-4 months, or even less.
> For most people, it’s simple.
If it were that simple, most people would be able to do it. The actual evidence shows it's far more complex than you think.
There's no cop out here. Many people's bodies simply refuse to burn fat until their metabolism has gone so low it has other dangerous health consequences.
Also, as for "move more", the evidence shows that people generally eat even more after exercise to compensate. Exercise is great for general health, but it's a terrible strategy for most people for losing weight. It simply backfires.
If it were that simple, most people would be able to do it. The actual evidence shows it's far more complex than you think.
There's no cop out here. Many people's bodies simply refuse to burn fat until their metabolism has gone so low it has other dangerous health consequences.
Also, as for "move more", the evidence shows that people generally eat even more after exercise to compensate. Exercise is great for general health, but it's a terrible strategy for most people for losing weight. It simply backfires.
That is why I said, you have to increase the workout intensity and duration gradually to offset the metabolic adaption that is triggered by the diet change
"Cutting out the daily donut for two weeks is about a pound of fat."
While I'm completely behind your post in general, unfortunately it's much more complicated. It comes down to calories in vs energy consumption. If you oversupply your buddy with calories however most science I read states 7.000 calories of surplus to be one kilo in fat in the average human. Highly recommend the Huberman episode about nutrition.
While I'm completely behind your post in general, unfortunately it's much more complicated. It comes down to calories in vs energy consumption. If you oversupply your buddy with calories however most science I read states 7.000 calories of surplus to be one kilo in fat in the average human. Highly recommend the Huberman episode about nutrition.
That's what I always felt like why keto helped me. Instead of just eating, I was now looking into everything. Almost 10 years ago, I went from 115kg to 86, and I had no issues keeping the weight.
Man, food is so addictive and not like you can just stop eating it like you can quit drinking booze or quit smoking!
What's unique about food is that unlike smoking, drugs or booze, a human will always have to go back to eating, it's essential for day-to-day life unlike Jameson, Marlboro and meth.
If you have a healthy relationship with food then you're fine, otherwise every day you're faced with willpower checks that you might struggle to consistently pass.
If you have a healthy relationship with food then you're fine, otherwise every day you're faced with willpower checks that you might struggle to consistently pass.
I don't think willpower has anything to do with it.
You don't think it requires any willpower to restrict yourself and change how you eat?
That might have been your experience but millions of other people claim otherwise. Either a million people are wrong, or you're an anomaly. I think the latter is more likely.
That might have been your experience but millions of other people claim otherwise. Either a million people are wrong, or you're an anomaly. I think the latter is more likely.
I'm saying that if you rely on willpower, you will fail.
Of course you should change how you eat if how you ate caused you health problems. But I'm advocating for making a conscious change that will then enable you to eat without having to use willpower.
That's why "just eat less" is terrible advice and works for practically nobody.
It's like finances. "Just save more" is terrible advice. Getting a degree or finding a high paying job or setting up automatic 401k contributions doesn't require willpower day-to-day, and has a much higher chance of success.
Of course you should change how you eat if how you ate caused you health problems. But I'm advocating for making a conscious change that will then enable you to eat without having to use willpower.
That's why "just eat less" is terrible advice and works for practically nobody.
It's like finances. "Just save more" is terrible advice. Getting a degree or finding a high paying job or setting up automatic 401k contributions doesn't require willpower day-to-day, and has a much higher chance of success.
Ahh basically try to make meta decisions that limit the willpower needed. Like don't buy a bag of chips in the store which requires a little bit of willpower once vs having to have the same willpower success everyday. Yeah 100% agreement.
Right, make a clever decision in a bright moment. Don't rely on willpower day-to-day. General life strategy :)
Not buying the bag of chips is an obvious example, as is buying a used car vs. leasing a new one.
Picking a diet that doesn't make you overeat is another one, and I'm in the process of figuring out what that means for me :)
Not buying the bag of chips is an obvious example, as is buying a used car vs. leasing a new one.
Picking a diet that doesn't make you overeat is another one, and I'm in the process of figuring out what that means for me :)
[deleted]
How come that you think this?
Ozempic and Wegovy.
https://www.nytimes.com/2023/01/31/opinion/ozempic-weight-lo...
https://archive.is/rnTGB
https://www.npr.org/sections/health-shots/2023/01/30/1152039...
https://www.nytimes.com/2023/01/31/opinion/ozempic-weight-lo...
https://archive.is/rnTGB
https://www.npr.org/sections/health-shots/2023/01/30/1152039...
I wouldn't try these until they've been studied further:
https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...
From the linked article:
>Among these patients, lean mass accounted for approximately 39% of total weight loss – substantially higher than ideal. In a substudy of 178 patients from the SUSTAIN 8 trial on semaglutide as a diabetes treatment, the average proportion of lean mass loss was nearly identical at 40%, despite lower doses and less total weight loss than in the STEP 1 trial. [...]
Or in other words, 60% of the weight loss was in fat. The article paints this as concerning, but doesn't provide justification why. Sure, it'd be better to have 0% lean body mass loss, but how does 40% stack compared to calorie deficit diets? The mechanism of action behind the drugs is to cause you to eat less, and if the side effects are consistent with eating less, I don't see why people should be extra concerned.
>Among these patients, lean mass accounted for approximately 39% of total weight loss – substantially higher than ideal. In a substudy of 178 patients from the SUSTAIN 8 trial on semaglutide as a diabetes treatment, the average proportion of lean mass loss was nearly identical at 40%, despite lower doses and less total weight loss than in the STEP 1 trial. [...]
Or in other words, 60% of the weight loss was in fat. The article paints this as concerning, but doesn't provide justification why. Sure, it'd be better to have 0% lean body mass loss, but how does 40% stack compared to calorie deficit diets? The mechanism of action behind the drugs is to cause you to eat less, and if the side effects are consistent with eating less, I don't see why people should be extra concerned.
Also from the article:
> Though a certain amount of lean loss is inevitable with significant weight reduction (usually about 25% of total weight loss)
The justification is provided: this is nearly double the lean body mass loss usually seen in drastic weight loss. Yes, 0% is impossible, but this is worryingly high. It might be OK in younger individuals who have a ton of fat mass to lose, and they might gain any lean body mass back. But in older individuals that are already having a hard time exercising, it's unlikely that lean body mass will ever come back.
Makes me think these drugs should probably be a measure of last resort. Unless more studies defuse this.
The justification is provided: this is nearly double the lean body mass loss usually seen in drastic weight loss. Yes, 0% is impossible, but this is worryingly high. It might be OK in younger individuals who have a ton of fat mass to lose, and they might gain any lean body mass back. But in older individuals that are already having a hard time exercising, it's unlikely that lean body mass will ever come back.
Makes me think these drugs should probably be a measure of last resort. Unless more studies defuse this.
Those are outliers.
For the rest of us there's discipline and sheer willpower, as well as smart energy management.
Train too hard? My appetite goes nuts. Train not enough? The weight loss is muscle. It kind of never stops.
(Speaking as someone fast approaching the big five oh, on the very upper end of the normal BMI and not enough muscle to sugar coat all the excess gut fat which somehow disappears when clothed thanks to an above average height yet is still very much a risk factor.)
For the rest of us there's discipline and sheer willpower, as well as smart energy management.
Train too hard? My appetite goes nuts. Train not enough? The weight loss is muscle. It kind of never stops.
(Speaking as someone fast approaching the big five oh, on the very upper end of the normal BMI and not enough muscle to sugar coat all the excess gut fat which somehow disappears when clothed thanks to an above average height yet is still very much a risk factor.)
BMI can be misleading sometimes, more than normal muscle mass for example is not really accounted for — if you have the chance have a look at your body fat percentage.
Cause I just lost 48lbs without using any willpower:
https://exfatloss.substack.com/p/losing-43lbs-in-144-days-on...
Give yourself some credit, you show a lot of evidence of willpower to try and execute things. If you are able to do 30 days of just about anything, you are better than most.
-------
To emphasize: the real point is the meta-framework of experiments. Formulate a hypothesis, design a 30-day experiment, test it. I’ve probably done dozens of these over the years.
Here are some examples from the last few years:
30 days of cold showers
90 days of no online news (I thought stress might contribute)
90 days of the carnivore diet
30 days of eating only at In’n’out burger
Doing Starting Strength, a beginner’s powerlifting program
Doing Simple & Sinister, a kettlebell training program
30 days of a low-fiber diet
30 days of a low-protein diet
30 days of a potato diet
30 days of drinking only distilled water (including for coffee)
Eating only pemmican, a raw meat paste invented by Native Americans
-------
To emphasize: the real point is the meta-framework of experiments. Formulate a hypothesis, design a 30-day experiment, test it. I’ve probably done dozens of these over the years.
Here are some examples from the last few years:
30 days of cold showers
90 days of no online news (I thought stress might contribute)
90 days of the carnivore diet
30 days of eating only at In’n’out burger
Doing Starting Strength, a beginner’s powerlifting program
Doing Simple & Sinister, a kettlebell training program
30 days of a low-fiber diet
30 days of a low-protein diet
30 days of a potato diet
30 days of drinking only distilled water (including for coffee)
Eating only pemmican, a raw meat paste invented by Native Americans
Ha, thanks :)
But I had that "willpower" for decades and didn't lose much weight. Certainly "pushing harder" didn't change anything.
And then flicking one little switch made it super easy with no willpower involved. So I just don't see how the willpower is related to losing fat.
But I had that "willpower" for decades and didn't lose much weight. Certainly "pushing harder" didn't change anything.
And then flicking one little switch made it super easy with no willpower involved. So I just don't see how the willpower is related to losing fat.
There is no little switch. Keto has been around millennia in various forms. Atkins' diet is well-known. That you took the time to test these various dietary restrictions and found no result until you landed on what is effectively a lopsided Atkins diet, isn't surprising.
Do have to add - it's impressive that you went through all these documented efforts. In the name of science and all that.
Do have to add - it's impressive that you went through all these documented efforts. In the name of science and all that.
1) If what you say is true, "keto" would be the little switch
2) I didn't lose the weight on keto. I did keto for 7 years and managed to gain 100lbs back while on keto. This fat loss is very recent, and while it's still a ketogenic diet, it really is some magic little switch that I've flicked - I just don't know (yet) which one :)
2) I didn't lose the weight on keto. I did keto for 7 years and managed to gain 100lbs back while on keto. This fat loss is very recent, and while it's still a ketogenic diet, it really is some magic little switch that I've flicked - I just don't know (yet) which one :)
Do you have a Youtube? I'd definitely follow and would love to see when you figure out what the switch is exactly.
The amount of willpower I'd need to stick to a diet consisting primarily of whipped cream and butter is pretty immense my dude.
It's far easier for me to just do caloric restriction. Granted I wouldn't lose weight as quickly.
It's far easier for me to just do caloric restriction. Granted I wouldn't lose weight as quickly.
[deleted]
For me, carbohydrate consumption and appetite are massively correlated.
When I reduce carbs below 30g/day, my appetite is naturally suppressed (or avoids over-stimulation). Food feels much less addictive. It's easier not to snack in the face of stress. Keto probably added 10+ years on to my life expectancy.
YMMV.
When I reduce carbs below 30g/day, my appetite is naturally suppressed (or avoids over-stimulation). Food feels much less addictive. It's easier not to snack in the face of stress. Keto probably added 10+ years on to my life expectancy.
YMMV.
Same for me with eliminating carbs; combining keto + IF is pretty effective and I've lost about half of the weight from ATH to where I want to be through it. IF is nice because it provides an "all or nothing, but not forever" restriction, and keto is a reasonable framework for food selectivity. Keeping enough protein for not losing muscle and overall ideal; I wish I'd done this when I was 16 and not when I was in my 40s.
I’m in my 50s and I will tell you that your metabolism changes. I was on strict low-carb and I hit a wall in terms of weight that I couldn’t get past. When I did low carb in my 30s I easily lost about 40 lbs but this time around I maxed out at 20 lb weight loss and couldn’t push it further.
Have you tried cutting out PUFAs as well? Check out the Croissant Diet:
https://fireinabottle.net/introducing-the-croissant-diet/
No guarantee that it'll work (I haven't tried myself) but seems like a thing that could help you.
No guarantee that it'll work (I haven't tried myself) but seems like a thing that could help you.
Cutting out carbs + protein worked even better for me:
https://exfatloss.substack.com/p/losing-43lbs-in-144-days-on...
Yeah for sure. I kicked a 3 cig a day habit overnight. I was still eating junk food even into into a diet. Never really stopped, but I lost a lot of weight through aggressive portion control.
I don't try to adjust my food intake. Instead I adjust my exercise upwards if I gain a few pounds.
This approach his its limits. I used to run, climb, do boxing... eat whatever i felt like eating.
But traumas do accumulate. 10 km a day becomes impossible. Joints, spine, heart - everything has limits.
Counting calories isn't that hard and it works by the very definition of energy.
But traumas do accumulate. 10 km a day becomes impossible. Joints, spine, heart - everything has limits.
Counting calories isn't that hard and it works by the very definition of energy.
> Counting calories isn't that hard and it works by the very definition of energy.
It doesn't "work" unless your definition of "work" is "lost a few pounds of water weight over a few weeks." Certainly does not work when going from obese to normal weight.
It doesn't "work" unless your definition of "work" is "lost a few pounds of water weight over a few weeks." Certainly does not work when going from obese to normal weight.
I don't understand how counting calories can not work. It's the law of evergy conservation: energy in, energy out. This is not about water at all. Fat is just your main energy storage mechanism. And what's good about fat is that you can burn through it relatively quickly unlike building muscle which takes years. You can even count how many steps you need to do to burn through a kg of fat.
I've lost "post-covid" 15 kg (93kg to 78kg, 180cm height) in about 3 months with counting calories and ensuring a reasonable deficit. MyFitnessPal did help here.
I was just getting about 1800-2000 calories daily (which is not too bad), walking about 10k-15k steps a day (a morning walk, lunch-time walk and an evening one) and doing some very lightweight kettlebell exercises. There are details on how you might want to track weekly averages instead of daily weight values.
Certainly, i was never obese just slightly overweight. Obesity can mean certain serious food-related disorders but most of the time it's just a bad diet together with not moving a lot.
I've lost "post-covid" 15 kg (93kg to 78kg, 180cm height) in about 3 months with counting calories and ensuring a reasonable deficit. MyFitnessPal did help here.
I was just getting about 1800-2000 calories daily (which is not too bad), walking about 10k-15k steps a day (a morning walk, lunch-time walk and an evening one) and doing some very lightweight kettlebell exercises. There are details on how you might want to track weekly averages instead of daily weight values.
Certainly, i was never obese just slightly overweight. Obesity can mean certain serious food-related disorders but most of the time it's just a bad diet together with not moving a lot.
> I don't understand how counting calories can not work. It's the law of evergy conservation: energy in, energy out.
It's very easy. Your calories in depends on your calories out, and your calories out on your calories in.
The body regulates both intake and expenditure dynamically, so if you mess with one of them and don't change anything else, it's most likely just going to adjust the other one.
This has been mainstream science for a generation or longer, read The Hungry Brain by Guyenet for a good introduction.
> Certainly, i was never obese just slightly overweight.
Then it works, of course. Your metabolism was not "broken." This is like buffing out a bump in your car door. Won't work to fix a full-on collision. It's just not the same problem.
It's very easy. Your calories in depends on your calories out, and your calories out on your calories in.
The body regulates both intake and expenditure dynamically, so if you mess with one of them and don't change anything else, it's most likely just going to adjust the other one.
This has been mainstream science for a generation or longer, read The Hungry Brain by Guyenet for a good introduction.
> Certainly, i was never obese just slightly overweight.
Then it works, of course. Your metabolism was not "broken." This is like buffing out a bump in your car door. Won't work to fix a full-on collision. It's just not the same problem.
As per your blog, your test is n=1. Besides, if people can really accurately count their calorie intakes and won’t overeat what they use up, then it is thermodynamically impossible not to lose weight. It is really hard to do in practice, especially for longer periods of time, but the theory behind is sound and straightforward.
This is the experience of practically everyone who's ever tried to lose weight, not just me. You think we had an obesity epidemic that's growing if counting calories really worked?
> Besides, if people can really accurately count their calorie intakes and won’t overeat what they use up, then it is thermodynamically impossible not to lose weight.
This is false. The body is a self-regulating system. You eat less, the body can just burn less. You eat more, the body can burn more. What you eat and what you do also plays a huge role.
> Besides, if people can really accurately count their calorie intakes and won’t overeat what they use up, then it is thermodynamically impossible not to lose weight.
This is false. The body is a self-regulating system. You eat less, the body can just burn less. You eat more, the body can burn more. What you eat and what you do also plays a huge role.
It ain’t going to burn less than like 2000 calories. We are just surprisingly efficient at turning food into energy, and too efficient to burn enough energy with even hard-core movements.
And it doesn’t hurt your last point in anyway, both statements can be true.
And it doesn’t hurt your last point in anyway, both statements can be true.
It absolutely will. I've tried it myself and stayed stable around 1,000kcal/day for 2 months straight.
This has also been proven to not work for people who are already obese.
they say ozempic curbs appetite for booze. ¯\_(ツ)_/¯
And Buproprion is used (among other things!) both as a weight loss drug and smoking cessation aide.
There was an article[1] about two gene mutations which cause (a) lose fat, lose muscle, and (b) lose fat, gain muscule.
If you could build a selector between these three modes (normal human, (a), (b)), you could solve HALF OF HUMANITY PROBLEMS. For real.
That's not a joke. I see a lot of people around whose lifes are crippled by the fact they're not in the body mass which would be most productive/healthy for them. People are losing a decade of life and another decade of productivity due to this. A lot of interpersonal problems are also due to this, more than you can imagine. Half of world's perceived social injustice go away once you fix BMI.
We do not even realize the amount of self-humiliation humanity suffers by not being able to control something so fundamental.
Disclaimer: My own body weight is normal, though I would perhaps accept additional muscle; but it pains me seeing people who suffer from this every day, people who are better than me in most other respects.
1. https://davidepstein.substack.com/p/the-diy-scientist-and-th...
If you could build a selector between these three modes (normal human, (a), (b)), you could solve HALF OF HUMANITY PROBLEMS. For real.
That's not a joke. I see a lot of people around whose lifes are crippled by the fact they're not in the body mass which would be most productive/healthy for them. People are losing a decade of life and another decade of productivity due to this. A lot of interpersonal problems are also due to this, more than you can imagine. Half of world's perceived social injustice go away once you fix BMI.
We do not even realize the amount of self-humiliation humanity suffers by not being able to control something so fundamental.
Disclaimer: My own body weight is normal, though I would perhaps accept additional muscle; but it pains me seeing people who suffer from this every day, people who are better than me in most other respects.
1. https://davidepstein.substack.com/p/the-diy-scientist-and-th...
It’s very weird that out of 95 comments in this thread (at the time of writing), practically half of them are one person.
Making GLP-1 agonists and related drugs (ozempic, mounjaro) cheaply/widely available seems like it would be excellent public policy.
It seems that they also make you lose tons of lean mass. Normal diets you lose 25% of the lost weight in lean, these seem more like 40%.
https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...
https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...
“Lean mass loss was 2.6% versus 10.9%. Those on tirzepatide had about a threefold greater reduction in fat mass than lean mass, resulting in an overall improvement in body composition. Fat mass as a proportion of overall body mass decreased from 46.8% to 44.7% with placebo, compared with 46.2% to 38.5% with tirzepatide. Similarly, lean mass as a proportion of body mass increased from 50.7% to 52.4% with placebo, compared with 51.0% to 58.1% with tirzepatide. Fat-to-lean mass ratio improved more with tirzepatide than placebo, with greater improvements observed in patients who lost more body weight.”
https://www.practiceupdate.com/content/easd-2022-substantial....
https://www.practiceupdate.com/content/easd-2022-substantial....
Yea, their overall composition still improved of course, because they lost more than 50% in fat. But they lost more lean mass than people who lose that weight in other ways, is my understanding.
In an apples to apples study it showed similar effects to canagliflozin which works through an entirely different pathway. So it's probably not related to GLP-1 but to the speed and effectiveness of weightloss which will most likely be faster than a typical diet.
https://pubmed.ncbi.nlm.nih.gov/31897524/
https://pubmed.ncbi.nlm.nih.gov/31897524/
Previously believed by whom? Pretty sure we've been aware that obesity is a huge problem for a generation now. I mean we literally talk about an obesity epidemic.
Next, science is going to find out that water is wet.
Next, science is going to find out that water is wet.
> Previously believed by whom?
The previous data/methodology. The whole point of the study was to look at three untracked externalities[0] in BMI-outcome research. They used historical NHANES data combined 2015 data on mortality data.
> (1) confounding bias from heterogeneity in body shape; (2) positive survival bias in high-BMI samples due to recent weight gain; and (3) negative survival bias in low-BMI samples due to recent weight loss.
https://www.tandfonline.com/doi/abs/10.1080/00324728.2023.21...
The previous data/methodology. The whole point of the study was to look at three untracked externalities[0] in BMI-outcome research. They used historical NHANES data combined 2015 data on mortality data.
> (1) confounding bias from heterogeneity in body shape; (2) positive survival bias in high-BMI samples due to recent weight gain; and (3) negative survival bias in low-BMI samples due to recent weight loss.
https://www.tandfonline.com/doi/abs/10.1080/00324728.2023.21...
I don't believe this myself, but I do know a lot of people who believe being overweight is unfairly demonized and not as harmful as TPTB would have us believe. Many point to BMI as an inaccurate gauge of healthiness (there's a fair point there about eating disorders and ethnic predispositions towards higher BMIs) and unhealthy obsessions with thinness (as opposed to fitness). Look up "Fat Acceptance" if you'd like to know more.
Personally, I don't think we should view fatness as a moral failing; some people do naturally tend towards higher weights, especially as they get older. But I also feel that fatness is really dangerous and unhealthy and the "Fat Acceptance" movement makes me a bit uncomfortable because, much like smoking cigarettes, some people need a bit of a push to kick bad habits like overeating. Obesity is very expensive, both in money and lives, so if we can reduce it, we should.
Personally, I don't think we should view fatness as a moral failing; some people do naturally tend towards higher weights, especially as they get older. But I also feel that fatness is really dangerous and unhealthy and the "Fat Acceptance" movement makes me a bit uncomfortable because, much like smoking cigarettes, some people need a bit of a push to kick bad habits like overeating. Obesity is very expensive, both in money and lives, so if we can reduce it, we should.
The dirty secret is that unhealthiness is demonized. Health has been adopted as a moral responsibility.
You’re not supposed to say out loud that you smoke, drink, or overeat because you enjoy it and have accepted that you might live a less long life and/or one with greater medical needs. You’re supposed to say that you’re ashamed and you can’t help yourself and that you know you’re supposed to be healthy.
This is the moral trap that makes people try very hard to find proof that X or Y is ultimately healthy. In Christian moral language, it’s like being handed a biblical passage that supports that thing you want to do. If being fat is healthy, you don’t have to wallow in shame, you just have to convince everyone that they misunderstand the facts.
It’s hard to make social systems like universal healthcare work when people are openly and unrepentantly unhealthy, but the fact is that health is no more universal a form of piety than faith in some specific God. Some people will just want to eat a lot of ice cream and hamburgers because they’re yummy.
You’re not supposed to say out loud that you smoke, drink, or overeat because you enjoy it and have accepted that you might live a less long life and/or one with greater medical needs. You’re supposed to say that you’re ashamed and you can’t help yourself and that you know you’re supposed to be healthy.
This is the moral trap that makes people try very hard to find proof that X or Y is ultimately healthy. In Christian moral language, it’s like being handed a biblical passage that supports that thing you want to do. If being fat is healthy, you don’t have to wallow in shame, you just have to convince everyone that they misunderstand the facts.
It’s hard to make social systems like universal healthcare work when people are openly and unrepentantly unhealthy, but the fact is that health is no more universal a form of piety than faith in some specific God. Some people will just want to eat a lot of ice cream and hamburgers because they’re yummy.
> some people need a bit of a push to kick bad habits like overeating
I think this is the real culprit - the idea that overeating is the root cause and not a symptom, and that a little bit of a push makes a difference.
I think this is the real culprit - the idea that overeating is the root cause and not a symptom, and that a little bit of a push makes a difference.
Overeating is the "cause" of obesity because that is the mechanism of action that facilitates obesity. How else could one reasonably become obese?
Overeating is the "how" not the "why" -- at least, that's how I see it.
It would be like saying alcohol is the root cause of alcoholism, when in reality, the root cause of alcoholism is often much more nuanced. Hence why many people with addictions tend to be polysubstance users or "hot swap" to a new vice after abstaining from another. It's not about the mechanism of escape, but rather the need to escape.
Overeating is the "how" not the "why" -- at least, that's how I see it.
It would be like saying alcohol is the root cause of alcoholism, when in reality, the root cause of alcoholism is often much more nuanced. Hence why many people with addictions tend to be polysubstance users or "hot swap" to a new vice after abstaining from another. It's not about the mechanism of escape, but rather the need to escape.
> I do know a lot of people who believe being overweight is unfairly demonized
Because it is. As you yourself allude to later...
> I don't think we should view fatness as a moral failing
It clearly is not. I suspect the only people who believe that are the folks 'born on third base' as it were.
> some people need a bit of a push to kick bad habits like overeating
Some people? The vast majority of people are overweight. Anyone who isn't fit & trim has no business commenting on anyone else's bad habits and moral failings. None. Got a little bit of a spare tire? Shush. Got some love handles? Shush. Skinny fat? Shush again!
> if we can reduce it, we should
100% agree.
Edit: Downvote all you want, guys, most of you pushing that downvote button need to lose weight just as much as I do.
Because it is. As you yourself allude to later...
> I don't think we should view fatness as a moral failing
It clearly is not. I suspect the only people who believe that are the folks 'born on third base' as it were.
> some people need a bit of a push to kick bad habits like overeating
Some people? The vast majority of people are overweight. Anyone who isn't fit & trim has no business commenting on anyone else's bad habits and moral failings. None. Got a little bit of a spare tire? Shush. Got some love handles? Shush. Skinny fat? Shush again!
> if we can reduce it, we should
100% agree.
Edit: Downvote all you want, guys, most of you pushing that downvote button need to lose weight just as much as I do.
> Because it is. As you yourself allude to later...
No its not. Its nowhere near demonized as it should be.
> It clearly is not. I suspect the only people who believe that are the folks 'born on third base' as it were.
It's a failure of self control.
> Some people? The vast majority of people are overweight. Anyone who isn't fit & trim has no business commenting on anyone else's bad habits and moral failings. None. Got a little bit of a spare tire? Shush. Got some love handles? Shush. Skinny fat? Shush again!
Untrue. The vast majority of people in rich countries are overweight.
No its not. Its nowhere near demonized as it should be.
> It clearly is not. I suspect the only people who believe that are the folks 'born on third base' as it were.
It's a failure of self control.
> Some people? The vast majority of people are overweight. Anyone who isn't fit & trim has no business commenting on anyone else's bad habits and moral failings. None. Got a little bit of a spare tire? Shush. Got some love handles? Shush. Skinny fat? Shush again!
Untrue. The vast majority of people in rich countries are overweight.
> It's a failure of self control.
Disagree. The root cause of the problem is that you can't apply to more willpower if you don't know how to actually fix it, and we don't.
There are currently 0 known methods to lose fat sustainably. Yea, you can starve yourself for a few weeks in a thousand ways, but none of them lead to lasting fat loss. Neither does any kind of exercise.
We need to find the true root cause, or this will not change.
Disagree. The root cause of the problem is that you can't apply to more willpower if you don't know how to actually fix it, and we don't.
There are currently 0 known methods to lose fat sustainably. Yea, you can starve yourself for a few weeks in a thousand ways, but none of them lead to lasting fat loss. Neither does any kind of exercise.
We need to find the true root cause, or this will not change.
Based on seeing what is in most shopping carts, most people are not even trying to control weight.
Starving one’s self is not necessary. Not buying ice cream, cookies, chips, added sugar foods, and beer is necessary. Do not eat out, and do not let unhealthy foods into the house. And do not shop while hungry.
The root cause is all that unhealthy stuff gives everyone a dopamine hit they want.
Living in an environment that discourages walking and physical activity in exchange for sitting in cars also does not help.
Starving one’s self is not necessary. Not buying ice cream, cookies, chips, added sugar foods, and beer is necessary. Do not eat out, and do not let unhealthy foods into the house. And do not shop while hungry.
The root cause is all that unhealthy stuff gives everyone a dopamine hit they want.
Living in an environment that discourages walking and physical activity in exchange for sitting in cars also does not help.
> Not buying ice cream, cookies, chips, added sugar foods, and beer is necessary. Do not eat out, and do not let unhealthy foods into the house. And do not shop while hungry.
I've done all that and more for 10 years and still gained 100lbs. Exercise didn't help, just made it worse. Yes, I've gained 20-30lbs (not muscle, I wish!) in a few months by exercising more. I've failed to lose fat doing 10 months of 4x per week intense exercise.
It just doesn't work.
Then I just lost almost 50lbs with some "crazy" diet experiment by eating as much heavy whipping cream as I feel like. No working out at all.
These mainstream theories of "just eat healthy" simply don't work for obese people.
I've done all that and more for 10 years and still gained 100lbs. Exercise didn't help, just made it worse. Yes, I've gained 20-30lbs (not muscle, I wish!) in a few months by exercising more. I've failed to lose fat doing 10 months of 4x per week intense exercise.
It just doesn't work.
Then I just lost almost 50lbs with some "crazy" diet experiment by eating as much heavy whipping cream as I feel like. No working out at all.
These mainstream theories of "just eat healthy" simply don't work for obese people.
I lost 150 pounds in 1.5 years doing literally nothing different but eating less, and kept it off for the next 15 (present)
You own failings are due to you lying to yourself about how much you eat.
Humans are not able to break the laws of thermodynamics. If you consume less than you burn, you will lose weight no matter what.
You own failings are due to you lying to yourself about how much you eat.
Humans are not able to break the laws of thermodynamics. If you consume less than you burn, you will lose weight no matter what.
> You own failings are due to you lying to yourself about how much you eat.
False. How much you eat is only indirectly related to energy partitioning, which decides if that food energy will be burned or stored. Trust me, I've tried more than you and am more obsessed with the topic :)
You probably decreased carbs and PUFAs significantly as part of "eating less."
> Humans are not able to break the laws of thermodynamics. If you consume less than you burn, you will lose weight no matter what.
Ah, the ol' accounting tautology :)
Of course you're right, but of course it has nothing to do with the topic. "Being in an energy deficit" does not necessarily come from "eating less" or "exercising more" and eating less or exercising more do not guarantee a deficit.
Turns out the human body is full of miraculous biochemistry, it's not an oven.
False. How much you eat is only indirectly related to energy partitioning, which decides if that food energy will be burned or stored. Trust me, I've tried more than you and am more obsessed with the topic :)
You probably decreased carbs and PUFAs significantly as part of "eating less."
> Humans are not able to break the laws of thermodynamics. If you consume less than you burn, you will lose weight no matter what.
Ah, the ol' accounting tautology :)
Of course you're right, but of course it has nothing to do with the topic. "Being in an energy deficit" does not necessarily come from "eating less" or "exercising more" and eating less or exercising more do not guarantee a deficit.
Turns out the human body is full of miraculous biochemistry, it's not an oven.
> I lost 150 pounds
Ah, that explains it. You had a serious moral failing and you corrected it.
Ah, that explains it. You had a serious moral failing and you corrected it.
Sorry to hear that, and while I obviously cannot speak for your experiences, the lifestyles of overweight people I am familiar with does not lead me to believe they are making the necessary sacrifices to be a healthy weight.
There aren’t any exercise (in whatever amount) that lead to fat loss? Sounds like massive cope.
It’s extremely obvious that doing something like running every day (if it leads to a calorie deficit) will make you lose fat.
When you start having a sense of how many cals any amount of exercise burns, no. It's way faster not to ingest them in the first place.
Well, I've tried it. I've lost tons of weight, but never with exercise. So it's not cope, it's just a matter of science.
> It’s extremely obvious that doing something like running every day (if it leads to a calorie deficit) will make you lose fat.
But what if it doesn't because your body is a self-regulating dynamic system that changes energy partitioning and intake demands based on output?
> It’s extremely obvious that doing something like running every day (if it leads to a calorie deficit) will make you lose fat.
But what if it doesn't because your body is a self-regulating dynamic system that changes energy partitioning and intake demands based on output?
If you spend more energy than your body takes in, there is no way you don’t lose weight, no matter what your body does with it.
If someone isn’t losing weight on a caloric deficit, they’re not tracking their food intake and exercise properly.
If someone isn’t losing weight on a caloric deficit, they’re not tracking their food intake and exercise properly.
Your body can't magic up energy out of nothingness. If you reduce your caloric intake enough, you'll always lose weight.
So you're saying science is wrong? Cause I ran the experiment and it failed.
The reason is, of course, that your body can downregulate energy expenditure according to energy intake. I've observed my body downregulate to about 1,000kcal/day. No fat loss on a 1kkcal/day OMAD diet for 2 months straight. No exceptions.
If you get below the bare minimum (say 1kkcal/day for me) your body will start shutting down pretty essential systems like the immune system, you won't be able to concentrate, sleep will be messed up.
Yes, I've done all these experiments, obviously.
The reason is, of course, that your body can downregulate energy expenditure according to energy intake. I've observed my body downregulate to about 1,000kcal/day. No fat loss on a 1kkcal/day OMAD diet for 2 months straight. No exceptions.
If you get below the bare minimum (say 1kkcal/day for me) your body will start shutting down pretty essential systems like the immune system, you won't be able to concentrate, sleep will be messed up.
Yes, I've done all these experiments, obviously.
> So you're saying science is wrong? Cause I ran the experiment and it failed.
So by "science", you mean your n=1 "experiment" and not conservation of energy?
So by "science", you mean your n=1 "experiment" and not conservation of energy?
Yes, of course. Only takes 1 experiment to disprove a hypothesis, remember?
Conservation of energy is a whole other story and I don't see how it's related to fat loss.
Conservation of energy is a whole other story and I don't see how it's related to fat loss.
The problem is: human body is very energy efficient, and processed food is very calorie dense. Burning enough calories to make up for all the junk food is almost impossible, except maybe for professional athletes that spend 5+ hours a day training or competing. You can't outrun a doughnut, basically.
The "science" has been saying for a long time now that there's might even be a health benefit from being a bit overweight, and that --as this article carefully explained (which means I guess you didn't read it)-- there is a "U-shaped" distribution of outcomes; in contrast, this study claims all that prior work is wrong, and that there is a "straight upward line".
The U-shaped distribution of outcomes has been discussed for many, many years, and I've never seen it mentioned without the caveat that most doctors and scientists suspect that it's a misleading statistic attributable to serious illnesses that cause weight loss. This definitely isn't the first study to support that interpretation, either.
In other words, the longstanding conventional wisdom (at least as presented in the media) is exactly what this study set out to vindicate, not the opposite, like the press release claims.
It's possible that this study is a significant step up in quality from existing ones, and it's possible that their method of considering past BMI is new and interesting, but the framing of it as the first to challenge conventional wisdom is pure marketing hype.
In other words, the longstanding conventional wisdom (at least as presented in the media) is exactly what this study set out to vindicate, not the opposite, like the press release claims.
It's possible that this study is a significant step up in quality from existing ones, and it's possible that their method of considering past BMI is new and interesting, but the framing of it as the first to challenge conventional wisdom is pure marketing hype.
This. The U (or typically J as I've heard it described) shape comes mostly from the fact that very many very unhealthy people lose a ton of weight and end up with a super low BMI.
Sprinkled with a coating of "body positivity" perhaps?
I use quotes, because I personally only believe in body positivity for matters that are beyond control - eg disfigurements related to genetics or trauma. No-one should shame anyone - or feel shame - for things they have no say on.
Matters within scope of control should be addressed, however. At the very least not lied about and promoted as healthy, more importantly.
I use quotes, because I personally only believe in body positivity for matters that are beyond control - eg disfigurements related to genetics or trauma. No-one should shame anyone - or feel shame - for things they have no say on.
Matters within scope of control should be addressed, however. At the very least not lied about and promoted as healthy, more importantly.
Yea. I think a lot of it is cope/helplessness. Clearly "we" as a society don't know how to stay lean or get lean, and it's not fun constantly being reminded of something that you feel you have no control over. Or being told that it's unhealthy.
The point is not that its deadly, but more deadly then previously thought (as indicated by the title).
https://asdah.org/health-at-every-size-haes-approach/ - and similar efforts have sprouted like wildfire these last several years in the name of inclusivity. Claiming or hinting that obesity is bad for one's health is considered highly gauche in polite company.
The health effects of obesity are well advertised yet people continue to eat a lot. You see it on social media: people dining out with friends at restaurants with large plates of food, huge Superbowl parties, etc. evidently these people are not concerned. There are three ways of looking at this: these people are obvious to the risk, do not care, or the risks of obesity or being overweight are overblown. If the NYTs cares about stopping obesity, they should get rid of their food section, as food is the main contributor to obesity.
This is a joke, right?
Indulging in a Superbowl party or birthday dinner will not make you obese.
Overeating or eating poorly over a long period of time will.
Cooking can be a great way to have healthy tasty food affordably
Indulging in a Superbowl party or birthday dinner will not make you obese.
Overeating or eating poorly over a long period of time will.
Cooking can be a great way to have healthy tasty food affordably
You're getting the causation reversed. These people are overeating because they're obese, not the other way around.
Does lung cancer make people start smoking too?
Probably not, but also not sure how that's related?
> Masters pointed out that a lifetime carrying excess weight can lead to illnesses that, paradoxically, lead to rapid weight loss.
Well I mastered the first part
Well I mastered the first part
This seems useful. However, some people, both inside and outside medicine, believe that negative consequences' education can be a solution to the overweight/obesity issue, even though after 40 years we've seen near no positive correlation. We've seen some positive outcomes from interventions (e.g. mental health treatments, actionable plans, etc.) but the funding/resources for those continue to be scarce. So the trend keeps falling back to education in the professional setting or bullying in the social one as a "solution" because it is free, ignoring the lack of efficacy.
I actually think our "personal moral failing" thinking is a large impediment to actionable solutions for society, because instead of looking at WHY even 18-year-olds have gone from below 20 BMI in 1879 to over 26 BMI in 2022[0] we just go around and around in circles about how it is a personal responsibility issue not a systemic one, while the data continues to show that it is across all of society. We continue to subsidize sugar substitutes (corn turned into HFCS) at the production side but sugar taxes to offset the subsidies are seen as "attacks on freedom." The US's overproduction of HFCS has even lowered the international price of sugar indirectly.
Because sugar is so cheap, and so addicting, in our capitalist system the manufacturer willing to exchange other ingredients (e.g. fats, proteins, etc) for sugars may be both cheaper AND taste better, even if ultimately it isn't satiating. So we have a bunch of foods which are high in sugar relative to historical norms or that simply never existed because they exist to act as a "sugar delivery system" (e.g. soda).
After the UK introduced a soda tax (SDIL), we can see that due to both manufacturers reformulating their drinks AND changes in consumer behavior it resulted in lower calorie intakes that they did NOT make up by buying alternative sources of sugar (e.g., candy)[1]
[0] https://www.calciumhealth.com/the-american-obesity-epidemic-...
[1] https://www.instituteforgovernment.org.uk/article/explainer/...
I actually think our "personal moral failing" thinking is a large impediment to actionable solutions for society, because instead of looking at WHY even 18-year-olds have gone from below 20 BMI in 1879 to over 26 BMI in 2022[0] we just go around and around in circles about how it is a personal responsibility issue not a systemic one, while the data continues to show that it is across all of society. We continue to subsidize sugar substitutes (corn turned into HFCS) at the production side but sugar taxes to offset the subsidies are seen as "attacks on freedom." The US's overproduction of HFCS has even lowered the international price of sugar indirectly.
Because sugar is so cheap, and so addicting, in our capitalist system the manufacturer willing to exchange other ingredients (e.g. fats, proteins, etc) for sugars may be both cheaper AND taste better, even if ultimately it isn't satiating. So we have a bunch of foods which are high in sugar relative to historical norms or that simply never existed because they exist to act as a "sugar delivery system" (e.g. soda).
After the UK introduced a soda tax (SDIL), we can see that due to both manufacturers reformulating their drinks AND changes in consumer behavior it resulted in lower calorie intakes that they did NOT make up by buying alternative sources of sugar (e.g., candy)[1]
[0] https://www.calciumhealth.com/the-american-obesity-epidemic-...
[1] https://www.instituteforgovernment.org.uk/article/explainer/...
> I actually think our "personal moral failing" thinking is a large impediment to actionable solutions for society
100%. We have no clue how to fix it, so we "do something" to feel in control as a society.
100%. We have no clue how to fix it, so we "do something" to feel in control as a society.
Are there any studies showing a significant reduction in population body mass (our primary endpoint) following sugar taxes?
nostromo123(1)
> Excess weight or obesity boosts risk of death by anywhere from 22% to 91%
A strange statistic, as the actual risk of death is 100% for all of us.
A strange statistic, as the actual risk of death is 100% for all of us.
Strange in the same way it's strange that people might say that playing Russian roulette increases risk of death by an easily-calculable amount.
What if you eat a lot of vegetables though
Would that make you immortal? If not, still 100%.
I am guessing they mean premature death.
So far.
"I intend to live forever, or die trying." - Groucho Marx
“I would argue that we have been artificially inflating the mortality risk in the low-BMI category by including those who had been high BMI and had just lost weight recently,” he said.
It's like the teetotaling bias — a chunk of people who teetotal do so because they have an illness that makes drinking very unwise (or would conflict with medication).