"Interestingly, animal studies show that the gain in fat mass is not due to eating more or moving less… Animals ate the same amount of chow, but those infected with adenovirus 36 increased fat tissue by 60-80%."
"A 2004 twin study showed that the Ad-36 antibody-positive twins were “significantly heavier and fatter as compared with their antibody-negative counterparts”. This was a groundbreaking study indicating that the Ad-36 virus was likely causing obesity."
It may be a contributing factor in some cases. The study published in Obesity you link says the adenovirus affects insulin, leptin, and corticosterone. An important note about the third item: "In many species, including amphibians, reptiles, rodents and birds, corticosterone is a main glucocorticoid, involved in regulation of energy, immune reactions, and stress responses. However, in humans, cortisol is the primary glucocorticoid..." [1]. Note that the adenovirus itself wasn't definitively causing obesity, but obesity is caused by the adenovirus' effects on certain hormones.
I highlight this because obesity is increasingly being reestablished as a hormonal problem. See my post and replies for more information about this change: https://news.ycombinator.com/item?id=38942521
A lot of viral infections impact cortisol in humans. Infection tends to ramp up cortisol levels, but prolonged or chronic infection can both deplete cortisol (so called adrenal fatigue) and/or make the body more resistant to the effects of cortisol. This is seen in the extreme in the case of HIV. I assume cortisol resistance is analogous to insulin resistance in prediabetics. Apparently chronic stress can have similar effects. And chronic stress may be associated with chronic viral reactivation. [1]
Great comment! Interestingly, depleted cortisol levels from chronic stress may be associated with the development of long covid. [2] I wonder if down the road we will see that people who have had long covid are at increased risk of developing or exacerbating obesity.
If this these extremely common viruses were the root cause of obesity, then why does obesity affect different countries so differently?
Viruses all passed around globally so you have to assume all developed countries are getting pretty much the same level of population infection.
Maybe it's because if certain viruses do play a role in obesity, it sounds like an evolved adaptation in humans. Ie, if you're sick, you respond by burning less energy and storing more of it as fat.
Like all evolved adaptations, they don't affect all populations equally. I'm guessing if ad36 contributes to obesity, you must first be genetically predisposed to it happening.
"In the reviewed studies, there was a high prevalence of Adv36 in all age groups, which exceeded 64% among adults and 73% among children and adolescents with obesity and/or metabolic disorders. The vast majority of the reviewed studies have shown a statistically significant association between Adv36 and obesity, adiposity, and related alterations, whereas only a few studies presented divergent results."
Adenovirus 36 prevalence and association with human obesity: a systematic review
"The obvious reason for obesity is eating too much sugar and refined carbohydrates. But statistically how much does this add to the risk of obesity?
A 2019 meta-analysis of different food intake studies and weight gain showed that consumption of refined grains increased the relative risk of obesity by 5% and the consumption of sugar-sweetened beverages increased the relative risk of obesity by 10%. Eating more legumes, fruit, and fish all tilted the scales in the other direction, reducing the risk of obesity by 5-15%. The study concluded, “The dose-response meta-analytical findings provided very low to low quality of evidence that certain food groups have an impact on different measurements of adiposity risk.”"
Food Groups and Risk of Overweight, Obesity, and Weight Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies
I was slack and didn't read your links last night, sorry.
From what I can gather, infection with adenovirus-36 basically improves glycemic control... ostensibly a good thing? I couldn't find whether adenovirus-36 was a persistent infection, or whether it only affected patients for a short time, but then they failed to lose weight after the infection had cleared.
This author states that the reason for obesity is eating too much sugar and refined carbohydrates. Why is there a distinction between refined and unrefined carbohydrates? There's no explanation for this, it's treated as given. It's the same chemical makeup, all that changes is the glycemic index. In other words, it's the same poison, it just takes longer to absorb.
The linked study backs this up, but makes no sense from a glycemic load point of view. I notice that vegetables are lumped in one category. Potatoes are not the same as celery. As are fruits, yet blueberries and mangoes have a vastly different sugar content. To add insult to injury, this is a meta-analysis of observational studies, which are notoriously unreliable.
Let me back all this up with a different meta-analysis of interventional trials which treats all carbohydrates the same.
Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails
"If the adenovirus infections are playing a role in our obesity epidemic, this would need to be due to infections rising, starting around the early 1980s, when obesity levels started steadily increasing.
I mentioned above that obesity has doubled since 1980 — and that adenovirus seropositivity had doubled by the mid-2000s (Swedish study).
Here’s the CDC graph again – looking at the green lines (dashed green is women and solid green is men)
One piece of the puzzle as to why this could be happening is the increase in kids in daycare, which has been rising since the 80s. A study looking at overweight kids (9-12) found that Ad-36 increased the risk of obesity by 3-fold and that kids who were in daycare before age 24 months were also at an almost 3-fold risk of obesity.[ref]
Another interesting puzzle piece is that Ad36 was first isolated in 1978 in Germany.[ref] (This may not mean that it first existed in 1978, though, just that it wasn’t well-known before then. Other adenoviruses were identified in the 1930s.)"
The slimmest country on Earth is probably Viet Nam.
Travelers from all around the world tend to remark that once they arrive to Viet Nam, they start losing weight effortlessly. Upon arrival to the US, the very opposite tends to happen.
Adenovirus/population genetics must be a minor influence compared to cuisine.
"Adenovirus infection statistically increases the risk of obesity quite a bit more than eating sugar, refined carbs, not exercising, or eating too much omega-6 fat. However, stacking all of those reasons together likely adds up to quite a bit of weight gain as well. There is no simple answer, but rather is a complex picture of multiple reasons for weight gain."
could also be... the high humidity & heat, smaller portions of food (which are heavily fish and veg based), high rates of smoking, general poverty and simply eating less, etc.
I lost weight in Thailand and later in Australia, and it was mostly because of the heat, sweating a lot, and generally smaller meals. No magic secret here.
Plus the inevitable "Bali belly" that travelers get the first couple days there.
the South is humid and hot but very obese. I think it has to do with metabolism. The rice diet does not metabolize into fat as readily there among the natives.
With something as essential as metabolism it's likely to be a combination of factors. Some might not cause a change when present in isolation but cause a large change when present simultaneously.
"Adenovirus infection statistically increases the risk of obesity quite a bit more than eating sugar, refined carbs, not exercising, or eating too much omega-6 fat. However, stacking all of those reasons together likely adds up to quite a bit of weight gain as well. There is no simple answer, but rather is a complex picture of multiple reasons for weight gain."
I can't remember the source, but I remember hearing that the two demographics in society who average at a healthy BMI were endurance athletes and vegans.
I struggled through my 20s to keep my weight under 200 lbs at 6ft tall. Then I went vegan 4 years ago, and started running during the pandemic. Nothing crazy, just 5-8 km once or twice per week when it's nice out, and lots of beans and tofu in place of meat and dairy. I haven't weighed in over 185 since, and that's without fasting or counting calories.
I'm sure that viruses and environmental toxins and whatever else contribute some amount at the margin, but I'm convinced that it's diet and exercise, in that order, that are primarily to blame.
The correlation between vegans and health is muddied by the fact that vegans put far more thought into their diet than the average person. Its entirely possible not eating meat is orthoganal to health and its just that they actually care about what they eat.
No evidence of this, but I also suspect that vegans care more about their health in other weights too (e.g. exercising, not smoking, etc). If they can keep up with a vegan diet, they likely also have the discipline to keep up with exercise regimes and keeping good habits.
Not just care about health, but they're on a very restrictive diet.
Many of my vegan friends can barely find something to eat when we're going out. As an omnivore you can eat anywhere, as a vegetarian, you can eat almost anywhere. As a vegan, at least in Germany, it's still somewhat restrictive.
If you're consistently refraining from eating, then you're likely to just consume a lot less calories.
Another factor here is that most restaurants cook for attractiveness, not for health. Adding copious amounts of butter, oil and sugar can make a lot of food taste better at the expense of a much higher caloric intake.
I have an overweight vegan friend. He eats fries everywhere. Fat and carbs makes vegans fat, too.
I'd argue it's basically entirely this. The modern food environment is incredible (over)-stimulating. Food is ubiquitous and abundant, with a dizzying array of novel variations. Food cues enticing you to eat are ever present.
Being vegan has the accidental side effect of counteracting much of this. A lot of the built-up food infrastructure suddenly becomes non-existent.
Imagine. You're walking into a busy mall in a foreign country. On your left, there's a café advertising a variety of tempting pastries. Your sister told you about that cafe. She loves their cream cheese cake. To your right, the sizzling flames from a steakhouse grab your attention. Moving to another level, you spot an ice cream parlor showcasing a new flavor: Strawberry Daifuku. But all this has to wait, because you're heading straight for the ramen shop you've heard so much about. They're known for their amazing pork bone broth. It's why your foodie friends have chosen to meet up here.
Now if you were vegan, all of that is just ... gone. Possibly the foodie friends as well ;)
Non-vegans don't think about this but they recognize it subconsciously -- most non-vegans would balk at having to go vegan even for a short time, just due to the inconvenience alone.
Some of the aspects of the modern food environment come back when you figure out where to look of course, but even the even a savvy vegan consumer won't encounter the same level of choice, variety and catering and let's not forget cost-competitiveness that a modern omnivore experiences.
It's only restrictive in a society that can't go a single meal without animal products. I don't eat animal flesh, secretions, or eggs. That leaves legumes, fungi, vegetables, fruits, nuts, seeds and grains. A veritable cornucopia spanning three biological kingdoms if we're counting fermentation.
The restaurant scene seems to be a lot better in Canada. Most restaurants have vegan options. My work's Christmas lunch was at a steakhouse of all places, and I still had several options to choose from.
Most of what I refrain from eating is the junk food that seems to suffuse work and social life: donuts, cookies, and cake leftover from one meeting or another, and buttery/cheesy/eggy snacks at social gathering.
>A veritable cornucopia spanning three biological kingdoms if we're counting fermentation.
I didn't claim anything counter to that. I can cook plenty of tasty vegan food. But if I go out there's not much left in my country to eat. You have to go to a handful of specialized vegan restaurants in the city to have even somewhat a choice. Otherwise it's fries or noodles with tomato sauce, which personally I wouldn't consider a meal.
That it's better in Canada? Great. I believe you, but I've travelled a lot, and I haven't seen many places that have such a variety of vegan food as USA and Canada.
Most of Europe is very meat heavy, vegetarian is still easy, vegan is picky eating. In East Asia there are vegan options, but often tasteless, because they're meant for Buddhist monks. Otherwise even vegetarian is somewhat difficult.
In India vegetarian is easier than meat, especially considering food safety. Had 0 gastric issues with vegetarian food, while one bad piece of meat almost ended the trip for a friend of mine. But a lot of dishes have butter and milk, so vegan again is difficult.
I'm really not saying it's difficult to cook great vegan food, just that it limits your ability to eat outside in most of the world, which probably influences average BMI more than the diet itself.
There's vegan food, the processed, pale imitations of animal products you'll find in the health food aisle, and there's vegan food: rich, hearty vegetable and bean soup, fresh rustic sourdough bread, and vegetables roasted until they caramelize.
Most people would think these foods boring, but that's because they've only ever had the shitty, mass-produced versions.
> A lot of chips contain animal based flavor enhancers.
I think this is mainly as a response to people using plant based fats for deep frying. Traditionally they were fried in beef tallow, no need for any flavour enhancers if you fry them in beef fat.
Good example. Fries used to be (when I was a kid) deep fried in beef tallow. Nowadays it's usually plant based fats and while still good, it's not nearly as good as those fried in beef tallow.
Just be sure you're supplementing enough. If you've been vegan for 4 years, you're starting to enter the danger zone for running out of certain vitamins that your body stores.
B12 is the big obvious one, but you should also check out vitamins K2 and A (beta-carotene is only converted by about 70% of people), as well as carnitine, zinc, iron and iodine.
I take zinc, B12, D, K2 and algal omega-3. B12 is the big one, you're just trading diabetes and heart disease risk for stroke risk without that one. And everyone in northern climes should be taking vitamin D. Our salt is iodized.
The first time I tried an endurance sport I was already skinny, and I did well at it and that encouraged me to do it more. The running DID make me skinnier, dangerously so, but I reckon the correlation runs both ways here. It's very encouraging to take up a sport and see yourself whizzing past your peers.
I think BMI is a little confusing when it is applied to some categories of healthy individuals like endurance athletes and others. When I ran (a lot) in my early to mid-twenties my BMI was always "underweight". Yet I have never felt better.
The same probably goes for climbers. Some of the climbers I know are inredibly lean and their BMI is certainly not in the "normal weight" range. Yet they are able to push their bodies to incredible feats.
All that is to say, I suppose BMI stops to be useful at some point while, at the same time, it may be a good instrument to measure your progress during weight loss. It can be both useful and not, depending on who you apply it to.
BMI is really a tool for helping to give indications of risk factors. If you have a BMI of 15, it's likely you have risks of various diseases. It's not a slam dunk, but a risk. But if you've chatted with a health professional and you're both happy that you're outside of the risk factors, then you'd not need to worry much. Some people are fine at BMI 26 or 17, some are outside of their healthy range at 24 or 19. It's a guide, not a rule.
The people who DO fall outside of the model are not that common though, especially if you're white. And these days the model accounts for more minorities, so even though it has issues, it's still worth listening to as it can highlight potential problems before they actually become problems.
BMI measurements do have some signal for endurance athletes.
People who win running competitions are quite tightly grouped BMI-wise.
And for running I guess that makes sense, a kg of muscle weights as much as a kg of fat. Even if that kg of muscle is a lot healthier than the kg of fat.
Yes I should have clarified: I think the BMI levels (underweight, normal etc.), that is the "wording" cannot necessarily be applied to athletes (edit: and could be misleading for people and their self-concept when their weight is perfectly fine). You are right of course that the top runners in a competition likely stand out BMI-wise from the rest.
I've heard that waist-to-hip ratio is a better measure of overall health because it more directly measures the amount of visceral fat, but that wasn't wasn't what the study being quoted was measuring.
"Protein-deficient vegans" is a joke among omnivores, who assume that anyone not eating meat must be malnourished, and among vegans, who find ignorance of that magnitude hilarious.
I'm a participant in runner groups. I was surprised to meet several exceptional runners with stories of moving from very unhealthy/overweight to their current level of marathoner+. Several of them had success not just with intermittent fasting, but prolonged fasting. Humans can run when they feel like you have no energy.
It's hard to believe that this isn't a psychological and behavioral issue:
>A 30 percent reduction in caloric intake results in a 30 percent decrease in caloric expenditure.
Often times I find it difficult to run or exercise, a lot of times I don't feel like I have the energy. Especially when fasting. I've fasted 7 days and run 3+ miles every day until I had no glucose left in my body. I've never met anybody doing prolonged fasting, distance running and a 100% commitment who couldn't transform their bodies. There may be some rare cases out there of individuals with severe disease/diagnosed health disorders, that's between someone and their doctor. For the rest, are they 100% committed? If you feel like this is you, please reach out, would love to talk and connect with you.
With obesity there is a constant refrain that people should be able to deal with it by willpower alone. Here is an analogy to explain why this is unrealistic:
A while back I had a massive immune reaction in my skin, which brought with it the constant urge to scratch. A lot of people idly comment that the solution is to just not scratch, but it turned out that I had a skin infection, and under those circumstances the instinct to scratch is incredibly strong; you do it as soon as your mental attention is turned elsewhere. Once the skin infection was cured, and a bit of steroid cream applied the urge to scratch went away.
Now imagine how strong is the instinct to eat. Eating is essential for life, the instinct to eat when hungry has been reinforced by evolution constantly since the nervous system developed. Have you read a description of what it's like to starve? The brain can think of nothing but eating, peoples behaviour becomes quite extreme. Some people do overcome it - those who starve themselves to try to save their children, for example. But that's an enormous external motivation.
There's a bit of cognitive dissonance in seeing a hugely fat person and trying to imagine that their nervous system is for some reason acting like they are starving. It's a lot easier to imagine that they just don't have the willpower to resist that extra snack, which is a situation a lot more familiar to most of us. But it seems likely that the further is more correct.
In December, I experimented with the potato diet from Slime Mold, Time Mold, and I actually lost some weight effortlessly. Not only I was way more satiated, I also noticed that I was losing appetite for meat etc.
I am inclined to believe that the root cause for the obesity epidemic is our satiety signals being out of whack. In which case "just eat less" is about as useful piece of advice as "just breathe less". In both cases you would be struggling against enormously strong, primordial bodily mechanisms.
> There's a bit of cognitive dissonance in seeing a hugely fat person and trying to imagine that their nervous system is for some reason acting like they are starving. It's a lot easier to imagine that they just don't have the willpower to resist that extra snack, which is a situation a lot more familiar to most of us. But it seems likely that the further is more correct.
yes, 100% this. Your analogy with scratching the itch is spot on. And you know that the itch that you can't scratch will continue forever until the end of your life. How depressing is that? It's not like running a marathon - with a marathon, it's long and hard, but there is a finish and you can rest after that. With being hungry all the time, there is never a finish. You just gotta keep on running. And running's kinda hard - and if you stop resisting and eat a few big meals, you offset weeks of weight-loss. Losing 100 calories a day for 20 days is hard, but gaining 2000 calories a day is real damn easy, and also feels great!
False premise. Fasting isn't forever, its for a set period of time. Running and fasting are very similar. When running you often feel the urge to stop and give up. You build up the strength over time to say no to that voice. Fasting is a method of short-term saying no to urges. As you learn to say no to that urge, you become better at saying no to that urge. A single prolonged fast can redefine ones relationship with eating. There are lots of reasons to eat, not all of them are the need for nutrition. There are lots of reasons to grab a phone, not all of them are necessary to function/social/work, yet many people feel the urge to pick up there phone 50+ times a day.
Well, thank you for telling me that I have understood my life all wrong.
About 10 years ago I weighed 113kg. I decided to really tackle it hard and not give up. Threw out all the sugar at home and went on a weightwatchers diet.
Over a period of 1.5 years I got my weight down to 97kg. It was very hard. It was a constant battle with hunger and feeling like crap. But I made it! I reached my goal and it was awesome!
So I crossed the finish line, right? No more hunger?
Guess again. I was back to 110kg a few years later. Still hungry.
So yes, please do tell me about how the urges will go away.
No, they do not.
It's a chemical reaction somewhere that in my body is happening with different amounts of components than some other people's body's. It's not a thing that I can wish really hard to change.
You've missed my point entirely and moved to a different discussion. I am not arguing about will power. What do you think instinct is? Are we simply slaves to our desires? No. Yet many still feel this way.
Have you ever tried meditating? Is it easy to just sit?
TikTok users have a strong urge to watch more TikTok. Should they just give into their urge for a short term dopamine rush? Will it feel difficult to not listen to this urge? Can they overcome it or are they trapped forever?
"Now imagine how strong is the instinct to eat."
Fasting is a methodology to reset your metabolism. Dopamine fasting is a way to reset your urge to doom scroll. Meditation is a way to clear your mind.
Metabolically fasting dramatically increases insulin sensitivity, has profound benefits and helps one to become a master of their urges. It is a practice, like dopamine fasting, meditation, anything else...
In poor health, willpower often fails long before physical performance, and there are many different possible barriers, like struggle to eat properly, poor nasal breathing, general fatigue, poor posture and running form, etc.
Personally, I can run for a longer time, but between having to push through mental fatigue and very poor nasal breathing, it's an extremely unpleasant, aversive experience. Even when I can do it, it's really harsh on me.
For the first 43 years of my life I was kind of always overweight. Not always obese but there were periods. I've also always known that it would be healthier to have less fat, so it was always a thing on my mind.
But, I was also always hungry. Mostly not starving, but just hungry. I could eat a big meal, that made my stomach feel physically full, even painfully so and still have the feeling of hunger.
Of course, I also understood that on pure physics terms it really is calories out vs calories in that makes the difference. So I did try to eat less.
Also, you read and see people eating a salad and at the end saying, "oh, I feel so full". I always tyhought they were lying, because that never happened to me, so I kind of dismissed it as bragging or something.
Now, could I eat less food? Yes, of course, but it's always a struggle. Every day, all day. And if you fail once, that's that week's gains gone. Imagine there's a fly that's buzzing around your face 24/7 and you can't swat it away, you just have to live with it and if you have a bad day and swat it away for just a bit, you get fat.
Some time ago I took ozempic for the first time and that's when I realized that yes, in fact, it is possible to eat a salad and feel satisified and full after that. Even after more than a year on semaglutide I'm still amazed at how little food I actually need. It kind of feels like I should have died by now due to lack of input calories. But I'm feeling great and almost to normal weight now!
For me the change of how I felt was really something I could not even have imagined before, that you could actually not think about food all the time and kindof ignore it and not really get hungry. And eat just a little and feel full. Amazing. But two years ago I could not have imagined that this is possible, as it had never been before.
This of course led to the realization that the opposite is true for some people, who have better regulation of whatever chemical makes you hungry. Apparently there are lots of people for whom feeling hungry after eating a large meal seems impossible. And since this is something they have never experienced, it's not really reasonable to expect them to understand or be able to imagine it. I wasn't able to imagine the reverse!
So yes, it is possible for everyone to lose weight just by commiting. But it is much harder to commit in a specific area for some people than others. Commiting to a lifetime of always being hungry is very very hard over the long term.
>the opposite is true for some people, who have better regulation of whatever chemical makes you hungry. Apparently there are lots of people for whom feeling hungry after eating a large meal seems impossible. And since this is something they have never experienced, it's not really reasonable to expect them to understand or be able to imagine it.
I don't know, I found the idea of "what if I was hungry, but too much instead of too little" pretty easy to wrap my head around I think. I also wouldn't call feeling full necessarily as being the same thing as being well regulated, anorexics can feel full but they're hardly well regulated.
I once knew this fairly average weight bodybuilder that hated fat people with a passion and practiced a strict diet. During one of his many anti fat people rants, he started ranting about how fat people have no discipline, I sort of snapped back at him and pointed out my many struggles with eating and asked him "why it is that you complain that fat people are undisciplined but don't criticise me in the same way when you know I don't have a good diet and struggle to put on weight?" He didn't have a response to that and the conversation awkwardly ended.
For me, it was pretty easy to come to essentially the same conclusion you did from the opposite starting point. That it's possible for everybody to change their weight by committing, but for some people like this bodybuilder they're going to be able to maintain a healthy weight without struggling, and for others it's going to be a slog.
It's those who seemed to control their weight at will I couldn't empathise with, fat people were relatively relatable.
Usually in debates around weight, people focus on the message of counting calories and metabolism, but the psychological aspects are not usually discussed and based on how I felt and what you said, it is a super imprtant important aspect of the puzzle. After all, the feeling of hunger only exists in your head, not in the cells of your stomach.
> Some time ago I took ozempic for the first time and that's when I realized that yes, in fact, it is possible to eat a salad and feel satisified and full after that.
I am currently taking semaglutide, and it's exactly the same.
Previously I suffered a lot with little effect. And everyone was giving me advice how I simply need to stop being lazy. Now I am losing almost 1 kg a week with zero suffering. The difference is not that I suddenly have more willpower; the difference is that I no longer have to spend all of it on fighting my hunger.
(By the way, it is also possible to have an opposite problem. I know a guy who is thin and wants to gain a little more weight, but he can't, because after he eats a little he feels so full that he is unable to eat more.)
This is a really weird gate keeping comment re "commitment".
As someone who was an ultra endurance rider (IE audax rides of 200/300/400/600/1200 km, where you stop only to sleep for the shortest sustainable time on the longer events), you are very much wrong. Your statements around .
There are plenty who complete these events who are skinny, and plenty who complete these events who are fat.
The training load to maintain this level of fitness/endurance is high. The mental commitment is high.
The sheer amount of energy required both during the event and to repair muscle damage after is huge.
The next level down is the physical discomfort (I don't like the taste of water but I know I need it); the hallucinations, fear or depression that can kick in... But you still have 25% of event to go.
Let's not forget those who get injured or have equipment failure and either wisely decide to DNF or drag themselves over the line.
Pray tell me how your jogging for what, two hours a day? Makes you more committed and enlightened.
It's kind of shouting into the void but I always wanted to try to teach high school physics starting from energies rather than forces/velocities/other vectors... And the easiest places where people run into energies are light bulb wattages and nutrition facts, and the latter always seemed more interesting than the former, so the idea was “The Biophysics of Weight Loss” as a first physics course.
As an example of how this looks a bit different to a physicist, most people go to an online calculator to get their TDEE or RMR, some measure of how much energy per day passes out of their body. If you're a physicist, you can't help but measure this at two different weights, current and target. So that gives you a slope, a delta: kilocalories per day per kilogram of fat lost. Except there is also a rough measure of how many kilocalories to lose to lose a kg of fat, so in dimensional analysis terms, this is really just a time constant. I forget the exact amount but it works out to something like nine months or a year or so.
And then you realize that that's a half life. You choose a lifestyle, you start living as if your weight were W, then after a year you will get halfway there, after another year you'll get halfway closer, and so on, and so on.
But that's not how anybody thinks on a diet. They are thinking, I'm going to intervene, get my life under control, then I can return to the lifestyle I had before but without the weight. But what you are describing is a severe lifestyle shift, “I became a marathon runner and my friends are all marathon runners and that is our new lifestyle.” Polar opposite of intervention.
But it's also, there's a selection bias. If the actual cause is depression related, and marathoning worked because it gave a new sense of purpose and self, how would you notice? You spend all this time on caloric output, that's trying to treat it like a linear system. When the circuit has transistors and op amps, that's not how you analyze it.
However, when you look at the physics, you have to admit that the human body is just about never an isolated system. Human bodies contain more microbes than they contain cells. The microbes, share the food supply, have their own energy consumption, multiply, sometimes die, are excreted from the body dead or alive, and may influence metabolism and/or appetite and food preferences.
It is truly remarkable what some humans can do when they commit. There was a person in my former runner group who weighed approx. 130 kg when he started running. He only started when he was in his mid-forties. Never really exercised previously in his life (as far as I know). It is also worth mentioning that he is a farmer, so his day job is not exactly energy conserving.
Ten years after starting to run in this group he was set to run a marathon under 2:50. Unfortunately a cramp around the 30 km mark made it impossible to continue and actually achieve it. But his grit certainly motivated everyone around him, marathoners and short-distance runners alike.
I would love to share his eating habits but I do not remember them in detail and I do not know enough about nutrition to confidently share any presumptions on this part. Your first paragraph simply reminded me of this great individual.
The gist of all three...from an evolutionary perspective, the human body is designed for lean caloric times. When there is more calories than there is activity to burn it, those calories will be stored as fat (in preparation for leaner times). There's no ceiling on that so you'll keep adding weight.
In modern times, our evolutionary advantages become disadvantages. The best way to lose weight, is to not gain it in the first place.
I've managed to keep a good amount of weight off for years, but only with vigilance, because even a couple weeks of unrestrained eating can be disastrous. I'm not at my lowest ever weight, that was during COVID, when I got hit with a nice Δ-variant, and lost my appetite for a month before force-feeding myself back to normal. That was the my first experience with truly unhealthy weight loss, and made me realize that while being nice and slim is good in the short term, in truth we aren't so far from the terrifying infectious diseases and famines that plagued humanity even last century, and if you aren't running around all the time desperate for something to eat, you probably don't need to be doing much moving anyway. Thinner people are healthier out of evolutionary necessity, the environment is working against them! It's desperation, all the other benefits of exercise still come to the heavy.
Encountering someone with a serious anorexic eating disorder, or watching a loved one with cancer -- who was formerly slim and healthy -- whither away their insufficient fat reserves while under treatment... can put things in an entirely different perspective. My mild obesity doesn't seem so bad now. I'd rather have a little too much and be fine with it... than be psychologically tortured by it, or not have enough in case of health emergency.
In those two case, sure extra weight seems like a positive. But have back problems? Or leg issues? And that extra weight will make you even less mobile. Can't move? That'll get you bed sores and perhaps eventually an infection.
The body didn't evolve to carry so much extra weight. You're on the wrong side of history.
In any case, thousands of years of evolution, boom and bust cycles of metabolism, show that having excess fat stores is very, very useful when you have to go months without regular sustenance. Those are the people we're descended from, not the ones who have "fast" metabolisms. It leads to problems later in life, sure, but not before one reproduces!
Why? How we came to be impacts how we deal with today. This is one of the problems...denial. That is, denial that where we came from has little to do with where we are.
> "when you have to go months without regular sustenance"
And this happens how often in modern times? Most people can't skip a meal, let alone go a couple of days or more without eating.
Its not happening now, but I don't think its reasonable to expect that food shortages won't be a norm in the coming years if there isn't serious political change in the world.
Speaking of the brain, I've often wondered if less focus and thinking is also contributing to weight gain. The brain is responsible for ~20% of resting metabolic rate. If the brain consumes just a bit less calories per day, that's also going to add up.
"There have been some experiments to show that abstract problem solving does raise the brain’s metabolic requirements, and the higher your IQ, the more extra energy you can expend in this way. But it’s unlikely to amount to more than five calories an hour, either way. So you can’t Sudoku yourself slim"
5 kcals x 15 hrs = 75 kcals.
Actually, this is significant in the sense that if you over kcal by 100 kcals per day that'll add up.
75 is 75% of 100.
It looks small but in the context of weight, 75 kcals per day is enough to make a difference.
I like how it's being positioned as "damage". It's the body working more efficiently with less fuel. That's not damage, it's adaptation and homeostasis.
Another factor not mentioned is when you exercise you get better at it over time. So even though you're doing the same amount, same perceived effort each day, you're actually burning much more.
A shift in understanding the metabolism has been gradually occurring since the 1990s with the isolation of leptin.
What is leptin? Discovered in 1994, leptin is a hormone that signals the availability of energy reserves in the body. "High leptin levels are interpreted by the brain that energy reserves are high, whereas low leptin levels indicate that energy reserves are low", the latter causing the body to enter a resource-minimizing starvation mode [1]. More recently, leptin has also been shown to regulate "neuroendocrine and immune function and [play] a role in development" [2].
Why is leptin so important to obesity? "Most obesity occurs in the presence of increased leptin levels", which suggests a form of "leptin resistance" in obese individuals [2].
Leptin changes our understanding of body fat, also called adipose tissue. We generally think of body fat as simply stored energy reserves, so fat can be burned by decreasing our caloric intake (diet) and increasing our energy usage (exercise), forcing our body to dip into its reserves. This approach is generally referred to the calorie-in/calorie-out (CICO) model. While true to an extent, this perspective is too simplistic, given one key fact: leptin is primarily produced in adipose tissue [1]. This fact means body fat is actually an endocrine system organ.
Consider this: an obese individual has elevated leptin levels. A decrease in adipose tissue causes a decrease in their leptin production. Due to leptin resistance, low leptin levels causes the body to enter starvation mode, and hardcore dieting causes leptin levels to drop further, which makes weight loss even more difficult. What they mean by "metabolic adaptation" may be understood as "leptin adaptation", though I'm just speculating there.
It's strange that so many articles talk about weight loss and "metabolism adaptation" without mentioning the hormone signalling energy availability. With leptin, we clearly see the body has an energy availability feedback loop, and fighting the intrinsic dynamics of a feedback loop rarely leads to good outcomes.
On this vein, I want to highlight slothtrap's comments:
>The more frequent the dieting and steeper the caloric deficit, the worse metabolic adaptation gets, and the longer it takes to return to normal.
>I wonder if those who sustained higher levels of exercise were actually in a steeper caloric deficit.
>perhaps it's fair to say that if you're going to exercise, you best sustain it.
These comments align with present understanding of leptin dynamics. A steep caloric deficit pushes the obese body into starvation mode, so net energy expenditure from high levels of exercise will be decreased. Weight loss will be maintained once the body adjusts its leptin production and usage, which, as of now, can only be accomplished with habit.
It's also worth mentioning here the hormone ghrelin, which was identified in 1999 and is nicknamed the "hunger hormone" [3].
> This approach is generally referred to the calorie-in/calorie-out (CICO) model. While true to an extent, this perspective is too simplistic, given one key fact: leptin is primarily produced in adipose tissue [1]. This fact means body fat is actually an endocrine system organ.
This part I think needs more explanation. The reason calories-in/calories-out model is too simplistic (I would call it almost useless if not completely wrong) is because of mitochondrial uncoupling proteins [1] that control how much energy in the protein gradient gets converted to ATP and how much is lost to waste heat. These uncoupling proteins are upregulated by leptin so when your leptin levels fall, your body literally changes how efficient its metabolism is to do more work with fewer calories. Body fat isn't just an endocrine organ, it might be the primary metabolic controller with a nasty catch 22 feedback loop - which would help explain why a certain minimum percentage of body fat is required or else a person enter organ failure.
That's why there are some people who don't seem to gain much weight despite eating a lot of food: their bodies are naturally less efficient and lose a lot more energy to thermogenesis. Without taking that metabolic adaptation into account, CICO is nothing but harmful dogma that needs to die. Otherwise people are fighting what might be one of the most important biological adaptations humans have.
CICO doesn’t work across individuals for reason you outline (just because I lose weight with a certain level of calories, doesn’t mean you will, etc.)
But for a single individual, working to establish your base metabolic rate by counting every calorie and weighing yourself regularly, you can always find a way to be successful with the CICO model. If you establish a baseline that your metabolic rate is (say) 2000 calories a day, then eating 1600 calories a day will cause you to lose roughly a half-pound to a pound per week. It does not mean that every individual’s baseline metabolic rate is the same.
As you also outline, your base metabolic rate also changes as your weight does, so re-baselining by continually measuring caloric intake and your weight to recalibrate is always going to be necessary.
Given the above CICO almost seems tautological: Measure the weight loss you actually observe at a given calorie level, and that tells you… how much weight you will lose at that given calorie level. So it is almost useless as you describe.
BUT, the main reason I’m still a proponent of CICO is that it simplifies dieting away from thinking about what you eat, and instead focuses on how much you eat. If I establish that I need to eat 1800 calories a day, I can still have a Big Mac meal and drink some beers. But I may not be able to eat much else that day. That alone makes it useful for me. What isn’t useful to me, are diets that essentially limit the type of food you eat and tell you to just go nuts and eat however much you want: I will often find myself hating the foods I’m restricted to, and the quantity I eat may end up being such that I gain weight anyway.
To me, CICO is simply a technique that says “actually measure how much you’re eating”, no more and no less. That is what makes it a useful tool.
> If you establish a baseline that your metabolic rate is (say) 2000 calories a day, then eating 1600 calories a day will cause you to lose roughly a half-pound to a pound per week.
At this point it's pretty safe to say that's likely untrue at the population level. This is a cutting edge area of research but the UCP1 adaptations seems to happen really fast, for some people on the order of weeks. On the order of months for the vast majority of the population. It doesn't take long for the basal rate to fall to whatever your intake is because the system evolved to naturally have a lot of room to spare. The human body always adapts and if I were a gambling man, I'd say this is largely why most people fail at dieting: after a month or two the results stop and they have to further decrease their intake which interferes with other pathways and tanks motivation.
If it works for you, that's great! You're one of the lucky ones, maybe because you've hit your floor for uncoupling proteins. But given just how hard dieting is for most people and how bad the obesity epidemic has gotten, it's probably not useful for the majority of people. A far more holistic approach that tackles macro- and micronutrient deficiency, motivation, lifestyle, and not just net calories is required.
> It doesn't take long for the basal rate to fall to whatever your intake is because the system evolved to naturally have a lot of room to spare
All this is accounted for in this sentence of my post:
> your base metabolic rate also changes as your weight does, so re-baselining by continually measuring caloric intake and your weight to recalibrate is always going to be necessary
If you’re actually measuring yourself at the scale to get the ground truth of your actual metabolic rate, and you’re doing this every single day, then there isn’t a single thing that can change this: UCP1 adaptations, fat viruses, leptin changes, hormones, stress… all of this is covered by the actual weight on the scale. If I ate X calories and gained Y lbs, I need to adjust my calories by Z, no matter the reason I gained those pounds.
You can argue that such a diet is too hard, and that for some people the adjustment to your calories is going to leave you essentially starving, but it doesn’t change the truth of the matter that it will work if you do it right. Now, whether it’s worth it for people, and whether the process is going to leave you utterly miserable or even extremely unhealthy as a result, I’m making no claim on.
Empirically it's really quite rare that eating less than your caloric expenditure is going to make you unhealthy for obese people. It's a rare caveat, not ground for blanket dismissal.
Feeling hungry or being unhappy with such a diet is more common, but it's generally also fixable, and it doesn't defeat the point either.
No, I’m saying I’m making no claim on that because I very much don’t want to get into the (very) subjective and context-dependent argument about whether a diet is a good idea for someone or not. My claim is much narrower: CICO works if you follow it. Whether it’s right for you, I can’t say.
(For my part, CICO worked amazingly well for me, and I was able to follow it without much trouble. But that’s just me.)
Now, whether it’s worth it for people, and whether the process is going to leave you utterly miserable or even extremely unhealthy as a result, I’m making no claim on.
then CICO is not practical for weight loss. the "CO" becomes so small that you're screwed
You will lose weight, in fact if you cut to 0 for long enough you are guaranteed to lose all soft tissue weight. Can I recommend you the “0 calories till you die” diet? The issue is that:
- many people can cut from a diet of 2200 calories per day to 1800 calories per day and pretty quickly and sustainably lose weight. This kind of calorie reduction is very manageable, and anyone who has lost weight this way starts saying “it’s just CICO man, so easy, just do it”
- meanwhile, in order to lose weight, some (probably not huge but very real) amount of people who maintain at 2200 calories need to drop to 1000 calories per day, or even lower, consistently, for months, in order to lose weight at a 0.5 lb/wk. This is miserable, not sustainable, and probably a net negative on your life (damage not worth the weight loss) unless you are morbidly obese.
The people in category 1 yell “you’re just coping, it’s not hard, just CICO” at group 2. Meanwhile they have never had to reduce calories in that way and have no idea how unsustainable it is. They are so sure their experience is universal, that they usually utterly deny the other groups existence, and smugly go about the world assuming people struggling with weight are just weak.
I get what you are saying. And you put forward a nice argument. The problem is that the ANTI-CICO-Crowd takes the stance that "CICO WONT WORK BECAUSE MY CO IS REDUCED HAH TAKE THAT CICO-FUCKTARDS"
Which is stupid.
If you want to loose weight and maintain a reasonable BMI during the long run you need 2 things.
1) A healthy diet, if you are in America this requires a bit of planning, if you live in Europe its easier. Limit the portion size (and if you are fat you don't know what a normal portion size is, look to you skinnier friends for inspiration).
2) Get your heart rate up a couple of times a week. If you are fat this might be the _walk_ to the store. If you are just weak weight training is great. And for 99% you most likely should aim to increase the amount of condition training, brisk walks, joggins, biking, chopping wood whatever.
Diet and exercise are indeed the keys to weight loss.
By focusing exclusively on CICO, one dismisses the fact that people dislike feeling hungry. To say it's simply an issue of willpower dismisses the importance role of hormones in driving behavior. When it comes to weight loss, some people are dominated by their hormonal responses, while others have more regulated responses.
I think I've found a good analogy: advocating CICO as primary strategy to lose weight is like saying all you need to do to complete a road track is to drive forward and stay on the track. The track shape analogizes to the unique dynamics of a person's hormonal feedback loops. Completing the race analogizes to hitting a weight loss goal, while going for fastest lap time is like a doing a 30-day weight loss challenge.
There's roughly 8 billion unique tracks in the world. Some tracks may be a drag strip, others may be Nurburgring-style circuits, and an unlucky few get the Baja 1000. Virtually everyone rides a normal car with gas, brakes, and a steering wheel, though performance characteristics do vary. At all times, you are the only driver on the track. Completing a drag strip track is trivial: just drive straight. Some tracks (like a NASCAR circuit) have banked turns which allow for high speeds with minimal focus on turning or braking. Many tracks, however, require different strategies. As an example, you MUST brake at turns on the Nurburgring because failure to break WILL cause you to leave the track, potentially causing a spinout or even a crash. If a racer aims for a specific lap time, they'll need to maintain a minimum average speed across the lap, which requires learning optimal driving, turning, and braking strategies specific to that course.
I think you can mine this analogy for more insight, but the primary point is: CICO is in all weight loss strategies, but because of personal hormone dynamics, not all weight loss strategies can be CICO.
If CICO isn't practical, what is? If you're someone whose base metabolic rate plummets so much when dieting that you have to basically starve just to lose weight, you're probably screwed no matter what. Why single out CICO as not being practical for these people?
it works until you run against the limit where it's not possible to cut more calories but are still overweight. I think this is mediated by genes. Even willpower is genetic.
Renaissance Periodization just did a video on calorie cycling https://www.youtube.com/watch?v=QwZfryrVddY (the video is titled carb cycling, which he dismissed in the first few minutes and he moves on to calorie cycling) and in it he discusses some of the benefits and disadvantages of calorie cycling vs just eating at a deficit.
The tl;dr is follow your body (e.g. not sleeping well, exhausted all the time, eat more for a bit), but try starting out around 2:1 for eating a fair bit under vs slightly above maintenance. (e.g. diet 6 days, eat a bit extra for 3 days, repeat).
In another video he also mentions that after weight loss, that it is a good idea to slowly increase calories until the scale doesn't move, and then eat at that level for a few weeks to reset the body's hunger signaling. (I am dramatically simplifying there).
> The human body always adapts and if I were a gambling man, I'd say this is largely why most people fail at dieting: after a month or two the results stop and they have to further decrease their intake which interferes with other pathways and tanks motivation.
This is why "cheat days" or even "cheat weeks" work. People are on a strict diet, weight loss stalls, they go on vacation and eat at a surplus for a bit, and then they find that after vacation they are able to resume losing weight.
Likewise a big thing in Keto awhile back (not sure now) was cycling off Keto for the weekend, which unless a person is very careful, ends up with people eating at least a little bit to "excess".
Plenty of people do "lazy keto" and eat a big Sunday family meal and so long as the excess calories on Sunday don't exceed the sum total of deficits from the other 6 days, they'll be A-OK, and now it turns out they may actually be better off.
Basically their view is that refeeding (aka cycling) probably doesn't do much physiologically speaking, but there may be advantages to adherence when people use diet breaks (typically longer than a cycle or refeed).
> As shown in Figure 9, results indicated that “intermittent energy restriction interventions,” which include relatively long diet breaks, led to a fairly negligible weight loss advantage that was not statistically significant.
The problems I am seeing with all these studies is that the participates in the control groups (just regular dieting) are still losing weight throughout the study.
Instead, do a study where you have a bunch of people who are calorie restricted, and when the scale stops moving, have half the participants do a re-feed before trying to cut again, and the other half keep soldiering on as is.
Or to put it another way, we all know people plateau with diets. Running a study that where participants do not hit a plateau, and instead having science just go "oh well! Sorry can't help you!" aren't of much use.
(It is funny because the author of that article starts out talking about plateaus, and then runs a bunch of studies that.... don't encounter plateaus.)
I've met people, who are grossly obese, who after going from 400lb to 300lb, find that they aren't losing weight at even 2500 kcals a day. So they drop it to 2000kcal. 25 pounds later the scale stops, and they try 1500kcal, feel like shit, and they give up. Math says at 250lb they should be shedding tons of weight at 1500kcal, but they aren't.
I want to see a study that investigates that, instead of "oh someone lost 10kg, woohoo!"
10-15kg is a lot of weight to lose, but almost any dietary intervention will pull of a 10-15kg weight loss (which is what all the studies looked at show!)
> Theoretically, reverse dieting should be most effective in scenarios where metabolic adaptation is most extreme, and to my knowledge, the Minnesota Starvation Experiment reports some of the most dramatic metabolic adaptation ever observed in the scientific literature.
Except it was taking people at healthy weights and having them drop to an unhealthy low weight, and then having them regain weight.
The situation we are faced with now is people at unhealthy high weights, with all the hormonal problems that entails, losing a bunch of weight, and messing up their hormones in a different way, and now the goal is to stabilize their body at that new lower weight.
> As previously discussed, the available research hints at a number of subjective and behavioral improvements related to hunger, satiety, diet adherence, mood, and perceived energy level, in addition to improved performance
All of those "subjective" feelings have basis on the body's physiological systems. With better measurements, the underlying cause of those "subjective feelings" can be found.
Edit: FWIW I think the extreme weights we are seeing in developed societies have multiple underlying causes, and that pure dietary interventions are not the solution for everyone. From gut microbiome to environmental pollutants, to the # of ads for fast food on TV, IMHO the problem is multi-causal.
I'd say this is largely why most people fail at dieting: after a month or two the results stop and they have to further decrease their intake which interferes with other pathways and tanks motivation.
Yes this is it. People with shit genes simply do not burn enough calories , so these people need to diet to absurdly low levels of calories to merely not be overweight, way lower than predicted by formulas/tables. Which is not sustainable , hence regain.
This is all so obviously refutable if you look at the fact that this affects the USA so much more than other countries and even there if you go back three generations, peolr with essentially the same genes just at fewer calories and - surprise - were less fat.
It's not the calories, it's the carbs (aka sugar). The modern Westernized diet is carb-heavy, and carbs are the main macronutrient contributing to obesity (see the clear increase in obesity following the creation of the food pyramid).
Many Pacific Island nations also saw massive obesity rates. The reason was carbs, not calories. Soda contributes to obesity because of sugar, not the calories.
This person didn’t say “everyone in America”, they said “people with shit genes”. Are you assuming this is the same set of people?
Amazingly, some people are different. Who knew. We shouldn’t gaslight them into thinking they aren’t different because they aren’t like the aggregate, and we get to feel so morally superior if every individual is like the aggregate.
I found CICO very helpful in losing weight (from 120kg to 90kg).
It was a relatively easy metric to track, and using it alone meant that I could still eat all the things I wanted, though I needed to balance what I wanted to eat with portion size.
CICO also meant I started out slow, making small cuts. So it wasn't bad in the beginning. Over time I had to find ways to adapt so I wouldn't go feeling hungry (mostly increase protein and fiber ratio significantly), but I never needed big changes.
On the flip side CICO also meant that if I messed up one day it wasn't so bad. It just moved the goal post one day or two further away. So it prevented me from feeling like there was no point and giving up, instead getting back into it the next day.
By following CICO I had a very linear weight loss, which didn't feel like a restriction or such. I estimated my CO and aimed for roughly 0.5kg per week and that's almost exactly what I managed.
Not being "prevented" from certain foods due to diet X was a big factor in making this bearable.
CICO is very nice if you put it into the proper context, which is,
1. The scale lies. Liar liar pants on fire it lies. (We could go into this in detail, my wife never seems convinced, but it is to my mind a basic fact of the physics of the system that the scale lies in multiple orthogonal ways.)
2. So you want multiple different probes into the same phenomenon so that you get a better insight into what is going on.
3. So, track calories as a second piece of data to try and check whether the scale is lying to you or not.
4. As part of that, they give you greater insight into the choices that you make. For instance you realize that it is functionally impossible to jog off a Krispy Kreme donut but very easy to replace half a meal with it. Or you discover that you can cut fruit juice for water with no dissatisfaction.
Regrettably this is not peoples’ usual relationship with food and the scale, which is exemplified by the Cheat Day phenomenon. The calories are viewed not as a separate data stream but as a morality judgment, which is then turned off for brief periods because constant judgment is hard on us, and these periods contain a lot of very relevant data such that if you turn the metric off selectively for them, the metric is no longer useful.
> But for a single individual, working to establish your base metabolic rate by counting every calorie and weighing yourself regularly, you can always find a way to be successful with the CICO model. If you establish a baseline that your metabolic rate is (say) 2000 calories a day, then eating 1600 calories a day will cause you to lose roughly a half-pound to a pound per week. It does not mean that every individual’s baseline metabolic rate is the same.
Anecdote: I did this over the past year and a half, weighing myself weekly and tracking all calories, including a period of weight loss and gain to get some good data points, and starting around 6-8 months in the linear regression stabilized: I found I burn on average 2200 calories per day even though I'm in my 30s and mostly sedentary. I've since found it to be pretty accurate.
Knowledge of leptin changes this because what you eat does actually matter. The goal should be intermittent fasting, where you eat little-to-no carbs about five consecutive days/week and then plenty of carbs two consecutive days/week. This approach ensures leptin levels in the obese body remain high enough to prevent onset of starvation mode while minimizing glucose levels to promote catabolic action on body fat [1].
The bottom line is: you're welcome to eat your Big Mac and beers, just only two days out of the week.
Also, stress has an important role to play on weight loss. Stress causes your adrenal glands to release cortisol. Cortisol increases glucose levels through gluconeogenesis by making glucose from non-carbohydrate sources, such as proteins from muscles.
> Knowledge of leptin changes this because what you eat does actually matter. The goal should be intermittent fasting, where you eat little-to-no carbs about five consecutive days/week and then plenty of carbs two consecutive days/week. This approach ensures leptin levels in the obese body remain high enough to prevent onset of starvation mode while minimizing glucose levels to promote catabolic action on body fat [1].
I hate to post the same video in the same thread twice, but this video dives into carb cycling, and explains that actually it is calorie cycling that makes the difference. https://www.youtube.com/watch?v=QwZfryrVddY
FWIW, and I'm a big keto proponent, the goal should be whatever works. Keto is super effective for some people, and completely useless for others. Research has started to figure out why some people respond to keto better than others, but low carb fails really hard for a certain % of the population, works obscenely well for another % of the population, and works as well as any other dieting system for the majority of the population.
As someone for whom keto works really well (I was on keto for 5 years, training 12hrs+ a week in the gym!), I totally spent time promoting low carb to everyone, until I tried to help some people for whom it just didn't work at all.
It sounds like any other of these diets that tell you when and how to eat but not how much. I’m pretty sure I could gain weight when doing everything you describe, if I eat really terribly during the days I eat “plenty of carbs”.
The key to CICO is that you’re actually measuring not just the calories you eat, but the weight you gain/lose, and are continually calibrating. If my diet jacks up my leptin levels such that I don’t lose weight, that will show up on the scale, and I have to adjust my calories down to compensate. With this system I am guaranteed to lose weight so long as I don’t cheat. This is trivially true: the calibration could technically push you all the way to zero calories per day (which will never happen in practice, obviously.)
Case in point, I lost 50 lbs with this approach, eating McDonald’s nearly every single day. I kept it off for roughly 8 years. (I since became a dad and have let myself go tremendously, gaining ~30lbs back, but I will cross that bridge soon.)
>If my diet jacks up my leptin levels such that I don’t lose weight, that will show up on the scale, and I have to adjust my calories down to compensate.
>With this system I am guaranteed to lose weight so long as I don’t cheat.
Unfortunately, that's just not true. Here's some great quotes from the book "The Obesity Code" (which I've just recently found and find an excellent book):
>The abrupt increase in obesity began exactly with the officially sanctioned move toward a low-fat, high-carbohydrate diet.
>A 30 percent reduction in caloric intake results in a 30 percent decrease in caloric expenditure.
>Total energy expenditure is the sum of basal metabolic rate, thermogenic effect of food, nonexercise activity thermogenesis, excess post-exercise oxygen consumption and exercise.
>Since hormones control both Calories In and Calories Out, obesity is a hormonal, not a caloric, disorder.
>If hormones regulate fat growth, then obesity is a hormonal, not a caloric disorder.
>Sugar will increase the blood glucose level and provoke an insulin response from the pancreas. Olive oil will not...[cause] significant increase in blood glucose or insulin. The two different foods evoke vastly different metabolic and hormonal responses."
All of this is to say that it's not enough to simply adjust calories. Yes, calories matter to a point, and everyone knows that starvation (e.g., 0 calories for an extended period of time) is effective in the long-term, but starvation will also harm your body, and no reasonably-minded person can suggest it as a viable approach to weight loss.
The best available scientific evidence shows that continuing to decrease caloric intake can make weight loss more difficult for an obese person.
That was the sound of you zooming right past my argument and pretending I was saying something I wasn’t.
I’m not saying CICO is a good idea. I’m not saying it’s healthy. I’m not saying it’s easy. I’m not saying it will have a high chance of success vis a vis people actually being able to stick with it. I’m merely saying IF you do it right, THEN you will lose weight. This is trivially and tautologically true (to the point of CICO being useless to most people!), but it’s extremely tiring having to explain it over and over that it still works despite all of this.
To put it another way: there are two operative definitions of “works” for a diet:
1. Will it work if you do it exactly as directed?
2. Is a typical dieter likely to have success by attempting this diet?
CICO fails miserably at 2. It passes with flying colors at 1. Its best not to conflate the two definitions in the middle of an argument because you end up talking right past one another.
This is something I've said repeatedly in other places and this is a certain segment of people who can't understand it.
CICO is, especially at the population level, terrible dieting advice. We have decades of experience and oodles of research showing that, as advice it does not work.
However, it is, as you point out, basically tautologically true/correct. For CICO to _not_ be correct would essentially be breaking physics and generating mass/energy from nothing.
Yes, your body can change it's energy expenditure in response to dieting, but this is accounted for in the CO part of CICO. If you consume fewer calories than your body expends (in all the myriad of ways that your body can/does expend calories), then you _must_ lose weight.
The fact that CICO is true does not make it good advice but the fact that it's bad advice doesn't make it false.
I think of it this way: CICO is an axiom we have to assume in order to figure out why a diet isn't working.
E.g. if your input is 1200 calories and you work out, but you aren't losing weight? Maybe your NEAT is way down (or you have a thyroid issue). You are super active but can't lose weight? Maybe you aren't tracking food calories accurately, or you need to eat more satiating foods.
CICO isn't a strategy, it's part of the landscape and your diet is a strategy to navigate that landscape.
But no matter what your particular strategy, it is always going to involve eating less hyper-pallitable foods and getting more activity. That may not be all, but you cannot go from obesity to a healthy weight without those things.
Pay attention to what I eat and how often I exercise.
I rarely actually count, but I do lower calories when I look at a label and say OMG. Like, who knew a shake was 2000 calories? Hmm, fries only 500. I just switch and cut my calories by 1500. I’m so good, I deserve these fries! Yum.
Well if CICO is not a good idea, not really healthy not really applicable to most people, then why bring it up when we are talking about solution to obesity ?
The main problem with CICO is that it is confusing the description of a process with an intervention designed to modify said process. Both things a very different.
> I’m merely saying IF you do it right, THEN you will lose weight...
> that it still works despite all of this...
That's the first part, the "works" include the IF... You mixing efficacy and effectiveness is here.
> 1. Will it work if you do it exactly as directed?
Try to apply CICO to water and hydration level : You can modulate your hydration level by driking more or less. BUT, you can go above a certain level or below a certain level independent of how much you drink.
The problem with CICO's is you fail to realize that CI and CO are not the control variables and you might be getting the causality wrong.
Much in the same way that you can change the temperature of a room by changing the value on a thermometer... You can't change the body set point and fat disposition by "just" changing CI/CO.
> Well if CICO is not a good idea, not really healthy not really applicable to most people, then why bring it up when we are talking about solution to obesity ?
You may want to read my first post again. I spend nearly the entire post agreeing about the problems with CICO. But in my last paragraph I explain that I still like it and that it works for me, and explain why. YMMV.
> That's the first part, the "works" include the IF... You mixing efficacy and effectiveness is here.
Right, that’s called propositional logic. It’s perfectly valid to make “CICO works” predicated upon whether you follow it correctly. This isn’t as trivial it sounds: there are diets for which this is not true!. I can totally stick to a low carb diet to the letter and still gain weight, because if you don’t include a calorie limit, you can still go way over your calorie expenditure even with low carbs. As trivial as my “definition 1” is for “works”, it’s still a bar that many diets don’t pass.
Well the point i am trying to make is that your explanation on why it work for you is probably wrong, and even more the advice you generate from your theory can be dangerous and counter productive.
> Right, that’s called propositional logic. It’s perfectly valid to make “CICO works” predicated upon whether you follow it correctly.
Well no. And that really the core of the issue. I see that you didn't answer to the example i gave you.
But if we want to be pedantic :
1 - There is no definition of "works" in propositional logic.
2 - Here what i understand from your logic deductions :
A - CICO can be rephrase as : For a given individual , for every time duration t : delta_weight(t) = CI(t) - CO(t)
B - What you are saying is : for a given individual , for every time duration t : delta_weight(t) = CI(t) - CO(t), THEREFORE, for every delta_weight, there is a time duration T, and CI(t) and CO(t) such that delta_weight = CI(t) and CO(t);
And my point is that B is false (empirically), and does NOT follow from A (logically). And to repeat myself you can try this game with room temperature and thermometer readings.
Your understanding of CICO (or at least the point I am making about it) is wrong in your “B” paragraph.
My argument boils down to the following:
For every individual, at any given time, there is a metabolic rate M for which, if their calorie intake was larger than that, they’d gain weight, and if their calorie intake was smaller, they’d lose weight. Crucially, M changes over time.
But going CICO properly means using the scale to measure M, every day, by diffing your expected value of your weight loss given how much you’re eaten, with the actual value on the scale. You now have an updated value for M to use in calorie counting.
Since M is determined by empirical observations of your weight loss/gain in response to the calories you have consumed, you will by definition lose weight if you consume less than M calories. This is the argument that CICO must work by definition. It’s a logical contradiction for it not to work.
> Your understanding of CICO (or at least the point I am making about it) is wrong in your “B” paragraph.
Just to clarify B is not cico, it's the inference that you seems to make from CICO.
> For every individual, at any given time, there is a metabolic rate M for which, if their calorie intake was larger than that, they’d gain weight, and if their calorie intake was smaller, they’d lose weight. Crucially, M changes over time
This is "not" the definition of CICO, and again does not follow from CICO. CICO is fundamentally a thermodynamic statement about the observed state of a system. You are making predictive statement about a possible future state of the system.
Again, if you want to believe that statement that's fine. The point i am making is just it's does not follow from cico, no have i seen anything empirically that validate that statement.
> Since M is determined by empirical observations of your weight loss/gain in response to the calories you have consumed, you will by definition lose weight if you consume less than M calories.
sure this derived from your "definition" of CICO... but your definition is not thermodynamically derived...
> This is the argument that CICO must work by definition
the premise (the definition of the argument) is flawed.
> It’s a logical contradiction for it not to work.
Not really, CICO not working (as in this case) can be just the result of sound logic based on bad premises.
You focus on carbs specifically, but IF is about all calories being eliminated for periods, and it doesn’t necessarily mean you eat plenty on the break days (if you take break days at all - some people exist on 16:8 or 20:4 or whatever perpetually). I think you have something important here but the wording is ambiguous and I am wondering if you can clarify your thinking?
Are you saying only carbs matter with respect to leptin?
Thanks for asking. I'll first explain the process (because I want to highlight why IF matters), and then I'll answer your question directly. It's going to take a little bit to properly elaborate, but I believe it's worth your time to read.
We first need to choose which of the following macronutrients contribute most to weight gain: protein, fat, or carbohydrates. Proteins (or, rather, amino acids) are not known for contributing to body fat in any significant manner. Fat was once thought to be the main contributor when calories--not carbohydrates--became accepted as fattening. However, modern science shows fat has little significant contribution to body fat and that the real contributor to body fat are carbohydrates. The discovery of leptin about 30 years ago finally shows why.
Carbs are sugars. Sugars, such as glucose, are the main source of fuel in the body, as they are eventually synthesized into ATP. Blood glucose levels are regulated by the hormone insulin. Elevated blood glucose levels increases insulin production, whereas low blood glucose decreases insulin production (with glucagon helping stabilize blood glucose levels). High insulin levels promotes anabolism, whereas low insulin levels promotes catabolism. Creating body fat is an anabolic process, whereas burning body fat is a catabolic process. Putting it all together, eating carbs inhibits the essential catabolic processes for burning fat.
While entirely cutting out carbs should be the answer, it's not. Many obese people report failure to lose weight on ketogenic diets. Why? The hormone leptin. See, leptin levels increase with insulin levels. Leptin signals the availability of energy reserves in the body. Adipose tissue (that is, body fat) is the primary producer of leptin. Importantly, leptin levels vary exponentially with body fat. The obese individual's body is so oversaturated with leptin, the body becomes resistant to leptin.
Decreased leptin levels will cause body fat to be burned. On a ketogenic diet, catabolic processes initially cause a reduction in body fat, which then decreases leptin production. Because the obese body has leptin resistance, the leptin production decrease is interpreted by the brain as a severe drop in available energy reserves, causing total energy expenditure to be immediately reduced and placing the body in "starvation mode." At this point, eliminating body fat actually becomes more difficult, as excess carbs become anabolized into body fat due to decreased energy expenditures.
So, to finally get to your question, how do carbs matter with respect to leptin? To lose weight over months and years, an obese person needs to eat carbs to (1) keep their leptin levels stable over the course of each week to prevent the body from entering starvation mode while (2) maximizing the efficacy of catabolic processes. As the body gradually recovers from its leptin resistance (which will likely take time), the body will shed fat without triggering the energy-minimization mode.
In this paradigm, your total energy expenditure determines how fast fat will be burned. According to the book "The Obesity Code", "total energy expenditure is the sum of basal metabolic rate, thermogenic effect of food, nonexercise activity thermogenesis, excess post-exercise oxygen consumption [(EPOC),] and exercise". Of these five factors, EPOC is mostly likely underutilized. A simple 10-minute HIIT routine every other day will regularly drive EPOC, which causes ATP synthesis. When an person isn't eating carbs, the body dips into fat stores to acquire the necessary glucose for ATP synthesis. Note that with this approach, exercise isn't strictly necessary but becomes extremely beneficial to maximize the efficacy of catabolic processes.
Intermittent fasting should work as long as the specific protocol doesn't decrease leptin levels such that the obese body enters starvation mode. In my opinion, the most workable approach for people is to try their best to completely eliminate carbs Monday-Friday, eat all the carbs they want on the weekends, and do the bare minimum of a 10-minutes HIIT routine every other day.
> Intermittent fasting should work as long as the specific protocol doesn't decrease leptin levels such that the obese body enters starvation mode. In my opinion, the most workable approach for people is to try their best to completely eliminate carbs Monday-Friday, eat all the carbs they want on the weekends, and do the bare minimum of a 10-minutes HIIT routine every other day.
This is just calorie cycling with extra steps.
It doesn't honestly matter if it is 5 days on, 2 days off, or 2 months on, 2 weeks off. It is up to a person's individual biology. When the scale stops moving, up calorie intake to the extent that the scale doesn't move up more than a smidge, wait a bit, then drop calories again.
TKD, CKD, intermittent fasting, dirty keto, keto with a once a month weekend pizza binge, whatever, almost any combo of "eat less for awhile, then eat normal for little bit, then eat less again".
That's almost right, but it's carb cycling, not calorie cycling. The difference does matter.
>TKD, CKD, intermittent fasting, dirty keto, keto with a once a month weekend pizza binge, whatever, almost any combo of "eat less for awhile, then eat normal for little bit, then eat less again".
I believe that the best approaches, for a given period, will be 2/3 of the time on minimal-to-no carbs, then 1/3 on carbs (which, for seven days, rounds to 5-off / 2-on). The leptin information also suggests that an obese person shouldn't be off carbs for long periods of time, and one week is a nice time frame for people (go low-carb during the work week, have carbs on the weekend).
CICO simplifies dieting so much that 2000 calories from drinking cola are equal to 2000 calories from eating a stew of chickpeas, beans and nuts. The human body is not a furnace literally burning fuel, it's a complex chemical reactor in a tight feedback loop with what it actually processes.
I mean, it’s not that far off. Take this guy who ate only twinkies/nutty bars/donuts/doritos for a month (with some veggies added in for fiber/ruffage):
> His body mass index went from 28.8, considered overweight, to 24.9, which is normal. He now weighs 174 pounds.
> But you might expect other indicators of health would have suffered. Not so.
> Haub's "bad" cholesterol, or LDL, dropped 20 percent and his "good" cholesterol, or HDL, increased by 20 percent. He reduced the level of triglycerides, which are a form of fat, by 39 percent.
I mean, yeah, of course if you eat less than your body needs, you will lose weight, nobody is denying that. You can lose weight drinking only coca cola every day. Now, how _easy_ that would be, how much hunger one would feel, the effect on health, mental health, energy, what the rebound is after the diet is done etc., that's a completely different discussion. And another discussion is how much the weight loss is sustainable/maintainable in the long term.
So yeah, in a vacuum, with a perfectly spherical cow, it's not that far off.
Genes play a big role. Some people have a faster (I think the more appropriate word is inefficient) metabolism, and can lose weight or stay thin despite eating more calories compared to someone with a slower/efficient metabolism, controlling for body size, age, and other factors. There was a thread on Reddit a while back where formerly or current obese people shared their old diets, and many people were commenting that it did not seem like much food. Even though people are generally bad at self-reporting calorie intake, that's called having a crap metabolism.
Imagine two individuals who both both need 2,500 calories/day to feel satiated, but the second individual stores anything above 1,500/day as fat, and a second individual stores anything above 3,000 as fat. The first person will constantly be fighting his body to not overeat and will feel hungry constantly. The second individual can eat to fullness and not gain weight.
Some men , particularly the formerly obese, have such slow metabolisms that anything stored above 1,200-1,700/day is stored as fat despite weighing 170 pounds or so, from reading personal accounts here and on Reddit. This is also why bariatric surgery patients regain weight and become obese again despite only eating around 1,200-1,500 calories/day. These people basically got short-changed when it comes to metabolism genes. If there is a famine, they will outlive everyone. But in abundance they become fat very easily. This does not answer why there are more obese people today compared to in the past, but there is still probably a genetic component nonetheless.
And on the other extreme are people who can be very slim despite eating a normal amount of calories or only slightly less than 2,000. These people are much rarer, as it's disadvantageous from an evolutionary perspective to have an inefficient metabolism, but they exist in the same way very tall or short people exist by virtue of phenotypic variance.
I am skeptical about reports of people who don't seem to gain much weight despite reading a lot of food. Most of those reports are merely anecdotes, or at best observational studies, and we know that most people are terrible at accurately tracking their caloric intake. More rigorous studies that involved putting subjects into locked environments and carefully measuring their intake have consistently found that the CICO model is accurate.
However, as a practical matter for people who want to lose adipose tissue there are likely more effective approaches than CICO.
Anecdote: throughout my life, on many occasions, I've gone on multi-month binges of over-consuming massive quantities (1500+ cals) of desserts on a daily basis, while retaining a sedentary lifestyle. I always seem to weigh the same weight (skinny).
I realized I've been doing this over the past month. I weighed myself yesterday. Same weight.
Clearly something is different about my body, at least when it comes to sugar calories. It just doesn't seem to readily convert it to fat.
Is it really that hard to believe that some people's bodies actually behave a little more rationally than most?
You need more than vibes to know how many calories you're eating. Unless you have Cronometer / calorie tracker receipts, I would dismiss your calorie estimations and so should you.
It really is that hard to believe. Have you ever had a resting metabolic rate test? Have you ever gone several weeks carefully tracking everything you consume using an accurate food scale? I am skeptical that even during binge periods you were really taking in as many calories as you claim.
That said, there are limits to what the human digestive system can absorb from a single meal. Binge eaters do sometimes exceed that limit and just poop out the excess without storing it as fat.
I got the taste for raspberry ripple ice cream in my mid-20s, and ate 10 litres a week - that's 2000+ kcal a day just in dessert.
That's not binging. I put that on top of 500g dry weight of pasta with cheese and sauce, and kept it up for months. Plus breakfast, lunch, and several beers. And packets of chocolate biscuits. I was covering 10km a week or less, no marathons. No tapeworms, either.
You may be right that I was shitting a lot of it out; the horrible shits are what turned me off the ice cream habit. Nonetheless, I ate well over 4000 kcal every day, for years, and never put on weight. 6000 was typical. And most of that was potatoes and wheat, which are very bio-available carbs. I've always been a black hole for food.
I suspect I radiate it as heat. Exes have told me I'm hot - in a caloric sense. I feel the cold more, now that I eat less.
To the overweight, if it helps at all, know that I have other struggles.
There is one individual Michael Rae who is able to do just this. He stays at 115 pounds despite eating 1,900 calories/day with a BMI of 15.6, which is insane. Most men would probably need to eat 1000-1500/day to get to that lean, as the infamous Minnesota starvation study showed, and even then many of those participants did not get that thin.
Michael’s regimen of 1,913 calories a day is exactly that: 1,913 calories every single day, 30 percent of them derived from fat, 30 percent from protein, and 40 percent from carbohydrates. Cooking for him is the same elaborate exercise in dietary Sudoku it is for all CR die-hards, only more so.
There is no evolutionary justification to have such an wasteful metabolism (for all of history until now it's a a disadvantage), so people like him are rare, but they exist.
Another is Roy Walford who got to a similar weight during Biosphere2 on a similar 1900/day diet when the artificial habitat began running out of food.
There's no evidence that Michael Rae has an unusual or wasteful metabolism. 1900 kcal/day really isn't very much. With his size and input level (CI), a moderate activity level (CO) would keep him in energy balance.
Note that there is no reliable evidence that caloric restriction to the point of having an underweight BMI will actually extend human lifespans. The experiments have all been done on smaller lab animals living in safe little cages where they are protected from injuries and infectious diseases. Under nourished humans are at severe risk of sarcopenia as they age.
The Minnesota starvation study showed that the formulas fail when extreme weight loss occurs. So if someone starts with a BMI of 22-24 or so and then tries to get to 15.6, will burn way fewer calories than predicted by the calculators/formulas. 1900 is not much but a BMI of 15.6 is pretty low. He did not start that low, so I wonder how much he was eating before he embarked on this experiment. As for extending lifespan, agree, that the data is iffy on that.
That's not insane at all. At ~183cm, his BMR at 135lb would be 1600 cal/day using a standard formula, so he would only need to expend 300 calories through activity in order to breakeven, which is something many people do with just their daily routine walking around. There's nothing even slightly unusual here.
The key is that very small changes in calorie intake, over a long time, have a large impact on equilibrium weight, and that height factors a lot more into BMR than people think.
A BMI of 16 is very rare. It's unlikely it was always that low for him. Assuming someone starts with a BMI of 22-24 and then diets to get it to 16, this would likely would req. fewer than 1900 even if the calculator says so, due to metabolic adaption and the breakdown of the calculations at extremes .
Of course it would take less than 1900 to get there. But it would take around 1900 to stay there, according to our models of basal metabolic rates. And it turns out that this person stays there at 1900, so our conclusion is that the BMR model we're using fits this data point.
It's possible that for some people at such extremes commonly available models would break down, but clearly for this person, they haven't. And while BMIs of 16 are relatively rare, so are 6 foot tall males that eat an average of 1900 calories for years.
Ultimately if you're trying to use this case to show that the models are inaccurate, that's not what this case does, it's actually remarkably close to what is predicted and if anything would be better used as evidence in their favour.
"I eat the same thing twice a day, seven days a week, 365 days a year," says Pomerleau, of his diet of 1,200 calories a day. "It's a lot of veggies with olive oil-based salad dressing, a lot of mixed fruits, almonds and hazelnuts, and flaxseed oil for omega-3 fatty acids."
.Bob Cavanaugh, a 54-year-old landscaper from Morehead, N.C., has trimmed his intake to two meals a day, totaling 1,500 calories. Breakfast consists of one cup of quick oats, two tablespoons of toasted wheat germ, one cup of skim milk and blueberries. For dinner, he eats vegetables, fruit and a small portion of fish. "I'm hoping to see my great, great grandchildren," he says.
Mr. Cavanaugh's diet may sound extreme, particularly since at 5-feet 9-inches tall and 158 pounds, he isn't overweight. But over the next several years, if the monkey results hold up, they could represent a major shift in how we view food and nutrition. The U.S. Department of Agriculture says the average sedentary woman should eat 1,600 calories a day and the average man 2,200 -- benchmarks already significantly overshot by most Americans.
Bob Cavanaugh's case is not relevant, as he has relatively recently made these changes, and therefore isn't at equilibirium. Same goes for your third guy, the BMI is from 2004/2009, while his caloric intake is from 2019 and was after a 5 year taper (and was therefore higher in 2009).
Your first example. Pomerlau, weighed only 121 pounds - that's a BMI of 18 - and lost 5kg/year, which means that if he did eat 1200 calories, he almost certainly wasn't at equilibrium yet, either - it would take a few more years.
They have been some studies where they showed that NEAT (Non-exercise activity thermogenesis) varies widely acros individual and even with the same individual at different time. I think variation as wide as 1500 have been observed. Enough to explain the people who eat a lot but don't gain weight .
CICO works quite well at the extremes. It's effectiveness varies, but it is directionally correct.
If someone is sitting at a 35+ BMI, then their caloric intake is so out of whack, that CICO helps ground them. Similarly, an anorexic who starves gets a clear directive for increasing weight by increasing calories.
CICO also promotes calorie general calorie comparison. It helps you understand that a milkshake has the same weight impact as an average Mediterranean lunch bowl.
Now the absolute impact on both foods will vary from person to person. But comparatively, it helps ground the unhealthiness of foods like sugar rich shakes and icecream.
The key insight from leptin is that the carbohydrates in the milkshake actually causes weight gain, not the calories. Yes, you do need to know how many calories your specific body needs to properly operate. For example, taller people require more calories than shorter people. However, obesity is a hormonal issue stemming from leptin resistance, not a caloric intake issue.
Just looked up his book "The Obesity Code"; not sure if that's the one you're thinking of.
Dr. Fung says obesity is a basically a hormonal issue, not a caloric issue. He discusses a "causality test": "If we inject this hormone into people, they must gain weight". According to Dr. Fung, leptin and ghrelin don't pass this test, but insulin and cortisol do. Still, leptin and insulin appear to have a close relationship. "Insulin promotes fat storage. Leptin reduces fat storage. High levels of insulin should naturally act as an antagonist to leptin. However, the precise mechanisms by which insulin inhibits leptin are yet unknown." He also says that "too much insulin causes obesity" and that "obesity is a state of leptin resistance." (Sorry for that mini book review; I needed to understand what he was saying.)
On the fasting point, he's explicitly supportive not of regular fasting but intermittent fasting: "Diets must be intermittent, not steady...we cannot fast all the time. It won't work."
Based on my fast read of his work and my own understanding, intermittent fasting keeps leptin levels high enough that the body doesn't kick into calorie restricting mode. One approach which seems to accomplish this is eating close-to-zero carbs five days/week (say, during the week) and then eating lots of carbs two days/week (say, on the weekend). The burst of carbs will cause leptin levels to spike since the body now has tons of available energy. Over the week, the leptin levels will remain elevated, but since you're minimizing carbs, the body will draw energy from adipose tissue.
Then why are so many people who are insulin resistant overweight? Yet people with type 1 diabetes tend to be thin. I don't think the connection between insulin and weight is well known, assuming one even exists. It's a basic CICO problem. Whether there is insulin resistance or sensitivity does not change this much. IF his theories actually worked, they would work on general population at fixing obesity, but there is scant evidence it does. Like Tabues and others, he built a career on some theory that falls short when applied to real people in controlled setting.
According to this article [1], many people with type 1 diabetes are also overweight. In fact, the article cites a research study showing that, for those with type 1 diabetes, higher blood glucose levels corresponded to higher weight gain. Clearly, this weight gain isn't CICO-related but is actually related carbohydrates.
As far as I understand, people with type 2 diabetes (insulin resistance) have excess glucose in their bloodstream, which becomes easily stored as body fat. Type 2 diabetes seems particularly caused by eating excessive amounts of carbs over a long period of time.
In both cases, excessive carbs leads to obesity. The type of calories matters more for obese people trying to lose weight than for healthy people maintaining their weight.
People with type 1 diabetes need to be conscious of what they are eating in a way the rest of us don't. I'm not sure you can draw much inference from them.
Agree, straying from thermodynamics is wrong.
Human fat holds around 8000Kcal per Kg.
Stop eating altogether. Every the 8000th Kcal more or less you would have lost 1Kg of fat.
There’s the issue of not being able to decide what gets burnt. I’ve read that under certain circumstances, the body can actually burn the muscles faster than it burns the fat. Which obviously makes exercise harder.
When losing weight, about 75% fat and 25% muscle is lost, with a ton of variables being in there (exercise routine, how much muscle you have, what your diet looks like, etc).
Lots of arguments about what diets maintain the most muscle (e.g. fasting people say they keep the most muscle, and as much as I love fasting, plenty of studies say that is probably not true.)
The problem is that it is overly simplistic. It is similar to saying "running a marathon is just a thermodynamic problem, expend 2500 calories in a single direction and you can do a marathon." Sure, that's true, but that's not the hard part. Existing at a caloric delta long enough to meet your goal is the problem!
> In 2016, Pontzer and colleagues published a study putting forward the constrained energy model: Energy expenditure does increase with more activity, but only to a point. Once physical activity gets really high, the body will adjust other components of the metabolism to keep your daily energy expenditure within a narrow range
How do people who constantly repeat the mantra of thermodynamics in such threads explain this? How is the body burning the same calories with increased physical activity? Not to mention that people can extract more or less calories from the exact same food and quantity consumed.
A couple of non-exclusive theories from a non-physiologist:
Your body needs to burn less to maintain / manage the fat you are or rather were carrying around.
Your body may be engaged in various processes that it turns down. It's possible, for example, that it may be engaged in various anti-cancer activities that aren't necessary as your body fat decreases (higher body fat is correlated with some cancers, though I don't believe a a direct causal link has been established...but this comment is all speculation anyway). Or the excess calories could signal your body to do other "discretionary" processes that it dispenses with in time of calorie deprivation. It's even possible that such discretionary processes could be statistically bad for you in our current environment, which might be a reason why calorie deprivation may extend lifespan, at least in modern humans.
Your gut could expend less effort to extract certain nutrients or vitamins from your food in a low calorie regime ("bah, opportunistically grabbing that extra Vitamin E is not worth the effort right now").
Just some off the top ideation, not meant to imply that these ideas are necessarily what happens but are ideas why simple thermodynamics is inadequate on its own to explain the phenomenon. The body is more than a simple calorimeter.
That could be explained if you start with an inefficient body. If you suddenly start running 5K races, you'll likely won't finish the first one, and it will hurt a lot the following days. As your body becomes used to the new activity, you'll start finishing your races and getting less drained afterwards.
> How is the body burning the same calories with increased physical activity?
As someone who runs marathons, the answer to “how does the body burn the same calories with increased activity” is: It doesn’t. You will feel a marathon metabolically no matter what. And if you don’t eat like an absolute monster that day, you’re literally going to feel insatiable hunger for multiple days until you get those calories back.
Feeling hungry when your stomach is so full that you can’t take another bite is quite an experience I’ll tell you that.
And yes, your grocery bill does get higher when training for a marathon. It's very noticeable.
Most people who quote thermodynamics don't understand it. They are just saying calories in = calories turned to fat + calories burned. Which is true, but not helpful. The body has many choices, including burning it and then using sweat to get rid of the extra heat. Since we have minimal control over if the body will do this there isn't anything more thermodynamics can input into weight.
The only plausible explanation is that it's at a cost of other functions that are vital long-term but can be turned down temporarily? Such as reduced creation of new blood cells etc.
This is it! Well based on what I have learned across books and podcasts, namely Dr. Andy Galpin's discussion with Andrew Huberman, Ultra Processed People and Racing Weight. The shutdown of these systems is believed to give them a break and is one of the reasons that regular exercisers have better health (just think why is exercise even healthy? It wouldn't seem so. Spike cortisol, burn a ton of energy, stress joints, jostle around the organs. Seems bad to me but of course its not).
Or you can find out for yourself. Touch your stomach during a run on a hot day. Its cold. Digestion is slowed and blood pulled away from the gut.
N of 1. But I do not eat much more on the days I run 15 miles on the trail vs days off. I do not need to due to these adaptations.
Couldn't your body burn more or fewer calories passively and release the energy as heat? Or you could make more or fewer micro movements throughout the day, in a way that adds up to whatever your body thinks energy expenditure should be?
Lowering body temperature would be precisely one of these things you can do short term to maintain the same calories expenditure but would be unhealthy if prolonged.
That the body is a complex buffered system of variable effeciency is not in dispute - nor is it intractable with the thermodynamic position.
It is always realistic to achieve a thermodynamic deficit, that there is some buffer or hysterisis to the curve (i.e non linearity) is not a big deal. The key insight is that the variability in the effeciency of your metabolism is not the bounding factor. A standard deviation of a few hundred calories in the natural variability of metabolism will meaningfully increase the difficulty of weight loss, but this simply means modulating the duration of your activity taking into account the diminishing returns of increased exercise and natural variability in metabolism. Now if this is psychologically or practically easy is an entirely different question.
Because it’s not. Thermodynamics is a law, not a political or mental thing!
My maximum effort in a day was an 8 hour off road bike ride. I burned 3500kCal just from the riding, as measured by a power meter. The body can’t even absorb enough carbs to replace that in the same time.
There is some difference in efficiency between people for muscular exercise - between 20% and 25% of energy burned actually gets converted to work.
And no people cannot extract more or less. They can absorb more or less in total for carbs - between 80 to 120 g/hr balanced between glucose and fructose is the limit for most people.
This is just to say: cellular metabolism is stupidly complicated. There is so much we either do not understand yet, or have difficulty piecing together in a consistent way.
the most obvious anecdata is that for some female endurance athletes, menstrual cycles delay or stop altogether. that's one of many things the body can turn off to reduce energy expenditure.
The straightforward hypothesis would be "by reducing other body functions". For the duration of a Barry's Bootcamp class, my watch (probably over-)estimates my calorific expenditure at 1000 kcal. I know that right after that, I could probably not do too much Mathematics. Frequently, I encounter visual snow. But most of the time, I can do Mathematics.
And then there's healing, and saliva generation, and digestion, etc. I'm sure there's a lot of room for energy savings.
I definitely notice brain fog when exercising heavily or on caloric restriction. It's like my ADHD goes into hyperdrive. Probably great for hunting down food on the savannah though.
I’m like that too sometimes after a particularly difficult workout. I can’t make conversation or make sense of things I would normally have no trouble with (programming related).
Seems in line with other phenomena such as resting heart rate decreasing after sustained cardio training regimens. Your body just starts expending less energy during resting periods. This doesn't entail loss of function because the body is capable of operating in a wide variety of energy expenditure regimes
> constantly repeat the mantra of thermodynamics in such threads explain this?
As someone that took three semesters of thermo. I don't understand thermo in a deep way and they have a Randall Munroe School of Science understanding.
That what I imagined as I was reading, the act of breathing and pushing blood around the body just becomes easier when you are fit. (requires less energy)
Your nervous system also becomes more efficient at zapping the right muscles at the right time. The effect of this can be pretty dramatic too. Even a slightly out of sync orchestra just sounds wrong.
The more frequent the dieting and steeper the caloric deficit, the worse metabolic adaptation gets, and the longer it takes to return to normal. As I understand it that's the result discerned from more than just one paper. Layne Norton explores this at length in his book Fat Loss Forever and yt channel.
The interesting thing in this link was the impact of change in exercise regimen. We know that exercise in itself can mitigate metabolic adaptation and leads to better outcomes, so maybe that should not be surprising (when they quit). The outsized impact is interesting. I wonder if those who sustained higher levels of exercise were actually in a steeper caloric deficit.
It's possible to lose weight sustainably even without exercise, so perhaps it's fair to say that if you're going to exercise, you best sustain it.
"damaged metabolism" was always kind of a semantic misnomer.
Yeah I saw. But you'll see that the Biggest Loser contestants chased weight-loss on a very aggressive timeline. They have a steep deficit, and relatively high intensity exercise regimen. Which could just further exacerbate the effects of a steep deficit. At any rate, all of them had lastingly bad metabolic adaptation, even if those who exercised more had it worse.
In other studies (alluded to here as those where participants don't undergo anything so extreme), exercise is both a strong predictor of long-term weight-loss success, and can dampen metabolic adaptation (since more muscle and good cardiovascular shape boosts metabolism, usually).
I'm not sure what the lesson is yet, but I would hazard that, in the long-term, it's more important to sustain tracking energy balance (sustainability of your diet is #1). Moderate exercise can probably help, but perhaps it should also be sustainable, and in that capacity there are rapidly diminishing returns to intensity of exercise (and perhaps going hard and then quitting is a risk factor for weight regain).
> At any rate, all of them had lastingly bad metabolic adaptation, even if those who exercised more had it worse.
Yes, but as I read it, they all lastingly changed the level of exercise they were getting, and the extent of the "bad" metabolic adaptation seemed to correlate strongly with how big of a lasting change they made in exercise.
> In other studies (alluded to here as those where participants don't undergo anything so extreme), exercise is both a strong predictor of long-term weight-loss success, and can dampen metabolic adaptation (since more muscle and good cardiovascular shape boosts metabolism, usually).
Yes, trading fat for muscle increases your baseline caloric consumption, but that's not the same as long-term weight-loss.
I'm curious about what studies you've seen, because I've seen several other studies that suggest the opposite: that diet is a stronger predictor than exercise of long-term weight-loss success, and this analysis suggests that the more exercise the more likely it is that it will feed in to metabolic adaptation.
> I'm not sure what the lesson is yet, but I would hazard that, in the long-term, it's more important to sustain tracking energy balance (sustainability of your diet is #1). Moderate exercise can probably help, but perhaps it should also be sustainable, and in that capacity there are rapidly diminishing returns to intensity of exercise (and perhaps going hard and then quitting is a risk factor for weight regain).
My speculation is that the lesson is that in general there are diminishing returns from having a caloric deficit, regardless of the means to achieve it. Which fits with the idea that it is easier succeed with small, lasting changes than to create a more significant deficit for a shorter period of time. It would explain the insane failure rate of the weight loss industry, which for obvious reasons needs to show significant short-term results.
> Yes, but as I read it, they all lastingly changed the level of exercise they were getting, and the extent of the "bad" metabolic adaptation seemed to correlate strongly with how big of a lasting change they made in exercise.
This doesn't contradict me.
> I've seen several other studies that suggest the opposite: that diet is a stronger predictor than exercise of long-term weight-loss success
That is not the opposite. I am not claiming that exercise is a stronger predictor than energy balance. I am claiming that it is a strong predictor.
I am not going to dig them up. Go check google scholar and check out Layne Norton's book Fat Loss Forever.
> there are diminishing returns from having a caloric deficit
The evidence seems to suggest that it's better to lose weight slowly to mitigate metabolic adaptation. If that's what you mean, it appears to be correct.
I would reiterate that I think the impact of exercise might be different with a small/modest caloric deficit.
> It's possible to lose weight sustainably even without exercise, so perhaps it's fair to say that if you're going to exercise, you best sustain it.
Exercise is for muscle gain and general health, not for weight loss. You have to exercise a truly absurd about to burn enough calories to lose any meaningful amount of weight. You'd have to run from SF to LA to lose 10lbs, and that's assuming you eat nothing else to compensate which humans are notorious for doing. Your body has a very strong homeostatic drive, and will absolutely push you to eat more and to be more sedentary outside of work-out time to compensate for any additional exercise you do.
There's no studies or evidence whatsoever that shows it has a meaningful impact on weight loss. Weight loss comes from what you put in (or rather don't).
This write-up from 2016 references 60 studies and meta-analysis which all show the same. [1]
tl;dr: you should exercise for health and for muscle gain, not for weight loss.
[edit] Note that metabolic adaptation results from caloric restriction dieting too, which is why 95% of diets fail. Basically only GLP-1s and gastric bypass have been clinically shown to result in meaningful, sustained, long-term weight loss. Obesity is a dysfunction of the gabaergic central nervous system. That's why everyone's so excited about GLP-1s.
You're confusing things. The real gains qua WL from exercise are what is lost from resting metabolic rate, not calories burned "during" exercise. Also: satiety, and other health benefits that have an impact.
> There's no studies or evidence whatsoever that shows it has a meaningful impact on weight loss.
Absolutely not true.
> Weight loss comes from what you put in (or rather don't).
It's energy balance. But just as increasing satiety helps (through food choices), exercise is a strong predictor of long-term WL success.
> This write-up from 2016 references 60 studies and meta-analysis which all show the same.
You're quoting a vox article, and it's making the aforementioned erroneous conflation about calories burned during exercise.
Please cite a study that shows that exercise results in long-term sustained, clinically meaningful (>5%) weight loss. I have looked extensively and found none. And that's not for a lack of extant studies.
> It's energy balance. But just as increasing satiety helps (through food choices), exercise is a strong predictor of long-term WL success.
As far as I can see, there aren't any successful long-term (>2y) weight loss studies that don't involve GLP-1s or bariatric surgery, so maybe that's where the issue lies.
> You're quoting a vox article, and it's making the aforementioned erroneous conflation about calories burned during exercise.
I don't think it is, I looked over the studies they link to, but I'm open to being wrong. I don't really have a horse in this race.
> Please cite a study that shows that exercise results in long-term sustained, clinically meaningful (>5%) weight loss
Those are not the words I used. Please engage in good faith. More accurately: exercise in addition to energy balance (and with a modest caloric deficit) is a strong predictor of WL success.
Check google scholar for meta reviews, I don't have this bookmarked and I'm not doing homework for you. If you don't want to believe me then don't.
I recommend Layne Norton's book Fat Loss Forever and his yt channel, he cites studies there.
I’ve done plenty of research and have not found a study that backs your position. If you’d like to have a discussion in good faith I’d like you to present some data. I did my research and presented my data. I don’t need to do your work for you. But if you dig something up I will happily read it.
> You have to exercise a truly absurd about to burn enough calories to lose any meaningful amount of weight.
I mean, kinda, sorta?
I can go to the gym and burn 1000 kcals, as measured by a chest strap.
I used to do this 3x a week. That is nearly 1lb of fat burned through just exercise.
In the context of someone who needs to lose 50 pounds, 1 pound seems small, but in reality 1-2lb of weight loss a week through diet is considered "healthy", adding another 1lb of weight loss via exercise is absurdly impactful.
Now, do most people, especially beginners, have the willpower to burn 1000 calories at the gym? Hell no. A 1000 calorie workout sucks.
> There's no studies or evidence whatsoever that shows it has a meaningful impact on weight loss.
The obvious counter example is any endurance sporting event, where by the end of the event athletes weight a lot less than when they started.
30 minute workout 3x a week? Of course no weight will be lost.
Now, instead go train boxing or MMA for 3 hours a day 5 days a week. If you track calories and don't increase your intake, I promise you'll lose some weight.
I generally agree, but the weight loss seen during endurance sports events is mostly just dehydration. I can do an Olympic distance triathlon and burn fewer calories than are stored in 1 pound of fat tissue (and I'm taking in carb supplements throughout the race).
Marathon runners apparently lose about 1lb, 50% of which is water.
People doing those bike races lose tons of weight, both muscle and fat.
That is the flip side of going balls to the way hard, it is easy to start eating into muscle, which is fine now and then for an event, but as part of a regular training regime it isn't the best idea.
All of these factors are why the advice "you cannot outrun a fork" is true for the general population, but it scientific fact that no amount of exercise leads to weight loss.
A truer statement might be "at the level of efforts an untrained individual is able to maintain, and for the length of training sessions that are available to an average person with a job and a family, exercise does not contribute meaningfully to near term fat loss."
But people who've been lifting weights for 5 or 6 years hard core may very well have increased their BMR by 500 or so calories, at which point they can eat a, reasonably sized, cookie each day.
> Marathon runners apparently lose about 1lb, 50% of which is water.
Yeah, you use about 100kcal running a mile, so 26mi gets you around 2/3 of a pound of fat.
This is why I said to lose 10lbs you'd have to run from SF to LA, which is about 400mi. Without eating more than baseline.
The problem isn't the micro. Yes, if you exercise a ton without compensatory eating and in excess of the expected drop in BMR that produces, you will lose weight in the near-term. The problem is your homeostatic mechanisms kick in and work against you making it extremely hard to maintain. Your body has a weight set point like it has a temperature set point. The follow-up study on the Biggest Loser showed basically every single one of them put on all the weight they lost. In some cases more. Here's the PubMed link. [1]
The evidence seems to point to the opposite of your conclusion - a lot of exercise reduces your BMR, it doesn't increase it. Makes sense doesn't it? A lower BMR means you're more efficient. While your TEE might be higher, your BMR is probably lower.
Yes, improved cardio results in a lower resting heart rate, which reduces BMR. Resting heart rate only gets as low as the 50s though, then it stops going down.
> Your body has a weight set point like it has a temperature set point.
And more recent studies have shown how to change it.
Eat at a moderate deficit for 4 months, then take up to 2 more months carefully eating at maintenance. Rinse and repeat to keep losing weight. This avoids the problems you are talking about.
But if someone has 100 lb to lose they don't want to hear "lose 1 lb a week for 4 months, then don't lose any weight for 2 months, repeat for a few years." Adherence to such a plan will be terrible, but it'd work.
Calorie cycling, as described in the video I linked to twice in this thread, also avoids the problems, and Dr. Mike explains how calorie cycling prevents the problems with hormone levels that a long term deficit can create.
Also
> Yeah, you use about 100kcal running a mile, so 26mi gets you around 2/3 of a pound of fat.
This is why I'm not a fan of running. I have recorded workouts (HR chest strap) of me burning 500 calories / hour.
Then again when I'm in shape (currently recovering from a rib injury....) I spend an hour with my heart rate in the 150s to low 160s on a 3-1 interval cycle.
Also it won't be 2/3 a lb of fat, it'll be carbs at first, some fat, and at those calorie burn numbers, some muscle mass as well.
(This is where the keto people jump in, but sadly research studies on high level athletes who are long term keto adapted doing intense stuff are hard to come by)
But most contestants regained a lot of weight and metabolisms slowed relative to bodyweight and stayed slow long after regaining weight. The adaptation explains why they regained weight so fast. It's incontrovertible that the show was a failure for the majority of the contestants. this also agrees with the high failure rates of diets overall and why formerly fat people regain so fast . Biology screws you over and has the final say. This is why it took so long to develop GLP-1 weight loss drugs and why they are such a big deal, by at last giving people a leg-up in this often losing battle against the body.
FYI the show was not an incontrovertible failure for most contestants
> Six years after the competition, median weight loss in 14 of "The Biggest Loser" participants was 13%...
That means at least 7 of them lost 13%. That's pretty significant. On Ozempic, average weight loss is 11% after six months.
The show worked for the majority, and the difference between the people who it worked for and the people for whom it did not work is Physical Activity not Energy Intake. This is covered in the OP link and also in https://pubmed.ncbi.nlm.nih.gov/29086499/
I don’t understand how this needs anything beyond surface level complexity… you have fat people who for show reasons were tightly controlled on exercise and food intake - which works for well understood reasons - then they took that away and left the people to their lifelong established habits.
Of course they regain the weight.
These people didn’t magically create mass from nothing. They ate too much for their activity. Done. Stop doing that if you don’t want to gain weight. Obviously easier said than done. But I’m sick of the idea that these poor souls are visited at night by globs of mass that force their way inside.
All these magic drugs are going to do is incentive bad food and bad habits. This isn’t good news.
Do you have first-hand experience with being overweight and/or losing a significant amount of weight?
I think you're vastly overestimating how much of this (particularly "calories out") is under voluntary control. We're discussing an article that showed that extra active calories burned tend to lead to a compensatory reduction in resting metabolism.
And there are some very strong psychological/physiological drives that influence "calories in" (read up on the Minnesota Starvation Experiment for examples).
It requires that complexity because a metric shit ton of scientific research shows that it is more complicated than that.
Permanent weight loss of more than ten pounds is nearly impossible from a scientific standpoint. The success rate after 5 years of weight loss is somewhere around 0.1%. You'd think that if it was as easy as everyone claims, more people would succeed. Heck, many people who have had gastric bypass surgery regain a significant amount of weight, even if their stomachs have been reduced to the size of a ping pong ball.
And yet I personally know several people who have dropped more than 10 pounds, and have kept it off (or even lost more) for more than 5 years. The statistical odds are meaningless on an individual basis. In most cases what it took was hitting some sort of low point and then making a major, permanent lifestyle change such as committing to a daily exercise program or quitting drinking (alcoholic drinks contain a lot of empty calories).
My weight floats in a range that's 40-50 pounds lighter today than I was a decade ago. It's because I eat less and move more.
Physically, weight-loss is utterly trivial. Literally everything that people say works, does. Eat less calories, eat less sugar, cut out snacking, cut out liquid calories, cut out processed food, reduce carbs, literally any and all of those work, choose whichever is most appealing to the individual.
The challenge to weight and diet in America is mental and cultural. Obese people remain obese because they have unhealthy relationships with food and eat addictively or emotionally, using food to soothe anxiety, depression, loneliness, disappointment, etc and because cultural norms and advertising have normalized obesity-causing diets.
The science of body metabolism is hard. But the rules for weight loss are simple: move more, eat less. For some people it's just "Move more, eat the same".
"Eat less" means "less calories", volume can be the same - really helps.
Not even that, if you change what you eat, you can have a dramatic effect as well. Try cutting out carbs and sugar as much as possible, results in two weeks.
I would suggest to be careful with cutting out things, this leads to bouncing back, like all dramatic changes.
I noticed that carbs such as bread or pasta really help with food satisfaction, unlike fat-intence or protein foods.
Remove sugar in secondary things: tea, coffee, soda. Understand the calorie count in carbs such as chips. East to the mild calorie deficit. Compensate with moderate excercise. And so on, setup new dietary habits one by one.
> Physically, weight-loss is utterly trivial. Literally everything that people say works, does.
You can't say this on HN, where weight loss is a myth and the only way out is to take a crazy life-altering medicine. Exercise? PFFT. I walked a flight of stairs once, and did not lose a single gram.
The number one in a thousand is simply a ballpark figure that is frequently used in nutritional science. There are literally hundreds of papers, and not all of them are good (you should look at the parameters because many of them are quite lax), but here are a few examples easily found online.
Perhaps you should read your own sources. From the abstract of the second study: "At the 3-year follow-up, 53% of the original sample (of 621 persons) maintained losses of 5% or more and 35% losses of 10% or more.". From the third study: "When successful weight maintenance was defined as maintaining a weight loss of 5% or 10% of initial (pre-treatment) body weight, 40% were maintaining a 5% weight loss at five years and 25% were maintaining a weight loss of 10% at 7 years." The other studies also don't back up your 0.1% estimate.
Your initial statement is completely misleading and shockingly you have provided hard evidence against it.
> Permanent weight loss of more than ten pounds is nearly impossible from a scientific standpoint. The success rate after 5 years of weight loss is somewhere around 0.1%.
Your sources indicate that your initial statement was wrong by a factor of ~100 at least.
If you deliberately misinterpret what I'm saying, I suppose I'm mistaken.
The majority of these studies consider a weight loss of 10 pounds over two years to be successful. If you start with 100 pounds or more, that is almost nothing.
Many of them consider anyone who starts at 300, loses 100, and gains 80 back in five years to be a huge success. Is it really?
In healthcare, an obese person is typically considered successful if they lose more than 30% of their body weight permanently. This is extremely unlikely to happen without surgery or medication.
Mate these studies are very clearly talking about percentages here, so they are directly comparable. You said 0.1% could lose 10 pounds over five years, the studies you cited mention 25-35% are able to do at least that after five years - the average man in the US is 200 pounds, and these are obese people, so the loss was actually higher than 10 pounds. Now you are changing the goal posts to 30%!
A good diet and exercise routine can have wonderful results, even in the long-term. The percentage of success in losing significant weight with those methods is far, far above 0.1%, and I think people should be aware of that.
I understand that you don't mean 10 pounds in a strict sense but even 20 pounds is an easily achievable and sustainable goal for fellow overweight 40-something HN readers.
It doesn't take more than restricted calorie intake and moderate excercise (walking, gym, etc). After a few cycles of gain/loss it becomes easier food consumption habits change
Sure, blame the people. Fat shame all you want. Problem solved. Done.
It's so easy, just stop eating so much. As if fat people haven't heard that one a bilion times over. As if fat people havent tried time and time again.
Personal responsibility! you put that stuff in your mouth, rah! rah!
Personally I'm actually sick of people having no eye for the bigger picture, for many systemic reasons and larger society, and just blame stuff like this on individuals.
For those contestants, weight loss was a full time job, and they had trainers and dieticians. How is that supposed to work for average people who have jobs and families or do not have a lot of willpower? Weight loss drugs can make it easier, which I am all for. Availing oneself of medical technology is not cheating; it's why the technology exists in the first place.
I agree that people should accept help if they need it, and should not feel ashamed for doing it, but having a strong willpower is a superpower that will help people in all aspects of their lives. I wonder if there are ways you can improve your willpower.
Welcome to weight loss discussion on HN, where any rational point like "eat less" or "calories in, calories out" gets downvoted and discussed to death.
Apparently for this crowd taking medicines is better than stopping stuffing yourself, because you know, if you take a medicine you can keep stuffing yourself.
Oh, and also "it's more complicated than that" is always a nice escape from the harsh reality of thermodynamics.
It gets downvoted because it's stupid and unhelpful.
If your body has the wrong idea of how much fat it should store, it'll do its best to force you to eat more to get that fat, even if it makes you unhealthily overweight. Medication can fix the body's idea of how much fat it should have.
Taking that medication doesn't mean you can keep stuffing yourself, it means you can finally _stop_ stuffing yourself, without your body incorrectly reporting that it's starving. The point of the medication is to make it possible to do the right thing.
> if you take a medicine you can keep stuffing yourself
That’s not at all how these new medicines work. You can’t (well, don’t) keep stuffing yourself on Wegovy (Ozempic) and Zepbound (Mounjaro), because you no longer spend all your time wanting to. These drugs work by switching off your desire to stuff yourself, not by allowing you to stuff yourself without weight gain. When you eat a big meal on these medicines, you feel satisfied and over-full, rather than like an addict who just got a partial hit and wants to ride it.
I take an immensely helpful SSRI for GAD, that no amount of mindfulness, therapy, or healthy living seemed to touch. I take a GLP-1 agonist for a food compulsion I’ve had for 25 years and couldn’t shake. I never got properly fat, but fighting a desire to EAT ALL THE FOOD no longer occupies 50% of my mental energy.
Have you ever come off nicotine? If so, you’ll know the little voice in your head that is continually telling you that you should have a cigarette for the first few days. You can’t shut it up. Hey, have a cigarette. You know what’s be good right now? A cigarette. Oh you just woke up? Have a cigarette. It fades eventually for nicotine. In my experience, and, in that of many/most fat people, you have that constantly for food, that food noise. GLP-1 agonists turn the food noise off.
it gets downvoted because there are tons of research telling it's more complicated than that.
it's also a very poor point because it's presented as a solution without addressing the fact that it's really, really, really hard for people to eat less.
We all know it’s easier to eat garbage than to exercise and eat healthy. We all know it’s more expensive. We all know it takes some degree of knowledge of what and when to eat.
That isn’t the point. It’s that HARD and UNKNOWN is not faultless.
> discovered that certain Russian populations had large intestines that were about 57 centimeters longer on average than those of certain Polish populations. Because the final stages of nutrient absorption occur in the large intestine, a Russian eating the same amount of food as a Pole is likely to get more calories from it. People also vary in the particular enzymes they produce. By some measures, most adults do not produce the enzyme lactase, which is necessary to break down lactose sugars in milk. As a result, one man's high-calorie latte is another's low-calorie case of the runs.
> Call out: Germ-free mice can eat more and gain less weight than conventional mice
Yes, of course. There are always outliers. But 50+% of the American population doesn't fall into this bucket, do they? Nor did they suddenly become that after they were born (i.e., obesity is a relatively new problem and not so much driven by DNA else why didn't it exist so much even just 50 yrs ago?).
We keep looking for all kinds of "answers" to obesity but we already have the one that works for most people most of the time:
Take in more calories than you burn, and those extra calories will become added weight.
That's it. It is *that* simple.
But people refuse to change their diet and/or lifestyle. In fact they're being told it's not their fault, as if someone else is responsible for what goes in their mouth and their sedentary lifestyles.
It might be that simple from a high level conceptual standpoint, but when the amount of calories you burn passively adjusts up or down as your body fights to maintain its weight, it is much more complex.
The more basic "Why has there been a rise in obesity?" keeps being asked, and that's already answered.
The idea that people are falling asleep next to a pod and waking up with too much weight for some mysterious reason is a false narrative. It's not making anyone any more aware or any healthier.
I agree that would be a false narrative to some extent, but in this thread I don't see a better explanation. Just the idea that in e.g. parts of the USA they have been told it's impossible to control their weight, so they then go on to eat too much and exercise less than in other places and other times in history, doesn't make any sense to me as an explanation. Apologies if that's not what you're saying.
But what if consuming as low amount of calories as needed to be equal to or less than energy expended leaves you constantly feeling tired and with headaches and such from eating so little?
Is this not something that actually happens?
It seems like a spiral of doom. Eat less, so now I have even less energy for activity and thus now I am burning less energy, so I need to eat even less...
Sure. That sucks. But so does diabetes, strokes, heart attacks, and premature death.
The ultimate solution is prevention. But bring that up and you're accessed of being insensitive, fat shaming, etc. We've normalized the abnormal, and too few what to see that reversed.
The things you linked are completely irrelevant. First link: The calorie counts of food are wrong? Sure. Absolutely. No shock there. Treat them as rough estimates.
Second link: different people are different? Whoa. Wow. Oh man, mind blown.
What you naively describe as "not true", the universe itself would describe as bedrock reality.
Despite the bad scientism (i.e. coping) everyone hides behind, nothing changes the fact that if you burn more calories than you consume, you'll loose weight.
If you aren't loosing weight AND counting all of your calories, guess what: you've counted wrong. Dial them back more. Keep dialing back until results are achieved. The gym bros have truly found This One Weird Trick that works 100% of the time.
The problem is, it still boils down to CICO due to thermodynamics. That means they're still eating too much given a certain amount of physical activity.
an extra 10 pounds of muscle, which is average for someone who has never trained, maybe burns only 100 extra calories. The problem also is that muscle hypertrophy also entails gaining some fat too.
I have a history of scale measurements with body fat shooting down and muscle mass going up that would disagree. If I'm doing muscle hypertrophy, I'm burning more calories, but I'm not necessarily eating more.
You might need to put on some fat to gain muscle EFFICIENTLY, but it's not a requirement for putting muscle on at all.
Depends on how you bulk. You’ll gain some fat sure, but you can limit this by eating healthier and not too much over your caloric needs.
But my point is, if someone loses a bunch of fat their bmr is going to take a hit. Could be pretty significant on the order of hundreds of calories a day.
100 kcal is ~0.5 kg of fat per month, or 6 kg per year.
Read that again. Six kilograms, per year. Every year.
Given a person consuming near their total daily energy expenditure, that’s the difference between losing almost 20 kg since the start of COVID, and gaining 20 kg.
Small changes over time compound in unintuitive ways, which is all the more reason not to dismiss them so flippantly.
It's sad to see what nonsense (like "metabolic damage") people will invent to justify failing at weight loss (or worse, never even attempting weight loss).
If you guys suggest (or submit!) some good submissions and let me know what they are, I can put them in the second-chance pool, which will accelerate the refreshing of the front page.
It looks to me like HN has been in a massive censorship mode in order to remove ongoing stories about the Bitcoin ETF, the SEC and the Twitter/X hack of the SEC's account.
That story was on the top by far yesterday and then it suspiciously disappeared, after the comments took a very decidedly (and very deservingly, in my opinion)
anti-Muskian bent.
Since then there has been no story about the bitcoin ETF on the front page of HN even though it is a very important time for bitcoin (the deadline for bitcoin etf inclusion is today) and HN loves talking about bitcoin.
https://www.geneticlifehacks.com/weight-loss-genetics-obesit...
"Interestingly, animal studies show that the gain in fat mass is not due to eating more or moving less… Animals ate the same amount of chow, but those infected with adenovirus 36 increased fat tissue by 60-80%."
https://pubmed.ncbi.nlm.nih.gov/17135605/
"A 2004 twin study showed that the Ad-36 antibody-positive twins were “significantly heavier and fatter as compared with their antibody-negative counterparts”. This was a groundbreaking study indicating that the Ad-36 virus was likely causing obesity."