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"What factors do you think are influencing your desire to eat more or less?"

There is a lipostat or setpoint in the hypothalamus. It acts like a thermostat for fat. Fat levels are controlled by a homeostatic system, just like body temperature. The highest amount of bodyfat you've had will typically be the bodyfat your brain will defend. It not only does this by making you hungry, it also will downregulate your metabolism. So you become less active. Anyone who has been obese, is fighting their own brain to maintain fat loss. Losing fat is easier than maintaining fat loss. Semaglutide disrupts this system.

BTW, the mechanism of the setpoint is Leptin, a hormone secreted by fat almost exclusively. Muscle also releases Leptin, but in small amounts.

So if you cut the fat out, if you use liposuction, or you diet down slowly, or you diet down quickly, it doesn't matter. Your brain still knows how much fat you have, based on the leptin signals it gets. You cannot trick it.

The reason bariatric surgery is effective is that cutting out the stomach reduces the amount of ghrelin released, which is a hunger hormone that the brain sends the body. Again, disrupting the homeostatic system...which is the only effective way out of this mess.

I was expecting more people on hacker news to know about homeostasis of fat by now. Leptin was discovered 27 years ago.

I would love to know how any of this would enable or disable a person whose mouth was sewn shut to continue to gain weight, because it was my understanding that in the vast majority of cases, someone must make a willful decision to lift their hand, pick up food, and insert it into their mouth in order to obtain any nutrition at all.

I was expecting more people on hacker news to know about the existence of how eating works. The mouth was discovered... well, millions of years ago.

You can overcome the starvation response caused by the lipostat with willpower if that's your point. Not many do. In fact, there's a registry of such people http://www.nwcr.ws/ . They report having to be diligent every day. They work out every day. They watch their calories. They can't relax about it. That's why it's so hard to succeed in the long run.

You don't seem persuadable, nor too interested in the science of the lipostat, so I'll just let you have the last word here.

Thanks, I think you’re ignoring the forest fir the trees here. We are not lipostat monitors attached to stomachs, we’re thinking, reasoning creatures who are not slaves to our impulses.

Many, many people, billions of people, overcome their animal instincts every single day in favor of reason. Fat people can do this too.

>”we’re thinking, reasoning creatures who are not slaves to our impulses.”

I’m not so sure about that.

We haven’t evolved past our animal instincts and it seems like our conscious mind is only an additional layer on top of the “reptilian brain” - for lack of a better term. It has not replaced our base urges and our intrinsic motivational systems.

We are only sometimes able to shut down our unconscious urges. Even so, we may only be able to do that temporarily, as people fall off the wagon all the time. In fact going “cold turkey” seems like one of the most counterproductive things someone can do.

I feel like much of our ability to succeed via “mind over matter” has to do with our biochemistry rather than rational thoughts. Our motivational systems are ultimately controlled by neurochemistry. So there seems to be a lot more to this than just conscious mindset.

You can "feel" however you want, the science is firmly against you.

Okay then, present your citations. And don’t just copy paste a bunch of studies saying willpower can be practiced. I’m saying there’s a chemical basis for motivation and willpower, which is also backed up by science.

https://en.wikipedia.org/wiki/Mesolimbic_pathway

> What factors do you think are influencing your desire to eat more or less?

Well, as you said:

> It apparently changes quite a lot as different factors in your life influence you

As far as

> Additionally, what do you think of the folks who were fat, who then got healthy, and remain healthy? It sounds like you don't believe they can exist

There's no implication that they can't exist; just that it's myopic to assume that what worked for them will also work for other people who are fat, particularly when they've tried the same thing and report that it's failed.

> Finally, what should we do to the people who have these [factors] that cause them to eat and/or gain weight with little or no control?

Accessible GLP-1 agonists are a good start.

If you believe that there are people who succeeded at losing weight and keeping it off, then you must necessarily believe there are people who succeeded at losing weight and failed at keeping it off, just as you must also believe there are people who failed at losing weight in the first place.

Are you proposing the people who succeeded at those two steps have something chemically the others didn't? Or what alternative explanation would you provide that explains the different outcomes?

Figure out a compelling answer for what that explanatory factor is, and you'll be a billionaire.

Chalking it all up to willpower is, however, unconvincing. When I managed to get down to ~22 BMI awhile back using the willpower approach, I spent literally every moment distracted and obsessing over the food I couldn't have, for months on end. That's not something that most people at 22 BMI do (unless you think that they also use their willpower to quash the constant intrusive thoughts). It's not a huge leap that others who struggle with getting to a healthy body weight experience something similar, especially because it's what they report happening. I wouldn't be surprised if the people who fail outright have even stronger cravings than I did.

What about 90% willpower? 80/20? I'm willing to go below 100% on ascribing this to willpower, but probably no lower than 70%, just based on the outcomes for folks who have willpower and for folks who don't.

There's just too much evidence supporting the idea that actively eating less and continuing to do so is a successful strategy for losing weight, combined with the obvious fact of simple human biology that eating involves consciously taking food and putting it into your mouth (sleep-eating notwithstanding).

I hesitate to speculate; for any individual, it could be a different mix.

It would be an interesting test to correlate obesity with other non-food related willpower tasks. If the correlation was high, on a population level I'd lean more toward willpower being the dominating factor; if the correlation was low, more toward the catchall non-willpower factor.

But you already speculated by claiming it's not 100%. So either you have another number in mind or are just being contrarian...

Further, your experimentation has a flaw; no two things carry identical risk factors and "willpower" factors. Food, as anything, is unique, so the idea of comparing it to other willpower exertions isn't relevant.

> Food, as anything, is unique, so the idea of comparing it to other willpower exertions isn't relevant.

So, you're backing away from the idea that people who struggle with weight lack willpower and are shifting to the stance that they lack some hunger-specific willpower that's unrelated to anything else meaningful?

That's completely indistinguishable from the idea that some people feel hunger more than others.

Nope, I’m reasserting that applying willpower to food consumption is completely possible, and to claim that willpower isn’t a skill is to deny decades of research that shows over and over again that it is.

You made some good points. I am under 40 so I might still have some changing to do as well I guess! As for factors changing during my lifetime, I am not sure. I don't think it's entirely genetic since genes almost always have some environment mediation.

I do believe fat people can get healthy and remain healthy, and I only meant to say that "metabolism" and desire are mediating but not wholly determining factors.

As for the people who can't stop eating, I don't propose to "do" anything with them. I don't believe in altering genetics or using advanced technology to solve the problem. I don't think we should split them out in terms of healthcare either because that would be cruel. I might also have some predisposition to some other costly condition like heart disease and then I would be in another "more expensive" group and just not know about it because it's not visible like obesity.

If "fat people can get healthy and remain healthy" then you agree that it is indeed a matter of willpower, right?

Well, I think people have different levels of willpower (which may actually also be genetic) and an interaction with their desire to eat. Some people clearly have much stronger wills than others, and that's probably genetic or at least imprinted early on.

What if you found out that willpower wasn’t genetic, but a learned skill like riding a bike? Would that change your opinion at all?

Well, yes and no. I guess it might change it a little. Plenty of things are learned quite early though, so it might be some learned skill that happens so early that the person themselves are not responsible for it. I mean it's a bit of a complex question isn't it?

It's actually a quite simple question; if you found out that willpower were entirely a learnable skill, a skill that you could improve with deliberate practice, would you change your mind about how much agency someone has over their own weight?

It's in fact a yes/no question.

I think the premise of your question is wrong. My reading of OP's comment is not that people have no agency, or that willpower is not a learnable skill.

My reading of OP's comment is that for some people, it is easy to lose weight. For others it is hard. I agree with this (while still saying that I believe that people have agency over their own weight and that willpower is a learnable skill).

There is no doubt that being fat or not fat is absolutely a function of how much you eat (and to a lesser extent, exercise), and that how much you eat is a function of willpower.

The question is the other parts of the functions. For some people, they can eat as much as they like without getting fat. Others get fat eating less than average.

For some people, it takes a lot of willpower to eat less. For others, it takes less willpower. Someone who's 5'5" will have a harder time becoming a pro-basketball player than someone who's 6'5". Doesn't mean they can't do it with a lot of effort and willpower.

So no changes of mind are needed, the answer to your question is 'no', because I already believe that willpower is learnable (and if I understand correctly, so does OP).

If you believe willpower is a skill, and you believe that deciding to eat or not eat is a conscious choice, then you must therefore believe a person can train their willpower to prevent them from making the choice to eat.

There are no other ways to see this. You don’t subconsciously eat, that’s not really a thing.

I don't agree with that reasoning, even with your premises. Willpower could be a skill, but some people could learn it better than others because of innate ability. Piano is a skill, but some people learn it much better than others.

A person might be able to learn some level of willpower but still lack a sufficient amount to prevent them from eating.

> then you must therefore believe a person can train their willpower to prevent them from making the choice to eat.

Yes. But for some people, that training will be very easy, and for others, the training will be hard. My point does not contradict yours, it adds to it.