With very few exceptions obesity is simply the result of eating more calories than needed for a long time. Very obese people eat a LOT of food. 10,000 calories/day for years is not uncommon.
- I take ADHD meds, amphetamines, which are appetite suppressants. They haven’t made me eat less, and they’ve reinforced “bad” eating habits I used to have before I lost so much weight, specifically reinforcing my tendency to eat one, large, meal per day.
- I’m much more active than I used to be, because I got a pup who needs the activity and with whom I like to be active.
My caloric intake is about the same as it’s always been. Once I actually paid attention to it I realized it wasn’t even very high. I very seldom reach the recommended 2000 calories diet metrics are based on. I still don’t understand how eating that way made me obese, but I have to assume now I was just absurdly sedentary.
I got lectures like this about caloric intake for years and always found it interesting but confusing! How was I so fat and never eaten much?
I’m not saying this applies to anyone else, but it’s bothered me for decades that I’d been told calories in -> obesity meanwhile my own caloric intake had next to nothing to do with my body mass.
Anyone who wants to lose weight should start with a resting metabolic rate test in order to establish a baseline. You just sit in a chair for a few minutes while a machine measures your inhaled and exhaled gasses to calculate energy expenditure. If you consume fewer calories than your RMR then it is impossible to not lose weight.
There is literally no way to take in more calories than you expend and not gain weight - short of hyper-specific and exceedingly rare medical conditions you'd be quite aware of.
Some people find this easier or harder than others due to a whole host of factors. Physics is physics though, and there is no way to run a calorie deficit and not lose weight. It's why this drug class is so interesting/popular - it lowers the bar for many people, making the effort of taking in less calories than they expend much easier to achieve.
When I started tracking things so closely, I was already concerned that I’d been losing weight and feeling very strong cravings for sweets which I don’t usually care for. The effect wasn’t that I ate less: I started making an effort to eat more, again much like I used to eat. The biggest change is that eating enough has been a concerted effort rather than fairly automatic.
I decided I want to lose weight for the third time in my life. A few weeks I was probably eating 5,000 calories a day. I’ve lost 15 pounds in three weeks. Basically before every day I’d eat and eat and never ever feel full. My stomach would hurt, I’d throw up every day, I felt tired and shitty every single day.
Now I can barely managed to eat 1400 calories a day. I’m eating red meat and kimchi, basically. That’s my diet. Once a week I’ll crave a nice big salad with mushrooms and olives and ranch dressing. I feel great. If I try to exceed that calorie amount I’ll feel super satiated (not full, like physically full) and stop mid bite, and save the rest for later. It feels like a long dormant part of my mind that controls calorie intake suddenly has a voice again and that voice has been drowned out for years.
So I mean it’s easy to say “it’s just calories”, but why when I eat a standard American diet am I craving thousands of extra calories per day and that stops when I eat like this? Even stranger, why do I relapse into these habits when I eat even a small amount of food like French fries or ice cream, over and over again? I know precisely why I’m fat, exactly what to do to lose weight, it’s not even difficult, but unless I have a very strong motivation to lose it I just don’t.
Most people don’t even have the requisite knowledge of how to deal with hunger cravings and get themselves in a state where they’re losing at all. They’ll eat chicken breast and a salad with no dressing then wonder why they feel awful because they’re not getting nourishment, then binge on ice cream. So how is the average person supposed to lose weight?
It’s true that the extra stored fat might must come from calories not used or excreted elsewhere, but that might be because their body is very poor at making immediate use of the calories as energy or is unusually efficient at storing energy that might otherwise be used. To put a number to it, a 2000 calorie diet as normally recommended may leave them depleted of energy and increasingly fat.
It can take years to discover that kind of “outside the norm” issue, and obesity can easily set in before its recognized let alone addressed. And of course, once obesity does become a part of someone’s life, there’s a whole spiral of challenges that make it hard to overcome. Even moreso when your body doesn’t work normally.
Of course, you could rightly reply that there are a lot of complicated things that happen between the food and the problem, and while those diseases require an energy surplus, that neither causes them, nor does trying to naively eliminate the energy surplus fix them. Contrary to popular wisdom, the same is true of obesity.
The idea that obesity could be avoided or cured with a little bookkeeping and self control is laughable to just about anyone who has tried. Telling obese people to eat less is like telling depressed people to get over it. You'd be astonished by how ultimately impossible that is if you haven't been there.
https://www.virtahealth.com/research
There are many people who have cured their obesity with a little bookkeeping and self control. Sue Reynolds and David Goggins are a couple of prominent examples, but there are many others. It's not easy, but it's certainly possible.
https://suereynolds.net/book/ https://davidgoggins.com/book/
Fructose, specifically, is the going theory. And I'm a big fan of Virtahealth specifically, and Dr. Fung's approach for treating type 2 diabetes generally. :)
However, I'd disagree that we know that that's what causes it. We know that treats it. Cancer is not caused by a lack of chemotherapy, and I think chemotherapy is a good analogy for the fasting and low carb approach in this situation. It is a treatment, not a generally normative lifestyle.
But my point is actually more limited, and you actually sort of made it for me by adding the detail about carbohydrates. To wit: just because sugar requires energy, does not mean that you got too much sugar by bringing in too much energy. It's not that simple. You won't get the disease by eating too much protein, for example (you'll get protein poisoning ;) ). You get the disease as a result of liver dysfunction, which you exacerbate and possibly cause by eating too much fructose. It's a control mechanism problem and an injury problem -- the fact that energy is involved (even required!) does not make that the central issue.
Cancer requires energy for growth, but that doesn't make energy the central problem. Blood sugar requires energy for dysregulated high levels, but that doesn't make energy the central problem. Fat requires energy for dysregulated growth, but that doesn't make energy the central problem. That's something you have to demonstrate, and rigorous attempts to demonstrate it fail.
> There are many people who have cured their obesity with a little bookkeeping and self control ... David Goggins
Citing David Goggins as an example of "a little bookkeeping and self control" is hilarious to me. I've read his book. I love his talks. But the guy is about as heroic and extreme as it is possible to get, and that is far from the only thing he did.
My point is that David Goggins is nothing special. He isn't a superhero from the planet Krypton. Anyone can choose to do those things (or at least lesser versions of them). Some people just prefer to sit on the couch eating cookies.
Eating too much is literally what causes type 2 diabetes.
"The idea that obesity could be avoided or cured with a little bookkeeping and self control"
It absolutely can. Again people just don't want to feel bad about not having enough self control.
It can’t. There are many people who, if they simply scaled down their diet without otherwise modifying their nutrient intake/lifestyle, start having health problems well before they lose weight. Hot flashes, fainting, severe stomach pains, nausea.
But there are subtler versions of this. People who live in food deserts, only have access to iceberg lettuce and freezer-burned tomatoes as produce are gonna have a tough time getting all the nutrients they need in 2000 calories or less. There’s also others who have very specific dietary needs that they’re not yet aware of.
That isn't true. Though it's a primary use, the opening paragraph of the wikipedia article on fat outlines that it actually has many biological functions (and is properly thought of as an organ!): https://en.wikipedia.org/wiki/Adipose_tissue
> ... because over human evolution food supply was unreliable enough for this to create an evolutionary advantage. Getting fat from eating a lot of food is completely predictable.
Not at all. While fat does have a primary function as an energy reserve, that does not mean that unregulated growth is a simple matter of putting too much energy into the system. After all, just as in nature there are times of famine, there are also times of feast. It would be pretty disadvantageous for animals to have no regulation on their fat growth in times of abundance. Something more has to go wrong to cross the line from "saving for a rainy day" to "killing you". Animals don't eat until they damage their stomachs, do they? Not generally. Why does it make any more sense that they should eat until they damaged their endocrine systems?
An interesting counterpoint: bears hibernate. In preparation for doing so, they become fat by eating a lot. Now, they do this, not just any time of the year when food is abundant, but specifically in the fall as they prepare for the winter. Are they just lucky that food happens to be abundant every fall? Or is something else going on? What happens in years of famine? Do they still manage to get fat so they can hibernate?
Another interesting counterpoint: Pregnant women eat a lot and put on weight. Why do they do that? Is it because more food is available? Or is something else going on?
One last counterpoint. Bodybuilders put on a lot of muscle, which also takes energy, and they eat a ton to support that growth. Why is it that if I eat an extra steak, my flab gets bigger, but when Ahnold eats one, his biceps get bigger?
Obesity is dysregulated growth. While growth does require energy, it is in the failed regulation of that growth that you will find the best explanation for the disease.
I really can't blame you for assuming this, but it actually turns out that food was scarce enough in human history that humans never actually evolved a limit on how much fat we will store. If we keep consuming a caloric surplus the body will keep creating fat to store it. This is the body working as intended. Things would be different if humans had a more reasonable max body fat percentage.
https://peterattiamd.com/rickjohnson2/
Anyone can build muscle instead of flab if they do sufficient resistance training and eat enough protein. Gains will tend to be slower for women and older people. Arnold Schwarzenegger used a lot of steroids and other PEDS which can certainly accelerate gains, but aren't worth the side effects and legal risks for most people.
https://www.essentiallysports.com/us-sports-news-bodybuildin...
> It absolutely can.
No it can't. ;)
Well, not always. I've experienced both sides of this: an effortless loss of 60 lbs with easy diet changes and bookkeeping over the course of a year and a half. And a few years later, an abject failure as the same strategy -- a moderate calorie restriction -- resulted in such profound physical distress that I developed psychological problems long before I made any physical progress.
Sometimes it's easy. Sometimes it's impossible.
My story is far from atypical. It's common. Practically universal. Everyone, just about everyone, who tries to lose weight, using any strategy, succeeds over a period of months, and fails over a period of years. The reason is that the underlying control mechanism is in a different condition, in different people who may be the same weight.
> people just don't want to feel bad about not having enough self control.
I know you're really attached to the energy imbalance theory of obesity. People often are. But I'd like to suggest that this comment suggests you may have a different motivation for believing in it than just that you find the evidence persuasive.
I often wonder why people get so attached to a theory that I think is in such obvious evidential crisis. A need to believe a simple solution will be there when they need it? A traumatic dieting experience that they need to believe was necessary and useful and healthy? Maybe it worked for them once and they're universalizing their experience? A desire for moral superiority? The fact that deliberately oversimplifying things makes for slam dunk messages on forums?
I don't know, but diet is one of those weird topics where people are attached to their opinion with the religious fire of a thousand suns. While I know I won't change your mind, it does seem fair to point out that your statements are both hyperbolic and inaccurate, and that's not a good sign.
It isn't a theory, it is a fact. It is basic thermodynamics. The human body requires a constant amount of energy for basic operation and activity. Any excess is stored as fat for future use. Creating fat requires calories that HAVE to come from food. Eat few enough calories and you WILL lose weight. Eat zero and you WILL die. Eat 20,000/day for a year and you WILL get very fat.
A good example of this is this man went 382 days without eating
https://www.diabetes.co.uk/blog/2018/02/story-angus-barbieri...
He had a calories surplus for long enough to weigh 207kg. While not eating his body consumed energy in his fat to stay alive and he got down to 81kg. ((207-87)kg * 7700 calories/kg)/382 days = 2539 calories/day, which is a very plausible number.
To say "it's just thermodynamics" might be right as far as the physics goes, but it doesn't recognise that biological drives overwhelm everything. It's hugely complicated how energy expenditure and steady state energy consumption interacts with weight gain, not least because the body will invariably work to make your actions as efficient as possible to maintain weight. For example, observational studies of hunter societies that might travel large distances daily, energy requirements bear little relation to daily activity after any transition time has elapsed when compared to relatively inactive Western counterparts. These people can't just will their activities to be less efficient if they hypothetically wanted to consume more energy.
Ultimately, the biology will decide what the effect of any intervention is, regardless of how motivated or not you are. Any advice that doesn't explicitly factor that in is just hot air.
If energy intake matches energy needs then body fat percentage stays the same.
If energy intake exceeds energy needs then body fat percentage increases as the body stored the excess as fat.
If energy needs exceed energy intake then body fat percentage decreases as fat is used as fuel.
no, it doesn't. the amount it uses for basic operation and activity will change. shrinking in response to your attempts to lose weight.
The basic metabolic rate varies between individuals. One study of 150 adults representative of the population in Scotland reported basal metabolic rates from as low as 1,027 kilocalories (4,300 kJ) per day to as high as 2,499 kilocalories (10,460 kJ); with a mean BMR of 1,500 kilocalories (6,300 kJ) per day.
These new generation of drugs (semaglutide, tirzapatide) deal with the signaling system (endocrine signaling, that is).
Yes it does, because it is basically just repeating basic laws of thermodynamics. Obesity is actually just the body working as intended by storing the excess energy for future use during a famine. CICO is why obesity used to be very rare in past when calories were expensive and is now common when calories are very cheap and artificially delicious.
That's just an extreme example. The real culprit is processed foods.
You don't know that.
It's like saying an overdose on heroin is simply someone doing too much heroin at a time.
Yes it is. It really is as simple as that, people just don't want to hear it. Historically food was scarce that it was nearly impossible to sustain a calorie surplus long enough to get fat. But some people did, that is why the rich used to be called "fat cats" but now calories are so cheap and delicious and lifestyles are so sedentary that it is very easy for almost anyone to sustain the caloric surplus needed to become very fat. I had a cousin who reached 650 pounds and then died. He would spend hours every day eating and almost as long shitting.
I'm skinny so I'm unbiased. There is nothing I "don't" want to hear because I'm literally not affected by it. Thus, I assure you I have more information than you. Read below:
https://www.theatlantic.com/health/archive/2015/09/why-it-wa...
Your reasoning is on anthropological timescales, which while technically true, doesn't explain why people were still skinny in the 80s and before. There was an actual turning point AFTER the 80s... A huge shift in weight gain where MODERN and well-fed people suddenly got heavier. Something happened with the food supply starting with the US.
We only have correlative studies that match a number of things with the sudden change in weight. Thus no causative confirmation on the exact source. Our educated guess says that it has to do with processed foods. Processed foods streamline calorie absorption to unnatural levels leading to unnatural weight gain.
The article above mentions a number of other factors that I think are possible.
But a reader questions the methodology of the researchers: “My main concern is that the calories are almost assuredly self-reported, which is notoriously unreliable.” Another reader agrees:
In the 1980s, we weren’t walking around with a computer in our pockets to look up accurate calorie counts for everything that allowed us to store an accurate list of everything we’ve eaten and compute the calories based on that database. It was 100% self-reporting and calorie lookups “from memory” or done manually (complete with calculations) long after the fact. So the reports based on that old data might be suspect.
The study authors addressed that point somewhat:
Whether self-reported dietary intake accurately reflects an individual’s true dietary intake has been questioned. Indeed, doubly-labelled water studies typically show that individuals underreport their energy intake, and that the magnitude of the underreporting may be larger in people who are obese.The fact of the matter is, people weighed less in the 80s then they do today. No amount of stretching can change this quantitative measurement. So something must've changed. What changed?
You can continue to talk about calories in and calories out just like we can blame the overdose problem on people doing too much heroin. Again, while YOU can do that, it's not a very useful position.
https://www.diabetes.co.uk/blog/2018/02/story-angus-barbieri...
"The fact of the matter is, people weighed less in the 80s then they do today. "
Because they ate less. Portions were smaller, Food wasn't marketed as much.
"No amount of stretching can change this quantitative measurement."
Self-reported calorie intake is not a reliable quantitative measure.
"You can continue to talk about calories in and calories out just like we can blame the overdose problem on people doing too much heroin."
I really don't understand why you think this statement proves. A heroin overdose IS caused directly by an excess amount of heroin in a given time interval, just like obesity IS caused directly by excessive calories in a given time interval. The time interval for obesity is years instead of hours.
Heroin and obesity are indirectly caused by people getting addicted to the dopamine levels consuming them cause.
You sound a tad like a 9/11 truther insisting on some over complex conspiracy theories to explain something fairly straightforward.
This is the part you're not getting. You DIRECTLY say you don't understand here, and I am here to confirm that you in actuality DO NOT understand.
A heroin overdose IS directly a result of too much heroin within a time interval. But that answer is too obvious and PEDANTIC. You would be stupid to characterize the opiate epidemic as just people doing too much heroin and that they should do less to improve their health. "Yeah that's the problem with opiates in America, people doing too much of it, I know you guys don't like to hear it, but it's the truth. Just control yourself and do less"
Obviously it's more than that. There's a problem with tolerance, with addiction, the fact that opiates were introduced as addictive pain killers by Purdue Pharma under the name Oxycontin. The story of heroin is much more then the completely idiotic characterization of just "doing too much."
So to bring it back around. The the situation is MUCH more complex then people eating more and becoming fatter.
>You sound a tad like a 9/11 truther insisting on some over complex conspiracy theories to explain something fairly straightforward.
I'll just be blunt. You sound like a fucking idiot for regurgitating something SO OBVIOUS. Look, you're not actually an idiot, so stop acting like one and stop calling me a 9/11 truther.
What's even stupider is that when I tell you that while TECHNICALLY more calories in does make you fatter there's clearly something else going on. Do you see the connection with the metaphor here with heroin? Heroin isn't just about people doing too much of it. There's many underlying reasons here for WHY something happens.
I have experience in this area with people who are overweight. Even the simple answer of calorie density in processed foods increasing due to industrial food manufacturing after the 80s leads to fatter people is a better characterization here.
However that answer above ^^ is inline with your simplistic calorie in-out logic so maybe that explanation can help you "get it".
First, don't be so rude. You think what I'm stating is obvious but there is an entire industry built to deny it. Even on this thread there are people who deny it.
Just because you honestly reminded me of their need for overly complicated explanations of well understood things.
Your explanations are simplistic you fail to see nuance and complexity within reality. I find your outlook on things to also be delusional. You think things are simple and well understood but that's just a reflection of your ignorance.
Not trying be insulting or anything like that but this is just what it is.
Just to drill it home. How stupid does a person have to be to think that comparing someone to a 9/11 truther isn't rude? You have to be pretty stupid.
Again not being rude. Just telling it like it is.