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Comment by mbac32768 | Hacker News Reader

The skepticism people have towards metabolic dysregulation models of obesity is too much.

We know for a fact the inverse happens: girl starves herself for years to slim down to become a ballerina, eventually decides it's not worth it and tries to stop being so dangerously thin and... can't. She never feels hungry. Every time she eats she can only stomach a few bites before pushing it away. Just eat ice cream? Instant puke. She cannot gain weight no matter what.

Obviously she broke her metabolic system and she obviously did it through diet.

Yes it's possible for some skinny people to gain weight. But that doesn't mean every skinny person simply can decide to be fat just by eating. It's like climbing Mount Everest for some skinny people to put weight on, even if they really desperately want to.

I don't think the situation with obese people is all that different.

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This concept would be hard to grasp for me if I did not know personally a person facing such issue. I don't think most people can understand that "just eat more" does not work in such cases, because most people can eat just fine even if not really hungry.

> because most people can eat just fine even if not really hungry.

I literally cannot imagine how this is possible. Don't you feel full? Doesn't your body start refusing to swallow? Doesn't the food turn tasteless and start making you nauseous? 100-200kcal over your BMR, sure, but beyond that?

Look at approximately any thanksgiving dinner in the US?

Throughout history, occasional lavish feasts have been very common in nearly every culture.

Hunger and satiation are two different neural pathways. Hunger is low blood sugar. Satiation is stretching of the stomach. You can still eat even with normal blood sugar if your stomach isn't full.

Which is a large part of why weight loss diet advice usually included a bunch of stuff about stuffing your face with iceberg lettuce and other high volume low calorie foods. It makes you feel satiated sooner.

No, those are symptoms of an eating disorder.

As someone in the same boat, what worked for me is to replace ingredients with higher calorie versions. A significant one is replacing milk in recipes (polenta, mashed potatoes etc.) with heavy cream, this provides a good 500 calories boost on the same portion of food. Also adding sugar here and there to recipes that allow it without ruining taste.

Just look at people with cancer. Many simply cannot eat. At all. They just cannot do it. It's not depression, loads of other diseases and conditions are depressing, yet people can still eat.

And while the person is clearly sick, every loved one tries to help by hoping to find food they can eat. Yet it just doesn't work. I've personally seen feeding tubes put in, to help in this regard.

There's some mechanism involved, and I've often wondered if the body knows food will also feed the tumor and is attempting to starve it. Regardless, the 'switch' is there.

I didn't buy into the whole metabolic health thing -- I thought a calorie was a calorie. But as a person who couldn't lose weight for years due to insulin resistance, just a single daily dose of metformin enables me to lose weight. I was advised to take either that or a miniscule dose of a GLP-1 agonist.

> Obviously she broke her metabolic system and she obviously did it through diet.

It sounds 'obvious', but I don't think it's obvious that she did it through diet.

> Obviously she broke her metabolic system and she obviously did it through diet.

No, she picked up a mental behavioral disorder that has nothing to do with her metabolism.

Is there a drug I can take to gain weight?

Ice cream and cheese

Fun fact: eating a bunch of black pepper cancels that out.

What's mj?

Sorry was lazy with the typing last night.

mary jane, marijuana, wacky-tobacky, pot, weed...

Weight from muscle? Or from fat?

Its called sugar

Caution: It's highly addictive

Apparently only for some people.

I don't want you to consider it among the flippant replies here but definitely alcohol will work up to a point, it's somewhat of a contradiction though because severe alcoholics are usually quite malnourished and thin.

Alcohol itself has a lot of calories. Or does it cause even more appetite in addition?

Antipsychotics tend to do the trick.

Gaining weight works by putting more fuel into your body than you use. That's physically the only way, there is no way to synthesize energy. Because of caloric density limits, there is no substitute for putting a certain amount of stuff in your body. A pill can physically not contain enough calories.

There are options around that, but that depends on what's driving your personal energy deficit. What's the job that the weight gain intervention needs to do for you, that whatever you try to eat right now does not? What's motivating your current diet? Are you for example disgusted by swallowing anything at all? Are you more partial to liquids than whole foods? Do you dislike sugar in particular?

> A pill can physically not contain enough calories.

No, but a pill can make you want to eat more or fidget less etc.

You have so much choice:

For the pure fat experience I suggest corticosteroids, lithium or a random antipsychotic. Insulin is also very useful here, but a tad dangerous.

If it has to be muscle mass, then anabolic steroids of course are preferable. But beta adrenergic agonists like clenbuterol also seem to have some effect.

And there are many more.

Corticosteroids are also pretty damn dangerous

They all have uncomfortable side effects, especially the fatty-inducing ones. But insulin stands out for being able to kill you very quickly from a moderate overdose.

Well corticosteroid withdrawal will kill you also, or ruin your life if you fuck up and dont taper off quick enough.

Steroids and antipsychotics usually cause massive weight gain.

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