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Full disclosure: Some of this post I’ve cut-and-pasted from an online debate I had with Helen Pluckrose.)
In the New York Times, neuroscientist Sandra Aamodt wrote about why weight loss diets almost always fail in the long run:
The root of the problem is not willpower but neuroscience. Metabolic suppression is one of several powerful tools that the brain uses to keep the body within a certain weight range, called the set point. The range, which varies from person to person, is determined by genes and life experience. When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.
The brain’s weight-regulation system considers your set point to be the correct weight for you, whether or not your doctor agrees. If someone starts at 120 pounds and drops to 80, her brain rightfully declares a starvation state of emergency, using every method available to get that weight back up to normal. The same thing happens to someone who starts at 300 pounds and diets down to 200, as the “Biggest Loser” participants discovered.
This coordinated brain response is a major reason that dieters find weight loss so hard to achieve and maintain.
Weight loss diets don’t work in the long term, for the vast majority of people. (This is true of all weight loss plans, including “lifestyle changes”). Especially if “work” means “turn a fat person into a non-fat person.”
And that simple fact, if it were accepted, turns nearly all of our society’s discussion of fat and “the obesity crisis” upside down.
What should fat people who are concerned about their health, or want to improve their health, do? The default answer, in our society, is “stop being fat.” Lose weight. But for most fat people, that’s nonsensical advice – and worst, actively harmful advice – because we don’t know how to make fat people stop being fat. At least, not in any way that lasts and works for most people.
Am I saying fat people who want to be healthier should give up? Absolutely not. I’m saying that for most fat people, becoming healthier doesn’t require futile attempts to lose weight. Take a look at this graph:
(Source.) The graph shows likelihood of mortality as it relates to weight and four other characteristics: fruit and vegetable intake, tobacco use, exercise, and alcohol. These are sometimes called the “healthy habits.”
On the left side of the graph, fat people who practice zero “healthy habits” – smoking, no veggies, immoderate drinking, no exercise – have a much higher mortality risk than so-called “normal” weight people with unhealthy habits (although the “normals” have elevated risk too).
On the right end of the graph, fat people who practice all four healthy habits have a mortality risk that’s just barely higher than their thinner counterparts. More importantly, we can see that fat people who practice all four healthy habits benefit enormously, compared to fat people who don’t. (“Normals” benefit enormously from these healthy habits, too.)
Most fat people can’t permanently lose enough weight to stop being fat. But most fat people can eat more veggies, can not smoke, can limit ourselves to one glass of hootch a day, can add moderate exercise to our lives. These things aren’t always easy, but they are all much more achievable, for most fat people, than stopping being fat.
Achievable advice is better than unachievable advice. There’s a positive way forward for most fat people who want to be healthier – one that’s more likely to work, and less likely to encourage self-hatred, than trying to stop being fat.
I find the idea of a anthropomorphic brain inherently funny; if we cut it open, would we find another, smaller brain inside?
I’m unusually happy with how this cartoon looks. Mainly for the brain, which was so much fun to draw (although time-consuming) and I think came out well. To make up for how time-consuming the brain was to draw, the little hormone-servants also look really good (in my opinion), and took virtually no effort or time to draw.
When I was working on this strip, I posted my design for the brain character on social media, to see if people would get that it’s a brain.
Nearly everyone got that it’s a brain (although a few guessed it was a raison, and I can kind of see that). But I had decided to use the cerebellum as pantaloons, and several people thought they were the brain’s balls. And that is why my final brain design has no cerebellum.
TRANSCRIPT OF CARTOON
This cartoon has six panels, plus an additional tiny “kicker” panel below the bottom of the cartoon.
At the top of the entire cartoon is a large caption, which says THIS IS YOUR BRAIN ON A DIET.
The first five panels show a human brain, but anthropomorphized: It has arms, legs, hands (gloved with three fingers, a la Mickey Mouse) huge eyes and a pointy crown. It’s in some sort of dimly lit round space.
The brain is speaking to a cell-like creature, with little blobs of oil falling off of it, and this creature has also been anthropomorphized, and has a mouth and two big eyes. The cell-like creature is wearing a black bowler hat.
The brain is speaking a bit imperiously to the cell-like creature, who is named Mr. Ghrelin. Ghrelin looks a little nervious.
BRAIN: Mr. Ghrelin, you have a report?
GHRELIN: Your majesty, I bring word from the stomach! We’ve been getting less food and we’re losing fat!
A close-up of the brain. The brain is looking up thoughtfully into the hair, one finger pressed to the side of what I’ll call its cheek, as if its trying to remember something.
BRAIN: Less food? Losing fat? There’s a word for this…
BRAIN: What’s that word? It’s something I learned millions of years ago in evolution school…
The brain has jumped up, holding the sides of its, er, head and with an extremely panicked expression; Mr Ghrelin is in turn surprised by the brain’s reaction. The word “starvation” is written in huge red letters.
BRAIN: This is called STARVATION!
A shot of the brain, raising its fists high as it yells, with a determined expression on its face. The background has disappeared, replaced by bright yellow, with waves of action lines (indicating great energy) shooting out from the brain.
BRAIN: I’m declaring a state of emergency!
BRAIN: Slow down metabolism! We must preserve our precious fat!
The brain is now surrounded by a bunch of Ghrelin-types, each of who looks the same, except they’re wearing different hats (we can see: bowler hat, top hat, cabbie cap, 50s dad hat). The brain, still yelling, is pointing decisively as it gives marching orders.
BRAIN: Release the stress hormones! Have them produce constant, extreme hunger! And store all the fat we can! Just in case!
BRAIN: We’ll keep this up for years if necessary!
A fat man sites on a sofa. Next to him, on an endtable, are a lamp, a drinking glass, and a pen. On his other side is a cell phone and a throw pillow. On the back of the sofa, there’s a folded blanket and, lying on the blanket, an orange cat. He’s wearing fuzzy slippers that are designed to look like mice, with little ears sticking up.
He’s holding a book; we can see the book’s cover, with the title “THE COMMON SENSE DIET.” A caption above the book shows what he’s reading in the book.
CAPTION: Just eat less! It’s easy!
TINY KICKER PANEL BELOW THE BOTTOM OF THE STRIP
Mr. Ghrelin is speaking to the brain again; the brain is facing away and looking anxious.
GHRELIN: Good news! We’re getting normal amounts of food again.
BRAIN: But for how long? Better store more fat.
Don’t forget sleep. Not getting enough sleep will tend to make people gain weight. As will working too many hours. As will poverty related stress. If we were serious about making people thinner, we’d limit working hours and number of jobs any one person can have, provide a minimum income so that no one has to work excessively, and provide health insurance to all. I’d like to see light and noise pollution addressed as well. Until we see these things, I’m not going to take the claim that we, as a society, want people to be thinner seriously.
Full disclosure: Some of this post I’ve cut-and-pasted from an online debate I had with Helen Pluckrose.
I read your debate with Pluckrose and I have to say that some of Pluckrose’s arguments are just awful! This one in particular caught my attention: “Nevertheless, the reason the majority of people (worldwide, not in America) are not obese is their diet. Either intuitively or consciously they eat the right amount of calories they need to be neither dangerously underweight or dangerously overweight.”
Um, no. People in countries with severe poverty are not obese because they are food insecure and at risk for starvation. Obesity appears as an issue in any country with adequate wealth (and adequately distributed wealth) to allow it to occur. No one intuitively eats the right amount of calories to be at an “ideal” weight. Evolution didn’t set us up for abundance.
Urg. Sorry, I know you know this better than I do, but I can’t help ranting from frustration. We (we=society, not you and me) have been preaching to people about losing weight and holding up thin as an ideal for at least as long as I’ve been alive, probably in fact much longer. If shaming people into losing weight worked, it would have a long time ago.
I haven’t weighed myself in years. I’m not going to be a slave to a number. I figure as long as my clothes fit, and I keep up my exercise and eat lots of veggies, my weight doesn’t matter.
This is why starving yourself is idiotic if you want to lose weight.
You ramp up exercise, increase the quality of food, get on a schedule that includes adequate sleep, and do not panic when the first thing that happens is that you start gaining weight.
And it works, as long as your income, free time, and willingness to subject yourself to moderate discomfort is up to the task.
By the way, people who say that dietary habits have nothing to do with weight gain should have to explain why ‘Communist’ Bulgaria had practically no fat people (I’d seen one in school, and one in the army in the first 20 years of my life)
No one lacked food. Any student or worker had access to all the cafeteria food they could eat for breakfast and lunch (not haute cuisine, but head and shoulders better than the swill served in my daughter’s school in the US.) For dinner, you had to make your own arrangements, but food was cheap, and it was real food. No preservatives, corn sugar, artificial flavors, ingredients where everything expensive has been removed for resale, etc.
30 years later, Bulgaria leads Europe in obesity. What has changed?
Stress, stratospheric prices for quality products, a flood of processed shit masquerading as food, and of course, the exodus of anyone qualified and willing to fight for a better life.
Thanks. I’m sharing this.
Thanks! Glad you like it.
I’ve shared it. I rather regret it, since I got mildly lectured about how people should eat to lose weight.
I also got told (I think this is correct) that metabolic rates don’t seem to fall from dieting. I wouldn’t be surprised if something else is going on– digestive efficiency?
Possibly it could have the brain saying “I don’t want to think about anything but food!”.
Here’s where I shared it: https://www.facebook.com/nancy.lebovitz/posts/pfbid0NUVdhxGKq7hEGaa2LaUpYxKP4WfqXdjAMHtuYcNjCSmxoqy9rNbYQ48K13V2Q2j7l
I followed your FB link and, indeed, encountered the account commenting that a better study seems to disprove long-held observations regarding metabolic adaptation from significant weight loss—namely, BMR decreases and with time falls below the mean—but I didn’t notice a link to the study they’re referring to. Do you happen to know where we can find that particular study?
Disclaimer: I am likely especially skeptical here because it still seems to me seriously counterintuitive that a high bodyweight individual, whose BMR has adapted to a particular weight and body composition, can seriously reduce fat (and, by extension, some muscle) by calorie deficit and retain their old BMR for more than a few months, or even achieve a BMR comparable to someone of the same age, height, and build, and who has always hovered around the new, reduced bodyweight. In short, they’ll have to eat less to maintain the same weight.
This appears to be true not only for Fat people but also athletes, among whom the practice of introducing carefully-timed waves of “re-feeding”/“reverse feeding” to stave off or at least reduce this lowered metabolic effect has become widely adopted. It’s possible there are exceptions, and it’s possible people who have reduced their bodyweight are overestimating their new caloric intake, but usually it’s the opposite: an underestimation of what one consumes. The differences there appear to be in degree, where the novice unconcerned about numbers is suddenly asked to self-report estimated daily diets will be enormously off in their calculations, the individual who has worked years to reduce their weight by counting, measuring, and logging, will still be off, but by less.
The key thus far appears less to be “digestion” and more to do with incremental weight loss by diet coupled with measures taken against hormone interference (starvation is a stressor) and the dire and cumulative effects of inevitable muscle and bone loss: a kind of low-grade schedule of bulks and cuts coupling calories with training is the only well documented and supported magic bullet, but for most it’s still a finite one.
As you say, such findings would definitely turn on its head the long-standing, verifiable principle that maintaining significant weight loss will invariably require eating less than similarly-sized peers. The inverse, where mass is intentionally acquired by a caloric surplus coupled with a periodized muscle mass building program, does not appear to require similarly unsustainable practices in order to maintain such gains. Even hard gainers over-eating for size appear to struggle less at holding onto their progress than people who have reduced their bodyweight through both diet restriction and resistance training.
I have a hard time even contemplating ignoring the role of metabolism (or, indeed, metabolic syndrome and its many pharmaceutical and surgical interventions) here. The success rate for maintaining significant weight loss, absent ongoing clinical intervention and medical monitoring, has proven rare if not elusive, so I’d be interested to hear what the driver would be for the steady erosion of “progress” gained if not rooted in metabolism.
Your last point about old eating habits dying hard and longstanding behavioral traits dying harder, however, is taken. It’s definitely a full-time second job for most people, requiring constant vigilance, and often psychological intervention and counseling, as well.
Nancy: I just left a couple of replies in your Facebook thread, which I hope is okay.
Here’s the reply I wrote to Bernadette:
I’m really curious about the role that medical discrimination plays in fat mortality. There’s both direct discrimination (refusal of appropriate care at the time) and indirect discrimination (avoidance of care due to prior discrimination). I don’t know how you’d measure it.
Also, stress. We know it has a major impact in other situations. Being fat in this society is incredibly stressful. How much does that impact mortality directly (by causing illness) and indirectly (by causing unhealthy behaviors generated by stress)?
(Thirdly, there are diagnostic problems where some tools designed for thin bodies don’t work as well for finding medical problems in fat bodies, but I don’t know much about that besides that it exists.)
For those who haven’t seen the articles on lab animals and obesity:
Vox summary: https://www.vox.com/2015/8/24/9194579/obesity-animals
original research paper: https://royalsocietypublishing.org/doi/abs/10.1098/rspb.2010.1890
Google scholar list of papers citing the Proceedings of the Royal Society B paper: https://scholar.google.ca/scholar?cites=10925269364062618050&as_sdt=2005&sciodt=0,5&hl=en
If nothing else, these give one something to think about. Many people lament how much “better” people were in the olden days about taking care of themselves, but smoking (suppresses appetite) and fewer/less processed food options also result in eating less. If there is some other environmental thing going on it would hardly be surprising.
I am a “normal” BMI person, and I have been able to (with some effort) shift my weight in a ~20 pound range throughout my adult life, but I have never kept off more than about 10-15 pounds from my maximum weight for any significant length of time. Once I hit about 7-10 pounds lower than my current weight, extreme hunger/constant thoughts of food set in. I have a lot of sympathy for anyone who is unhappy with their body size and has been unable to change it. I definitely believe people have tried many things that didn’t work. It is impossible to fight your body all the time and still have energy for working and spending time with people.
I have no doubt that encouraging achievable, healthy habits would have a much better impact on everybody’s health (not just overweight/obese people), but I also doubt that we as a society are ready to give up on exhorting fat people to do better. There have been some interesting studies showing that intermittant fasting/time controlled eating does not actually help with weight loss, but does help with improving metabolic biochemistry. As we do good quality studies on different eating patterns, I am sure we will learn a lot more about nutrition and eating, and how to best improve health. That should be the ultimate goal of all of this in the end.
This can’t be emphasized enough. Like, duh, we know that if you starve yourself you’ll lose weight. But also, duh, almost nobody can starve themselves voluntarily. It’s just too unpleasant to be able to do.
Slightly random thought: Several people have noted that eating becomes more rewarding after weight loss. Are yo-yo dieters (people who gain and lose weight rapidly due to severe caloric restriction and then abrupt increases in caloric intake) actually seeking not weight loss, but the sensation of eating being really rewarding? I’ve heard it claimed that some opiate users detox in order to lower their opiate resistance and be able to get better highs from less opiate later on. Don’t know if/how often either happens, but it strikes me that there could be something similar going on here.
This comment isnt written as well as it could be; i beg indulgence if it comes across weird or condescending. Not at 100% capacity here. Insomnia.
No, I don’t think that’s a dieting thing. I do know people detox from pot in order to reset their tolerance, idk about opiates but probably.
I don’t know if you’re suggesting yo yo dieters a r e consciously trying to improve the taste of food (never heard of it, i highly doubt it), or unconsciously getting addicted to a physiologically exciting experience (possible, I guess). However–
Its true that eating after denying food in the very short term causes the food eaten immediately afterward to taste better. Most people probably know this whether or not they diet. Miss a couple meals and your tastebuds will be damn happy to get the food.
Eating after long term denial is weird and no doubt inflected by one’s relationship with eating disorders — but honestly the high from refusing to eat food at all is really strong, and if feeling good were the goal, you could just chase that. When you eat very limited or no calories for a long time, for me and rhe people I’ve talked to, your body starts to produce a kind of shadowy wave of something that feels a bit like delirium. Hunger becomes a weird blurry thing that’s both predominate and also outside your body. Imagine taking a lot of painkillers or having a fever that’s blurring your consciousness. It’s not necessarily pleasant exactly, but it’s physically compelling and addictive. (Of course, you may have experienced this yourself, in which case: condolences).
(Separately: The “most people can’t starve themselves” thing interests me because it’s probably true. At the same time, for many people, *starving* themselves is perfectly accessible if admittedly hard work, but they also know doctors don’t actually like it when you do because you tend to eventually die. I point this out because even the proposed solution for weight loss, starvation, actually interferes with the purported goal.)
The longer a discussion of weight loss goes on, the higher the probability that I’ll link to this: https://humoncomics.com/new-doctor
I don’t remember seeing that cartoon before, but I really like it!
You mean, a study where people who became fat once, starved themselves to lose weight, and then went back to the same diet and life style magically failed to become just as fat, once again?
No, I would not waste time looking for it.
No, I mean a study which shows that the majority of fat people who “ramp up exercise, increase the quality of food, get on a schedule that includes adequate sleep, and do not panic when the first thing that happens is that you start gaining weight” lose weight as long as their “income, free time, and willingness to subject yourself to moderate discomfort is up to the task” were able to lose enough weight to stop being fat, and able to maintain it long term.
If you don’t have a study, then – whether you admit it or not – you actually have no idea if your weight-loss plan is viable for most fat people or not.
Every single kayaking, kickboxing, rock-climbing, etc. club is its own case study. Even serious hiking groups have NO fat members. Not one.
I know a couple of personal trainers, nutrition specialists, etc. Not the cut rate ones you find in a gym, the kind that can steer you into becoming a muscle bound freak who, if he lucky enough to steer between kidney failure, injuries, etc. will mess up his eating habits and never find balance again. No, the kind that work with wealthy clients one on one, and have a success rate of about, what 100%, while the client stays with them.
I have been a member of dozens of athletics clubs. I have taught a few myself, and am instructing in two currently. Plenty of overweight people join. One month and a half is what they have to endure before they start seeing results. We do not talk about dieting, and we actually share snacks between classes.
People who survive long enough to get in the groove, quit only due to lack of time. And no one regain the weight while active. It just does not happen. Once your body gets used to one-two hours of physical activity per day, fat becomes fuel that slowly get consumed, and you simply cannot stuff yourself like before.
And yes, Snicker bars, donuts, pizza, etc. somehow disappear from your diet, just like the time to sit on the couch and watch the infantile, incompetent fat dad get rescued by his hard-working, brilliant, tolerant, beautiful wife.
California is, I think, in the middle of the pack when it comes to obesity. And yet, I see practically no fat people when I take my kid to school, at work, at practice, or at parties. Every now and then, siblings, significant others, or nephews will show up carrying a dozen extra pounds. If they stick around, they will lose them.
Is this anecdotal evidence? Of course. Have I seen enough of it so that I will never change my mind? Yes.
But the process involves changing your lifestyle, as in finding something that is physical and makes you happy. It will involve eliminating a bunch of crap from what you eat, and it will take enough time that you will drop some activities.
Now, I bet that someone will come and say that it does not last. Eh. There is no such thing as a true Scotsman. If you go on living the life of a fit person, you remain a fit person. And vice versa.
OK, I lied. There is a fat mom at my daughter’s Girl Scout meetings. But that’s it. That is the one fat person I see repeatedly. She does not look like someone who is into any kind of activity. She certainly cannot catch her daughter when she runs to the meeting room, and her daughter also looks like she is gaining weight every month. When she becomes a teenager, she will have to choose her way. If I were among the Girl Scout leaders, I’d be planning about it already. But it is not my circus.
Another ??? moment.
I have never been in a kickboxing club, but I’ve kayaked and I’m a fairly serious rock climber and hiker. I also bike about 1 hour/day, walk 10K steps, and lift weights on a moderately regular basis (trying for 7x/week, usually end up closer to 5).
I’m pretty sure that you’d call me “fat” if you looked at me. Nor am I the only fat person I’ve seen while kayaking, rock climbing, or biking. And I’m practically never the fattest person on the hiking trail. I’m afraid I suspect selective blindness or at least selective recall on your part. Then again, you implied that you’re wealthy and wealth is negatively correlated with obesity. Almost as though stress had something to do with weight gain.
You are a serious rock climber? In addition to walking 8-10km per day (which would take me over an hour, and I walk fast) and biking another hour and lifting weights? (almost) every single day?
I cannot fathom how you can be something I would call fat. I consider BMI bullshit, so if that’s what you go by, don’t. When I was kickboxing semi-professionally, every single person in the club was overweight by BMI, and the taller ones were obese.
If you are able to do things like one-armed pull-ups and one leg squats (which I sorta expect from most serious rock climbers) you may be carrying a few extra pounds, but you’d be stout, not fat.
Would you call the contestants of Strongwoman competitions fat?
“Have I seen enough of it so that I will never change my mind? Yes”
What’s the point in discussing this if you will, as you say, never change your mind?
Why would you expect anybody else to change their mind based on what you say?
What do you mean by “serious”? What’s your best climb?
I also note the moving goal post. First it was “you need to exercise.” Now it’s 2 hours/day of exercise.
I walk 5.2 miles almost every single day. And I walk fast. Fast enough that I pass the slowest joggers. Does that take me over an hour? Yes it does. I walked a half marathon last September. I do another half hour of exercise on those days, too, to bring me to a total of nearly 2 hours. Somehow, though, when my thyroid function dropped and I gained 10 pounds 3 years ago, I was never able to lose that weight. Not by starting my exercise program. I was only able to drop the 10 lbs when (due to a freak side effect that makes what I’m doing unlikely to be possible for most people) I restricted my intake to 1200kCal/day or less.
I’ve been tracking this latest development for 6 months and, whether I do my exercise program or not, 1200 kcal keeps my weight steady. More than that and I gain weight, less than that and I lose weight.
Human bodies are complex systems and there is no single action (other than starving oneself) that is a foolproof method for achieving and maintaining weight loss. Even aside from these anecdotes we tell about ourselves, the science is pretty conclusive.
That’s always how it goes.
“You wouldn’t be fat if you weren’t eating at McDonalds all the time. Try eating a salad for once.”
I eat at McDonalds about twice a year. My most frequent meal is having a salad.
“Salads, huh? I bet you’re using dressing instead of just a little vinegar and oil. And you probably have meat in the salad. You’re basically pigging out. And do you ever exercise? Try doing some movement a couple of days a week.”
I exercise an hour each day, usually six days a week.
“So by ‘exercise,’ you probably mean walking. You need to be running uphill on a treadmill or it doesn’t count.”
It’s all bullshit. People who initiate these lines of questioning are certain of the answer before they ever began, and will continuously shift their goalposts so that they never have to shift their conclusion.
And – at least for me – it’s difficult to have these conversations without falling into the “good fatty” trap, too. Or feeling that I am. Because yes, I eat a much healthier diet than I used to, and I exercise frequently. But that doesn’t mean there’s anything wrong with being fat and not doing these things. (Or being thin and not doing those things).
(And I know that you (Diane) haven’t said anything of that sort, of course. Please don’t think I’m accusing you of that, or asking that you change how you’re commenting here.)
But the idea that exercising and eating “right” are things that people should feel guilty and lesser for not doing is extremely prevalent in our society, and whenever I get into these discussions I worry that I’m falling into that trope.
OTOH, I also don’t want fat-acceptance folk to feel like can’t talk about their accomplishments (because doing something like setting up an exercise goal and doing it is an accomplishment) the way thin people routinely do. And I worry that’s the outcome of avoiding “good fatty” narratives.
So, basically, I’m worrying no matter what I do. :-p
The “exercise will make you lose weight” narrative simply isn’t true.
And it’s a harmful narrative, because it encourages people to think exercise isn’t “working” if they don’t see substantial weight loss, or to think that they’ve failed to “really” exercise if they’re not losing weight. And it encourages people to de-emphasize the much better-proven health benefits that exercise can bring about, regardless of weight loss.
Finally, David, if it’s true that there’s not a single fat person in any of those clubs, etc.., you mention, then I suspect that’s because you’re unconsciously selecting for clubs where people are bigoted and disdainful towards fat people – and fat people are naturally gravitating away from those environments.
That is the basic problem: If someone is convinced that someone who exercises and eats right can’t possibly be fat then they’re going to have to move the goalposts every time it’s pointed out that there are people who exercise, eat right, and are fat.
I think the advice Petar gave would be better if it were simply, “Exercise as much as is sensible for you, eat well, get enough sleep, and don’t worry about your weight.” As you pointed out, a good diet, enough exercise, good sleep habits, and not smoking will improve health regardless of weight. Actually, I think I’d go even further and say that you should exercise as much as you enjoy, eat food that gives you pleasure, sleep as much as you need to feel good, and don’t worry about your weight. It’s true that moderate daily exercise will improve health as will eating mostly vegetables, but the point of life is not to extend it as long as possible, it’s to enjoy it and help others. So better to eat what you want than eat the perfect diet and not enjoy it.
Incidentally, the particular example they gave about Snickers, donuts, and pizza? I don’t regularly eat any of them. The Snickers is your fault. I don’t eat them any more because of the cartoon you did about how cacao production exploits children. I’ve gone to chocolate that has a documented non-exploitive source and that doesn’t include M&M/Mars.
I will gorge myself past sickness on pizza if I don’t stay alert. Truthfully, I’ll gorge myself on any food I can tolerate if I don’t stay alert. That’s the other side of the freak side effect. In any case, nobody would say I’m fat.
Nobody would have said I was fat before I exercised or before I became a vegetarian. And so nobody ever criticized my diet. If I’d had a different metabolism, though, I never would have heard the end of it.
I’ll say what I always say… Nobody has an obligation to be attractive to me and they don’t have an obligation to be attractive to you, either. It’s weird when you complain about people not fitting your image of attractive and I wish you’d stop because that’s really TMI.
There’s no link there.
And I did not say that you should exercise to lose weight. As a matter of fact, I said that the first thing that happens is that you will gain weight, unless you you starve yourself, and starving will of course sabotage the exercise’s benefits.
But I honestly do not understand what some of you are saying. That you can eat, no, gorge yourself, not exercise and not gain weight? Then you are sick. That you can exercise a lot, eat as much as someone who does not, and not lose weight? Then your body is magic.
When I kickboxed, I ate over 3000 calories per day, normally, and I used to eat a cheese cake (a round plastic tray) and a 1/2 gallon container of yogurt in the 24 hours after weight-in, in addition to normal food. The reason that fighters do not get love handles from it is not because there is something magic about their metabolism, but because at that time, their bodies have better things to do with the nutrients than store them as fat.
Just as a body tries to store fat as it is starved, a body tries to repair and build muscle, and NOT store fat, when it is pushed constantly every day. Once again, this is not about “How to lose weight, and then go back to your life”. This is about the theory (which I have never seen reason to disprove) that people who lead a certain lifestyle do not get fat, unless they stop. I am sure we have all seen obese gym teachers, former athletes who stopped exercising without stopping to eat like athletes.
It is a small stretch from there to say that people who assume that life style will see their bodies change to fit… in a reasonable period of time.
But hey, keep saying that fat people are just fat, and that’s it. As someone said, you owe no one to change how you look. I am sure that people will agree that overweight people can be hardworking and motivated just as easily as they agree that short people can be confident and good leaders.
Broken link has been fixed, thanks for pointing that out.
Hey, Barry, I was wondering if you’d heard about this study and what you thought of it: study
This drug does appear to help people lose weight in at least the intermediate term (72 weeks or nearly 1 1/2 years). It’s not clear to me what happens when people stop taking it or if it’s supposed to be a lifelong treatment, but it does open the possibility of actual weight loss.
Probably over-optimistic speculation: If this and similar drugs work out, it might actually decrease fatphobia. Why do I think that? Because of eyeglasses. Prior to laser surgery for vision (and to some degree contacts), wearing glasses was considered a terrible thing: ugly, weak, and generally inferior. There was (bizarrely IMO), some moral blame to it: You don’t eat enough carrots. You read too much. Then came contacts and later laser surgery and people actually could control whether they continued to have visible nearsightedness (I think it works less well for farsightedness, but am not sure). Suddenly, there were fashionable eyeglasses stores everywhere and “four eyes” appears to have largely disappeared as an insult.
So my conclusion is that when a physical characteristic really is under a person’s control, even partly, it is considered less of a moral failing to have it. I guess actual uncontrollable physical issues panic people and they get morally outraged about it whereas if it really is a choice it becomes to some degree a fashion decision? As I said, wild speculation on my part.
I think the most important use of tirzepatide, if studies continue to be good, is going to be its effectiveness at controlling glucose levels in diabetics. It seems to be similar to semaglutide, another relatively new treatment, but more effective. (At the cost of being slightly more likely to cause stomach distress).
So I’m very pro-tirzepatide.
As a weight loss treatment: Even a loss of 20% body mass – which is very high compared to most weight loss treatments – isn’t going to turn a typical obese person into a “normal” weight person. (Someone who weighs 350, if they lose 20%, will weigh 270 – which means they’re still a fat person). And the study you linked to only looked at results after 16 months; in virtually all cases, weight loss treatments are effective at first but not effective when looked at five years out. Maybe tirzepatide will be the exception to that, but I don’t think history gives a lot of reason to be optimistic.
So I think that, before we can say being fat “really is under a person’s control” with tirzepatide, even partly, we’re going to have to wait for long-term studies to be done.
But who knows? Unexpected things do sometimes happen.
I think in a non-fatphobic society, a 15-20% weight loss wouldn’t really matter much. But in our society, if there’s a safe, sustainable way to reliably lose 15-20% of weight, that would probably help some fat people feel better about themselves, and could make life more convenient depending on size (for instance, a person may find it easier to fit in airline seats at 300lb than at 375lb). And of course I want that for them.
A non-fatphobic society would be better, but that may not be an option on the menu. :-(
Despite the eyeglasses example, I’m skeptical that tirzepatide, even if it pans out, would reduce fatphobia. But I’d be happy to be proven wrong.
Both tirzepatide and semaglutide retail at about $12,000 a year, by the way. (Insert “eek” emoji here.)
Sorry, I should have clarified that I was speculating about what would happen if tirzepatide were the first of a series of gradually improving actually effective weight loss drugs. I agree that it by itself is not going to allow people to control their weight to the degree that society demands. Also, long term studies desperately needed before drawing any conclusions.
That being said, I’m standing by my speculation for the case in which tirzepatide both works long term and is the first in a series of breakthroughs regarding fat metabolism and weight. I think that last statement is possible, but not especially likely yet. We’ve been here before with drugs that looked good in (relatively short) clinical trials but didn’t do great in the long run.
Also, it’s apparently pretty amazing in terms of blood sugar control in diabetes, including making some people euglycemic (normal blood sugar), so there’s that regardless of whether it helps with weight loss or not.
I’m going to go further out on a limb and say that if this all comes true (effective and safe weight loss drugs), that might actually also improve health care for thin people. My impression is that thin people tend to get undertreated for things like cholesterol because their doctors look at them and say, “Yeah, your cholesterol (blood pressure, etc) is marginal, but you’re skinny so it’s probably fine.” It’s not probably fine and they start having unnecessary heart attacks, strokes, etc. Yeah, I know this is a minor issue compared to what doctors do if they think you’re overweight or FSM forbid obese, but it does seem to happen. (This is a personal experience anecdote, which can tell you whether something happens, but gives no information at all about how often it happens so all due caution in interpretation.)
A pill that might make people want to not eat as much after exercise.
Nancy, that drug is at this point only tested on mice. It’s a long, long road from mice to having anything that humans can take. And the article has some dubious claims which make me doubt it’s objectivity.
There’s a very very long history of press releases and media saying “look, the magical pill that turns people skinny is coming!” So far, it has never panned out. The drugs turn out to be ineffective in humans, or to have nasty side effects, or to only work temporarily and for less-than-lifechanging amounts of weight, or just never get to the stage of being tested on humans, or some combination thereof.
The miracle weight-loss pill is something people desperately want to see, because of anti-fat ideology and because of the money motivations, so they see it very easily; and publishing bias favors “we found something that worked!” over “we tried this, and it didn’t work” papers.
Without evidence from long-term studies of humans, it’s all garbage.
And it’s distracting garbage. For fat people who are concerned about their health, we know what will work for many: Improved diet, regular exercise, not smoking. But this won’t make most fat people thin, it’ll just make most of us healthier, so that’s not sexy and doesn’t get reported on much. But it’s what we should be paying attention to.
Actually, I was assuming the worst– that it won’t work very well and the side effects will be at least somewhat serious, but I thought, alright, I’ll be accommodating if you want to hear about weight loss drugs. You can believe it or not, but I just was just not up for posting about it being likely to go wrong.
I entirely believe you! I apologize; I’m sorry I misunderstood.
It’s alright. I wasn’t exactly ideally clear.
@Petar I just met up with a friend who is an avid rock climber and hiker (he has a practice wall in his garage, and goes indoor climbing in winter and outdoor climbing in summer as much as he can, but often once a week or more). He rarely eats processed food. He is also indisputably fat. It is great for you that your metabolism allows you to relatively easily balance your caloric intake and your caloric burn rate without spending hours each week carefully planning and measuring your meals and being constantly hungry. That is definitely not the case for everyone. I agree with Dianne. Perhaps fat people feel unwelcome in the clubs you belong to.
I think most of the people who insist that diet and exercise can make a fat person thin without them living in a state of constant semi-starvation with hours per week spent meal planning are like you – your upbringing combined with your genetics left you with an internal set point that allows you to maintain your desired weight (or close to it) with a lifestyle you can live with. Discussing practical, achievable lifestyle goals (walk more, eat more vegetables, smoke and drink less, target 7-8 hours of sleep) without directly discussing weight would be highly beneficial for most people AND improve their health. I am “normal” weight, and my doctor has NEVER discussed my eating habits (though she does ask about exercise, smoking, and drinking).