> "what if the obesity epidemic has nothing to do with calories in vs calories out, and actually there is some toxin which the body has to sequester in subcutaneous fat and that's why everyone's getting obese"
Everyone loses weight on a caloric deficit. And "doubly labeled water" experiments show that people vastly underestimate how many calories they actually eat each day.
In a test of people who believed themselves to be diet resistant, every single subject lied about how much they ate when asked to self report.
> The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis.
I think this means that obese people have something wrong where they are prevented from accurately gauging portion sizes. I’m not talking like they’re stupid. I’m talking like something is wrong with their bodies and the inner satiety mechanism is broken. Counting calories sounds insane to me as a thin person. I’m not counting the calories of a fucking croissant I had for breakfast today, I just know I really preferred a lighter lunch! And I don’t gain noticeable weight without giving a crap about it, just eating what my body says fulfills me keeps me at healthy weight.
In my opinion the fact ozempic, which has nothing to do with calorie consumption or calorie counting but instead is a hormone working on satiety, tells me somethings wrong with the hormones of fat people. And I wouldn’t begrudge a fat person they’re overeating any more than I would begrudge a hyperthyroidic person their thinness!
When asked to objectively measure their food and keep a log, fat people will lie about it, as revealed in "doubly labeled water" studies. Read the study I linked.
Yes, something is sick with fat people that’s causing them to do that. Anorexic people exaggerate how fat they are and how much (how little) they eat, and that’s clearly some kind of illness that needs medical intervention and medication as needed to get them proper. Same for fat people, I think fat people have something wrong with them where the whole process of eat food -> feel sated is off. If everything I ate felt like half the portion is actually was I’d also be totally fucked up in how I understood my portion sizes too and would probably inadvertently lie on “objective” measures too!
Like I don’t know how much a portion of chicken is. But damn if I ate a chicken leg, and I feel like I ate nothing, I’d be sorely tempted to argue I didn’t have a full portion of protein… because it doesn’t feel like I did, in my body. I think that’s what’s happening to fat people. Otherwise drugs like ozempic wouldn’t be working like they do— the fat person doesn’t become suddenly honest on some dumb journal and suddenly the pounds come off! They just actually feel full when they should like normal people for once so their bodies are getting to normal people sizes.
> I think fat people have something wrong with them where the whole process of eat food -> feel sated is off.
This isn't something that's wrong with fat people, it's something wrong with the food environment they're in. 75 years ago your idea would have some intrinsic plausibility, as only a very small number of people had obesity. Now, in the United States, we're at a point where ~40% of adults have obesity. The explanation almost certainly lies with changes in the food environment, instead of with a huge portion of people catching an unknown disease that causes them to not know how much they're eating.
That's because in fact we do know about changes to food environment that could cause this. Since roughly the 1970s we've switched to foods that are more calorie-dense and less nutritious because they have become cheaper to produce. The relative cost of soft drinks and other sugary goods has increased much less than the cost of fresh vegetables, and in fact the industry has higher profits on these foods. I bought two liters of sugary soda for $1 the other day, that's a common offer at a grocery store near me.
If you drill down to how this is being accomplished, you'll notice that the rates of corn and soy production per person have vastly increased over the last 50 years. That's not because people are eating more tofu (which would be healthy), it's because (a) they're both used as additives or sweeteners (corn syrup), and (b) they're used as feed for animals who get turned into cheap meat at fast food restaurants. The US heavily subsidizes these crops - in fact they make up close to half of US farm land. As a result, the same (genetic) individual would almost certainly experience a much worse food environment today than in 1960.
People who aren't affected by this are those who are either (a) genetically blessed, and would hardly gain weight in any environment, or (b) are socially blessed, in that they are wealthier, live in places with a strong culture of exercise, and/or have easy access to nutritious fresh vegetables.
> People who aren't affected by this are those who are either (a) genetically blessed, and would hardly gain weight in any environment, or (b) are socially blessed, in that they are wealthier, live in places with a strong culture of exercise, and/or have easy access to nutritious fresh vegetables.
or c) are disciplined enough to count their calories and stopping when they hit 2,000 kCal/day or so.
Yeah, that obviously works for a small number of people. I'm talking about the large scale demographic changes though - they're clearly the result of changes in food availability in one's environment. In an environment like that seen in most of America, the majority of people are going to be fat. You don't solve that problem by emphasizing personal responsibility, even if it can in theory work for some individuals.
The actual Slime Mold Time Mold analysis is more nuanced than the previous characterization. Yes, you'll lose weight if you run a caloric deficit; the SMTM argument is that something is messing with what they call the "lipostat", which regulates how much your body thinks you should be eating. So when your body is yelling at you that you're starving (even though you aren't), it's very hard not to overeat, because hunger is right there at the bottom of the Maslow pyramid and it takes inordinate willpower to consistently ignore it.
For some real life examples see the "Secret Eaters" TV series. When people claim that they gain weight despite not eating much they are lying or delusional.
"You know, if we starve people, they lose weight. Obviously it's just self control."
"Yeah. Weird. Well, guess I'll go have a donut or whatever and think it over. It's a mystery why they aren't just thin like us, must be a personal failing."
Most people do not count calories and calorie counts aren’t accurate anyway. The people sitting around counting calories because they have to are afflicted with the same thing that obese people are, they’re just putting in. A bunch of effort to manage it (or more likely actually aren’t).
The issue you are missing is that the real question is not “can we create a totally artificial situation where one of the outcomes is managed” but instead “why isn’t the system that manages this in healthy people working?”
In the counting calories example, it’s like saying the answer to diabetes is an insulin pump. People who d think this way are missing the point and basically are engaging in the shallowest of thought.
Just to be clear, I am trained as a physicist and I am not criticizing the thermodynamics as incorrect but rather insufficient.
It is also incorrect, which is to say that there is only a vague relationship between the kilocalories reported on the side of the box and the actual marginal energy absorbed into your body. This is due to multiple factors. The most basic is measurement methodology: “count up the carbs in grams and multiply by 4 because this one ancient paper claimed that was the right fudge factor to average all carbohydrates with”; then there is the reality that the carbs described as “dietary fiber” on the label should never have been counted in the first place; add to this that the fudge factor for protein is also 4 kcal/gr even though it is known that proteins require twice the energy input from your body to be metabolized. If you're a physicist you're hoping for very clean simple measurements, “we put this into a calorimeter and burned it, or maybe we let some bacteria rot the thing in a sealed jar and monitored the oxygen in there” or something. The nutrition facts are nothing of the sort! (Related: the scale llliiieeesss, it lies, liar liar pants on fire how it lies.)
However the bigger problem is that it is insufficient. For instance if you are worried about health outcomes, like diabetes risks, it turns out that calories in minus calories out doesn't predict those well. Both Omega-3 fats and trans fats are given the same fudge factor of 9 kcal/gr, but one is significantly less healthy than the other.
It's not even terribly helpful to understand the full context of weight gain. Did you know that before our species grew up in Africa, our ape ancestors actually grew up in Europe? During this process they lost the ability to make an enzyme called uricase, which helps most other mammals eliminate a waste product called uric acid from the body. The loss of this enzyme is usually chalked up to, “those apes needed to put on a lot of weight really fast at harvest time before the winter came up”—google «uricase evolution» to learn more. So we actually have a hardwired tendency which most mammals do not have, to consume fructose and not consciously register those kilocalories as satiety signal, and instead we pack on those kilocalories as fat because of our artificially high uric acid levels. Wild stuff.
The physics curriculum does touch on this but in a strange place: it's the courses where we teach kids to analyze circuits made with nonlinear components like op-amps and transistors. So there's the thermodynamic fact of calories in, calories out... but it also comes with a sales pitch which is trying to provide a simple answer that would work for a linear system, “just perturb this input a little bit and you will get the corresponding output.” But nonlinear systems don't work that way!
The thing about CICO is that it's not a very good scientific model for obesity because it says nothing about hunger or satiety, but tracking calories is useful for ordinary people looking to control their food intake, so it sticks around.
CICO doesn't have any opinion on the relative satiation offered by sugars vs proteins, or bread vs potatoes, but it turns one's diet into a marketplace for satiation, which does teach which foods are the best "value" per kcal (even if a kcal is itself very inaccurate).
Maybe we'll see it as a dated but situationally valid tool, like leeches or "Red sky at night, shepard's delight".
Yeah I am inclined to agree. The “calorie counting fad diet,” such as it is, is like other fad diets where it does have good short-term results, and it can have good long-term results for the people who really stick with it: as you say, you can get a sense for a healthier rhythm.
But remember this was a thread about a game where you think about these “K factors” that make us laugh at history, and imagining ourselves being laughed at and what sort of K-factor could that be. When I play this game, it's not really truthfinding, it's fun because it's kind of a constructive way to direct a conspiracy-theory impulse that wants to deny a mainstream view by latching on to all of these little details. By declaring myself as the sheeple up-front, the end place is always Socrates’ “well, at least I know that I don't know!”
In that vein, it is fun to think about SMTM’s thesis or, say, K=“obese people literally have a hormonal imbalance H which makes them feel like shit, and them feeling like shit is why they eat and don't exercise, and these people in the past just thought they would cure the problem by making obese people feel EVEN MORE like shit and the less it worked the more goofy shit they tried!”
It's not that this is something I know to be correct, it's not. But if this became the mainstream scientific view 100 years down the line, they would laugh at me trying to do a smoothie cleanse and drinking kale-ginger-cinnamon grossness, “they didn't know that they just needed more lycopene hahaha that green glass is the wrong color!!” and it's fun to imagine yourself as ridiculous. “Well shit, my conspiratorial instincts have generated an alternative explanation to my preferred one and I don't know what is true, haha, see me walking around like some smarty pants knowing nothing.”
Everyone loses weight on a caloric deficit. And "doubly labeled water" experiments show that people vastly underestimate how many calories they actually eat each day.
See this often cited paper: https://www.nejm.org/doi/full/10.1056/NEJM199212313272701
In a test of people who believed themselves to be diet resistant, every single subject lied about how much they ate when asked to self report.
> The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis.