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Obesity is a disease.

Started by bgmnts, June 17, 2021, 02:58:43 PM

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touchingcloth

Quote from: JamesTC on June 19, 2021, 09:20:08 AM
But where does the energy go? It is either used by the body, converted into fat/muscle or leaves the body as waste. From what I understand, we lose very few calories as waste (unless you are suffering from something like diabetes).

It is also worth noting that average adult male is 25lbs heavier than one in the 70s which would account for around 200 of those calories (heavier bodies need more calories to function). Any exercise/movement would burn more when you are a heavier weight too.

If it's not shitted out, your metabolism can speed up to burn it off through a faster heart rate or a raised body temperature.

pancreas

Would suggest anyone in this situation could consider trying to pull their suet together.

Paul Calf

You don't shit out energy. The stuff you excrete is undigested and is never stored as fat or used in any way by the body. Most of the energy that you lose is exhaled as carbon dioxide; a small proportion is dispelled as heat.

jamiefairlie

Quote from: Paul Calf on June 20, 2021, 10:11:10 AM
You don't shit out energy. The stuff you excrete is undigested and is never stored as fat or used in any way by the body. Most of the energy that you lose is exhaled as carbon dioxide; a small proportion is dispelled as heat.

True but undigested food (such as fibre say) contains potential energy but in a form that is unavailable to the human digestive system.

Video Game Fan 2000

Quote from: Paul Calf on June 20, 2021, 10:11:10 AM
You don't shit out energy.

You've never sat next to me on the National Express

thenoise

Quote from: Poirots BigGarlickyCorpse on June 18, 2021, 09:09:35 AM
But why are we less active? Where did the high fat and sugar convenience food come from? Why do people gravitate towards convenience food?

Look, I was the stereotypical fat person. I did it to myself by eating garbage and washing it down with gallons of sugar-water and I have no excuse for that. But the people I see at my weight-loss class are overwhelmingly working mothers. They have early starts and long commutes and other people in the house to shop and cook for and children who need to be ferried places. They're not just changing their lifestyle, the rest of the family has to adapt too. You're talking about 3+ other people who are used to living a certain way and in many cases are bound by working hours and other people's schedules. "Less cake, more exercise!" is meaningless if you can't find a way to get more exercise and if the people you live with insist on cake.

My weight has crept up since we had little noise two years ago. I kept it in check when I lived alone, despite having no self control whatsoever and a generally unhealthy attitude towards food, by simply only stocking the food i intended to eat according to a written menu each week and not buying things like bread (my weakness) more than a couple of times a month.
Now my two year old eats nothing but beans on toast,pizza and grapes, and the odd omelette (with plenty of cheese of course). I find it really difficult to throw away good food and he only eats tiny portions of course.
We did baby led weaning, all the trendy advice, he is still fussy.

MojoJojo

Quote from: JamesTC on June 19, 2021, 09:20:08 AM
But where does the energy go? It is either used by the body, converted into fat/muscle or leaves the body as waste. From what I understand, we lose very few calories as waste (unless you are suffering from something like diabetes).
Calories in calories out is technically true - the laws of thermodynamics still apply. But it's reductive to the point os uselessness - it's like telling someone who wants to improve their marathon time to run faster.

The body has mechanisms to control calories in calories out. Stuff like hunger and how much it takes to feel full, and how energetic you feel.

An important difference to running a race though is that while there are lots of training plans to run faster that are proven to work, there's no proven method to lose weight.

Another example of the calories in/calories out idea being useless: pregnant women. They don't need to eat more to grow a 7lb baby.

druss

Quote from: flotemysost on June 17, 2021, 11:14:05 PM
Exactly, or pretty much anything that people are convinced "no one used to get offended about until now".

There isn't any logic at all, especially given that you can't tell from looking at a random stranger the circumstances behind their body mass at that particular time. I was bulimic/binge eating for years and no one had a clue I had an eating problem, not my friends or flatmates or anyone, because I wasn't overweight (but not extremely skinny either) - but in the meantime someone else who happened to be bigger, but with a far healthier diet and mindset than mine, might be ridiculed as a gluttonous slob. It's fucked up.

The whole "it's just laziness/stupidity/poor life choices and therefore they don't deserve nice stuff/normal lives/to exist at all" mindset also completely disregards the fact that for lots of people, binge/overeating is often a coping mechanism and it's incredibly common in people who end up being carers (officially or not) in their home environment because, as I saw written once, it's a way of "fucking yourself up without getting fucked up" i.e. it doesn't incapacitate you in the same way that booze or drugs would - and for many it might essentially be a survival tactic. (Not saying every overweight or obese person has a binge eating disorder obviously, but yeah there's a complete unwillingness to see it as a symptom of anything other than feckless selfishness, with none of the pity that's *sometimes* reserved for other mental health issues and coping mechanisms.)

And a you say the abuse that fat people get, especially fat women, is vile. The excuse about "glorifying unhealthy lifestyles" whenever a bigger body is celebrated is fucking bullshit too, otherwise these same people would be up in arms every time someone was pictured with a drink or cigs or whatever. It's almost as if to some people, seeing an overweight person have the sheer audacity to do things supposedly reserved for normal people like exercising, or wearing nice clothes, or having a sex life, is like an affront to their world view and has to be shut down because they can't comprehend it.
Hope you're okay now.

Binge-eating disorder affects the same part of the brain as other addictions like alcoholism. There's still a bit of stigma around alcoholism but thankfully advances in cognitive neuroscience have helped to show that the brain of an alcoholic functions differently to that of a healthy control. So whilst the stigma still exists, there is more understanding than there was 30 years ago.

But binge-eating disorder is even further behind with regard to the stigma, despite the same reward system in the brain being affected. A friend of mine suffered with it and whilst she would put on a bit of weight whenever she relapsed, she was still a relatively skinny girl. After multiple relapses she couldn't cope anymore and took her own life. Obviously not everyone with this disorder will die but the consequences can be every bit as fatal as alcoholism or heroin addiction in extreme cases.

News stories like the one mentioned in the opening post in this thread will inevitably face a bit of a backlash at first but hopefully it is a sign that the times are changing.

Zetetic

If you need to look at meat to decide whether to try to treat someone with compassion, then I think the battle is already lost.

idunnosomename

I've never put on any weight in my entire life.

thugler

Quote from: touchingcloth on June 17, 2021, 05:03:28 PM
It's a shame that metabolism is so poorly understood as possibly the main factor in obesity, when intuitively everyone must know that there's more to the equation than calories in versus calories out. Most people probably know skinny alcoholics, when if they were processing all of the energy in their booze they'd be the size of houses.

There is a mechanism in terms of alcohol where heavy drinkers do not process all the calories in booze as a normal person would I believe. Still while it's not all there is to it, the idea that calories in/calories out is the main part of the equation is absolutely true. Noones body is magically getting larger or smaller by itself without the means to do so. Water weight fluctuates massively though so the scale is not always very helpful except over a longer period of time. Obviously food, and particularly sweet/fatty/salty food is incredibly addictive and hard for people to cut back on or quit. People also routinely unintentionally misreport how much they are eating as well, so that's another reason why people don't really believe the calories in/out thing. 

Quote from: purlieu on June 17, 2021, 05:34:23 PM
I eat fewer calories now than I did in my teens and twenties, and exercise more. I used to be between 8 and 10 stone, since my early 30s I started piling weight on, hit 14 and a half last year. It's frustrating, because I used to be able to have cereal for breakfast, sandwich and crisps for lunch, something with chips or a massive plate of pasta for dinner, and spend half my days being sat at the computer or watching TV and stayed so skinny that I was sometimes asked if I'd considered I might have an eating disorder, and frequently told I "need to eat more". These days I mostly tend to eat salads, soups, stir fries and other veg-based low-carb meals, walk my dog for an hour and a half and do a couple of hours on the exercise bike a day, yet I can barely shift the weight at all. My partner thought it might be related to the medication I was on, but since coming off it's had no effect at all. What's going on there then?

Your metabolism has slowed down certainly. Still it's almost certain that you're taking in too many calories compared to what you burn. It's impossible for you to have piled stones of weight on without the fuel for your body to do that, stuff like medication etc. may have helped but that's fundamentally it. Your carb intake isn't especially relevant, it's the calories that matter.

I have basically the opposite story, I was pretty chubby in my teens and up until my mid 20's, lost a bunch of weight and have pretty much stayed the same weight for many years now despite my metabolism probably slowing down a bit by this point (35). I don't do tons of exercise either. When I lost weight initially I did a bit of calorie counting and found it a very accurate predictor of the weight loss I would end up with each month, but now it's largely instinctive based on knowing roughly the content of various foods. Muscle mass helps your body burn more calories at rest too so it's worth trying to do a bit of strength based exercise rather than just cardio, since your body will get used to the cardio anyway.

JamesTC

Quote from: MojoJojo on June 21, 2021, 07:59:51 AM

The body has mechanisms to control calories in calories out. Stuff like hunger and how much it takes to feel full, and how energetic you feel.

Weight loss isn't easy. Very few people would say it is. Feeling hungry is a normal part of weight loss. You aren't going to burn excess fat off your body without leaving your body at a calorie deficit.

What I've found on my weight loss journey is that energy can be as much about nutrition as it can calories. Eating more calories doesn't always mean I can run further.

I think much of the problem with CICO is it often doesn't always being immediate results. You can sometimes put on weight when you start as there is more to weight than just fat. Water retention plays a huge part in weight. Your body retains water when it isn't getting enough.

I firmly believe that if you eat lower calories than your body requires then you will lose weight long term. Variables come into play in the short term but they will not matter over time. This is when measuring weight daily can be a problem. Believe me, I know as much as anybody how hard it is to get out of the mindset of short termism. I've been doing this weight loss for nearly a year and a half and I am still perilously stuck in it.

People need to find The diet that works for them and there isn't a single answer to diet success. But CICO is nearly always going to be the starting point of a successful diet. A body that currently uses 2700 calories will not suddenly adapt to 2200 calories a day and remain at the same weight.

touchingcloth

Quote from: thugler on June 21, 2021, 10:48:06 AM
Noones body is magically getting larger or smaller by itself without the means to do so. Water weight fluctuates massively though so the scale is not always very helpful except over a longer period of time. Obviously food, and particularly sweet/fatty/salty food is incredibly addictive and hard for people to cut back on or quit. People also routinely unintentionally misreport how much they are eating as well, so that's another reason why people don't really believe the calories in/out thing.

The evolved response to a famine is to adjust things like appetite and metabolism to help you conserve energy and increase stores of fat, but at the subconscious level there's no difference to your body between a true famine and a weight loss diet, so there's a bit of a vicious cycle where if you've ever been overweight, your body works really hard to prevent you from getting back to a healthy weight.

Quote from: JamesTC on June 21, 2021, 10:58:07 AM
People need to find The diet that works for them and there isn't a single answer to diet success. But CICO is nearly always going to be the starting point of a successful diet. A body that currently uses 2700 calories will not suddenly adapt to 2200 calories a day and remain at the same weight.

That, basically. Your body needs to learn to adjust to a new baseline weight, which takes an incredibly long time, and longer still if you were previously extremely heavy. Beyond a certain point of obesity, my understanding is that it's basically impossible to shift the weight long term without bariatric surgery, because the hunger response is so incredibly strong that even with things like jaw wiring people will resort to drinking melted ice cream through a straw. Well, I suppose one alternative to surgery is imprisonment.

thugler

Quote from: touchingcloth on June 21, 2021, 11:31:08 AM
Your body needs to learn to adjust to a new baseline weight, which takes an incredibly long time, and longer still if you were previously extremely heavy. Beyond a certain point of obesity, my understanding is that it's basically impossible to shift the weight long term without bariatric surgery, because the hunger response is so incredibly strong that even with things like jaw wiring people will resort to drinking melted ice cream through a straw. Well, I suppose one alternative to surgery is imprisonment.

Only anecdotal, but from my own personal experience, I do find eating tons of low calorie food a good way of feeling incredibly full while cutting back on calories significantly overall. Being mostly vegan helps. I don't doubt that it's seriously difficult beyond a certain point though. With the morbidly obese people that get to the point where they are stuck in a bed barely able to move though, I do tend to blame the people who have been bringing them masses of food every day.

madhair60

i'm well fat, wish i wasn't, clearly starting to affect my health. ah well, grave

popcorn

Quote from: madhair60 on June 21, 2021, 11:43:27 AM
i'm well fat, wish i wasn't, clearly starting to affect my health. ah well, grave

Get a calorie counting app and try it just for a week. Weigh yourself each morning and write down the weight changes. No big commitment, just an experiment. After a week see how you feel about it. Good luck mate, if you want to change it can be done.

madhair60

thanks popcorn. i'm sorry for being a bad poster almost all the time

JamesTC

Quote from: popcorn on June 21, 2021, 11:48:03 AM
Get a calorie counting app and try it just for a week. Weigh yourself each morning and write down the weight changes. No big commitment, just an experiment. After a week see how you feel about it. Good luck mate, if you want to change it can be done.

Honestly that is how it started for me. I read about CICO and just thought I would give it a go keeping a diary and monitoring lower calorie intake just to see if I could stick to it and make it work.

Previous to that my weight loss attempts were all half hearted and pathetic. As if adding fruit and veg on top of the shite I already ate was going to make any difference.

MojoJojo

Quote from: JamesTC on June 21, 2021, 10:58:07 AM
Weight loss isn't easy. Very few people would say it is. Feeling hungry is a normal part of weight loss. You aren't going to burn excess fat off your body without leaving your body at a calorie deficit.

I think a diet that means you are spending a lot of time hungry is not sustainable long term. There is only so long that people can willingly put themselves in discomfort.

Quote
I firmly believe that if you eat lower calories than your body requires then you will lose weight long term.
I don't think anyone is disagreeing with that.
Quote
People need to find The diet that works for them and there isn't a single answer to diet success. But CICO is nearly always going to be the starting point of a successful diet. A body that currently uses 2700 calories will not suddenly adapt to 2200 calories a day and remain at the same weight.
I definitely agree that people do have to find what works for them, and that the biggest problem with the diet industry is that they are all one size fits all. I don't really think CICO is a useful starting point, beyond the very broadest aspects of it. Being hungry all the time is not sustainable.

popcorn

Quote from: JamesTC on June 21, 2021, 11:59:32 AM
Honestly that is how it started for me. I read about CICO and just thought I would give it a go keeping a diary and monitoring lower calorie intake just to see if I could stick to it and make it work.

Previous to that my weight loss attempts were all half hearted and pathetic. As if adding fruit and veg on top of the shite I already ate was going to make any difference.

Said this in the COVID-fitness thread but I am a huge believer in the difference data makes. As soon as you start actually tracking things consistently (calories, weight, max lifting weight, the distance you can run in 5 minutes, whatever the fuck it is you're trying to improve) - instead of just having a vague reckon all the time - everything starts to make sense.

popcorn

Quote from: MojoJojo on June 21, 2021, 11:59:57 AM
I don't really think CICO is a useful starting point, beyond the very broadest aspects of it. Being hungry all the time is not sustainable.

Been doing CICO for 4 months now and the most surprising thing is that I'm not hungry all the time. It has only required me to just be more conscious and strategic about what I eat and when. (I won't lie, I do sometimes go to bed feeling I could do with a sandwich, but not often.)

touchingcloth

#81
I've yo-yoed on CICO-type diets for years. I've lost 10KG since New Year this year, and it feels like it's a long term manageable thing this time rather than just a crash diet. Part of my success this time around has been codifying my eating habits, specifically fasting until I eat lunch (usually 2PM, a small bowl of oats with yoghurt), avoiding snacking, and avoiding most refined sugars in the form of bread and pasta. Beyond that I haven't really changed what I eat, it's just changing the quantity of what I eat from reducing the number of times I eat each day, and keeping an eye on portions when I do eat. Pasta in particular was always my Achilles' heel, because I will eat it until there's none left or I'm physically incapable of fitting more into my stomach. It flips some kind of mental switch and any sense of satiety is replaced with the impulse to just scoff and scoff and scoff and scoff.

Quote from: popcorn on June 21, 2021, 12:07:12 PM
Been doing CICO for 4 months now and the most surprising thing is that I'm not hungry all the time. It has only required me to just be more conscious and strategic about what I eat and when. (I won't lie, I do sometimes go to bed feeling I could do with a sandwich, but not often.)

Whenever I diet I find the hunger pangs only last a couple of weeks, and then you just adjust and any snacking you do becomes habitual more than necessary. Skipping breakfast or morning snacks helps in my case I think, because cereals, toast, crisps and chocolate all cause a blood sugar spike which leads to cravings when the levels crash.

Kankurette

Is exercise really completely useless? Does it help at all?

JamesTC

Quote from: Kankurette on June 21, 2021, 12:10:08 PM
Is exercise really completely useless? Does it help at all?

It helps but diet should come first when losing weight.

It isn't a firm rule to live by but the mantra of diet for weight loss and exercise for fitness is a good one, I find.

Between January and May I tried to outrun a stress induced bad diet and in the end I was just lying to myself over how it was working. I've lowered my mileage but lowered my calorie intake and am back on track losing weight.


Sebastian Cobb

Quote from: Kankurette on June 21, 2021, 12:10:08 PM
Is exercise really completely useless? Does it help at all?

Exercise gives you energy but you need energy to exercise so at the very least it's a pyramid scheme.

MojoJojo

Quote from: Kankurette on June 21, 2021, 12:10:08 PM
Is exercise really completely useless? Does it help at all?

Well, you have to do a lot. A pound of fat is 3500 calories. A half hour run burns around 500 calories. So if you start running for half an hour 7 days a week you should start losing a pound a week. For most people, it's easier to tackle the input side. You've probably heard the phrase "you can't run away from a bad diet".

That said, when I was doing a 1200 calories a day diet, going for a run and having a few hundred extra calories at dinner really helped make it less of a burden.

touchingcloth

Quote from: Kankurette on June 21, 2021, 12:10:08 PM
Is exercise really completely useless? Does it help at all?

It helps. It can help build muscle, which requires more energy than fat to maintain and so a more muscular person will burn more energy while not moving. It's definitely not the sole solution, though, as the energy requirements of just being alive account for most of what you burn off in a day. Doing something like running "only" uses between 100 and 150 calories a mile, so if you eat 2,000 calories and run a mile every day, the running accounts for less than 10% of the energy you eat.

Blue Jam

Quote from: touchingcloth on June 18, 2021, 02:12:30 AM
There's not an hour that goes by when I'm not thinking about what the next thing to go into my mouth will be, shortly followed by thinking what a disgusting worm I am for daring to have such thoughts.

This is the problem I had too. I was just always hungry no matter what even though I felt like I was doing everything right- eating lots of protein, drinking protein shakes, and getting lots of fibre in the form of fruit smoothies which I made from scratch, with oats and oat milk added. Lots of satiating fibre and protein and grains in there and yet I'd still end up feeling hungry and reaching for a bit of chocolate or a biscuit. I tried drinking more water to see if I was just mistaking hunger for thirst, and that did absolutely nothing. I also realised I wasn't doing emotional eating, I genuinely was just very hungry.

About six weeks back I had a check-up for my asthma and mentioned that I'd just taken up running with the primary goal being improving my lung function, but that I'd like to lose some weight as well and for some reason was really struggling with it. The asthma nurse told me that the practice had just taken on a new GP who was also a qualified dietician and a practitioner-academic who did research into diet and weight loss.

I booked an appointment and had a nice long nerdy chat with him, and he told me that while protein and fibre are the way to go, having them in a liquid form which makes them very easy to digest is just going to leave me feeling hungry again shortly afterwards. And that it's actually possible to get a blood sugar spike from eating lots of protein!

The solution then: Don't put the fruit and oats in the blender, put them in a bowl and have them as muesli instead. Eat less protein, because humans don't really need that much, and try and fill the plate with veg instead.  Don't have mash, have small boiled potatoes with the skins on. Hell, even a cheese sandwich is good if you have it on wholegrain rye bread, and have dark chocolate because that's satisfying in smaller amounts. Basically: eat mostly whole foods, nothing highly processed.

Been losing weight gradually ever since, been a bit frightened of weighing myself but I just checked and I've lost 2kg so far. Also my clothes feel looser. And I mainly put this down to having muesli for breakfast and then not craving anything for hours afterwards, or having cheese with wholegrain bread. The dietician suggested that I snack on dark chocolate or apples but I've hardly been craving snacks at all.

This approach won't work for everyone of course- an emotional eater or a binge eater for example would get different advice- but I would recommend getting a referral to a dietician and trying to identify what your specific problem is and what you can do about it.

The other thing is to examine habits. As the GP explained to me, an individual's behaviour is essentially a bundle of habits. Everything from brushing your teeth every morning to all the little things you need to do to drive a car, we learn to do these things automatically and that's because we essentially develop a habit. This is very handy because it makes life a lot easier by removing the need to think about every single action before we do it, but it also makes it easy to develop unhealthy behaviour patterns. If you can identify a habit loop and how it works, you're a little closer to knowing how to break it, or to replace it with another one.

I have realised that my own habit loop developed last year when I was on Venlafaxine (nasty nasty drug, should be banned) and it made me feel hungry and tired all the time. When you're very hungry, but also tired, it's very tempting to grab something that will give you a nice instant blood sugar spike without having to put any work into it like cooking or baking. Basically my habit loop was:

Trigger: Hunger
Action: Eat something sugary and processed
Reward: Very quickly no longer hungry

For someone else it could be

Trigger: Stress
Action: Drink booze
Reward: No more stress

or:

Trigger: Anxiety
Action: Bite nails
Reward: Calmness

etc. This also explains how addiction displacement works, you find a new action which leads to the same reward, such as going for a run or eating olives instead of smoking crack. For me I had to identify the trigger and try to stop it going off so much.

This is all in the book my GP also recommended, The Power of Habit by Charles Duhigg, which turned out to be a fascinating and very helpful read:

https://www.amazon.co.uk/Power-Habit-Why-What-Change/dp/1847946240/

It describes understanding of the habit loop when applied to everything from Alcoholics Anonymous and problem gambling, to sports coaching and business success- as our behaviour is largely a collection of habits, this thinking can be applied to almost anything.

Unfortunately even this isn't foolproof as a treatment approach because humans are just too complex and unpredictable, and understanding a habit won't necessarily help to break it, but for many it's a useful starting point.

purlieu

Quote from: thugler on June 21, 2021, 10:48:06 AM
Your metabolism has slowed down certainly. Still it's almost certain that you're taking in too many calories compared to what you burn. It's impossible for you to have piled stones of weight on without the fuel for your body to do that, stuff like medication etc. may have helped but that's fundamentally it.
While obviously true, I'm struggling to get my head around it when my exercise bike says I've burned off 2000 calories, I've been for a 90 minute walk, and all I've eaten is a bowl of soup and a salad and my weight hasn't changed (obviously over a few days). It's like my metabolism has slowed to an absolute crawl. I'm just baffled by it, honestly.

Blue Jam

Quote from: Pijlstaart on June 18, 2021, 02:41:33 AM
In a rare moment of sincerity, I'm glad to see the ideas discussed in the article may be slowly permeating the mainstream. I've been running a side project on metabolism and I have a fair few disease models where food consumption and activity levels don't correlate in the way the CICO brigade would expect with lipid stores, in these mutants dietary intervention doesn't do much unless pushed to extremes, genetic manipulation at key metabolic chokepoints can be ineffectual too, can even have the opposite effect on mutants as it does in controls, it really is amazing how stubborn metabolic homeostasis can be and how many workarounds it has. Loads of interesting stuff to be unpicked, but if I'm struggling to modify fat stores in these animals in controlled conditions, what hope for us on the side of the cage where the turkey twizzlers are?

Are you my new boss, Pijlstaart? Arrrrggghhhh ;)

Seriously, I start a new job in July and will be researching obesity and type 2 diabetes myself. I'll be mainly processing tissue samples to see if I can identify any differences between protein-RNA interactions in wild type tissue and tissue from individuals who seem more prone to weight gain. Might have to try and analyse my own tissue while I'm at it.