Speaking of Fat People: The National Association to Advance FAT Acceptance(NAAFA).

[Dantheman]

Doesn't need to be "deep-seated", could just be fear/anxiety from current life events (divorce, death of a loved one, illness, etc) because eating is an escape and feels good. That was me when I did chemo, and for about a year after. I ate food because it felt good, when I was otherwise depressed/scared/anxious. It was my non-selective serotonin reuptake inhibitor, so to speak. That's my N=1.

Food is indeed, a highly psychological experience. I'm not sure how you sort that out in a 20 minute appointment in primary care, easier to just prescribe Ozempic and hope for the best. Cynical, but true.

I didn't mean to imply that it's not also true acutely. But, every person on the show that wasn't eliminated early had a psychological breakdown at some point. When it happened it usually became pretty clear that there were some serious issues that had been crushing their sense of self-worth for many, many years. No, you definitely cannot address those issues in a 20 minute PCP visit.

It also demonstrated that regular people can lose an incredible amount of weight very quickly in very controlled (I'm not going to say safe) conditions, but probably also demonstrated how unsustainable maintaining that reduced weight is for a very large percentage of those same people. I guess at least they made some cursory attempt to get the contestants to demonstrate they could maintain their "new" lifestyle outside the perfectly controlled conditions.

Yes, losing weight very fast in an inpatient setting completely divorced from your normal everyday life is very unlikely to work out long-term.

That kind of hot take gets said here so often it’s pretty much a cliche not an insight. Let’s assume you’re an outdoor athlete…is it likely that someone in your family or social group has struggled with obesity? The takeaway I get from the ‘diet & exercise’ posts is more along the lines of ‘what tools help people get at least started on the journey toward healthier diet and more active lifestyle?’ I don’t think anyone with 2 brain cells thinks it’s easy. That doesn’t change the fact that it is a worthwhile goal.

Methods are many, concepts are few.

In our world of unimaginable abundance you have to restrict something and there are numerous tactics and strategies available that are going to work better for some individuals than others. Unfortunately the choices also can be overwhelming and confusing, so it's easy for people to get seduced by charlatans and proselytizers who claim to have found the one true path.

[halliday]

This drives me crazy - whether it’s ozempic/obesity or covid vaccines or whatever - people appear to be viewing their anecdotal observations/experience as robust evidence of how things work at a population level and then making broad statements from that.

I comment on my experiences. These things happen in my home with somebody that Im married to and care a great deal about. It's tough to watch this happen to a once proud kick ass lady who was always willing to throw down while skiing or biking. You need to pull your head out of your ass.

[bennymac]

And you need to reread what I said until you actually understand it.

I never once discounted your experience.

I did criticize how you use that valid experience to make sweeping generalizations about how it must be for everyone.

“people appear to be viewing their anecdotal observations/experience as robust evidence of how things work at a population level and then making broad statements from that”

You ran a study with an N of 1. And therefore your conclusions about how the world works are not backed by strong evidence.

[halliday]

And you need to reread what I said until you actually understand it.

I never once discounted your experience.

I did criticize how you use that valid experience to make sweeping generalizations about how it must be for everyone.

“people appear to be viewing their anecdotal observations/experience as robust evidence of how things work at a population level and then making broad statements from that”

You ran a study with an N of 1. And therefore your conclusions about how the world works are not backed by strong evidence.

The world is full of obese people and I wish it was not that way. My major concern and point of observation is what goes on in my home. I really don't care about what every obese woman, who I see driving down the road stuffing Chick Fil-a into her mouth, does or does not do to take care of herself. I also don't care to generalize and make sweeping statements about what happens on a population wide basis. Maybe it seemed like I did? I didn't mean to. It's a tough thing to watch this happen up close.

[californiagrown]

So the alcoholics and depressed folks need to seek help for their condition, but the obese people should just stop eating and exercise more. Lulz.



Strawman. I haven't seen anyone here say that.

Yes an obese person needs to stop ingesting excess calories. And the alcoholic needs to stop drinking alcohol excessively. Fundamentally, that is what needs to happen. Is it not? How a person achieves those basic fundamentals, what strategies are best for them, etc are where it gets complicated.

All i ever said, for which i was ignorantly shouted down, was that calories-in vs calories-out determines whether a person gains, loses or maintains weight. And that is a fact that for some reason is hard for people to swallow (pun intended).


No one ever got sober without wanting it badly. Like as bad as life itself. And drug addicts live life on a knifes edge where a single high blows up years of sacrifice and anguish. To equate that experience and struggle to that of a fatty who just needs to be "sober"(with food) 80% of the time, and go for a 15 minute walk everyday is asinine, IMO. And yes, Bennymac did directly equate the two conditions.

[bennymac]

Thanks for revealing that you struggle with any degree of nuance or any situation that can’t be boiled down to a binary.

Saves me a lot of time and typing.

[Cisco Kid]

So, an Engineer, a Bariatric MD and a Rabbi walk into a bar.................

[Trackhead]

I didn't mean to imply that it's not also true acutely. But, every person on the show that wasn't eliminated early had a psychological breakdown at some point. When it happened it usually became pretty clear that there were some serious issues that had been crushing their sense of self-worth for many, many years. No, you definitely cannot address those issues in a 20 minute PCP visit.



.

I know you fully get it. Was just pointing out my personal nuance with food. Some lose weight with acute stress/grief, others do what I did, and eat like a gluttonous pig.

[fastfred]

You turd eaters can argue all kinds of bullshit all day for or against

As a professional eater and drinker myself this is why fat fucks are fat

Question 1

A donut is in front of you and a whole apple what do you choose?

Question 2

A soda or a glass of water is your next choice

Question 3

A bean and rice burrito with a few tiny pieces of meat or a burger from a fast food joints

Trg posters all being above average at everything in life know the right choices the average out of breath waddling prefer the drive through american that makes ip 90% of the population will choose

[dan_pdx]

I have what is probably a mild eating disorder where I freak the fuck out if I go over 160 lbs, but I think it serves me well. It's all in how you look at things, right?

As in everything in American society today, I think your family makes a huge difference in your outcomes. If you grew up on a diet of ultra processed foods, seeing all the adults around you being overweight, I think it's hard to flip that switch because you think that's normal. I have a buddy who just straight up didn't eat salads until his forties because it kind of didn't occur to him, the same way it doesn't occur to me to have Pop-Tarts for breakfast.

[The AD]

As in everything in American society today, I think your family makes a huge difference in your outcomes. If you grew up on a diet of ultra processed foods, seeing all the adults around you being overweight, I think it's hard to flip that switch because you think that's normal.

Not just those in your family, but I think where you live is a bit of a factor, too. There are plenty of places in this country where the majority of the people you encounter are clearly obese and I think people start thinking that's the norm. 250 lbs starts being the new 200.

[bennymac]

The world is full of obese people and I wish it was not that way. My major concern and point of observation is what goes on in my home. I really don't care about what every obese woman, who I see driving down the road stuffing Chick Fil-a into her mouth, does or does not do to take care of herself. I also don't care to generalize and make sweeping statements about what happens on a population wide basis. Maybe it seemed like I did? I didn't mean to. It's a tough thing to watch this happen up close.

I hear you. I hear your frustration and I’d feel exactly the same way in your shoes.

I know people who are on Ozempic who are very interested in doing everything they can to improve their health - including exercising, diet changes, and becoming educated about obesity.

Yes me saying that is anecdotal - but I’m not using my narrow experience to then say “all people on ozempic are motivated to learn and do everything they can to improve their health”

Nor in turn can you say “People who take ozempic and zepbound rarely figure out what the root cause of their obesity is. They never educated themselves nor do they want to.” based solely off your personal experience

You can say that if you provide evidence that this has been shown in studies.

[topwater]

There are countless studies reflecting American caloric intake trends increasing over the past 50-75 years coupled with modernization of society, increased processed/calorically dense foods. The obesity epidemic is pretty easy to understand the root cause.

Weight loss is fundamentally challenging and against primitive survival instincts where eating everything in site meant the ability to survive long stretches without food. We don’t have that problem anymore and will never evolve past it. Not to mention we walk to the pantry to “forage” or “hunt”.

One of the best takes in this entire thread. As someone who has lost over 100 pounds and kept it off for decades I know I am in the minority when it comes to obese people trying to lose weight.

Evolution made us fat storage machines for when winter comes and there's less food. We now live in a world with hyper-caloric food absolutely everywhere. Food companies intentionally create processed food to trigger our dopamine receptors and most severely obese people are quite frankly addicted to the way food makes them feel.

The data shows that it's easier to kick heroine than for an obese person to have long term success keeping weight off. First, you can remove yourself from drugs and alcohol if you have a problem with those substances but if food is your thing you cannot stop eating. You can eat healthier but you are still surrounded every day by processed food. If you work in an office people bring in shit food for everyone all the time. Visiting family for the holidays... good luck avoiding the social stigma of trying to eat healthy. A get together with friends at a restaurant.... hopefully they'll pick a place with some healthy options but get ready for the ridicule and jokes directed at you. Food culture is everywhere, and to avoid it you have to give up a bunch to stay healthy if you struggle with food addiction. I wish I could eat hyper-caloric food in moderation but it just doesn't work for me.

I wish it was easier for people to be healthy but until the culture around food changes that isn't going to happen. I think Ozempic and drugs like them will have long term health effects for many but the health benefits of just losing weight may offset that. It's not the world I wish, but it's the world that exists.

[bennymac]

GLP-1 receptor agonist medications have been on the market for close to 20 years.

That doesn’t mean there is zero chance of any issues with long term use - but these are not new drugs.

And the well known long term issues with chronic obesity is the flip side of that risk vs benefit equation.

[Trackhead]

GLP-1 receptor agonist medications have been on the market for close to 20 years.

That doesn’t mean there is zero chance of any issues with long term use - but these are not new drugs.

And the well known long term issues with chronic obesity is the flip side of that risk vs benefit equation.

Your last point is important and thus far somewhat overlooked (admits guilt). Obesity is the root cause of so much bad shit (heart disease, hypertension, diabetes, hypogonadism, chronic kidney disease, cancers, etc, etc) that over emphasizing rare bad outcomes or some intolerance in folks isn’t the right approach on a population/public health viewpoint.

[bodywhomper]

For women, hormone changes from perimenopause and menopause seems to do a lot.


Sent from my iPhone using TGR Forums

[Viva]

The carbohydrate-insulin hypothesis is pretty much dead. In met ward studies where protein and calories are controlled weight loss is not different between high carb and high fat diets. GLP1RAs fly in the face of the CIH since they *increase* insulin production.

I'll have a look at that, thanks. It's been well over twenty years since I was a researcher in this space.

Caloric restriction, not a caloric deficit. That makes sense.

Creating matter from nothing would be pretty wild from these magic mice.

[Dantheman]

GLP-1 receptor agonist medications have been on the market for close to 20 years.

That doesn’t mean there is zero chance of any issues with long term use - but these are not new drugs.

And the well known long term issues with chronic obesity is the flip side of that risk vs benefit equation.

Tirzepatide is relatively new, but seems to have a similar safety profile to semaglutide and is more effective. All the new ones coming will act on multiple incretins so those will be "new" drugs, but it's probably more likely to work out like statins or any other drug class where refinements lead to more effective drugs with fewer side effects over time.

I agree strongly about weighing hypothetical risks vs. known and guaranteed risks.

[Dantheman]

Four oral GLP-1R drugs are in Phase III trials and 63 are in active development: https://www.clinicaltrialsarena.com/...e-intensifies/

[XXX-er]

I agree strongly about weighing hypothetical risks vs. known and guaranteed risks.

are we still speaking of fat people ?

IME I can follow the white label and/or weigh my food,

a package of tortellini from the freezer sez the proper dosage is 141 grams but who among us hasnt inhaled the entire 225 gram bister-pack ?

any loose pasta the the proper doasge wil be 85grams

the white label even tells you how many potato chips to eat which is 17 if memory serves not the entire bag

[bennymac]

^ And the alcohol guidelines would say no more than a pint of beer per week…

[XXX-er]

don't they say 2 drinks a week, I'm doing good at 2 drinks a day

but like I said stopping drinking ( as oposed to quiting ) for 6 months didnt do much for the weight or a1C

[bennymac]

2 drinks of like 350ml per drink - so basically one pint of beer per week

[frorider]

The McRib thread is sandwiched right next to this one right now

[The AD]

2 drinks of like 350ml per drink - so basically one pint of beer per week

Whose guideline is this?