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

[bennymac]

There's a measurable, non-trivial difference but it's relatively small, 5-10%.

Question 2: assuming all 1000 calories will get absorbed - does the presence of significant indigestible fiber slow the absorption and lead to any significant difference in hormonal response to those calories that it effects where/how those calories are used/stored (all other factors bring equal)

[Norseman]

Late 80s / early 90s

[Viva]

The mice were in a caloric surplus if they gained... None gained weight in a caloric surplus.

Are you a native anglophone?

These fat, mutant animals gained weight whilst under calorie restriction.

But none of that disputes conservation of energy drives weight gain/loss.

Obesity is not an energy balance disorder, but a dysregulation of fat storage and metabolism, and a disorder of fuel-partitioning. These hormonal responses underlying this are dominated by the insulin signaling system, which in turn responds primarily (although not entirely) to the carbohydrate content of the diet.

So many people aren't turning into fatties because they eat too much, but because the carbohydrates in their diets, both the quantity and quality, establish a hormonal milieu that fosters the accumulation of excess fat.

I've had this same fucking debate on TGR with Gonzostrike*, like fifteen (15) years ago in a different thread.

At least Gonzo was smart

*That was his Epic Ski name, as I now recall. I forget his TGR name....Uncle Fester?

[californiagrown]

These fat, mutant animals gained weight whilst under calorie restriction.

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

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


The fact remains, it is impossible to gain weight in a caloric deficit.

[Trackhead]

My Opinion: It’s not as simple as calories in/calories out, but the nuances inside that argument for most people are not big contributors to their inability to lose weight. Their inability to lose weight is largely influenced by limited activity/underestimating caloric intake/living in a modern/sedentary world.

The biochemical responses (leptin, thyroxine, glucagon, etc) to calorie deficits, donut diets, blah, blah are interesting but not really necessary in the practical discussion of weight loss for most people.

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”.

[neufox47]

No one gained weight on the Batan Death March.

It’s really difficult to lose weight and exponentially so if you have a lot to lose. Additionally your body will fight you losing more weight and make changes to make it more difficult including, decreasing the amount of heat your body produces, making you more efficient, making you more hungry, and altering your hormones so your body tries to store fat.

Both of these things are true.


Sent from my iPhone using TGR Forums

[Trackhead]

No one gained weight on the Batan Death March.

It’s really difficult to lose weight and exponentially so if you have a lot to lose. Additionally your body will fight you losing more weight and make changes to make it more difficult including, decreasing the amount of heat your body produces, making you more efficient, making you more hungry, and altering your hormones so your body tries to store fat.

Both of these things are true.

Indeed they are.

My thought is, if your sitting across a desk from a patient, do you give them hope and tell them they can lose weight with or without pharmaceuticals/lifestyle changes, or do adopt a pseudo hopeless stance and discuss all these nuanced, biochemical interactions they won't understand that will make weight loss seem impossible to them?

Bottom line: How do you get your patient, husband, wife, child to lose weight?

[californiagrown]

Indeed they are.

My thought is, if your sitting across a desk from a patient, do you give them hope and tell them they can lose weight with or without pharmaceuticals/lifestyle changes, or do adopt a pseudo hopeless stance and discuss all these nuanced, biochemical interactions they won't understand that will make weight loss seem impossible to them?

Bottom line: How do you get your patient, husband, wife, child to lose weight?

IMO the patients need to feel empowered and motivated to make the necessary lifestyle changes. The explanation needs to not be overcomplicated, nor give the patient the incorrect impression that they don't have any control over their condition without pharmaceutical intervention.

Telling them that they are obese because of hormones, metabolic damage, etc without also HAMMERING home the need for lifestyle changes just leads to folks feeling vindicated for being obese instead of being motivated to get healthy, and feeling like they have some control over their outcome. It is incredibly rare to see an obese person (not including those technically considered obese because of their large amount of muscle) who has consistently eaten very healthy and consistently rigorously exercised for the preceding years. Health is more than just about a persons weight and BF%, but their weight and BF% is a really good indicator of their health and their lifestyle habits.

As I'm sure you'd agree, the psych component is huge. People motivated to be healthy who take an active role in their health have much better outcomes than folks unmotivated and only willing to take a passive role.

[neufox47]

Indeed they are.

My thought is, if your sitting across a desk from a patient, do you give them hope and tell them they can lose weight with or without pharmaceuticals/lifestyle changes, or do adopt a pseudo hopeless stance and discuss all these nuanced, biochemical interactions they won't understand that will make weight loss seem impossible to them?

Bottom line: How do you get your patient, husband, wife, child to lose weight?

I don’t practice medicine, but I’d be inclined to tell someone (especially if they have repeatedly tried and failed to lose weight) that they have to make lifestyle changes but this pharmaceutical will help you be successful.

[halliday]

I heard something on NPR a while back about how measuring a patients weight actually led to worse health outcomes because of the associated stress, anxiety and fixation on weight above other health factors. I would have to assume that this study was mostly geared at overweight people, and likely women as they are the most likely to suffer from eating disorders.




I fundamentally do not understand, why people dont understand your weight is a simple calculation of calories-in vs calories-out. Point blank, simple. You get it- "I used to be super active at my job, but now im a desk jockey... I need to adjust my diet and make an effort to move more". It really is that simple.

It is that simple. Whenever Im working from home or traveling to the North East for work I cycle every day that I can. Cycling at home is 30-40 miles every morning. Cycling in NYC, MA, NH, or ME is around 20-30. I eat around 7-8 AM and then at 230-330. That's it. Sometimes I need to adjust when meeting with clients or Im at a trdeshow. I tend to eat a natural, balanced diet and I'll cook whenever I can while traveling. I have no regard for carb intake or calories and I tend not to over eat unless Im at the Crystal Beer Parlor or Markey's Lobster Pool and I keep McDonald's to a minimum. It takes work and you have to figure out what you are taking in and putting out. On a usual morning ride I burn ~ 1000 calories. A little insight into your individual physiology and how you need to fuel your body can be a big help to people who are seriously over weight. 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. I live with a person who is like this. It's difficult to watch and it's very expensive.

[Trackhead]

^^exactly.

We can debate the nuances of obesity all day long, citing this blogger, that doctor, this Ph.D., but ultimately it's largely pointless when we consider the bottom line.

How do we lose weight?

Diet, exercise, and/or meds for those who chose that path. Not much else to discuss.

/The End

[bennymac]

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. I live with a person who is like this. It's difficult to watch and it's very expensive.

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.

[Trackhead]

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.

N = 1 bro.

[Dantheman]

Question 2: assuming all 1000 calories will get absorbed - does the presence of significant indigestible fiber slow the absorption and lead to any significant difference in hormonal response to those calories that it effects where/how those calories are used/stored (all other factors bring equal)

Yes to the first part, not really to the second in the context of that specific meal. However, you are likely eat less at that meal and in subsequent meals. Reasons you will stop eating once you've started:

-You've eaten a sufficient amount of essential amino acids
-You've eaten a sufficient amount of essential fatty acids
-You've spent a certain amount of time chewing
-You've eaten enough for the mechanoreceptors in your stomach to register a stretch response
-Sensory specific satiety (we eat more in the presence of variety, i.e. the "I'm stuffed and can't eat another bite. What's for desert?" phenomenon)

There's a few others I'm forgetting, but like the list above they also have little or no direct relationship to caloric balance. You'll keep eating until you've met your protein requirement and feel full, which means you're basically guaranteed to overeat low-quality energy-dense foods.

Obesity is not an energy balance disorder, but a dysregulation of fat storage and metabolism, and a disorder of fuel-partitioning. These hormonal responses underlying this are dominated by the insulin signaling system, which in turn responds primarily (although not entirely) to the carbohydrate content of the diet.

So many people aren't turning into fatties because they eat too much, but because the carbohydrates in their diets, both the quantity and quality, establish a hormonal milieu that fosters the accumulation of excess fat.

I've had this same fucking debate on TGR with Gonzostrike*, like fifteen (15) years ago in a different thread.

You might want to look up the research that has been done in the ensuing 15 years. 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.

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.

Average caloric consumption has increased by ~500 kcal/day in the last 40 years. In that same time ultra-processed food consumption has increased from 10-20% of total calories to 60-70+%. Under ad libitum feeding conditions people eat about...wait for it...500 kcal/day more on an ultra-processed diet than a minimally processed diet (https://www.cell.com/cell-metabolism...131(19)30248-7).

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.

The Biggest Loser was a predatory piece of shit show, but one thing we learned from it conclusively is that many, many obese people overeat to self-medicate some deep-seated untreated psychological issues (childhood trauma, abuse, neglect. etc.).

[Trackhead]

The Biggest Loser was a predatory piece of shit show, but one thing we learned from it conclusively is that many, many obese people overeat to self-medicate some deep-seated untreated psychological issues (childhood trauma, abuse, neglect. etc.).

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.

[The AD]

The Biggest Loser was a predatory piece of shit show, but one thing we learned from it conclusively is that many, many obese people overeat to self-medicate some deep-seated untreated psychological issues (childhood trauma, abuse, neglect. etc.).

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.

[dan_pdx]

People on an outdoor forum who don't get why people don't just exercise and eat right is like people on a yoga forum wondering why everyone doesn't fix their rotten posture/lack of flexibility. "All you have to do is commit to a regular yoga practice!"

[XXX-er]

People on an outdoor forum who don't get why people don't just exercise and eat right is like people on a yoga forum wondering why everyone doesn't fix their rotten posture/lack of flexibility. "All you have to do is commit to a regular yoga practice!"

After a 3 yr layoff due to covid fuckery lessons started up and big results right away in only 2 sesh

[Trackhead]

People on an outdoor forum who don't get why people don't just exercise and eat right is like people on a yoga forum wondering why everyone doesn't fix their rotten posture/lack of flexibility. "All you have to do is commit to a regular yoga practice!"

Are you saying were biased?

Nah, say it ain't so.

[frorider]

People on an outdoor forum who don't get why people don't just exercise and eat right is like people on a yoga forum wondering why everyone doesn't fix their rotten posture/lack of flexibility. "All you have to do is commit to a regular yoga practice!"

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.

[bennymac]

Obese people just need to eat better and exercise more.

Alcoholics just need to stop craving alcohol.

Depressed people just need to cheer up.

[Danno]

Obese people just need to eat better and exercise more.

Alcoholics just need to stop craving alcohol.

Depressed people just need to cheer up.

Hey now, that's not correct.

Alcoholics just need to stop drinking, they can crave all they want.

[dan_pdx]

After a 3 yr layoff due to covid fuckery lessons started up and big results right away in only 2 sesh

Ha! I've done yoga off and on and it's awesome, just hard to find time since other sports/activities tend to take precedence

[californiagrown]

Obese people just need to eat better and exercise more.

Alcoholics just need to stop craving alcohol.

Depressed people just need to cheer up.

Correct. More or less.

Nah, they need to go to rehab, AA, hypnosis, or find support somewhere/somehow to address the problem and stop drinking alcohol.

Depressed people need to seek medical help and try different options to treat themselves.



NONE of these folks should throw up their hands and say "welp, there's nothing i can do, its just genetic/out of my hands. I might as well keep on going down this path of destruction".

[Danno]

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.

NONE of these folks should throw up their hands and say "welp, there's nothing i can do, its just genetic/out of my hands. I might as well keep on going down this path of destruction".

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