What do you think needs to be done to combat the obesity epidemic?

[baxus]

1 hour ago, Week said:

Uh ... there is a ton of history on a plethora of eating disorders as well as new research that suggest that there are similar behaviors and biological pathways involved in drug addiction and food. Considering the importance of sugar in the latter -- and the ubiquity of sugar-added foods (i.e. high fructose corn syrup as the first ingredient in a condiment like ketchup) -- there is a clear comparison to be made.

Read the part you quoted again. I'm saying that there are billions of people who have no addictions to food, not denying the existence of eating disorders.

EDIT:

It seems to me that I need to point out that in no way am I trying to free food industry of their share of the blame in the obesity problem around the world. I'm just saying that individuals (myself included) can't rely on food industry to do the right thing so we need to do our best to live healthier (including eating better and exercising more).

[Week]

2 minutes ago, baxus said:

Read the part you quoted again. I'm saying that there are billions of people who have no addictions to food, not denying the existence of eating disorders.

There are billions of people who have no addictions to a lot of things that some people do have addictions to. I don't understand your point here.

[baxus]

If the obesity problem was ONLY down to food industry (which is shitty all over the world), we'd all be obese.

[.H.]

1 minute ago, Conflicting Thought said:

And of course those psychological forces are heavily influenced by external sources such as advertising. 

I find it strange that people are fighting against such a proven thing. Advertising has an important  role and a big impact on how we internalize this things, and it acts in very subtle ways in our brains. 

I'm not saying that advertising has zero effect, but no, I don't believe that someone who chronically and habitually buys unhealthy food and over-eats it would do better if they were somehow sheltered from advertising.  Advertising does "normalize" certain things, but people aren't devouring ice cream, for example, because they saw it on TV, they are doing it because it tastes good and things that taste good are pleasurable.  I sure like pleasurable things better than unpleasurable ones, as I'm sure those people do.

[Erik of Hazelfield]

Many good posts here. I'll try to answer more of them when I get to a computer. 

Just a question though, to those of you making the argument that people should just take their responsibility and stop eating so much unhealthy stuff: what, if anything, do you think should be done to combat the obesity epidemic? (It's actually the same question as in the thread title.)

Because it seems obvious to me that for whatever reason, leaving it up to people to help themselves doesn't work. Obesity and related illnesses are still on the rise. Is there something we as a society should do about that, or do we just accept it?

[Heartofice]

What I find interesting, is that in the age of Instagram, where gym usage is shooting up, why is there such a divide, where some people are getting into better shape and some people are going in the opposite direction. Is it socio economic, and will our new narcissism actually improve our health?

 

[.H.]

10 minutes ago, Erik of Hazelfield said:

Because it seems obvious to me that for whatever reason, leaving it up to people to help themselves doesn't work. Obesity and related illnesses are still on the rise. Is there something we as a society should do about that, or do we just accept it?

Well, the simple answer is "there is no simple answer."

Essentially post-scarcity, most people for whom this question is applicable don't eat to live, they "live to eat" and so eat what they find pleasing.  It's not advertising, or any sort of mis-information, that informs people that ice cream tastes better than squash.  For 99.99% of humans, this is a directly experimentally verifiable fact.  Food companies don't need to brainwash people into wanting unhealthy food, unhealthy food just flat out tastes better most of the time.  The question is less, "why do people eat unhealthy?"  It's more "why, when "better tasting" unhealthy food is cheaper and readily available, does anyone eat healthy?"

So, the issue at hand really seems to be, why aren't people considering their eating in a way that fosters continual healthier living?  The answer to that is likely a bundle of all sorts of maladaptive, short-sighted, immediate-gratification and consequence-blind psychological factors bound up to the already somewhat complex topic of human nutrition.  Not to mention, complicated by various economic, socio-cultural, and just plain practical factors that add yet another complicating layer on top of all that.

And that is just things I can think of off the top of my head, let alone other factors like food manufacturers putting things into food that they know aren't healthy at all, but are either cheap, or designed to have you desire more of them.

[Jo498]

The interesting thing is that in most of the US and Europe we have been post-scarcity at least since the 1950s. We have been considerably more health-conscious since ca. 1970 but be also became considerably more obese in the last 30-40 years. Therefore we should look at factors that changed and are so strongly pushing in the obesity direction that the health and fitness crazes of the last 40 years could not counterbalance it.

There have been suggestions above in #20:

"1 Reduce social stress. Improve job security. Allow more holidays. Take a stricter approach to regulating monopolies (there is actually a correlation in the US between obesity increasing and the spread of Walmart to a particular local area).

2 Tax the hell out of added sugar (get it out of breakfast cereal, for a start). America's corn syrup problem is unique to them, but the general sugar problem still stands. The stuff is sodding poison.

3 No more advertising for fast food. It can go the way of cigarette advertising.

4 Nutrition and food preparation compulsory in schools.

5 Change food labelling laws to make it easier to identify the healthier options.

6 Investment in effective public relations to push back against the power of the Sugar and Fast Food industries. These guys have their lines all sorted. They don't and won't take an attack lying down."

The first point is easy to support but very hard to implement (note also rising obesity in European countries that have a little less social stress than the US). 4 should be fairly easy because this will not go directly against the powerful food industry and it is also the most important as people become empowered to understand food and nutrition better. Not sure if 2 is politically viable but 5 and 3 could maybe tried stepwise. The industries will fight against it but there is the precedent of tobacco ads and we already have obligatory nutrition info in many countries so one could sneak in the labels.

[.H.]

27 minutes ago, Jo498 said:

The interesting thing is that in most of the US and Europe we have been post-scarcity at least since the 1950s. We have been considerably more health-conscious since ca. 1970 but be also became considerably more obese in the last 30-40 years. Therefore we should look at factors that changed and are so strongly pushing in the obesity direction that the health and fitness crazes of the last 40 years could not counterbalance it.

Well, I agree with that.  But my general point is just that post-scarcity is what the background condition is, which allows other, more psychological factors, to play larger and larger role in the choice of what to eat.

I'm not really buying the "educational answer" though, mainly because, for the people who eat chronically unhealthy, it's less that they are legitimately unaware that, say, ice cream is unhealthy compared to broccoli, it's that they are no philosophically and psychologically inclined to care that it is.  Nor, from the practical standpoint of what they want to do, are they inclined to suffer the vegetable in lieu of the ice cream.  So, why would they do what they don't really want to do?  Why does anyone?

I know someone, who, when told by a doctor that they were pre-diabetic, due to poor eating habits, literally said, "I'd rather die than change what I eat."  That isn't an educational, knowledge issue, that is a purely psychological and ideological one.  Granted, that is yet another "extreme" example, but it is (to me) illustrative of my general point.

[Erik of Hazelfield]

1 hour ago, .H. said:

Well, the simple answer is "there is no simple answer."

Essentially post-scarcity, most people for whom this question is applicable don't eat to live, they "live to eat" and so eat what they find pleasing.  It's not advertising, or any sort of mis-information, that informs people that ice cream tastes better than squash.  For 99.99% of humans, this is a directly experimentally verifiable fact.  Food companies don't need to brainwash people into wanting unhealthy food, unhealthy food just flat out tastes better most of the time.  The question is less, "why do people eat unhealthy?"  It's more "why, when "better tasting" unhealthy food is cheaper and readily available, does anyone eat healthy?"

So, the issue at hand really seems to be, why aren't people considering their eating in a way that fosters continual healthier living?  The answer to that is likely a bundle of all sorts of maladaptive, short-sighted, immediate-gratification and consequence-blind psychological factors bound up to the already somewhat complex topic of human nutrition.  Not to mention, complicated by various economic, socio-cultural, and just plain practical factors that add yet another complicating layer on top of all that.

And that is just things I can think of off the top of my head, let alone other factors like food manufacturers putting things into food that they know aren't healthy at all, but are either cheap, or designed to have you desire more of them.

I don't disagree with any of this. But still the question remains: what to do about it? Just saying it's complicated, even though it's true, doesn't bring us closer to a solution. 

Jo498: thanks, I saw those, and I agree with many of them. My question was more directed to those who argue the personal responsibility angle.

[.H.]

5 minutes ago, Erik of Hazelfield said:

I don't disagree with any of this. But still the question remains: what to do about it? Just saying it's complicated, even though it's true, doesn't bring us closer to a solution.

Sure, but simple solutions are bound to fail to address the complexity of the situation.  We are in such a damn mess it is unlikely to be tackled in baby steps and baby steps are likely all we'd be able to agree on right now.  What's needed is an entire paradigm upheaval that is so unlikely to occur that no one, not even any large collection of someone's could even fathom it in practice.

So, what do we do?  Well, what I am trying to point out is essentially, that you can't fix anything unless you can properly frame just what the problem is.  I will agree with anything that makes it easier for people to access, purchase, prepare and consume healthier foods.  That means, in all likely hood, ending subsidies for the type of crap ingredients (looking at you corn) that lead to poor food being cheaper.  Tax, or manage, contents of food, like sugar.  Offer education where and when needed.  Some of that will work to minor degrees or other, with little doubt.

But how do you solve the meta-issues at hand?  How do you convince people to have a personal ideology that is not about pleasure in this moment now, at any cost?  How you do teach people responsibility for themselves?  What is the educational strategy to combat short-sightedness?  Or rejection of responsibility?  Or the idea that things pleasurable aren't necessarily beneficial?

I don't think that's a question of education.  That's a moral outlook.  A philosophical, cultural ideology.  How do you change that?  I don't know, I am just a random jackass with a keyboard.  If I could fix the world's problems just by thinking, we'd already be in the hell of my mind's utopia.  So, what I am doing?  Well, I'm trying to be better, myself.  And I am trying to teach my kids to be better too.  That's all I've got.

[Kalbear]

5 hours ago, Tywin et al. said:

I feel like there’s so much other thinking here. Just go outside, exercise and eat better. It’s not hard.

If it's not hard, why don't half of the US population do it now, and why did they somehow miraculously do it 50 years ago? 

4 hours ago, Tywin et al. said:

And there you go. This is as much a will power thing as anything else. Technology has made humans soft. There’s always an excuse. I interact constantly with people who complain about their weight, and after just a few questions you can figure out why. It’s one thing if you have a medical barrier, but not wanting to work out and eat healthy seems to be the overwhelming reason why people are out of shape.  

People don't want to stop a whole lot of addictive behaviors, even when they know they're bad for them. That's how addictive behaviors work. 

[Jo498]

The educational angle is not merely about knowledge. This is one aspect. People really are in error insofar that low fat can make them fatter than normal fat (because they will eat more of it and more carbs).

There is also self restraint. And this is where the paradoxes come in. In a consumerist society some kinds of self restraint and asceticism mark you as a weirdo. Others (dieting, pumping steel, veganism etc.) are respected or even obligatory.  And while this might have been one of the 60% of psychological findings that could not be replicated, there were indications that "willpower is a limited ressource". If you need all your mental strength to survive work and other ordeals of the day, you will not be able to refrain from indulging in unhealthy food and it will be too much to ask even moderate exercise. That was Marquis Leech's first point, I think.

But obviously the goal should be to enjoy food without having to force down unappetizing celery stalks. Admittedly, I cannot really speak from experience. I was at low to normal weight until early 30s, then slowly gained a little, so between early 30s and mid-40s I hovered between normal and about 8-10kg too much. I got back to normal about a year ago within 6 months or less by intermittent fasting and cutting snacks. Another year later with more exercise, I am somewhat leaner, probably at BM 23. But then I never drank soda regularly, almost eliminated alcohol several years ago for a different health reason (and even before I never drank with any regularity) and I am only moderately tempted by snacks. (I am also in a country with walkable cities, normal portions and no food deserts etc.) So I basically only had to restrain myself a little and get used to skipping dinner (or rather usually having a very light dinner around 4 pm and then nothing until next morning). This was not hard at all, so I can only offer sympathy for those trying to lose 20, 30 or more kg.

The educational goal has to be to enjoy in moderation to make asceticism not necessary. For some it might be too late. They might only have the choice between hard restraint and remaining obese.

It is similar with exercise. It should at least to some extent be enjoyable.

[Kalbear]

4 hours ago, baxus said:

Read the part you quoted again. I'm saying that there are billions of people who have no addictions to food, not denying the existence of eating disorders. 

There are billions of people who consume opiates without a single problem in their life. There are plenty of people who have alcohol and are not addicted either. 

That does not mean either of those things are not addictive. 

4 hours ago, baxus said:

EDIT:

It seems to me that I need to point out that in no way am I trying to free food industry of their share of the blame in the obesity problem around the world. I'm just saying that individuals (myself included) can't rely on food industry to do the right thing so we need to do our best to live healthier (including eating better and exercising more).

Alternately, you can force the food industry to do the right thing. I agree - the food industry has a massive incentive to have you overeat. They design their food precisely to make you want to overeat. This sounds like hyperbole, but it isn't; it was literally designed to provide just enough taste, just enough salt, and just enough flavor for you to want to eat more without going overboard. They are deliberately making their food to be as highly consumed as possible, because that makes them more money. 

Therefore, we as a culture need to stop putting the onus on individuals to fight basic tenets of human genetics and start pushing back on obviously dangerous systems of food. Does it mean banning? In some cases, probably. In others, it means things like taxes, advertising bans, putting food in places that are out of reach of kids, restricting of food in schools, vending machines, education processes. 

But the idea that any individual is going to fight back against this kind of onslaught of advertising, marketing, peer pressure, guilt, shame, loathing, and environment is laughable. And we know it to be laughable, because it does not work. 

[Kalbear]

1 hour ago, .H. said:

I'm not really buying the "educational answer" though, mainly because, for the people who eat chronically unhealthy, it's less that they are legitimately unaware that, say, ice cream is unhealthy compared to broccoli, it's that they are no philosophically and psychologically inclined to care that it is.  Nor, from the practical standpoint of what they want to do, are they inclined to suffer the vegetable in lieu of the ice cream.  So, why would they do what they don't really want to do?  Why does anyone? 

I think this is massive projection. From what I've seen, people all over are absurdly uneducated on what healthy is, largely because for the last 50 years the US has been telling them bullshit like 'eat a ton of grains and carbs' and 'don't eat fat, eat sugar'. 

And let's not conflate the real edge cases. Obesity isn't that people all weigh 600lbs. It's that a whole lot of people weight 40-50 lbs or more than they 'should'. 

1 hour ago, .H. said:

I know someone, who, when told by a doctor that they were pre-diabetic, due to poor eating habits, literally said, "I'd rather die than change what I eat."  That isn't an educational, knowledge issue, that is a purely psychological and ideological one.  Granted, that is yet another "extreme" example, but it is (to me) illustrative of my general point.

And that's why I said it was a cultural thing. 

Let's take a thought experiment - of a generic Italian mobster family seen on the Sopranos. Their entire social life, when not spent wacking people and exploiting sex workers, is about food. Big dinners, big sandwiches, alcohol, wine, etc. They eat to celebrate, they eat to console, they eat for fun. And tell that person, okay, you can't have bread any more. No gluten. You have to weigh your portions. You have to watch how much salt and cheese you have. You have to watch the beer you drink. 

That isn't just cutting something out - that is a massive change to their entire life, and likely represents ostracism in their social order. They'd get wacked because they didn't belong. 

One of the things my program said was a leading indicator of prolonged success was how supporting your family and friends were. If your family was into it and adapted some of the changes you made, you had about a 50% success rate. If you didn't? About 20%. 

[Kalbear]

9 hours ago, baxus said:

I love how you just go with the assumption that 100% of people who claim are doing the "diet and exercise" combo are actually doing it. I mean, it's not as if anyone ever lied about that, is it? Do you have the percentage of people that really stick with diet and exercise long enough to actually get results? Comparing that percentage to this 7% you speak of would give us a better picture. 

We've got a whole lot of scientific studies about it. This isn't just me saying it. It's a program that I attended that was lauded as being very effective because almost 50% of the people who did it sustained it for more than 2 years. This is considered a gold standard in the weight loss industry - the only thing more effective is bariatric surgery. 

But if you go and talk to a dietician and you claim that all these people are lying about it, they'll laugh in your face.

9 hours ago, baxus said:

What the hell does "genetic pressure" mean? Or "overcome their existence as humans"? Where do you come up with these? 

A whole lot of humans - probably all of them, but definitely most - have genetic components that basically cause unhealthy eating patterns. For example, if you diet too much you reduce your metabolism heavily, and it never comes back, because your body considers that as a sign that you're in a food-poor environment. When you eat 'normally' again, you find out that you gain back the weight faster because of this. This was, as a hideous example, what happened with most of the people who did Biggest Loser - in that study, 13 of the 14 ended up gaining back almost all the weight, AND had a worse metabolic rate. 

9 hours ago, baxus said:

Is the person in question cooking dinner for 4 hours each day? 

Sometimes? What's especially interesting is that TV time has actually gone down, physical activity has gone up, but obesity has not gone down. 

9 hours ago, baxus said:

Is someone forcefully shoving all this excess food down Americans mouths? Or is there a moment where they choose to eat so much? 

Choice in the face of addiction is illusory. 

9 hours ago, baxus said:

So, the way to lose weight is to force everyone else to adapt to your lifestyle? Have everyone pack lunch before you can do it? Guess what, you can wait for that but it's not going to happen. You need to do what's best for you - if that means packing lunch then it's packing lunch. If you choose to not do that, you can't blame it solely on food industry or society as a whole. 

For any specific individual, sure. For the actual health epidemic that is hitting the US? No, sorry. 

If we took the same attitude towards climate change, we'd tell the major polluters and carbon emitters that they're fine, but the real thing we need to focus on is whether or not people bring reusable bags and straws. Yes, those things help, but they aren't the major cause. 

9 hours ago, baxus said:

As stated already, obese people shouldn't do intense exercise at first. So, there's no need for gyms or equipment one might find there. You can take your kids for a walk or ride a bike with them, shoot some hoops or do whatever. No reason to exclude your family from these activities. 

They don't have the time either. Or they do, in which case they're probably already doing it. 

But again, not the real issue - exercise is great, but it is not great for losing weight.

9 hours ago, baxus said:

I know a bunch of people who bring their kids to workouts. You know what? Kids love it! Of course they don't do any weightlifting and stuff like that, but they like running, tumbling and climbing all over the place. 

Workouts cost money. Again, if you can afford to work out chances are good you're already in a good spot to deal with it. You can afford better food and better exercise options. 

9 hours ago, baxus said:

Businesses are businesses. They are not your friend. They look after their own best interests that may or may not match your best interest. 

It is your responsibility to not let them sucker you into eating junk too often.

Again, the notion that it's the individual's responsibility to fight back against the massive cultural, environmental, and physical things going against them is ludicrous. And again, we know this, because we are in the middle of a crisis, and the individual responsibility thing doesn't work. 

9 hours ago, baxus said:

I guess you'd say that "have everyone pack their lunch so I can pack one, too" is a much more effective one? 

I'd say that until everyone regularly packs their lunch, it's going to be a problem. Either the restaurants need to be healthier and have lot more healthy options, or people need to understand better the limits of what people should and shouldn't do. I'm not advocating banning eating bad food; I'm advocating shunning it. 

9 hours ago, baxus said:

The whole point I'm trying to make that, while obesity is a problem partially caused by the food industry, it's not the food industry's problem. Food industry is doing just fine. 

And I'm trying to make the point that it is them that are the biggest cause, and we as a society need to MAKE IT their problem. They won't do it for us, and until we make it their problem it will be ours. 

9 hours ago, baxus said:

It is the people who are having a problem and it is people who need to take action. 

Which is why I advocate doing so, as a group, with some kind of laws and public pressure. 

9 hours ago, baxus said:

How can you "make a human forget that they ate a meal"? What kind of crowd you are hanging out with if people eat until they can fit no more food in their bodies? And, even if that's the case, how on Earth is that NOT a personal thing? How exactly is it that the food industry is forcing you to eat until you can't eat any more? I understand that there are some psychological issues such an individual might be experiencing but then it's once again up to that individual to seek help. 

Again, science. I'll see if I can find it, but I didn't just take this as an anecdote - this was a study that people eat not just when they're hungry. I think it had to do with people being in a room and losing track of time or evidence that they had eaten a meal. 

The food industry isn't forcing you to eat, precisely; they're designing food that makes you want to eat more of it, far beyond your calorie needs. 

9 hours ago, baxus said:

And stop comparing food to heroin. It is not the same, it has never been the same and it will never be the same, no matter how many times you repeat that. There are literally billions of people around the globe who have enough food and are still not obese and have no addiction to food (aside from the obvious biological "I need to eat to live" one). 

Again, there are billions of people who have taken opiates and are not addicted. 

9 hours ago, baxus said:

 

Once again, food ≠ heroin. I hope we don't need to get back to this again. 

Maybe when you can prove that food addictions aren't a thing? Because we have studies that imply sugar is more addictive than cocaine. And up to 20% of people appear to be addicted to food or behave with addiction-like behaviors - which is higher in the obese population. 

No, food isn't equivalent to heroin. Processed food, junk food, fast food - all of these act on similar parts of the brain as other drugs, cause similar pleasure-seeking behaviors, and can cause people to simply lose control and rationalize behaviors. Not everyone is affected the same way, just like not everyone gets addicted to alcohol - but the notion that food isn't addictive is belied heavily by the 2 million people currently in eating recovery centers for various eating disorders, and the studies that indicate that food is, in fact, designed to be addictive. 

If you ignore this, you essentially are telling 1/5th of the population to just deal with it, and then you'll be shocked to find out that they can't. 

9 hours ago, baxus said:

And you think that rural wherever is much different from rural US?

I have no idea, honestly; I just know what it's like in rural US, with sprawl. My impression of rural Europe is that there are a lot more townships and small villages around with small stores and the like, and that is decidedly not the case in the US in many places. 

[.H.]

2 minutes ago, Kalbear said:

I think this is massive projection. From what I've seen, people all over are absurdly uneducated on what healthy is, largely because for the last 50 years the US has been telling them bullshit like 'eat a ton of grains and carbs' and 'don't eat fat, eat sugar'. 

And let's not conflate the real edge cases. Obesity isn't that people all weigh 600lbs. It's that a whole lot of people weight 40-50 lbs or more than they 'should'. 

Well, I don't think you are wrong, but this inversion you present here, it isn't the same (I don't think).  I doubt (but, hey, maybe again I am just plainly wrong) that almost anyone thinks McDonald's, for example, is healthy, even if they don't actually know what is healthy.  So, my point though is, I have a hard time believing that, say, most Americans, imagine that eating a pint of ice cream is healthy, even if they don't understand why exactly isn't healthy.

My hunch though and I am specifically not a dietitian, not an expert in anything at all, ever, but if everyone actually just followed CICO, it would likely matter little (generally) whether 2,000 calories of grains went in and 2,000 went back out.  Of course, this simplistic example fails to take into account the role of exercise and other "needs" but still.  What can sometimes be a problem is that it's relatively easy to overeat calories of pasta than it is to over eat calories of broccoli.  If you over ate 6,000 calories of broccoli, you'd likely be in the same problem position than if it was pasta.  The kicker here though, of course, is that no one eats dry pasta in reality.  So, instead maybe it was only 4,000 calories in pasta, but it came with 2,000 in sauce, 1,000 in meatballs, 500 in cheese and so on.  Add in some "creative accounting" and people don't "understand" why they are gaining weight.

8 minutes ago, Kalbear said:

One of the things my program said was a leading indicator of prolonged success was how supporting your family and friends were. If your family was into it and adapted some of the changes you made, you had about a 50% success rate. If you didn't? About 20%. 

I agree with this absolutely.  One woman told my wife that she started buying "healthier" food (although, it wasn't great choices, but at least they were better) and her husband and kids were making fun of her, nonstop, for it.

Why would they do that?  I can only imagine that it was, as your example points out, is the enforcing of their norms.  Why would they do that?  Again, I can only venture to imagine, but likely in some way they want her to conform, because they don't want to face fact of their own unhealthy eating.  So, if the norm is to gorge yourself, damn right they are going to give you dirty looks when you peck.  Who wants the party pooper around?

That's part of the ideology of rejecting responsibility and of short-sightedness, I think.  To me, it sure just looks like a codependent cycle of enabling.  But again, you might be right and I am just wildly projecting.  What do I know?

[Kalbear]

1 minute ago, .H. said:

Well, I don't think you are wrong, but this inversion you present here, it isn't the same (I don't think).  I doubt (but, hey, maybe again I am just plainly wrong) that almost anyone thinks McDonald's, for example, is healthy, even if they don't actually know what is healthy.  So, my point though is, I have a hard time believing that, say, most Americans, imagine that eating a pint of ice cream is healthy, even if they don't understand why exactly isn't healthy. 

McDonalds has spent a whole lot of advertising revenue indicating that their chicken sandwich is healthy, or their salads are healthy, when they are almost certainly anything but. 

And eating a pint of ice cream sucks, but that's really not what is causing people to eat 500-1000 extra calories a day. 

1 minute ago, .H. said:

My hunch though and I am specifically not a dietitian, not an expert in anything at all, ever, but if everyone actually just followed CICO, it would likely matter little (generally) whether 2,000 calories of grains went in and 2,000 went back out.  Of course, this simplistic example fails to take into account the role of exercise and other "needs" but still.  What can sometimes be a problem is that it's relatively easy to overeat calories of pasta than it is to over eat calories of broccoli.  If you over ate 6,000 calories of broccoli, you'd likely be in the same problem position than if it was pasta.  The kicker here though, of course, is that no one eats dry pasta in reality.  So, instead maybe it was only 4,000 calories in pasta, but it came with 2,000 in sauce, 1,000 in meatballs, 500 in cheese and so on.  Add in some "creative accounting" and people don't "understand" why they are gaining weight. 

I'm not a dietician either, but I've talked to some, and this ends up being not true. Even leaving out that some foods are trigger foods that make people want to eat more, or crash your blood sugar and cause you to eat more, or lower your inhibitions and cause you to eat more, some people simply react differently to certain foods and it causes problems. And this is not a global thing - people are different all across the board on this. 

Add to this that there are a lot of food that are calorie fine but bad for you in other ways, and you have problems. 

1 minute ago, .H. said:

I agree with this absolutely.  One woman told my wife that she started buying "healthier" food (although, it wasn't great choices, but at least they were better) and her husband and kids were making fun of her, nonstop, for it.

Why would they do that?  I can only imagine that it was, as your example points out, is the enforcing of their norms.  Why would they do that?  Again, I can only venture to imagine, but likely in some way they want her to conform, because they don't want to face fact of their own unhealthy eating.  So, if the norm is to gorge yourself, damn right they are going to give you dirty looks when you peck.  Who wants the party pooper around?

That's part of the ideology of rejecting responsibility and of short-sightedness, I think.  To me, it sure just looks like a codependent cycle of enabling.  But again, you might be right and I am just wildly projecting.  What do I know?

I think it's just more of a human's desire to mock and ostracize the non-ingroup people, and food choices are a massive ingroup indicator. What people eat, how people eat, where they eat - all of these things are norms, and if you violate those norms you are not One Of Us. Eating human flesh is fine when everyone does it, but shameful when not everyone does it. 

[.H.]

2 minutes ago, Kalbear said:

McDonalds has spent a whole lot of advertising revenue indicating that their chicken sandwich is healthy, or their salads are healthy, when they are almost certainly anything but. 

And eating a pint of ice cream sucks, but that's really not what is causing people to eat 500-1000 extra calories a day.

That is true.  But are people really buying that?

Shit, what am I suggesting, they probably are...

3 minutes ago, Kalbear said:

I'm not a dietician either, but I've talked to some, and this ends up being not true. Even leaving out that some foods are trigger foods that make people want to eat more, or crash your blood sugar and cause you to eat more, or lower your inhibitions and cause you to eat more, some people simply react differently to certain foods and it causes problems. And this is not a global thing - people are different all across the board on this. 

Add to this that there are a lot of food that are calorie fine but bad for you in other ways, and you have problems.

Right, I mean, all generalities will fall apart on the individual level.  But indeed, if all you ate was 2,000 calories of lard, you are going to have some problems.  But the issue at hand, where you eat too much, is still an issue of calories at the end of the day, no?  So, for you, maybe carbs spur you to over eat carbs.  If you stuck to CICO, religiously, it really wouldn't matter in the long run, I don't think.  For example, if you were literally rationed out 2,000 calories of food, and you chose those as 90% carbs, and still have 2,000 calories going out, you likely aren't doing too bad.  Granted, if you are someone who just happens to not process carbs well, then yeah, you are going to have a problem.

The problem still comes down to over eating, be it carbs or fats, or whatever.  Carbs are just, maybe for me only, vastly easier to over eat.  It doesn't mean that carbs are evil, just hard to appropriately portion.

15 minutes ago, Kalbear said:

I think it's just more of a human's desire to mock and ostracize the non-ingroup people, and food choices are a massive ingroup indicator. What people eat, how people eat, where they eat - all of these things are norms, and if you violate those norms you are not One Of Us. Eating human flesh is fine when everyone does it, but shameful when not everyone does it.

Sure, I don't doubt that is a major component of it too.

[lokisnow]

I was having a science fiction moment earlier today, trying to imagine how a drug therapy treatment for obesity might present.

I was imagining the primary cocktail treatment as intravenous, given on a drip in a controlled hospital environment. The first treatment would include an 72 hour stay in the hospital for observation and leveling, after taking in a treatment, it would stay in your system for about a month, continuing it’s slow functions, and you’d have to return every month for the next treatment—but after receiving the full drip, these subsequent treatments could be done outpatient and you could return home. 

The treatment would have a short term component that deliberately makes you drowsy, because going to sleep right after finishing your drip would be the best way for your body to handle it, so most treatments would be scheduled around 6:00pm on Fridays, so you can get maximal sleep the first night and adapt to the post treatment state over the weekend. (So you couldn’t drive yourself).

But how would it work, my sci fi treatment?

First, the treatment would trigger inflated adipocytes to gradually deflate—the treatment would of course be titrated down to not exceed a level of energy release the body can accommodate in a day—and then would trigger a steady state accelerated apoptosis of the depleted adipocytes by tagging only depleted adipocytes and once tagged emitting the chemical signal for the body to recognize they need to undergo apoptosis. This is so that the empty state of a large amount of depleted adipocytes does not trigger the body to demand kcal to re-inflate them (which is the usual yo yo cycle). Since apoptosis of depleted adipocytes usually takes months, a tag and signal system would be needed to accelerate this process, to match the treatment induced accelerated adipocyte deflation.

If you figured a titration level that maxed out at 2500 kcal per day freed from the inflated adipocytes, steadily spaced out over 24 Hours, this would result in a 5 lb loss per week, and successfully treat mild obesity (40 lbs overweight) over a two month period, and would treat severe obesity (200 lbs) over the course of a year; But such extreme cases might need more staggered treatment schedules.

Freeing 2500 kcal per day ought to result in a depressed appetite, and commensurately reduce food consumption (possibly by a shocking amount) and/or cause increased energy levels (which may lead to spontaneous exercise uptake.)

But since food intake is generally habitual and ritualistic and many obeseogenic foods are engineered to be addictive, the efficacy of the therapy would probably be enhanced with a combination with an anti-addiction medication (in the vein of naltrexone, for example) to mitigate the addiction behaviors (and habit behaviors, perhaps) of patients while they are a weight loss state

And to match the accelerated loss and depletion of adipocytes, a leptin intervention would also be needed to have the body adapt at a matched pace, so the body is not left fighting the therapy because it’s been left behind and is still trying to regulate for the obese homeostasis it is adapted to.

The leptin and anti-addiction medications would stay at a maintenance dose for at least six months after the cessation of the anti-obesity therapy. But if the body refuses to reset on its own, leptin therapy may need to be maintained lifetime, like thryroid interventions.

/this has been your science fiction moment of the day.