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Excess weight, obesity more deadly than previously believed

colorado.edu

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Re: Excess weight, obesity more deadly than previously believed

#81

Earlier quoted context omitted.

Based on seeing what is in most shopping carts, most people are not even trying to control weight. Starving one’s self is not necessary. Not buying ice cream, cookies, chips, added sugar foods, and beer is necessary. Do not eat out, and do not let unhealthy foods into the house. And do not shop while hungry. The root cause is all that unhealthy stuff gives everyone a dopamine hit they want. Living in an environment t…

> Not buying ice cream, cookies, chips, added sugar foods, and beer is necessary. Do not eat out, and do not let unhealthy foods into the house. And do not shop while hungry. I've done all that and more for 10 years and still gained 100lbs. Exercise didn't help, just made it worse. Yes, I've gained 20-30lbs (not muscle, I wish!) in a few months by exercising more. I've failed to lose fat doing 10 months of 4x per wee…

Sorry to hear that, and while I obviously cannot speak for your experiences, the lifestyles of overweight people I am familiar with does not lead me to believe they are making the necessary sacrifices to be a healthy weight.

Re: Excess weight, obesity more deadly than previously believed

#82
post #64

Earlier quoted context omitted.

> Not buying ice cream, cookies, chips, added sugar foods, and beer is necessary. Do not eat out, and do not let unhealthy foods into the house. And do not shop while hungry. I've done all that and more for 10 years and still gained 100lbs. Exercise didn't help, just made it worse. Yes, I've gained 20-30lbs (not muscle, I wish!) in a few months by exercising more. I've failed to lose fat doing 10 months of 4x per wee…

I lost 150 pounds in 1.5 years doing literally nothing different but eating less, and kept it off for the next 15 (present) You own failings are due to you lying to yourself about how much you eat. Humans are not able to break the laws of thermodynamics. If you consume less than you burn, you will lose weight no matter what.

> You own failings are due to you lying to yourself about how much you eat.

False. How much you eat is only indirectly related to energy partitioning, which decides if that food energy will be burned or stored. Trust me, I've tried more than you and am more obsessed with the topic :)

You probably decreased carbs and PUFAs significantly as part of "eating less."

> Humans are not able to break the laws of thermodynamics. If you consume less than you burn, you will lose weight no matter what.

Ah, the ol' accounting tautology :)

Of course you're right, but of course it has nothing to do with the topic. "Being in an energy deficit" does not necessarily come from "eating less" or "exercising more" and eating less or exercising more do not guarantee a deficit.

Turns out the human body is full of miraculous biochemistry, it's not an oven.

Re: Excess weight, obesity more deadly than previously believed

#83

Earlier quoted context omitted.

I don't think willpower has anything to do with it.

You don't think it requires any willpower to restrict yourself and change how you eat? That might have been your experience but millions of other people claim otherwise. Either a million people are wrong, or you're an anomaly. I think the latter is more likely.

I'm saying that if you rely on willpower, you will fail.

Of course you should change how you eat if how you ate caused you health problems. But I'm advocating for making a conscious change that will then enable you to eat without having to use willpower.

That's why "just eat less" is terrible advice and works for practically nobody.

It's like finances. "Just save more" is terrible advice. Getting a degree or finding a high paying job or setting up automatic 401k contributions doesn't require willpower day-to-day, and has a much higher chance of success.

Re: Excess weight, obesity more deadly than previously believed

#84
post #17

Earlier quoted context omitted.

The U-shaped distribution of outcomes has been discussed for many, many years, and I've never seen it mentioned without the caveat that most doctors and scientists suspect that it's a misleading statistic attributable to serious illnesses that cause weight loss. This definitely isn't the first study to support that interpretation, either. In other words, the longstanding conventional wisdom (at least as presented in…

This. The U (or typically J as I've heard it described) shape comes mostly from the fact that very many very unhealthy people lose a ton of weight and end up with a super low BMI.

Sprinkled with a coating of "body positivity" perhaps?

I use quotes, because I personally only believe in body positivity for matters that are beyond control - eg disfigurements related to genetics or trauma. No-one should shame anyone - or feel shame - for things they have no say on.

Matters within scope of control should be addressed, however. At the very least not lied about and promoted as healthy, more importantly.

Re: Excess weight, obesity more deadly than previously believed

#85
post #40

Making GLP-1 agonists and related drugs (ozempic, mounjaro) cheaply/widely available seems like it would be excellent public policy.

It seems that they also make you lose tons of lean mass. Normal diets you lose 25% of the lost weight in lean, these seem more like 40%. https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...

In an apples to apples study it showed similar effects to canagliflozin which works through an entirely different pathway. So it's probably not related to GLP-1 but to the speed and effectiveness of weightloss which will most likely be faster than a typical diet.

https://pubmed.ncbi.nlm.nih.gov/31897524/

Re: Excess weight, obesity more deadly than previously believed

#86
post #54

Earlier quoted context omitted.

True, but don't feel like you have to run for 30 minutes. Walking for that long will go a long way for a lot of folks. Really, walking should probably be looked at far more closely for many folks.

Walking for 30 minutes will go a long way to promote general health, but it's not a lot of calories burned.

On a day to day basis it usually isn't a lot of excess calories eaten either, but over a year or 10 those small discrepencies can add up.

Re: Excess weight, obesity more deadly than previously believed

#87
post #80

Earlier quoted context omitted.

I wouldn't try these until they've been studied further: https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...

From the linked article: >Among these patients, lean mass accounted for approximately 39% of total weight loss – substantially higher than ideal. In a substudy of 178 patients from the SUSTAIN 8 trial on semaglutide as a diabetes treatment, the average proportion of lean mass loss was nearly identical at 40%, despite lower doses and less total weight loss than in the STEP 1 trial. [...] Or in other words, 60% of the…

Also from the article: > Though a certain amount of lean loss is inevitable with significant weight reduction (usually about 25% of total weight loss)

The justification is provided: this is nearly double the lean body mass loss usually seen in drastic weight loss. Yes, 0% is impossible, but this is worryingly high. It might be OK in younger individuals who have a ton of fat mass to lose, and they might gain any lean body mass back. But in older individuals that are already having a hard time exercising, it's unlikely that lean body mass will ever come back.

Makes me think these drugs should probably be a measure of last resort. Unless more studies defuse this.

Re: Excess weight, obesity more deadly than previously believed

#88
post #54

Earlier quoted context omitted.

True, but don't feel like you have to run for 30 minutes. Walking for that long will go a long way for a lot of folks. Really, walking should probably be looked at far more closely for many folks.

Walking for 30 minutes will go a long way to promote general health, but it's not a lot of calories burned.

This is an area where calories is scary misleading. The 30 minutes walking is indeed low in the direct impact. For some reason, it punches well above expectations, though. Probably something about base metabolism and such, but whatever it is, you will lose more weight from walking than you'd expect.

Similarly, people probably walk way way less than you would expect. It is kind of scary to see how few steps I can get on a standard day.

Re: Excess weight, obesity more deadly than previously believed

#89

This seems useful. However, some people, both inside and outside medicine, believe that negative consequences' education can be a solution to the overweight/obesity issue, even though after 40 years we've seen near no positive correlation. We've seen some positive outcomes from interventions (e.g. mental health treatments, actionable plans, etc.) but the funding/resources for those continue to be scarce. So the trend…

Are there any studies showing a significant reduction in population body mass (our primary endpoint) following sugar taxes?

Re: Excess weight, obesity more deadly than previously believed

#90
post #79

Earlier quoted context omitted.

> It's a failure of self control. Disagree. The root cause of the problem is that you can't apply to more willpower if you don't know how to actually fix it, and we don't. There are currently 0 known methods to lose fat sustainably. Yea, you can starve yourself for a few weeks in a thousand ways, but none of them lead to lasting fat loss. Neither does any kind of exercise. We need to find the true root cause, or this…

There aren’t any exercise (in whatever amount) that lead to fat loss? Sounds like massive cope. It’s extremely obvious that doing something like running every day (if it leads to a calorie deficit) will make you lose fat.

Well, I've tried it. I've lost tons of weight, but never with exercise. So it's not cope, it's just a matter of science.

> It’s extremely obvious that doing something like running every day (if it leads to a calorie deficit) will make you lose fat.

But what if it doesn't because your body is a self-regulating dynamic system that changes energy partitioning and intake demands based on output?

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