
As obesity keeps rising, more Americans are just giving up - upen
http://www.latimes.com/science/sciencenow/la-sci-sn-fewer-americans-diet-20170308-story.html
======
quotemstr
Is it really in the best interest of society to allow food makers to advertise
superstimuli-level [1] food products that we _know_ in aggregate make is less
happy and likely to die earlier? Why? We regulate all sorts of substances that
we know are harmful when ingested. We shouldn't make exceptions for things
that happen to be called food. Even if we don't want to enact anything as
drastic as a "soda tax" or a ban on refined sugar, we can at _least_ stop
processed-food companies advertising to children and creating life-long bad
habits.

The FDA could also be more eager in approving appetite-regulating drugs,
allowing people to choose to take on certain risk in exchange for large
potential weight loss. Several effective agents have been known since the
1920s; is a small risk of cataracts or heart valve damage in a small number of
people really worth allowing millions of people to be sicker than they would
otherwise be?

Speaking of drugs: smoking decreases BMI quite a bit. Granted, it damages the
lungs, but like most things, tobacco has a mixture of positive and negative
effects. Given that we have an obesity crisis, was taboo-ing one of the more
popular and effective anti-obesity tools really the right choice?

[1]
[https://en.wikipedia.org/wiki/Supernormal_stimulus](https://en.wikipedia.org/wiki/Supernormal_stimulus)

~~~
lacampbell
At what point do people take responsibility for their own bodies and their own
lives? We all know the secret to not being obese. Asking the government to
step in and help us just seems... childish. Are we not adults? Do we have no
agency?

~~~
krisroadruck
Do we all know? I currently weigh 270lbs (and climbing) and I

    
    
      * Don't consume soda or sugary drinks of any kind
      * Go on 3 mile walks 3-4x weekly
      * Have switched to soylent 100% of meals to make calorie counting dead simple
      * Recently cut out alcohol too
    

And yet pounds are adding on not coming off. I've been gaining about 10-15lbs
a year every year since I hit 30 after being at a stable weight of 170lbs for
all of my teens and 20s and none of the adjustments I've made have had ANY
impact on it what-so-ever. So maybe its not just "eat less, fatty". Maybe
there is something else going on?

~~~
matthewmacleod
Perhaps unfortunately, the human body cannot ignore physics - weight gain does
ultimately come down to "you are consuming more calories than you are
expending"!

You're right that "eat less, fatty" is not a helpful message. That's actually
the key point in these discussions - we do know how to avoid weight gain in
the abstract sense (consume less than you burn), but the implementation of
that is what's difficult. Different foods have different effects on
metabolism; it's difficult to count calories accurately; people often
overestimate the calories that exercise burns and underestimate their
consumption. It's made more difficult by sedentary lifestyles, prepared foods,
and so on.

If you are gaining a pound a month consuming nothing but soylent, then you're
consuming too much of it. There's no way around that fact. But the point is
that it's not a failing on your part - it just demonstrates how difficult it
is in practice to control one's own lifestyle.

~~~
prostoalex
> weight gain does ultimately come down to "you are consuming more calories
> than you are expending"

That is incorrect, but it does help sell gym memerships.

Moreover, expending more calories via exercise typically leads to weight gain,
according to emprirical studies (and anecdotal look around gym's elliptical
machines next time you're in one)
[https://well.blogs.nytimes.com/2014/11/12/exercising-but-
gai...](https://well.blogs.nytimes.com/2014/11/12/exercising-but-gaining-
weight/)

Fat accummulation (and disposal) are governed by insulin, whose production is
triggered by sugars and other carbohydrates.

Confusingly, consuming a high-fat, low-protein and zero-carbohydrate diet will
also lead to a severe decrease in calories (as it's pretty hard to overdose on
olives, coconut oil or lardo), but it's nevertheless a correlation.

~~~
piva00
No, that's not incorrect. By thermodynamics it's impossible you are gaining
weight by not consuming more calories than what you are spending, you don't
absorb this energy out of thin air or radiation, you've eaten it, not used and
your body has stored it.

It can be that our models for calculating TDEE, etc. are wrong and not
accounting for a multitude of factors that might affect energy expenditure but
still, it boils down to calories in -> calories out in the most simplistic
level.

~~~
prostoalex
Calorie is a unit of energy. Wooden logs have calories, and so does paper and
chalk. Leaving safety concerns aside, I cannot substitute my salad with some
paper I can get from the shredder. If I did, I am unlikely to get extremely
obese on shredded paper diet, as most of it is fiber, so it just hits the
output channel of the digestive track.

Calorie present != calorie consumed != calorie processed by digestive system
!= calorie deposited in the fat tissue

If all calories were the same, consuming 300 calories from a can of Coke and
consuming 300 calories of green salad would lead to same outcomes. In long
term they do not.

~~~
sn9
The idea that biologists aren't aware of the difference in the digestibility
of paper versus lettuce is just insultingly ignorant.

There's a reason why you lose weight if you have a tapeworm or have chronic
diarrhea while eating the same amount of food isn't a mystery to the
scientific community.

Most people don't see that much variation between the calories that pass their
mouths and those that are digested by their GI tract. It's usually constant
enough that calories in - calories out is enough to figure out how much you
need to eat to lose weight. Even if there was a disparity between calories
consumed and calories processed by the GI tract, that would only present
itself as a "higher/lower metabolism" and wouldn't mean lowering calories
wouldn't work to lower weight.

You can't get around physics and biology.

~~~
prostoalex
> you lose weight if you have a tapeworm or have chronic diarrhea while eating
> the same amount

Okay, but that seems like an outlier case. The study I am looking for would be
summarized roughly as "100 fat people start on a lower-calorie diet and
increase their exercise routine over the course of 180 days. 98% of them (some
statistical variation to account for weird genetics) consistently lose X
pounds, a large group (60-70%) loses as many as Y pounds".

Most experiments that were set up that way either ended up reporting the
results "inconclusive", or worse, as the caloric intake generally decreased,
the weight increased
[http://www.amjmed.com/article/S0002-9343(96)00456-1/abstract](http://www.amjmed.com/article/S0002-9343\(96\)00456-1/abstract)

I am looking for the one, or two, or a dozen, that doesn't. Should be
relatively easy to replicate.

------
buzzybee
Our culture has acquired a lot of poor health habits that are seemingly
inescapable, depending on your socioeconomic background:

* Most industrial food products are adulterated with dairy, sugar, or both

* Industrial food is also cheap and widespread. It takes dedication to avoid it or restrict its impact: At parties, the default non-alcoholic beverage is sugar water, and the default food is pizza

* "Sleep is for the weak" is an oft-repeated, sometimes praised meme

* Driving everywhere is expected in many cities. In some neighborhoods, "taking a walk" is looked upon with suspicion

* Most jobs now are low on physical intensity, while work hours and work-related stress remain high

* The most popular recreations involve "screen time"

* Fitness is polluted with snake oil, "bro science" superstition, and image-driven advice; exercise and training itself as a form of character-building is viewed derisively

* Diet advice is similarly polluted with snake oil and superstition. Commerce drives the market, leading to quick-fix bandaids that promise a temporary change followed by a return to the original (unhealthy) habit

Lots of people are stuck in this scenario, because it takes uncommon
dedication and some financial freedom to break with the culture and build a
lifestyle of your own design. When their health fails we all pay the price.

------
tzs
Here's a nice map of the US showing the adult obesity rate in each state:
[http://stateofobesity.org/adult-obesity/](http://stateofobesity.org/adult-
obesity/)

Note that you can select earlier years using the controls below the map. Some
depressing observations:

• In 1990, the highest rate was 15% (Mississippi) and the lowest was 6.9%
(Colorado).

• In 2000, the highest was 23.9% (West Virginia) and the lowest 14.5%
(Colorado). Note that in a mere 10 years, the lowest was almost equal to what
had been the highest.

There are plenty of other charts on the site. There is one for physical
inactivity. That shows two interesting things:

• The states with the highest obesity have the most inactivity, and the states
with the least obesity the least inactivity.

• However, for each state the level of inactivity has remained fairly flat
over the last 10 years, even though the obesity rate has risen in those
states. Inactivity might explain why some states are more or less obese than
others, but it doesn't appear to have anything to do with why we are getting
fatter everywhere.

~~~
rpcorb
It really is interesting that only in the last 20-25 years has the obesity
rate really taken off. In other words, it doesn't seem like this was gradual
linear trend starting much earlier. So, why didn't it happen earlier? What
changed (the most)? Was it a convergence of forces reaching a tipping point?
Or did a single major change occur in the 90s, such as the food industry
introducing a key st of addictive ingredients?

------
delerio
It honestly is pretty simple, self-control and discipline. I lost 75lbs over
the last year. I was at my high weight (250) for over 8 years. I finally just
gave up almost all "sugary" things, which was the most difficult part, I
didn't realize I was so addicted. I ate much less calories than I used to. I
started exercising regularly, not too much at first, but eased myself into it.
After 4 months, and a significant weight loss, I stepped up my calorie intake
a bit and then started exercising more vigorously. Currently I go through
periods of eating a lot, and then eating very little. My weight continues to
go down. It really is simple, if you can get over the feelings of "severe
hunger" for the first few months you can shrink your stomach. I hardly get
hungry anymore, and have been trying to eat more recently to get my stomach a
bit bigger so I don't lose too much. It's just willpower and dedication.
Companies are to blame for making it easy to eat unhealthy, but I feel
healthier than I ever did just by cooking my own meals and eating a reasonable
amount.

------
sssilver
As a skinny immigrant who moved to USA and started growing a tummy, I have a
few questions.

\- Why does American food go bad so much later than back home? It shocks me
how strawberries here can stay in the fridge for over a week and not go bad,
same about tomatoes, or yogurt, or even bread! Back home if you don't eat your
strawberries on the same day, the next day they're just gonna be mushy, and
the day after they're gonna be inedible. I get so skeptical whenever I see any
food that can last over a year

\- The portions are just monstrous, I remember when I was new I couldn't
finish a single restaurant main course, and now I sometimes catch myself that
I could actually get a main course _and_ an appetizer, and a dessert! Wouldn't
restaurants make more money if they sold less food for the same price?

\- The culture of "snacking" is quite interesting, I used to only eat during
dinner/breakfast, now I find myself snacking in between, because snacks are so
accessible and yummy and almost addictive

\- Ingredients are often tasteless, so you guys add a lot of sauces to make
them taste better. The sauce usually contains sugar and other stuff that
doesn't help you stay fit. Why not just have food with more natural flavor?
This applies to everything from blueberries to meat

\- Meat sizes are completely bizarre! I've never seen such huge chicken
breasts where I'm from. They're also quite bland and not soft/juicy at all.
How does this even work?

\- The concept of zoning is a disaster, if I wanna eat I need to sit in a car
and drive where the restaurants are, and if I want booze I need to sit in a
car and drive where the bars are, and if I wanna work again sit in a car and
go where work is, then for sleep I need to sit in a car and drive home. Why??
Why can't I live in a residential building where first floor is restaurants
and cafes, and a few blocks away is my work? You have huge residential
communities where it would be foolish to even attempt to walk out of them,
because the nearest grocery store is several miles away! Who came up with
this, and how can this be a thing?

~~~
capsule_toy
\- Most fruits in the US are bred to last longer and picked earlier so that
they can survive long trips from the farm to the grocery store.

\- Take a closer look at the ingredients in your bread. You're most likely
buying bread with preservatives. There are bread makers that make bread
without them and those will go bad sooner. Look for sprouted bread. Those can
go bad within a couple days of the sell by and the sell by itself is only like
3 days from when they get it in.

\- Why would a customer want to pay more for less versus your competitors?

\- Ingredients are tasteless because same as with breeding fruits for
transport, we do not optimize for flavor but quantity and cost. Good meat is a
function of what the animal eats and if they exercise. What you're looking for
can be most likely found at your local farmers market.

------
minikites
> Replicated by other studies, that research helps explain the discouraging
> finding that within five years of having lost weight, 95% of dieters will
> regain all the weight they lost. And most will gain a few extra pounds as
> well.

I'm part of that privileged 5%. I lost around 60 pounds in 2009-2010 and I've
kept it off. It really is a lifestyle change. You have to be constantly aware
of the portions you choose and remember what you've already eaten that day to
keep in "budget". There are tools and processes that can help, but it's a
constant struggle against your body that is constantly lying to your brain. I
can definitely see why many people would give up.

~~~
brohoolio
Do you still have to actively manage your calorie intake?

~~~
wccrawford
I'm not who you asked, but...

I lost 55 lbs and have kept it off for a year now.

It's a constant struggle. If I stop watching what I'm eating, I'll start
overeating immediately and start gaining weight. I went to a wedding a week or
2 ago and gained 5-7 lbs. Watching my diet since then, I've dropped most of it
again. If I hadn't watched it immediately, it would have stuck and I'd have a
hard time losing it again.

I'm very careful about what I eat for breakfast and lunch, to the point of
almost always having the same thing. Dinner is very varied, but I still have
to watch things or I'll go overboard.

I eat burgers, Mexican food, Italian, pizza, etc etc... But I do _not_ eat
dessert. I've found that there's no way to avoid gaining weight if I eat any
dessert at all.

To deal with my sweets craving, I drink diet sodas (they've improved a lot
lately) and Tic Tacs.

If I really need a snack, it'll be peanuts and pretzels. They're high in
calories, but no sugar.

------
cletus
As much as people like to jump up and down about public health issues like
cigarettes or even guns, what I find interesting is how few people seriously
talk about the car being one of the biggest public health crises to originate
in the 20th century.

There is of course the direct effect of the hundreds of thousands of vehicular
related deaths per year (globally) as well as serious injuries but there are a
bunch of other effects.

One of these is the change in urban planning where life is centered around the
car such that Americans, in particular, walk far less than people in other
countries [1].

There's a big difference here between walking and needing to walk. People in
NYC for example pretty much need to walk. I'm not saying it's impossible to
become obese when your daily life requires you or even just encourages you to
walk more but it sure makes it more difficult.

[1]
[http://www.slate.com/articles/life/walking/2012/04/why_don_t...](http://www.slate.com/articles/life/walking/2012/04/why_don_t_americans_walk_more_the_crisis_of_pedestrianism_.html)

------
dageshi
I think most of the comments in this thread miss out the fundamental issue,
which is bad food not only tastes better than "good food" it also often is
cheaper and crucially is more convenient.

Convenient food, that tastes good but is bad for you will beat out
inconvenient food that tastes "ok" and is healthy for you.

For a lot of people cooking is just more work and if they've got the choice
and the money they'll order take out or buy pre-made ready meals.

Moaning about sugar and advertising is just tinkering around the edges, to me
if you want to solve this problem you've got to make eating healthy as
convenient if not more convenient as eating badly.

------
aplomb
We're at a point where there is so much technological, cultural, malicious
disruption that people don't know how to live anymore and are trying to find
their way on the fly or based on some diet/lifestyle du jour.

Yes personal responsibility and all, but we've made it awful easy to fall into
this trap.

------
beloch
Losing a significant amount of weight and keeping it off is difficult but
possible. My brother and I both did it, but in very different ways.

Personally, I maxed out at a BMI of 34. I lost about 70 pounds, got back into
the normal BMI range, and have stayed there for about a decade now. I changed
my diet, changed my physical activities, and changed a lot of habits and modes
of thinking. That last one is perhaps most important of all. For example, as
kids, we were taught not to waste food, and that meant eating everything there
was. Well, cleaning your plate (and the pot) isn't going to put food on the
plates of starving children. Whether you eat it or not, the waste happened at
the supermarket when you bought too much food!

My brother saw me losing weight and wanted to do it too, so I tried to help
him. He hated the food I was now eating. He didn't want to work out. He didn't
want to change the way he thought. Instead, he got a _lot_ fatter and,
eventually, a sleeve gastrectomy. He's not in the normal BMI range yet, but
he's been making steady progress and it's not optional for him. He literally
can't eat enough to stay fat. His stomach is now tiny and fills up rather
quickly. The prep for the surgery was harsh, and included a brutal, several
week long crash diet. The surgery itself went off without a hitch, but he
still had to recover on a morphine drip. I have no idea what kind of pain that
involves, but it can't be pleasant. Bottom line, he thought he was choosing
the easy way at the time, but we now both know it was the _hard_ way. Harder
by far. I got healthy. He inflicted a disability on himself that has the side-
effect of losing weight. He still isn't active and, not surprisingly, has
terrible energy levels.

After both our experiences, I can reasonably say the media does a terrible job
of helping people. It tells them about healthy things to eat, but never
mentions these things are only healthy if you eat them _instead_ of your usual
fare, and in appropriate amounts. It tells people they need to be ripped,
cross-fitting gym-bunnies to be fit, when doing just about _anything_ besides
sitting on your butt will be an improvement for many people. Finding a
physical activity you can _enjoy_ is far more important than being ripped.
Above all, it rarely attempts to help people change the way they think, which
is the key to making permanent changes.

TL;DR: If I had to offer one piece of advice to those wishing to lose weight
and become more active, it would be to ignore all the crap articles out there
on diet fads and gym-crazes and pay some attention to how you _think_ about
food and activity. Change how you think, and everything else will come as a
consequence of that change.

------
CPLX
> weight bias and discrimination raise the risk of developing heart disease
> and diabetes

The idea that a study conclusively demonstrated that in a meaningful way seems
extraordinarily unlikely. I'd be awful curious to see the methodology of that.

------
Neliquat
Until this is treated like the public epidemic it is, and promote education,
this will only get worse.

Calories in - calories out = fat accumulation. It is literally that simple.

~~~
wavefunction
You're of course leaving out the complexity in how "Calories in" and "calories
out" are derived for individuals.

Some people consume too much calorically as a mental-health coping mechanism.
Some people consume too much calorically because the food culture they were
raised in promotes that. Some people consume too much calorically because they
have a lack of real options to purchase fresh whole foods.

Some people don't expend enough calories because their lifestyle makes it
difficult (work + family + etc). Some people don't expend enough calories
because the lifestyle they were raised with doesn't promote that.

These are just some of the ways that simple equation you've posted become
immediately more complex.

~~~
DoodleBuggy
Every complexity you posted still comes down to consuming more calories than
is needed.

The reality is the vast majority of people eat way too much, and the dietary
guidelines for caloric intake are far too high for a largely sedentary
society.

~~~
lacampbell
That's one of the things you really have to accept if you want to lose weight
- yes you will have to eat less, and yes you will feel hungry a lot.

~~~
montecarl
I do not want to sound like I am arguing with you for the sake of arguing, but
I have lost weight and several of my friends and family have lost weight
without feeling hungry by switching to a low carb (ketogenic) diet. It was so
crazy to eat mostly fatty food and green vegetables and lose weight very
quickly. One major thing I noticed was how much longer I was able to go
without eating on this diet without feeling hungry. I used to feel very ill if
I did not eat at least 3 meals at day. I can now, if I choose, eat a snack in
the early afternoon and then eat dinner and feel fine (1.5 meals instead of
3).

~~~
sokoloff
This matches my experience as well. The transition period (~1.5 weeks, but
especially brutal on days 2-5) was rough, but once established, it was the
easiest diet to stay on if you could control your environment and mostly cook
for yourself or choose where to eat.

It is somewhat harder to stay on the diet while traveling, attending
conferences, or business meetings. Having a host choose a place to eat, offer
you local cuisine, etc makes it harder to stay in keto. Hunger though, was
never a problem after the first full week.

~~~
Jach
Keto is great but there's still a willpower component, it can be more or less
difficult depending on the person. I don't really like cooking a lot, but I
don't mind eating the same things most of the time. It would be a lot harder
for someone who hates cooking and hates eating the same thing all the time.
While raw hunger never bothered me I did find cravings an occasional issue
(never constant, but even after months never quite disappearing) and sometimes
they'd be for things I haven't had in years. Eventually it might be something
easy to satisfy like a pizza and when you give in once it's easy to say "screw
it", though some people can only continue if they have an occasional cheat
day.

I'm an on-and-off-again keto dieter (I appreciate that for me it seems to take
at least 2-3x as long to put the weight back on as it takes to take off as I
inevitably revert to former diet choices...) and I never find the transition
period difficult, but there's a consistent point where I hit "eh, still fat,
but don't feel super fat anymore" and that's when the cravings or the
pressures of eating non-keto with company have the highest chance of getting
to me. There are also unforeseen stressors that can make things difficult (in
my case a forced house move) but I'm ok with the state of flux. I don't want a
six-pack physique enough, not really, and that's the last willpower component
-- how long can you stick with it (and introduce more exercise), even with
bumps and setbacks? My friend who introduced me to the diet lost 100 lbs by
forcing himself to do keto for about 5 months, but he was fat enough at the
start that he could stand to lose another 50 lbs but it's not as easy now.
Still, he's much happier and healthier now than before. One's level of
willpower is still involved even with how great keto is and is the difference
between losing 50 lbs (not bad), 100 lbs (pretty awesome), and 150 lbs (your
ideal).

------
DrScump
Am I the only one who got a _Reese 's_ video ad when loading this article?

------
DoodleBuggy
Is this really different from smoking or another harmful unhealthy lifestyle
choice? It's abusing food, and it has negative consequences.

The cost of health care to manage obesity and related issues is staggering and
will only increase.

Maybe the USA should start having a BMI tax?

~~~
bijection
It may be that that lower income means lower quality food means higher BMI, in
which case a BMI tax would exacerbate the problem. Food for thought.

~~~
DoodleBuggy
OK, so tax garbage food and tax BMI.

Really, it should be no different than any other sin tax. It's behavior you
want to discourage, so tax it.

~~~
sethammons
Simply raising prices on bad food would not be enough. Food education and
getting healthy food choices to be more affordable are key. There are huge
swathes of people who have no clue what eating healthy looks like. And eating
healthy is more expensive.

------
BadassFractal
I haven't really paid attention to men's physiques, but there's a stark
difference between the silhouettes of women in many cities of Europe and those
in even the most "superficial" US states such as California.

I know the PC police will eat me for lunch for saying this, but the dating
pool, at least in the 20s and 30s range, shrinks considerably in the US for
anybody used to European body image standards.

Whatever's happening to the population here is not normal. I don't know if
it's our lifestyles becoming totally sedentary, if it's food marketing having
reached absolutely irresistible heights, or if it's the lack of a culture of
slow eating, but something is clearly not working and it really doesn't feel
like the individual's fault, it seems actually systemic.

One thought is perhaps we should start treating the constant incessant
advertisement of food the same way we treated the cigarette industry and
regulate its appeal to children, put up disclaimers about what happens when
you down that entire bag of cheetos etc.

~~~
rglover
No, it's the individual's fault. I was severely overweight a year ago and lost
80lb doing nothing other than eating healthy, exercising, and...being patient.

The deferment of responsibility and lack of self-control is the problem. Of
course, companies–and more specifically, their marketing teams/firms–know
people are weak-minded and as a result, can more or less control people's
habits (read: greed outweighs public concern). It doesn't help that the
culture has tilted toward justifying poor health in the form of all the body
image propaganda.

~~~
BadassFractal
The point is that until this last century the average human didn't have to
obsess over this stuff as much as we do now. No keto, no HIIT, no fitness
trackers, no low carb, no leptin management.

You ate what you could get your hands on and you mostly stayed in pretty
average shape because food wasn't that stimulating, that heavily processed,
heavily advertised, and you have to be a lot more mobile than you are today.
Humans didn't evolve to have to count calories, no animal in nature does it or
is capable of doing that effectively.

~~~
scruple
Well, that and people are incredibly inactive by the standards of last
century.

