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After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight (nytimes.com)
305 points by yanowitz on May 2, 2016 | hide | past | web | favorite | 364 comments



Well, I'd say that the endocrine reason sounds like a valid one. I can at least be counted in that group.

Last December, I was diagnosed with T2 diabetes. After talking with a researcher about this (have worked with diabetes research school locally due to job), I came across a few things:

1. Damage is done to the pancreas at 140mg/dL 2. Too long at 140mg/dL or above can cause permanent damage to the pancreas. 3. Early estimates indicate that 110mg/dL is a lower limit of beginning damage to the pancreas

Ok. There's a lot of moving parts in food. Nutritionists will tell you all sorts of bunkum, other than mineral assays and tests have discovered. But there's a simple way here: keep blood sugar under 140mg/dL, no matter what.

Is that possible? To keep your blood sugar under 140mg/dL? Yes. The answer is "Don't eat foods that raise your blood sugar above 140mg/dL". That's interestingly easy. What it amounts to, is cutting out sugars and carbohydrates out of your diet, and extensively testing when you come across foods you're unsure of.

My research shows that all the standard sugars are bad for me (Sucrose, glucose, fructose, lactose). I spike, and then fall. It also depends on what I'm eating with them. In those cases the rise and fall are longer.

Some complex carbohydrates I can handle. Potatoes are a nope, as are bread products. But spaghetti squash works with me well. I can handle it nicely, with a very low rise and fall.

I also end up eating a lot of fats, protein, and veggies. But I don't crave sugar at all. I've always liked meats, and this gives me the ability to continue that.


^ This times 1000000. There is so much chicanery and malfeasance in the nutrition and fitness industry.

I was diagnosed with T2 diabetes a few years ago. I went to dietitian who prescribed a diet with 60% carbs (I believe its roughly the same as the ADA dietary guidelines). The standard treatment is medication, followed by more medication, then insulin shots.

Frustrated, I read everything I could get my hands on, and found two books that I'd highly recommend: 1) Dr. Bernstein's Diabetes Solution, and 2) Think Like a Pancreas by Gary Scheiner. Dr. Bernstein is notable because he was diagnosed with T1 when it was a fatal condition. He survived, became an electrical engineer and ultimately went on to become an MD. He lobbied the AMA to allow patients to have blood glucose meters, when the AMA wanted them to be restricted to doctors offices.

I stopped listening to medical practitioners and starting experimenting with the foods I ate, using pairs testing with a glucose monitor. There is no question that a low carb diet is the way to go.


> I stopped listening to medical practitioners and starting experimenting with the foods I ate, using pairs testing with a glucose monitor.

I sometimes wonder if the state of medical ethics is killing us. We've made it so expensive to do a medical study that nobody is going to do it unless the end result is something they can sell, so the only "solutions" we get are drugs because there is no money to be made in prescribing diabetics a diet of fish and vegetables.

It's a sad state if an individual can learn more by experimenting on themselves than their doctor knows because the doctor isn't allowed to participate in or publish the result of the same experiment without a multi-million dollar budget.


Generally I would say the responsibility of doing something that is beneficial to society but not economical rests on government. Vote for politicians that will increase research funding


That is a very low standard of morality. Historically private institutions had greater trust and expectations from society. They may have abused that trust - but the solution is not to absolve them of what was their historic responsibility.


Aren't there tons of studies on whether some particular food is good for the heart, good for the brain, etc.? It's not that nobody does them, it's just really hard to get a conclusive result that applies to everyone. There are lots of foods that are both good and bad for you, depending on the study.

I think the problem might be more that there aren't very many universal results, and the fish and vegetables diet that works for one person won't work for others.


> Aren't there tons of studies on whether some particular food is good for the heart, good for the brain, etc.?

Not really. There's tons of studies on whether some particular food is connected to some very narrow positive or negative outcome for the heart, brain, etc., on which popular ideas about the food being generally good for the heart, brain, etc. are built. (And, from those, even flimsier popular ideas about the food being generally healthy or not.)


I went to an interesting talk the other week about the potential for personalized medicine to and how what seemed like just throwing data at medical issues can eliminate this problem.

ie, you gather medical data from thousands of people and find someone similar on a micro level to the current patient and see what has helped them.


> It's not that nobody does them, it's just really hard to get a conclusive result that applies to everyone.

Exactly. The research is starting to show that individual reactions vary dramatically.


> "...no money to be made..."

That's the ethics of business. We have no healthcare; there's a healthcare industry and we are how it extracts its profits.

This inevitably corrupts the goals of an "ideal world" healthcare system which would exist to provide efficient and affordable healthcare.


I've heard the theory that establishing these high standards was actually in the best interest of the pharmacy industry. A great way to keep competition at bay, because only huge companies can afford to comply with the regulations.


Yes, this is sadly correct. In the pharma industry, we call it pleasing "the stakeholders." Many times more expensive tests/treatments/etc are developed over cheaper ones, as the risk seemingly (if the MBA stakeholders are to be believed) necessitates chasing medical innovations that will have the largest ROI.


The limiting factor on medical research isn't ethics: it's samples large and diverse enough to have a meaningful ability to distinguish between null and alternative hypotheses.

We produce shit studies with small sample sizes and dodgy methodologies all the time. They just don't add to the pool of human knowledge.


> We produce shit studies with small sample sizes and dodgy methodologies all the time. They just don't add to the pool of human knowledge.

They actually do. A crappy study with p=.70 isn't enough to justify changing the standard treatment for a disease but it is enough to justify doing the more comprehensive study to see if the result still holds.

We have a choice between doing ten comprehensive studies only to prove that nine of the things didn't work, or using the same resources to do a hundred crappy studies and then repeat the five with the most promising results using the more robust methodology and discover that three of them still hold.


You confuse p-value with methodology. P-value is entirely a product of sample size and effect size. For a given effect size, the cheaper I want the study to be, the smaller I make the sample, and the less likely I am to reach a significant p-value.

The problem is when the methodology itself is broken. For instance, using case-control methodologies on things with small-to-moderate effect sizes. Past studies comparing such studies with eventual RCTs showed that the case control studies gave absolutely no indication of what the RCTs would show as a consensus: it was entirely random.

There is no amount of money, small or large, worth throwing at studies that shift our prior probability to posterior by 0 units.


While doctors don't always know the most about a diet there is also the aspect of actually following the diet. People suck at following diets so giving one that is as little adjustment from a normal diet as possible might increase compliance and will result in predictable insulin levels.

If you pick a very strict diet then people drop the diet completely or cheat all the time, resulting in uneven insulin levels.

It is like inflammatory bowel disease. Many doctors rarely prescribe rectal medication for long term use even if it might be more effective than alternatives just because it is difficult enough to get people to take their pills.

But I do think diet suggestions will change more in the future when it comes to diabetes.


We don't need more research to answer most questions on what to eat - eating real food, namely plants, prevents diabetes, atherosclerosis, etc. When doctors do tell people to eat plants people usually don't listen.

I think Doctors need to be better trained, Americans need to completely rethink nutrition and health (I can't speak for other countries), government needs to help inform people, and laws about marketing food may need to be changed.

In addition further research could help, but in my opinion nutrition is a solved problem, eat real food and avoid meat and processed junk.

My opinion is based on how little my friends in the medical profession and/or training know about nutrition and the book How Not to Die which focuses on how diet affects deadly diseases.


potatoes and corn are plants, both of which cause enough of an insulin spike to be worrisome. Just eat plants isn't a good enough answer.


So are seeds and carrots. In reality, all root vegetables store a great deal of carbohydrates that us diabetics must watch out for.

I've been 'gotten' by carrots in a crock-pot beef. I miscounted and got waylaid by them.



Buying a blood glucose meter is not an expensive investment (provided you don't really need it, ie. don't have diabetes) and it will pay dividends in terms of health. With a meter and about 200 strips and lancets, you can determine a big list of foods that raise your blood glucose and foods that don't.

I've been customizing my meals based on what my glucose meter tells me raises my blood glucose the least and I am losing weight. The weight loss is gradual, but the most important thing is I am doing it eating foods I will eat, setting up a diet I can stick to long term, and I know that this will be good for me because the numbers back it up. Like you, I've always liked meats and testing myself with the glucose meter shows that eating more meats and less carbs is good for me personally. I should note I am not diagnosed with diabetes, I just bought the glucose meter to guide me in what I eat.


This is the first time I have heard glucose meters being used specifically for weight loss, very interesting. If this is a safe and effective way to encourage weight loss, this could be a huge business opportunity.


I had actually read about it last year. In the study, they used continuous glucose monitoring rather than glucose meter to track the blood sugar response to different foods precisely. They found that different people had different blood glucose response to different foods. The study only tracked participants for 1-2 weeks, but they do speculate on using personalized interventions devised from glucose measurements to treat and prevent such conditions as obesity and prediabetes. I decided to try it for myself.

Link: http://www.cell.com/cell/fulltext/S0092-8674%2815%2901481-6


Great, thanks for the follow up and link. Personalised approaches to health/medicine is an exciting area.


Continuous glucose monitoring (CGM) could be extremely effective for weight loss.

Dexcom has a CGM system that hooks up to your phone/watch, but is only available with prescription (and is extremely expensive without coverage), so this is effectively only available if you already have severe health problems.

Some former Dexcom employees founded a startup some time ago to do CGM for preventative healthcare, but I haven't heard anything of where it went. http://mobihealthnews.com/32601/dexcom-alums-develop-blood-s...

There are probably others.

To me these sorts of subcutaneous CGM systems seem more convenient for users than other initiatives (e.g, the contact lens projects). The sensor stays embedded for a week at a time, you can sleep with it in, and you get measurements every 5 minutes or so.


Sadly, Glucovation's latest update on their site was from 2014. I did some research recently, and it looks like Nemaura has a device aimed at launching at the end of 2016. Echo Therapeutics and Sano appear to be actively building/testing devices, but there are no firm dates.


"Dexcom has a CGM system that hooks up to your phone/watch, but is only available with prescription (and is extremely expensive without coverage)"

Can you elaborate ? What do you mean by extremely expensive ?


Prescription is required: http://www.dexcom.com/faq/do-i-need-prescription-obtain-dexc...

My "extremely expensive" was unfair. Some quick searching suggests ~$650 for the transmitter ~$100/week for sensors. "Not cheap" would be more accurate.


No, $5000+/year is definitely "extremely expensive," and out of reach for the majority of Americans. (Particularly as it seems very unlikely that there's any actual technical need for replacing the sensor weekly.)

Don't let the fact that lifesaving treatments are often even more unaffordable shift your frame of reference.


> If this is a safe and effective way to encourage weight loss

It is, presuming that your macros and micros are still in line. It's easy to eat the same meal for lunch and dinner every day and lose weight but be very unhealthy while doing so.


Could you elaborate? What are macros and micros, and how can i measure them? Assume i'm hypothetically interested in trying the (C)GM method of diet modification.


I assume pc86 means macro and micro nutrients. The point being that regardless of what your blood glucose monitor tells you, you still need the right balance of protein, carbohydrates, vitamins, etc.


Its the golden goose for wearables - the problem is there's no technology to continuously and reliably measure blood sugar without taking samples of blood (pricking).

If everyone had an apple watch, fitbit, etc that told you your blood sugar levels, with an immediate effect you could usher in a hugely effective treatment and prevention of diabetes and obesity. Assuming you can get people to wear it and you don't have to prick their fingers.


Do you have a particular suggestion? prices seem to vary a lot in amazon and other sites..


In my area, Kroger, CVS, and Target all have a house brand meter that has very inexpensive strips and seems to be accurate. The meter is silver/white and the strips are black. While it seems identical at the different stores, I found out that the strips have different notches on the end, so a Kroger meter won't take CVS strips.

Either way, the meter is about $10 and 25 strips is around $7, 50 is $12, 100, is $20. Very afforadable.


I came here to say very similar to what you're saying. I'm down 50 pounds in a little over a year after being obese my entire life, with very minimal exercise (I walk to and from work, about 3 miles a day, but only walking) but weight-loss and slimming has accelerated greatly after cutting out carbs and sugars, which wasn't as painful as it seemed - replacing carb-rich noodles with Zucchini or Spaghetti Squash is amazing.

Lots of fats, proteins, and veggies, staying away from carbs and sugar, and I feel better than any other time in my entire life (at 34). I'm no longer eating simply to eat, and at this point I'm not craving the crap I used to. The sickness that now ensues after ingesting processed sugars or carbs, does make it easy to skip. While this story is anecdotal, it seemed worth a try because I kept stumbling on research supporting it.


you did it right - pound per week - it's a lifestyle change you'll be able to maintain

just shave 400-500 calories per day and sure enough, each week on average you'll lose a pound

hmm spaghetti squash, I'll have to try that


The whole point of the article is that this isn't true. The article says the body resets its metabolism so that it survives on less food, making weight loss more difficult.


The body resets its metabolism to survive on less food IFF you're burning enormous amounts of kcals daily while on an extremely restricted diet, as these subjects were.

"His routine went like this: Wake up at 5 a.m. and run on a treadmill for 45 minutes. Have breakfast — typically one egg and two egg whites, half a grapefruit and a piece of sprouted grain toast. Run on the treadmill for another 45 minutes. Rest for 40 minutes; bike ride nine miles to a gym. Work out for two and a half hours. Shower, ride home, eat lunch — typically a grilled skinless chicken breast, a cup of broccoli and 10 spears of asparagus. Rest for an hour. Drive to the gym for another round of exercise."

This is crazy. Huge caloric burn, but no calories to coming in, so your body burns fat and muscle, but there's still a deficit, so the metabolic rate starts lowering.

I really hate TBL for so a many reasons. As this research is showing, it's a total sham that hurts the participants for life. And for the millions of people watching, it creates completely unrealistic expectations, eg "Kenny lost 180 pounds, I can't lose 50 in the same amount of time."


The article says they were losing a pound per DAY.

Of course the body cannot maintain that metabolism.

I am talking a pound per WEEK.


If you're not losing weight after cutting 500kcal/day from your diet then you were gaining at least a pound a week before you made the cut.


I think the problem with most sugars is that most people don't understand that the bulk of it is stored as glycogen in the muscular system.

Sugars really only have several places to go once they are ingested: Held in the fiber of undigested food, blood stream, liver and muscles.

We do really well with vegetables even though they are carbs since veggies are mostly fiber and very low carb. The high glycemic foods are okay provided that muscle glycogen is going-to-be/has-been depleted in the form of physical exertion.

Building muscle would also increases ones capacity for storing said glucose, but it's not easy or popular since the rate of muscle growth at best is about 1-2lbs/month under ideal conditions of physical exertion, nutrition and rest.

However, exercise and low-glycemic diets do explain the efficacy of reveesing t2 diabetes.


CHO storage in muscles and mostly kidney only amounts to about 2000kcal worth of energy. So there is a very high turnover and already over a week it's averaged out to the point where it doesn't really matter if what you eat is carbs or fat.

So for healthy, non-diabetic people it really doesn't matter.

(With the obligatory addendum that going all "low-carbs" or "keto" is a very, very bad idea if you expect to do any exercise at all)


Why would keto be a bad idea? Genuine question. A friend of mine just run a 54k mountain track (2600m elevation) after 7 months keto. I have barely eaten carbs for 2 weeks now, and just cycled 120 km two days ago.


The short summary is that aerobic exercise performance in humans is limited by the maximal rate of oxygen uptake or VO2max. Oxidation of fatty acids requires more oxygen per unit of "energy" produced than glycolysis; they are simply less bang for buck (or oxygen). Hence chronically depleted (particularly muscle) glycogen stores are a great recipe for bad exercise performances as you force the body into deriving more energy from fats.

Now, in reality, energy during exercise is always derived from a mix of both fatty acids and glycogen. In general, as exercise intensity increases (you are getting closer to VO2max), a larger ratio of energy will be derived from glycogen. So for your friend, running 54k of mountains is only going to be done at rather low intensity (50-60% of VO2max), where ~60% of energy will be from fatty acids, saving glycogen and preventing hypoglycemia.

Hypoglycemia, incidentally, is also known as "bonking". It's rather unpleasant. On long, high intensity exercise sessions you can't usually replace all the glycogen you deplete through food intake. So if you start with lower glycogen stores through a low carb diet, what you are doing is priming your body for hypoglycemia.


Do you have a scientific source for these claims? Dr. Peter Attia's personal research seems to claim otherwise.

http://eatingacademy.com/how-a-low-carb-diet-affected-my-ath...


Most Olympians are going to be on a high carb diet. What records has Attia set in sports?


Very scientific.


Very crass.


These kind of scary warnings apply to almost no one, basically olympic atheletes in ketosis, and can be treated with a glass of orange juice. For the other 99% of us, ultimate performance is not the goal, and keto is a great way to stabilze blood sugar.


What scary warnings? This is basic exercise science. It applies regardless if your VO2max is 88 or 30, and indeed John Doe is more at risk of hypoglycemia as higher utilization of fatty acid oxidation at lower exercise intensity is one of the primary adaptations gained through training.


> The answer is "Don't eat foods that raise your blood sugar above 140mg/dL".

Is that related to glycemic index?


Sort of. The glycemic index is not really useful because it is based on arbitrary quantities of food. Glycemic load was created to be useful to people, as it is based on reasonable quantities people would eat. Like GI says watermelon is bad because its calories come from sugar. But it is based on eating 100g of carbs from watermelon. That's a huge amount of watermelon, which is mostly water. GL shows watermelon is fine, because you only eat 10g of carbs from it in a normal serving.


So glycemic load is more or less glycemic index times carbohydrate density times the quantity of food you'd need to eat before feeling full?


Thanks. I never realized that glycemic index and load were different things.


Yes. https://en.wikipedia.org/wiki/Glycemic_index:

"The GI represents the total rise in a person's blood sugar level following consumption of the food; it may or may not represent the rapidity of the rise in blood sugar. The steepness of the rise can be influenced by a number of other factors, such as the quantity of fat eaten with the food."

But only "related to". GI is complicated. The whole blood sugar thing is complicated. I don't just mean in principle, I mean in practice, too. Measuring your own body's own reactions to foods may be the most practical route to go; reading that page leads one to the conclusion that any concrete numbers for GI you ever see are at best weak approximations even under the best of circumstances.

Which is a pity, seeing as how it seems like it would be very useful.


I was diagnosed with T2 diabetes. Changed my diet to lots of veggies, fruits, beans and legumes. Symptoms disappeared.

At first I was heavy on meat when I removed the carbs but it didn't help at all.


if you eat too much meat it just gets converted to sugar anyway


The results of this study, while interesting, seem flawed to me because losing 200+lbs in only 8 months' time is ridiculously fast. I would be more interested in a study following people who lost weight very slowly and steadily over time, and curious about their metabolisms and recidivism rates.

I've lost 100lbs over the last three years and have had zero issue (so far, not saying I won't ever) with keeping at this weight. I maintained the same weight, +/- 3lbs, for most of 2015 without counting calories or following a diet. In December 2015, I decided I was ready to start intentionally losing more weight, so I tracked calories and lost an additional 15lbs over the course of three months. My experience with losing weight and maintaining weight loss are completely different than the results of the study in the OP, and I am curious how much of that difference can be chalked up to how long it took me to lose that weight.

Studies like the one in the OP are fascinating to me because no one seems to go "Hey, your body achieved homeostasis at 450lbs (maintaining that homeostasis for however many years the person was at that weight) and it probably royally screwed with everything dropping half your body weight in 8 month's time." It seems obvious to me that at that point the body is in full blown crisis mode trying to get back to the homeostasis it had developed previously. Eight months is not a long enough time to adapt to a new homeostasis, not to mention whether or not the body is freaking out because it's "starving" and dropping fat stores at such a high rate.


I seem similar. I've lost 92 lbs over 8 months, and I don't seem to be having problems. In particular, I'm not having any feelings of hunger. I've pretty consistently been averaging a tad under 2000 calories/day, 35% carbs, 21% proteins, 44% fats.

One interesting thing is that if I go significantly over 2000 calories in a day, which happens maybe once every couple of weeks, I find myself automatically eating less the next day. For example, last Thursday I went over (2390), and then Friday I went way under (1150). I went over Saturday (2240), and under Sunday (1740).

I'm hoping the fact that I'm not feeling hungry eating this way, and the fact that if I go over my goal I automatically go under afterwards means that my body is adapting well to the way I'm eating and so I won't have trouble continuing to lose weight and keeping it off.

I've done similar twice before. Those ultimately failed, but I believe I know why. Both times I changed my eating habits, lost weight, and it was staying off. Then both times I had major career changes that threw my schedule into disarray. I didn't have time usually for home prepared meals or sit down restaurant meals. For instance in the first case I was working at a small consulting firm that specialized in taking contracts to step in on failing firmware projects for new hardware and redesign/rewrite the firmware--and these were fixed price contracts with hard deadlines and penalties for missing the deadlines. I'd often be in the office very late, and by the time I realized I needed food the only places open were fast food drive throughs, or the Dominos half a block down the street.

Next time I have a job change, I'm going to make sure that the new job won't mess up my eating habits even if it means taking lower pay.


As someone who (over the last 6 years has) lost 65 lbs (245>180), regained 45 (225), lost 40 (185), and am now up 25 and back at 210 I can tell you that this will creep up on you if you don't remain diligent about sticking to your new eating habits. Sugar addiction has continually crept back in my life despite sticking to low carb diets for almost a year on more than one occasion.


I second this. Sadly I am up about 35 pounds from when I hit bottom.

Sugar-addiction, at least for me, is harder to beat then smoking. I am able to go without sugar for one to two weeks and then it hits me and I binge on chocolate again.

Hope to find the strength to restart my efforts.

Does any of you have helpful suggestions?


Remember that relapse is part of recovery. Fall down seven, get up eight. Corny, but it got me through my hard times (and still does!)

DO NOT HAVE CHOCOLATE IN YOUR HOUSE. Ever. Even shitty chocolate. Even someone else's chocolate. If you know you'll binge on it, get rid of it.

Remember that chocolate will exist today, tomorrow, next week, next year. There will be a time in your life when you can eat chocolate again. For me, part of what always brought on bingeing was feeling like OH MY GOD I WILL NEVER EAT THIS FOOD AGAIN IN MY LIFEEEE. I had to, and still have to, remind myself that I can eat the food again so I don't have to EAT IT ALL RIGHT NOW OH GOD.


I actually had a friend who successfully resolved cravings in a completely different way - she'd binge on the food she craved until she'd never ever crave it again. I've never been able to bring myself to try her approach, but it worked for her.


Alternate:

have the bitterest chocolate around(90-100%), such that you can only eat a square inch or so at a time.


I've cut a tremendous amount of sugar by cutting way way back on Pepsi. I could not stand diet soda, so when I started aiming for under 40% calories from carbs I was trying fairly hard to make sure that I was way under 40% for most of the day, so that my evening snack could include a Pepsi.

I tried adding some low sugar gelatin cup desserts to my diet to have a nice cool dessert on occasion, not expecting much since I usually cannot stand the artificial sweeteners such things use...but to my surprise I was OK with these. That led my to give diet Pepsi and diet Dr. Pepper another try. Nope, still did not like them...but I disliked them a lot less than I used to. The diet Dr. Pepper was close enough to acceptable that I was able to start drinking it a bit, and after a couple of weeks I was OK with it, and after a couple more I liked it.

Pepsi dropped from daily to once or twice a week, and then to none. Everywhere I'd normally want a Pepsi I'm now fine with diet Dr. Pepper. That's cut calories from whatever falls under the "sugar" line on the nutritional information label from 15% of my calories to about 8%.

Of course, as soon as I got to where diet Dr. Pepper was acceptable, I saw an article claiming that new research showed that people drinking diet sodas lost less weight than people drinking regular soda, and sometimes even gained. WTF?

That research, thought, was based on surveys of people who had tried to lose weight for a year asking about their eating habits, so I don't think it is applicable to me. I doubt that most of those people seriously tracked their eating, whereas I have a spreadsheet with almost everything I've eaten for the last 8 years entered.

I suspect that what happened with the people who lost less or gained on diet sodas is that they offset the calorie savings from the diet sodas with more calories elsewhere. If you are trying to cut calories, and you have a regular soda for lunch, you might pass on dessert at dinner because you know that you did something bad at lunch. If you had the diet soda at lunch, you might feel virtuous, and reward yourself by allowing a sugary dessert at dinner which might be more calories than a regular soda.

One suggestion I have for the next time you try to cut sugar is that if you set a daily sugar goal of below X% of calories from sugar then adopt a strict rule of no borrowing against future meals.

What I mean by borrowing is this. Let's say you set a goal of no more than 10% of calories from sugar per day. One way to achieve this would be to have no more than 10% of calories from each meal or snack be from sugar. Another way is to have some meals and snacks be over and some be under, as long as at the end of the day you are overall under.

Borrowing is letting the earlier meals and snacks be over, and then counting on later meals and snacks being under to meet the daily goal.

The problem with borrowing is that you can easy get yourself in a position where it is hard or impossible to get yourself back down to 10% for the day. Now you feel bad and are discouraged.

Instead, try to make the early meals and snacks under, so that the latter meals and snacks can go over and still meet the daily goal. If you do good enough on avoiding sugar during the day, you might be able to have a nice treat in the evening. But note that this presupposes you are keeping track of your sugar, so that when you give yourself a treat at the end of the day as a reward, you won't go over. Without numbers, it is too easy to end up like those diet soda research subjects.


As a kid, my grandma wanted me to drink less soda (I spent the summers with the grandparents). So she switched me to iced tea, but had me add as much sugar as I wanted. As time went on, she had me add less and less sugar until I no longer needed to add sugar.

Today it's almost exclusively what I drink. The only times I don't is when I know the restaurant I'm in can't make drinkable iced tea to save their life (for some odd reason, it mostly seems to be Cuban or South American restaurants [1]) and I'll switch to soda.

[1] I live in South Florida. I suspect the reason is that Cuban/South American restaurants use coffee brewers to make tea, and I can't stand the taste of coffee.


Yeah, you can get used to anything if you can stick it out at least 2 or 3 weeks.

You might try soda water with no sweeteners, its what I drink now when out.


Re: diet soda and weight gain. There's some very early research that suggests artificial sweeteners may change you gut flora in very bad ways.


Similar to me. I've lost ~60 pounds over the last 5 years. I always maintain and slowly lose more. I don't crave anything or fight hunger, etc.


How many times have you lost and regained? I ask because I am a little older and have done that cycle multiple times. This last time I am going on a decade without periods of large weight gain. The first time you lose a lot of weight you feel like you have it mastered and that is one of the ways your brain gets you. Eventually you figure you have it handled, relax and then two years goes by and you are heaver than when you started. I've done that at least 3 times


First time ever. I had an eating disorder my whole life, which is how and why I gained up to 300lbs in the first place.

I no longer have the mental issues that caused me to turn to food for comfort, which is what I credit my successful weight loss to. And again, I lost the first 75lbs or so just through recovering from my eating disorder and not through dieting or changing anything about what I ate other than no longer turning to food for comfort and not listening to the binge urges my brain was sending out.

Eventually you figure you have it handled, relax and then two years goes by and you are heavier than when you started.

Having maintained within +/- 3 lbs for the entirety of 2015 I'm not worried about this in the slightest. Even though at that time I was not actively trying to lose weight, I still weighed myself every week and took measurements every month, as well as continued to exercise regularly (and even learned how to ride a bike!) I also maintained vigilance for ED-type thoughts and identified them quickly if I began relapsing. I absolutely adjusted my eating if I gained more than 2 pounds in a week or when I knew I'd been letting my vigilance slip. Still didn't count calories or anything, just mindfully ate smaller portions and stayed away from desserts for a while. It helped a lot that I have learned that if I eat sugary stuff more than two days in a row I start craving it badly and will eat it every single day unless I stop eating it entirely for at least two weeks.

I view my weight loss as the side effect of recovering from my unhealthy relationship with food. For me, that was bad enough that it was a full-blown eating disorder, but I absolutely believe that many people have an unhealthy relationship with food which causes weight gain that is impossible to reverse without first addressing the mental issues that got them to that weight in the first place. Take that and add in this new potential issue of the body wanting desperately to get back to the homeostasis it was at when the person was at their heaviest, and the rebounding of everyone who was on The Biggest Loser is no surprise.


"...I'm not worried about this in the slightest". Your brain has already begun its master plan to make you fat again


Damn son, dial it back a bit.


Maybe there's something different about the metabolism of people who manage to reach a weight of 450lbs in the first place. Without exercise and watching what you eat, almost everyone will gain weight, but most people never get anywhere close to the 300lbs+ range.


Well, clearly the contestants were at the far end of the weight spectrum to begin with, but regaining weight after an intensive, successful weight loss programme isn't rare, even for people who were only mildly to moderately overweight. That suggests that their problems aren't unique to their particular metabolisms, just more extreme.

Also, their pre-competition metabolic rate was normal for their size, and after their weight loss it cratered, and never properly recovered. Even if they had pre-existing physical or psychological abnormalities that contributed to their heaviness, this is a clear, objective measurement that started normal and has become different, simply through losing weight.


Maybe! I was 305 at my heaviest, but I was also a serious powerlifter and was at the gym 10-15 hours a week lifting, plus training for competitions. I often wonder if having that strength base made it easier, in some ways, to drop the weight than if I had been totally sedentary and had to start from zero with regards to exercising.


Having a lot of muscle will increase your base metabolic rate. Being a serious powerlifter, I imagine the increase due to muscle was significant (speaking just as someone who reads into this, not as a qualified professional!). Also, being a powerlifter, if you don't maintain the muscles, they would atrophy, taking a lot of weight with them.


Interestingly enough, I stopped powerlifting about a year ago and the atrophy hasn't happened as quickly or as much as I thought it would. Now, I say that with the caveat that I have NO idea how big my muscles were when I was at my strongest (which is also when I was 300 pounds), but I still have 25+ pounds of muscle that I didn't have the last time I was the size I am now (scientifically deduced from being able to fit into the same pair of pants that I did when I was 180lbs, when I am now 205lbs). I currently have a knee injury that's keeping me from doing any lower body lifts, and am only doing upper body bodybuilding style stuff twice a week. I'm absolutely not as strong as I used to be, but I'm still muscular... although, again, don't know how much of that is a hold-over from my powerlifting heyday because at the time I was like a muscular manatee... couldn't see the muscles for all the blubber on top.

[edit] 5'11", about 1.80 meters


How tall are you?


The last point is important. Many people claim that muscle turns into fat if not exercised for maintanence. This obviously isn't true. What is interesting is where that idea may come from: the habit of eating a larger amount of calories to power a huge masses of muscle that doesn't entirely go away along with the muscle without conscious planning.


In my experience, this is the case. Or at least, it's the case after they reach that weight and maintain it for a significant period of time. I don't think there is any clear indication of which comes first though.


True enough, but those are just more extreme cases of a trend we see pretty widely.


The article did also talk about people who lost 360 calories per day by urinating it out. They also unwittingly at 200 more calories per day. This amounts to losing something like 1.5 pounds per month. But they also note that this increase in calories eaten is what causes weight gain later -- so even slow approaches hit the same problem.

And while 3 years is good -- you really should watch for over 5-10 years. I previously lost about 40 pounds, and kept it off for about 6 years. Over the course of four years after that I gained most of it back. About 8 pounds per year like clockwork. I didn't even realize it was happening until I was 18 months or so into gaining the weight back. I did nothing different the first six years versus the last four. But something happened...


I contend you should then force it to adapt to a completely different athletic / exercise reality.

Of course the problem is that people drop back into their same lifestyles, and American lifestyles are pathetically nonactive.

Hint: 20 minutes 3 times a week is not "active". It's just better than pathetic.


It's pretty well-known that if you drop more than 2 lbs/week you're very likely to gain it all back later.


Do you have any source for the claim that if you lose it slower you're more likely to keep it off? While intuitively appealing, I keep seeing it without any evidence.


I can't find the source now, but years ago in an agricultural class in high school I was told that studies had been done on weight recovery in cattle who had been through drought conditions and who were either malnuritied or had lost significant weight. I believe the results were that the cattle recovered and increased their weight after this occurred.

Wish I could find that study! But it would be an interesting hypothesis to test for: if someone reduced their calorific content too quickly then the body will attempt to compensate when normal eating resumes. Obviously it would need to use animals and a control group but it might be insightful.


> Wish I could find that study! But it would be an interesting hypothesis to test for: if someone reduced their calorific content too quickly then the body will attempt to compensate when normal eating resumes. Obviously it would need to use animals and a control group but it might be insightful.

There's a natural experiment of sorts in re-feeding people with anorexia. Many people think this is a risky time because they think it's easy for someone to gain wieght too rapidly.

(I'm not talking about the related, but different, "refeeding syndrome" https://en.wikipedia.org/wiki/Refeeding_syndrome)


Interesting! Evidently this is a bit of a hot topic though, I seem to have raised the ire of some, but others found my comment interesting.

Very good info, though I honestly don't think it was exactly what I was thinking of. I'll keep looking for that info...


>if someone reduced their calorific content too quickly then the body will attempt to compensate when normal eating resumes

Ever fast? I find fasting extremely effective at reducing my post fast appetite dramatically. In fact, fasting occasionally the only thing that keeps me from gaining more weight, it "resets" my appetite.


Interesting - I've heard this also. I wonder if there is something that would only help someone in a normal weight range, and exercises?

It sounds like gradual improvements are the only way to handle weight loss. So it takes time and effort...


Not sure why the downvotes except maybe not sourcing it.

What you are saying is 100% right in my experience and watching others.

Cut 500 calories per day and you lose a pound per week and that can be maintained.

Those poor people were losing a pound per DAY which there is no way you can maintain that lifestyle. You aren't teaching habits for life with that kind of diet, you are teaching how to crash and burn.


I managed to lose 40 pounds last year, using intermittent fasting. That impressed people, but what's impressed me is how easy it was to keep it off. I expected to have to do a lot more work than I have, I really seemed to have found a new 'set point', where I can simply let my body self-regulate eating and I won't gain weight. Sometimes it even goes down.

I think a person's state of mind plays a huge role. I used IF because it seemed the easiest way to incorporate a sustained caloric deficit into my lifestyle. The knob of "how many times a day I'm eating" was far easier to tweak than "what I'm eating" or "how much I eat when I'm eating." I'm just really fucking lazy and found that over time, skipping meals works with my laziness.

With IF, I can eat what I want, as much as I want, just only once a day. I used to be really strict about once a day, now I'll have a snack here and there, sometimes I'll even have what amounts to a light meal outside of my main one. Getting adjusted was a pain, but I'd alleviate it by eating small amounts outside of the 'window' and trust that I'd cheat less over time. Which I more or less did.

Ultimately I feel it's not really worth it to try to fight your body too hard. If your system perceives a shock, it will defend itself. But humans seem hard-wired for big, dramatic gestures, and so they'll do grievous damage to their metabolic systems like crash dieting simply because they can't trust themselves to maintain a safer, more sustainable course of action like simply "eating less and exercising more." I think a lot of people think of the idea of "sustained lifestyle change" and balk. Like they can never eat ice cream again or something.


Yeah, the actual mechanics of losing weight is pretty basic calories-in calories-out. The difficult part is engaging in behavior that consistently gives a caloric deficit without making unsustainable trade-offs against willpower or other things. Intermittent fasting is a very good way to remove "how much willpower do I spend while holding a fork and looking at food" out of the weight-loss equation. I lost about 60 pounds using keto, which basically moves all decision making over what to eat (and gives compelling reasons to stay on the wagon - restarting the ketogenic biochemistry is not a particularly fun process).


I'm finding that most of the weight loss strategies people talk about are really calorie-reduction mechanisms. Intermittent fasting, keto, carb-free, paleo, all generally boil down to "eat less and maybe exercise".

The "eat less" part is caloric, really, not by volume, so vegetables are better than most for eating. I'm not saying those plans are bad - a scheme that works is a good scheme. It's interesting to see how they all come together.


A year is awfully short to be chiming in with advice for long-term weight loss.


> A year is awfully short to be chiming in with advice for long-term weight loss.

How about nine years? 2007-03-28: 192lb; 2016-04-30: 153lb. I hit 160lb in late September of 2007 and haven't been above it since, typically fluctuating these days between 150-155lb. I did it by simply eating less and paying more attention to hunger signals. If you want to be sure you're not overeating, track calories in and your weight using something like MyFitnessPal. Weight loss is possible; CICO overrides everything.


Tracking calories would blow most people's minds about the quanta of food they're eating. I've been tracking for a while, and sometimes I'm still surprised.

Scale and app. It's never been easier.


Truth! Most people just don't realize because they've never done it.

Side note: it makes me very sad and disappointed to see comments like this downvoted. Do we not claim to value rationalism and the scientific method here? Take the challenge: weigh your food and yourself and log it, and see if you can disprove CICO. If you can, there's a Nobel prize in physics awaiting you!


A scale with wifi was where I started. I downplayed it before but simply measuring kept me thinking about it and once I started losing weight the graphs served like nothing else as reinforcement. Well, not quite. Sites like Weilos helped me feel like even small steps were possible. The biggest jump so far was the combination of discovering MyFitnessPal, Apple Watch exercise calorie monitoring and joining a budget gym within walking distance. The app, and CICO turned it into a numbers game. I was amazed at how many calories were in movie theatre popcorn. But I did have a takeaway from this article, combined with seeing my own results slightly plateau -- it's key that MyFitnessPal is calibrated as much as possible to your resting calories. Or you might find yourself having banked exercise calories and wanting to "spend" them like a savings account. It doesn't actually work that way. Food qualities then play a role. Still figuring that one out for myself though...


Nothing says "science" like a sample size of one.


I'll concur with this. I have been practicing one meal/day for almost 3 years now. I think it took my body over a year to really adjust to all the benefits. Now I realize I have some big eating days, some small eating days, I mostly crave healthy stuff and I let the rest take care of itself.


What about feeling tired/lethargic during the time in which you fast?

Also, can your body really efficiently utilize all of the micro/macro nutrients it needs in a day when it's handed them all at once?

I agree that IF can be a good little mental trick for a quick cut, but I'm skeptical on one meal a day for a life time and if there's any negative effects that could come up.


You've got the energy levels and eating relationship reversed. Over the short run, digestion uses a lot of energy and generally does not give super quick results. Especially if you're eating cleaner food (vs giant piles of sugar etc).

The more involved answer involves talking about the sympathetic and parasympathetic nervous systems (SNS vs PSNS). The SNS is activated when doing things like going for a run, focusing on a specific problem, fight-or-flight, and other generally short-term "do things or have issues" situations. It does large systematic things that make your body better at overcoming the short-term obstacles in your life.

The PSNS, on the other hand, is responsible for more long-term survival goals. Sleep, digestion, relaxing, general awareness, etc.

Another important fact is that activating one of the circuits tends to deactivate the other. Eating activates the PSNS. Having "high energy" and not feeling tired/lethargic is basically a high SNS activation state.


I'm more curious about the second question I raised. I've read stuff before saying x grams of protein can't be absorbed when consumed in one meal. I've heard differing claims, some saying it's a myth, but I would imagine it's possible.


Anecdotally, I usually feel dramatically better when I fast. There is an incredible mental clarity and productivity that itself makes fasting worth it. I don't feel tired when I fast - in fact, I often feel like I could easily go for a 10-mile run.

FWIW, it takes getting used to. If you drop everything and do a 24-hour fast after years of "6 meals a day", you will feel cold, irritable, and unproductive.

Also, coffee is a powerful thing.


I've never been overweight, but eating ~once per day works for me too.

Good point that laziness helps. Being busy helps. Eating only after exercising (I run ~3 miles daily) also helps.

Eating only once per day also helps to learn what food is good and bad for me. If hours after the meal I feel bad taste in my mouth - the food probably had a component that I should eat less. Sugar in big quantities is definitely once such bad component.


I think the message here is to listen to your body. Too often one finds themselves eating just because they were invited to lunch, or even because they are bored. If you listen to your body and just eat when you are hungry, magical things will happen.


Although this may work for some people, it definitely won't work for me, and many others. I constantly get "cravings" which, AFAICT, are indistinguishable from hunger. I have to consciously add up my calories to know if I've been eating too much. If I was to "listen to my body", I would overeat constantly.


Agreed. I never eat when I'm not hungry. I can't imagine doing that. I'd suspect a real eating disorder if I were forcing myself to eat.


I think the idea is to not eat because it feels good or because you've got to finish your meal, but only because you're hungry.

Says I, who just completed my meal even though it was slightly painful....


I guess that's the only exception I can think of - I may continue eating at a restaurant when I'm full because I don't like to waste, and I also don't like to take things home.

That alone doesn't explain the 40 pounds I need to lose, though.


Same. It's even worse for me though because the more I eat the hungrier I get. It's an awful positive feedback loop.


In my experience, that's great advice for already thin people. I could only lose 10 stone and reach normal weight by ignoring my body demanding it was starving for a year or so.


The biggest scam that the diet industry ever pulled on the general public is the perception that "a diet" is a short term thing which you do until you're a healthy weight, and then you can eat whatever you want again.

The second biggest scam is the perception that most people can lose weight without either doing an absolute ton of exercise, or feeling hungry quite a lot of the time.


Unfortunately that doesn't really work as a guiding principle. The body is entirely too easy to ignore, and social concerns ultimately are more important and urgent than personal ones. How exactly are you going to handle getting invited out to eat if you're not particularly hungry but could eat anyway? I had to answer this and way more in the year-long or so path to really getting serious about losing it and keeping it off.

And boredom is a real problem.

I liken trying to lose weight to trying to quit smoking. If all you had to fight were the nicotine cravings, nobody would be smoking today. It's the habits you have to fight, those things we build our life out of, and to fight habit you have to fix a lot of other parts of your life. Just finding ways to take five minute breaks that don't involve smoking. We want to treat these things in isolation, but they're not isolated, they all interact with each other. To do something like this forces you to deal with your entire life up to the present and be confronted with your own inadequacies. So there's that too.

Somebody who manages to quit smoking or lose weight and keep it off hasn't just managed to do that one thing, they've also managed to effect a complicated and difficult lifestyle change, and should by all rights be considered a completely different person. I don't feel particularly different from the me that was 210 pounds, but when I look at the big picture, I can understand why women aren't just being shallow when they wouldn't even look at me before, and now all seem to beg for attention.

That's why I focus at the level of lifestyle rather than on more mechanistic concerns like whether the keto diet is better than slow-carb and whatnot.


I'm interested in how you did handle the social aspects. What adjustments did you make? How did you handle the invites-to-lunch when you weren't really hungry?

That's one of my biggest issues. I'm on a meal plan at the moment which is great during my workdays and I'm really feeling good.... but then on the weekend when I'm not home and I'm visiting family or friends, I don't know how to stick to it without being a) extremely tempted by the food or b) potentially feeling rude or out-of-place (bringing my own food, etc).


If I get an invite to lunch, I'll make that my one-meal-a-day. If I don't, I'll generally wait until around 5-6pm before either hitting a friend up for dinner or just going to grab whatever I feel like eating. My social life isn't good enough that I often get lunch and dinner invitations on the same day, I'm looking forward to solving that problem when it becomes one.

Long-term IF essentially made hunger a non-issue for me. I believe something neurological happened where my vagus nerve system got decoupled in some way from my CNS brain. I get hungry, but it's easy to ignore and to make my decisions on socially-practical grounds rather than the purely immediate.

Yesterday I had called up my business partner for dinner in my car right as I was about to leave. He didn't pick up, so I started driving. I get a few blocks down the road and he calls back, accepting my invitation. I did not mention that I was already in my car and hungry, simply drove back home. It was another two hours before we finally sat down for dinner. None of it bothered me, the hunger just went away when I willed it to.


Extreme diligence seems to be the only way to fight this. If I stop exercising, the pounds pack on within weeks. If I insure I burn at least 3000 calories a day (usually much more), I can maintain my weight indefinitely. But I walk to work and I exercise for 1-2 hours daily. Most people cannot or will not do this.

Add in the extreme carbohydrate and fat-laden diets most readily available to America and it's a perfect storm for our Wall-E future, no?

When I cook at home, I can avoid this by eating a little bit of meat/tofu/tempeh/etc with a pile of greens, but restaurant fare is a little bit of vegetables, a small slab of meat, and a super-size portion of some fancy grain of the week if not just white rice. Sigh...


> If I insure I burn at least 3000 calories a day (usually much more), I can maintain my weight indefinitely.

If you're having to burn 3000 calories a day, you're eating too much. That energy has to come from somewhere. Have you tried calorie tracking?


As a decently sized guy (6'3 ~300), my BMR is around 2700.. so it wouldn't be that hard to add 300 calories worth of energy expenditure, at which point I'd be eating below maintenance level.

Would depend on your height and weight I think.


You are asking a person who clearly has spent a ton of time figuring out how to manage their weight if they've tried calorie tracking?


When you hear someone stating that they find burning 3,000 calories a day necessary it seems like a logical question. You can't burn that many calories without first adding them.


I assume this person has found that burning that many calories is easier for them than restricting their diet more.


Exactly. I eat pretty healthy, but I like food. Sure, I could starve myself and be miserable. But why do that when exercise solves the problem and it has all sorts of other positive side effects? So I can sit on my butt all day like the people from Wall-E? No thank you.


All of my serious (recreational) bike rider friends eat a lot more than 3000 calories/day prepping for their weekend bike rides.


Yes, some exercise routines require well over 2000 calories a day, but that's still pedantically missing the point of my comment.

If somebody is confused about why they need to burn 3000 calories a day to keep from gaining weight, they're eating too much.


Serious cardio will burn a LOT of calories. If a person who is NOT doing serious cardio needs to exercise to a 3000 cal deficit every day to maintain weight, they should lower their caloric intake.


I'm not sure if it's that simple. My body maintains a low but healthy weight no matter what I do. I can avoid sports for years and eat as much as I want, to the point of feeling uncomfortably full, without increasing weight. It seems likely that in some or even most obese people, a regulation system has been broken.


Study after study has repeatedly shown this to be untrue. People who think they "eat as much as they want" really don't eat as much as people who think they "eat almost nothing"

Try actually counting your calories over the course of a week.


> Study after study has repeatedly shown this to be untrue. People who think they "eat as much as they want" really don't eat as much as people who think they "eat almost nothing"

This doesn't actually refute what the OP was saying, which is that he could eat as much as he wants without gaining weight. Presumably he simply wants to eat less than many people.

Anecdotally, I find this to be true. Some people simply seem to "know" how much they need to eat to maintain a healthy weight on some instinctual level. It's not that they magically make the calories disappear, it's just that they feel satiated at appropriate levels of caloric input with respect to their physical output.

The Biggest Losers clearly lack this characteristic, and the way in which they lose the weight boot-camp style doesn't seem to impart that ability upon them. Some of us will always simply have to use other means to manage input and output if we want to regulate our weight effectively.


Valid point, but I think there's more here. Kenji is saying that he is satiated. It doesn't really matter what he eats compared to others if his brain/body is happy eating the correct amount.

The real question is: Why are people like Kenji satiated at an appropriate level of calories while others are not?

And I think the answer is going to be a complex mix of physical, psychological, and societal factors.


I don't think there's more to it.

Eating three meals a day at about 2,500 calories for a few weeks, and my body will adapt to feeling full at those portions.

Upping that to 3,000+ calories a day when on a bulk, and the first week or two are difficult, but then I adapt and feel hungry if I eat the smaller portions I used to eat.


Applying a sample size of one to the general population is anecdotal and works for you based on your physical, psychological, and societal factors.


Actually, study after study found that overfeeding resulted in an enhanced metabolism, leading to much less weight gain than predicted, and even that weight gain disappears very soon with return to a non-forced diet.


I find that interesting. Could you mention some of those studies?


There are also differences between gaining weight, getting fat, and being fat.

People gain weight when they gain muscle, and heavier people by the mechanics of supporting their weight seem to gain and hold muscle more easily than lighter people. More muscle mass has been associated with better health outcomes despite other factors.

I've also read that it's not being fat that's bad for you, but getting fat. Some people are unable to shed subcutaneous fat they gained at one point in their lives and carry a stigma of being fat despite being otherwise very healthy, even in their diet and lifestyle. It's a common idea that not shedding that kind of fat is a problem, but it probably isn't as much as people believe.

Being apparently not-fat could also be an indicator of worse health if you generated corporeal fat more easily than subcutaneous. That's what's being referred to when they say "belly fat" and apple bodies being associated with health problems, not the love handles and soft flab. Many people who look healthy because they're not fat could be skinny-fat, have higher corporeal fat, and not take care to exercise or watch what they eat, thinking that their weight and apparent size are indications that they're doing everything right.

But in cases of obesity, I do see people cheating their diets, focusing on easier but less important factors like steps per day, celebrating their daily water fluctuations as weight loss, and otherwise coming up with endless tricks and reasons to justify not not-eating.

There are many people I've never seen eating, but their trashcans and purses always fill up with food wrappers. They don't count that 900 Calorie Starbucks because it's just a coffee, and Weight Watchers says that's 0 points. Or they didn't use all their points last Tuesday, so they can have a treat today, and probably tomorrow since that doghnut just made up for last week and doesn't count.

That's certainly a broken regulation system, but it's one within their capacity to change.


e: 's/corporeal/visceral/g'


Could I ask you how old you are? I know at a younger age, it was much easier for me to maintain a healthy weight like you but now it is a much more challenge. Some of it is due to my level of activity (work, driving, exercise) but I think some of it just comes with age.


since you are atypical, maybe yours is the one thats malfunctioning


Have you tried deliberate weight-gaining diets? GOMAD (take your normal diet, and throw in a gallon of whole milk a day on top of it) apparently works particularly well.


Each pound of fat ~= 3,500 calories up front, but also another 3,500 calories every ~4.8 years if you never moved. Keep active and it's significantly higher as your effectively walking around carrying weights 24/7.

Thus, you really need to eat far less to maintain a healthy weigh long term, and or become significantly more active.


How do you manage the 1 to 2 hours of daily exercise with a programmer lifestyle(assuming you are a programmer)?


I get up from my desk and go to the gym mid-day or I do so at the end of the work day depending on my flow. Also, I've cut most meetings out of my life, especially pointless time-eaters like daily scrum.

Also:

1. No kids

2. I only watch 4-6 hours of TV per week

3. I walk to work, there's an extra hour right there at the expense of a higher rent (totally worth it). Previously, I worked from home

4. Most of my social life revolves around exercise rather than tech

5. Don't work for self-destructive managers

TLDR: Find your way to a results-oriented rather than a process-oriented position.


I so want to try this. Any tips and pointers? I'd quit the industry due to health issues (Obesity, NAFLD, Plantar fasciitis, etc) and would love to return if I can stay healthy in such a manner


One tip that may help: find a social, physical activity that you enjoy (for me, it was ballroom dance, but rock climbing, various sports, etc., can all work -- some sports may be less useful from a lifestyle perspective because the activity is highly seasonal, though if you have a social group they can probably be a source for alternate activities for the off-season.)


While everyone's situation is unique, what's stopping you?


Depression I guess, I see most activities as fruitless given countless attempts to lose weight or strengthen my muscles. I recently met with an accident that destroyed my only healthy knee (ACL + Meniscus tears). Had an ACL reconstruction a month ago and for some reason I'm actually hopeful.

I've charted out a diet and a fitness routine and have surprisingly kept up with the rehabilitation process fairly well. I guess this is one of my last opportunities to lead a healthy life.

Also, not having a social group to aid in activities could've been an issue I guess. I'd like to learn the social aspects of sticking to a routine (Gym buddies, mates who take part in a physical activity, learning some new tech with a similar group of friends, etc).


Can you explain what is a "programmer lifestyle"? I'm a programmer, I work out 1:30 every day after work and that's it, there's nothing special in my schedule: wake up, take a shower, go to work, get off work, go to the gym, go home and do whatever I please.


What is the programmer lifestyle? I work 40 hours a week and have time for whatever I want to do in my free time


As a software engineer who does this - you make time for it.

These days, I work out during lunch usually. I used to hit the gym on the way home in the evening. I take public transit and it was right at my stop.

It's not different than any other industry, honestly.


I'm at the gym every day from 5-7. I'll allow almost nothing to interfere with that. Others I know get up at 5:30 and run 10 miles. Some I know do both!


I cycle 7 miles to work, and back. That's some 25 minutes both ways. During the day, I go for a 4 or 8 mile run. That's another half an hour or hour.


Not the OP but the way I achieve that is by getting up at 5:30AM and running for 60+ minutes. I wasn't always such a morning person but routine exercise was important for me and so I adjusted my lifestyle to match.


I could never force myself to get up that early to run. Instead, I started going to the Y at 6 am to play pickup basketball for an hour or two. It was a lot easier for me to sustain. I'm not a morning person, and it was really helpful to know there were a bunch of guys who were counting on me to show up so they could play. I have trouble running in general though. I'm very competitive, and I find it much easier to exercise if I'm playing a sport.

That being said, I am the kind of person who generally has to try to actively maintain weight. I exercise for health benefits other than weight loss. Most casual or semi-casual rec sports are very friendly to people who are trying to lose weight though. Gyms and rec sports are probably two of the most welcoming places I've ever been. It can be almost cult-like at times.


Well, if you can find a job where you're working ~40 hours per week, this can be achieved. I know this is not the case for many people.


IMO if you're working more than 50 hours a week and you don't own at least 3% of the eventual outcome, you should consider a less stressful position. Don't short change your health and well-being for a lower expected return than just working for one of the big guys. All IMO of course.


Oh I wish this were true. I am clocking in 60hrs a week. I work under ridiculous deadlines.


Get... Out...


When I am done working at the office, I drive home and then walk to the nearest gym. That's about 30 minutes of walking. I then spend 30 minutes doing cardio and 1h00 doing weight lifting. I then walk back home. If it's a nice day out, I skip the initial 30 minutes of cardio and run to the gym instead. Listen to tech podcast while doing your workout.

Buy a crock-pot and precook your meals. They will be ready when you get back home.


"Programmer lifestyle?" I'm at the gym 6:30-7:30. At work by 9 and home by 6:30. I have enough time to cook my own meals too, which I find to be as important as the exercise. Granted I don't have kids.


Cycling to work can be a great hassle free way to get exercise if you are able.


The right hobbies help out a ton. Like, I've been doing social dancing twice a week, and that usually takes up 3-4 hours. Plus, there's fun movements to do while bored waiting for transit to show up.


Exercise has nothing to do with weight loss. Caloric restriction also doesn't work without consuming the correct fats to satiate your appetite. As you age there is no amount of exercise that will allow you to maintain the amount you weigh in you 20's or 30's. It will all depend on your diet of the correct foods.

I would suggest probably the best book ever written about why people get fat.

Why We Get Fat: And What to Do About It -Gary Taubes

Fantastic book that looks at the science of Obesity and weight loss among other things like Insulin resistance and genetics.


"As you age there is no amount of exercise that will allow you to maintain the amount you weigh in you 20's or 30's."

This seems overly general and anecdotally total BS. I still eat what I like just like I did in my 20s/30s. It's just that what I like is generally lots of vegetables and sufficient protein, with occasional vices slipped in because YOLO(tm).

That said, without the exercise, I gain about a pound per week. That means I am atoning for an extra 400-500 calories daily, no? Or what would you suggest is really going on here?


As you naturally age you will burn less calories. So as you continue to eat the same way and the same amount you will have to up your exercise to impossible limits. What needs to change is your diet. No sugars and lots of healthy fats.

Here is an excerpt from the book I mentioned.

Why We Get Fat: And What to Do About It by Gary Taubes

http://amzn.com/0307474259

>The authors were Paul Williams, a statistics expert at the Lawrence Berkeley National Laboratory in Berkeley, California, and Peter Wood, a Stanford University researcher who has been studying the effect of exercise on health since the 1970s. Williams and Wood collected detailed information on almost thirteen thousand habitual runners (all subscribers to Runner’s World magazine) and then compared the weekly mileage of these runners with how much they weighed from year to year. Those who ran the most tended to weigh the least, but all these runners tended to get fatter with each passing year, even those who ran more than forty miles a week—eight miles a day, say, five days a week.

This observation led Williams and Wood, both believers in the doctrine of calories-in/calories-out, to suggest that even the most dedicated runners had to increase their distance by a few miles a week, year after year—expend even more energy as they got older—if they wanted to remain lean. If men added two miles to their weekly distance every year, and women three, according to Williams and Wood, then they might manage to remain lean, because this might mean expending in running the calories that they seemed fated otherwise to accumulate as fat.

Let’s see where that logic takes us. Imagine a man in his twenties who runs twenty miles a week—say, four miles a day, five days a week. According to Williams and Wood (and the logic and mathematics of calories-in/calories-out), he will have to double that in his thirties (eight miles a day, five days a week) and triple it in his forties (twelve miles a day, five days a week) to keep fat from accumulating. A woman in her twenties who runs three miles a day, five times a week—an impressive but not excessive amount—would have to up her daily distance to fifteen miles in her forties to retain her youthful figure. If she does eight-minute miles, a nice pace for such a distance, she’d better be prepared to spend two hours on each of her running days to keep her weight in check.


The math seems fishy here. Let's assume your young woman's base metabolism (without any extra exercise) is ~1500 calories a day. Running 5 miles a day burns 500 calories putting her at 2000 total. For her to maintain 2000/day while running 15 miles a day, her base metabolism would've had to drop 66% down to 500 calories a day. I simply don't believe that. Your metabolism might drop a few percentage points per year, but the drops will eventually tail off as your metabolism reaches its lower limits. You can't just linearly extrapolate the drop down to zero, as your examples imply.


It's not true for myself at all. On the contrary. And looking at a crowd in any European city, older people don't look significantly more obese than younger people (excluding teens maybe). I very much doubt that they're all doubling and tripling their workout as they age.


It's also well known that as you become fitter, your body becomes more efficient at performing the same activities. It doesn't surprise me that people who habitually run get fitter, burn fewer calories per mile, and need to run farther to maintain the same burn rate. That these people are also getting older at the same time might just be a coincidence.


My anecdotal experience seems to confirm this. I've gained ~30 lbs throughout my 20s (130 --> 160), even though I've become at least twice as active as I have ever been in my late teens.

The weight gain has been both fat and muscle, however, but I'm not exactly sure in which proportions (I can notice both more subcutaneous fat in the belly area as well as more pronounced muscles)

By far the biggest metabolic cliff seems to occur around ~25 years of age +-1-2 years. I've noticed a very sharp increase in weight around that time, despite keeping my diet constant.


An alternative would be that in the weeks where you don't exercise, you feel a little worse, and therefore submit to slightly more of them YOLO vices.

I mean, I have no idea which it is, but there's plenty of explanations for your observations other than the one you gave.


My health prof in college said people gain weight because they don't maintain their muscle as they age...muscle requires 30 calories/pound just to maintain.


Not even close. It takes about six calories per day to maintain a pound of muscle. And it takes two calories per day to maintain a pound of fat. That's why people who think they're going to be able to eat radically more if they change ten pounds of fat to ten pounds of muscle are deluding themselves - it adds up to about forty calories a day, which is half a teaspoon of butter.

Anyway, the thirty calorie figure doesn't pass the smell test - men average about seventy three pounds of lean muscle mass, so at thirty calories per would be 2190 calories per day even if you ignore all activity and every other metabolic process. Your average sedentary middle aged guy is going to gain weight if he eats more than about 1500 calories per day.


> Your average sedentary middle aged guy is going to gain weight if he eats more than about 1500 calories per day.

That's not true. The average middle age man (say 50 years old, 5'9", 160lbs) has a BMR around 1600 calories, and unless he's bed ridden will burn around 2000 calories per day.


Bed ridden or has a desk job. From a calorie perspective it's probably not much different.


There is a big difference between bed ridden and has a desk job. We can calculate that difference to some degree of accuracy using this equation https://en.wikipedia.org/wiki/Harris%E2%80%93Benedict_equati...

For a sedentary office worker with no exercise, to maintain weight he should consume 1.2xMBR. With a BMR of 1600 that means he should consume a bit under 2000 calories per day.

It takes a good bit of energy to move 160lbs around even if you're not purposely exercising.


That seems far too high based on my own experience and that of my coworkers. Depending on their level of exercise, slender men at my office tend to fall somewhere between 1500 an 2000 daily calories, with 1500 being the 6' guy who doesn't do any exercise.

Yes, we compared notes.


Most people underestimate the number of calories they consume. It's much more likely that your small sample is underestimating than that numerous studies with much larger sample sizes are incorrect.

> with 1500 being the 6' guy who doesn't do any exercise.

1500 calories is right at the recommended maintenance intake for a sedentary 120lb middle aged woman (women have lower BMRs than men).


> muscle requires 30 calories/pound

There's a unit of time missing there. You probably mean "per day" (though 50 calories/pound/day is the more commonly quoted, and apparently, wrong number.) The places I can find that seem to actually be linked to some kind of reasonable source seem to have 5-10 calories per pound per day to maintain muscle.


This is just wrong. Weight loss on the short scale is literally a function of the difference between calories in vs calories out. You can increase that difference by eating less, or exercising more. You can easily maintain your weight as you age by increasing the amount you exercise, it might involve more exercise than expected, but it is perfectly doable.

Fat is not satiating to everyone. If it works for you, good, but stop making sweeping generalizations.

Eating the correct foods will influence the amount of metabolic slowdown in response to calorie restriction, and also the percentage of weight lost from fat versus lean body mass. What exactly the correct foods are depends on your genetics, your activity level, and your gut microbiota, and are different for everyone. Pretty much the only constant is that a high fiber diet is better than a low fiber diet.


Absolutely, but without stating the blindingly obvious the calorific content of some foods is so high that exercise can not be the dominant factor of that function.

This article [1] from last week seems to support that view. There was something else on HN on Friday that offered the same opinion but included a lot more studies. Can't find it now, but the message is the same.

[1] http://www.theguardian.com/society/2015/apr/22/obesity-owes-...


That's a bit excessive. I did a ride of 3 hours on the weekend and put 1832kJ worth of energy into the pedals, that translates (at 25% efficiency) to 1750kcal total energy expended.

It's actually pretty difficult to eat back those 1750kcal if you don't go out of your way to stuff your face with sweets.

The point most people (and certainly the press) misses with the "exercise doesn't work!11" meme is that of course it will never work if you simply see it as some kind of tool for weight loss or necessary evil. You are just going to stop the moment you have your "goal weight". The point is to turn the exercise (rather, find a sport) into a habit, a hobby.


>> It's actually pretty difficult to eat back those 1750kcal if you don't go out of your way to stuff your face with sweets.

Disagree. Over the course of a week it only means over eating 250kcal per day. What's that an extra muffin? Seems entirely plausible to me. Of course if you're expending 1750kcal additional kcal a day on cycling then THAT's a bit excessive, IMHO.


> Exercise has nothing to do with weight loss. Caloric restriction also doesn't work without consuming the correct fats to satiate your appetite. As you age there is no amount of exercise that will allow you to maintain the amount you weigh in you 20's or 30's. It will all depend on your diet of the correct foods.

What? Every one of those points are wrong.

* Exercise has a modest effect on your energy balance (assuming we're talking less than an hour a day - if you're running marathons then the effect is much bigger). You can out-eat any reasonable amount of exercise but it still has a significant effect.

* Caloric restriction works regardless of your macronutrient balance, if you eat fewer calories than you burn then you will lose weight, that's not just biology, it's the law of conservation of energy.

* Aging doesn't allow you to mysteriously break the law of conservation of energy either. You will find it harder to keep the weight off but by controlling your energy balance and engaging in regular exercise you can absolutely maintain the same weight you maintained in your 20s. (As a single data point, I weigh the same now as I weighed a decade ago, and 20kg less than I weighed 8 years ago.)

It's true that sticking to a reduced calorie diet is more difficult if you eat some diets than others, maybe that's what you meant?


For another perspective on this, see: http://anthonycolpo.com/stephan-guyenet-debunks-gary-taubes/


The link you provided is a no-value-added wrapper to the actual article:

http://wholehealthsource.blogspot.com/2011/08/carbohydrate-h...


Anthony Colpo has a lot of articles beyond just that one.


Interesting how Stephan Guyenet says that:

I'd like to begin by emphasizing that carbohydrate restriction has helped many people lose body fat and improve their metabolic health. Although it doesn't work for everyone, there is no doubt that carbohydrate restriction causes fat loss in many, perhaps even most obese people. For a subset of people, the results can be very impressive.

From Stephan Guyenet

>This is where he should have mentioned leptin signaling, and the circuits in the brain that regulate body fat mass, which would have taken the book in a more compelling direction. According to literally thousands of publications spanning nearly two centuries, the brain is the only organ that is known to regulate body fat mass in humans and other animals-- neither fat tissue itself, nor the insulin-secreting pancreas have the ability to regulate body fat mass as far as we currently know. Leptin is the system that Drs. Jules Hirsch and Rudy Leibel have shown in carefully controlled human studies is responsible for the metabolic defect Taubes alluded to (1). It's also the system that is mutated in the genetically obese rodents he discusses (2, 3). Yet it receives no mention in the book. This is a fork in the road, where Taubes discards a solid hypothesis in favor of a shaky one.

From Wiki

Leptin (from Greek λεπτός leptos, "thin"), the "satiety hormone",[a] is a hormone made by adipose cells that helps to regulate energy balance by inhibiting hunger. Leptin is opposed by the actions of the hormone ghrelin, the "hunger hormone".

From Gary

>Another remarkable aspect of the last half-century of discussion about obesity and weight loss is that medical experts have been remarkably uninterested in the fat tissue itself and how our bodies happen to regulate it. With very few exceptions, they’ve simply ignored the fat tissue because they’ve already concluded that the problem is behavioral and lies in the brain, not in the body. Had we been discussing disorders of growth—why some people grow to be more than seven feet tall and others never make it to four feet—the only subject of discussion would be the hormones and enzymes that regulate growth. And yet, when we’re discussing a disorder in which the defining symptom is the abnormal growth of our fat tissue, the hormones and enzymes that regulate that growth are considered irrelevant.*

I think if you read the chapter on The Laws of Adiposity, you will see that Gary discusses much of what Anthony claims he doesn't.

I would cover the other points Stephan Guyenet makes but this would turn into an essay. Honestly he debunks nothing. I am curious if he ever read the book.


Guyenet seems to specifically claim that Taubes focused on the hormone insulin instead of the hormone leptin. But, since leptin is still a hormone, I don't see how Taubes' quote that you included is relevant. He also provides plenty of citations for why insulin is the wrong hormone to be looking at.


Gary Taubes is a fraud. He deliberately misrepresents research the scientists he quotes out of context in his books have come out repeatedly saying this. Everything Taubes says is nonsense, and he is doing this deliberately to sell books on the back of a fad diet craze. There are no magic satiety fats. Fat is not higher satiety than carbs. Protein is.


Nonsense. No one has come out and said anything of the such. Try reading his book before you comment.


I have read his books, plural. And yes, they have: https://www.sciencebasedmedicine.org/gary-taubes-and-the-cau...


> A study of Season 8’s contestants has yielded surprising new discoveries about the physiology of obesity

No it didn't. Just another example of junk science.

> Now burns 800 fewer calories a day than would be expected for a man his size.

"Expected for a man of his size" is a fiction. What they are insinuating here is that the rapid weight loss did long term damage to his metabolism. But to confirm that, you have to have data on what is burn rate was when he was previously at his current 295 weight. (Which he must have reached at some point in his life long before the participation of Biggest Loser, on his way to becoming 400-something). Comparing to what can be "expected" based on plugging 295 into some model is not adequate.

Maybe he previously also burned hundreds of calories less than what can be expected of someone of his weight. Maybe it's been like that most of his life!


And that may well be why he was heavy to begin with.


There are at least three equilibriums that are apparently of relevance, based on what I have read. These are:

1. the hunger cycle - the hormones emitted during hunger

2. the metabolic cycle - the neuropeptide y's and other such unmemorable names, near the decision making part of the brain

3. the hydrocarbon cycle – the hormones emitted as a result of fat cells that are not flush with hydrocarbons

Diets address number 1. Number 2 and 3 are the more relevant for long-term success, but not enough is understood about them.

Here's a TED talk with some illumination:

https://www.ted.com/talks/sandra_aamodt_why_dieting_doesn_t_...

Research about weight control and loss is further conflated by profit-oriented companies that derive their primary income from "diet cycles".

That said, the failure of dieting is not new information: http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA...

The only known sure way to achieve substantial long-term weight loss is hyper-diligence in portion control and metabolic stimulation. Few can do it.

One of the unknowns is whether fasting survives long-term trends, such as the "5-2 fast" https://thefastdiet.co.uk/

All to say, the long-term results of the biggest loser accord with the latest research in weight control and loss.


Now, here's my opinion, and I know it might be wrong. Anyone, please feel free to correct me, but:

Everything I've read suggests that 1lb muscle requires about 50 calories a day to maintain.

The workout programs these contestants are using are focused solely on cardio, or very heavily focused on cardio.

If as part of the 239lb weight loss, Mr Cahill lost 8lbs-10lbs of muscle (and never regained it), there's your entire 400-500 calorie difference right there.

Like I said, I could totally be wrong, but over the last year I lost 93lbs (as of today), but my measured BMR is actually higher than it should be (and higher than it was when I started). I attribute that difference to my focus on lifting weights more than cardio.


Muscle burning 50 calories a day is a myth. Gaining 20 pounds of muscle adds 80-100 calories to your RMR for a typical person: http://articles.latimes.com/2011/may/16/health/la-he-fitness....


Yep. It's muscle recovery that is very calorically expensive. Those who have lifted or lift can probably attest to that crazy post workout appetite.


Thanks for the correction. I will point out that the article does indicate that there is some type of difference, so I would still think that such a loss would have some sort of impact (though obviously not ~400-500 calories worth).


They mentioned that they have a lower metabolic rate than someone of the same size. I doubt they have less muscle than the average person at their weight


From his picture from the biggest loser, he looks a lot different at 191lbs and 5'11" than I do at 195lbs and 5'11".

With as much cardio as they did, with as little as they ate, I can easily see them having a different body composition than someone else of their height/weight.


> The difficulty in keeping weight off reflects biology, not a pathological lack of willpower affecting two-thirds of the U.S.A.

Fifty years ago, two-thirds of the USA were not obese. Biology has not changed in that time. What has?


1) How do you know biology hasn't changed? The human gut microbiome has changed wildly over the past 50 to 100 years due to changes in modern diet.

2) Another point, the article is talking about the biology of people who have already been obese and then lost the weight. Given that people have more disposable income and obesity trends have risen, the inability to lose weight only after you first become obese would help explain why things like childhood obesity have negative impacts for the rest of a person's life.


Environment (available food type and quantity) has changed massively. We have the same potential as before, expressed diffeently now.


>Fifty years ago, two-thirds of the USA were not obese. Biology has not changed in that time. What has?

Other commentators have mentioned the food aspect, but there are significant lifestyle changes since the 50s. The rise of the suburbs greatly reduced the amount of walking for many Americans to basically just walking to a car in the morning and walking from a car in the evening, with maybe some walking back and forth to a bathroom or water cooler in between. Contrast that to the past where most American cities were laid out with public transit in mind (including LA; it used to boast a larger rail system than NYC). This meant burning more calories just to exist.

I myself moved from the land of sprawl to a walkable urban city and I lost quite a bit of weight since most, but not all, of my trips were on foot, bike, or public transit. Very few trips were undertaken in a car. I then moved to NYC and get even more activity, though that's counterbalanced by the delicious food everywhere.

You'll notice that most walkable urban areas tend to be slimmer than sprawling areas, all else being equal.


I think this is it. Cars.

The Fitbit general population statistics - which I would presume is a self-selected group of at least activity interested people, are quite scary in terms of the large number of people in the <5,000 steps bracket, and the relatively few in the > 10,000 bracket.

10,000+ steps is a normal day walking around London for me, to from work etc. but if I'm driving I may not even get up to 3,000.


Fat cells never go away once you've got them. Fat cells also really don't want to be empty. When you loose weight the fat is broken up in to H2O and CO2 (you literally breath and pee fat away) but the fat cell generally holds onto the water for a while and then, along with a load of other fat cells, will expel that water in one go(which is why you tend to keep a stable weight for a few days and then find you've lost 1 or 2 lbs "overnight"). It's called the Woosh effect I think?

Problem is that the body doesn't want to get rid of that fat cell because "hey, it might be handy one day to store extra energy when we can't eat for a few days because the baboons ate everything" and so it's fairly easy to top that cell back up with fat in the future.

With regards to the slow metabolism refereced in the article (I skimmed it) this is tied to leptin levels which needs to be topped up with "refeed days" every now and then just to kick start you metabolism again. A refeed day is basically a day where you eat a lot of carbs and keep your protein and fat as they usually are on the normal diet days.

Very broadly speaking (and short cutting lots of science and variations), it is easier for a previously fat person to get fat again than it is for a skinny person to get fat in the first place.


Why is it that fat cells never go away but your muscles will start catabolizing as soon as you stop drinking protein shakes ?

Are there any studies on this or is it more bro-science ?


Because, survival. Muscle is expensive - your body wants only enough to survive. Fat is life - your body wants all the stores it can afford.


This, our DNA isn't set up to maximise muscle mass. Big cats however are a good example of animals that are designed to keep muscle mass on - damn things can eat once a week, sleep all the time and look like they work out everyday


Right, I understand the idea.

I just haven't seen any studies on the idea that an empty fat cell will never be destroyed.

I have seen quotes like "your whole body is reconstructed over a period of years", i.e. cells have a lifespan, so if your body is reconstructing cells why would it put resources into rebuilding empty fat storage containers. Or, the other option would be fat cells are immortal, which seems to be extreme as well.

Just looking for some actual studies on this ...


ah, ok - get what you mean. To be honest I can't point you in the direction of any studies so any explanation from me would be educated guess work.

Ok, a quick google pulls up this article in the NYTimes referencing a study - have read the first paragraph or so and article is on the right lines of what you are after.

http://www.nytimes.com/2008/05/05/health/research/05fat.html


Thanks for the link, it didn't really satisfy my curiosity though :)

Obviously there are a lot of biochemical triggers for fat storage, muscle growth etc. Leptin has a very large part to play along with insulin, etc.

If something controls the fat storage levels, it makes sense that they will grow back after being removed via liposuction, especially if the person doesn't fundamentally change what / how they are eating. Their insulin resistance, leptin levels, etc will control this regardless of the actual surgery implications.

I'd be interested in a longer term study where an obese person undergoes something like liposuction, then also changes their diet to something more in line with low carb to fix these insulin and leptin issues and see if those cells actually regrow.


You are supplying potentially very interesting information... could you please point to sources?


No specific sources for my official comment, this is knowledge I've accumulated from 4 years of lifting weights and tracking calories.

Places I learn from along the way:

http://strengtheory.com - Greg knows his stuff

http://fitness.reddit.com - has gone downhill since becoming a default sub but they are looking at changing that, still good

bodybuilding.com is pretty good to be honest once you get over the hard sell of supplements, Jim Stoppani has a PhD and was a researcher at Yale I believe

"The mathematics of weight loss" TED talk by Ruben Meerman is pretty solid from memory

Elliott Hulse is a YouTuber (so take some of the stuff with a pinch of salt) but pretty good.


Well, not willpower. The human condition is pretty steady. The industrialized food chain, on the other hand, has changed dramatically.


Intake of refined sugars. The amount of time spent sitting at a desk.


If you believe the internet memes, the desk was not invented until 1980. Ditto the car, the burbs, the commute...

Pictures of my great grandpa's accounting firm open office compared to a typical 2016 open office from 1920 (yes I'm old, a sterotypical HN reader's G-Grampa would be in the 50s) are pretty enlightening WRT just how little of an effect the magical post-1980 desk has on obesity.

Now what happened in the 80s ... well, not the magical fat generating desk. HFCS? Hmm. What a coincidence.

Another pictorial example of a consistent social class for decades is the local masonic lodge has an annual pix of the lodge leaders and members going back to the civil war. Yes a hallway lined with over a hundred annual photographs. Even among the semi-wealthy who sat at desks all day, nobody was fat until post 1980s pix. I'm the first in four generations not to be a Mason.

If you're into genealogy its very interesting to pull group family reunion photos from the last century or so. Same people, same genetics, same social class, same lifestyle, same geography, suddenly in the 80s people start getting real fat, across the board, across occupational classes, across lifestyles. Even the jocks got fat (note that jock fat is a staggering doubling of body fat from 4% to 8%, they're both skinny compared to the general population AND twice as fat as they were)


It's anecdotal observation of course, but my memory is that the 80's were the era where suddenly people became afraid of high fat diets. Hence a corresponding increase in sugar and simple carbs.


People didn't just start getting fat in the 80s. Where is that coming from?


Here is a chart that supports exactly that: https://lanekenworthy.net/2012/05/31/why-the-surge-in-obesit...

The hockey stick starts exactly at 1980.


Could it be we all quit smoking in the 80's?


That doesn't explain how someone can just let it happen to the point of suffering of it every day without taking simple measures to reverse it.

Most of the time the difference between steady gaining or losing weight is a few hundred calories a day. That's far from a lifestyle change.

When moving around becomes difficult, when dating becomes harder, when the aches and pain start... there's gotta be more to it than just a lot of sugar in your everyday stuff.

I always wonder (for other drugs too), if they're a way to slowly remove yourself from situations, or whatever it is, that make you uncomfortable. A way to permanently disqualify yourself from the race, because the idea of running (no pun intended) makes you anxious?


"That doesn't explain how someone can just let it happen to the point of suffering of it every day"

Abstract out the obesity, and you've described every chronic health condition, ever. A huge number of emergency room admissions read something like: I thought it was normal that road signs were getting a little blurry after 40. Sure my heart screams in agony when I climb stairs, but who's doesn't? My knees are in crippling pain for days if I hike more than two miles. Every time I drink, I drink till I pass out or are arrested, but doesn't everyone? After I eat sugary food (aka modern american diet) I feel faint and fuzzy, that's normal, right? I hear voices in my head more often as time goes on. Why how odd that pain pill has smoothly and gradually gone from something to make life bearable after surgery, to life is unbearable without it, to life is unbearable even with it.

People tend to be pretty good at getting medical care for acute things like bleeding out more than a quart or so, or broken bones, but not so good at getting help for chronic things. Gettin fat is obviously not an acute problem.


The food industry has a significant number of people employed whose whole job is to make you think foods are healthier than they are and get you to eat more of them. I mean it's not by accident that almost every food in the supermarket ended up with some health claims on the box (my favorite examples of this are, like, "natural" eggs and "gluten-free" meats).

That's assuming you're buying your own food; if you're eating in a restaurant or something you don't even really know what you are consuming.


Interesting, so I guess it's an education problem?

I guess just like real-talk sex-ed went against the interest of big-church, teaching some basics when it comes to nutrition would hurt a lot of big-food...


I don't think it's just that, although many have found it suspect that the dairy industry gave a lot of funding that helped the development of the original food pyramid with dairy as a core food group.

To me it's more like the current environment, to borrow a programming term, makes it difficult to "fall into the pit of success."

The NYT ran a great article on this a few years ago: http://www.nytimes.com/2013/02/24/magazine/the-extraordinary...


People generally do what those around them do. Why was smoking so much more popular 50 years ago? Why do people still smoke in 2016? Why is spanking almost child abuse, now?

It's not like we're rationally considering each small action. Instead, at any time, in a give society, there are a set of behaviours that are considered within the normal range. We're mostly on autopilot.


Often forgotten is the incredible increase in drug consumption. Popular drugs like painkillers or antidepressants can have a significant effect on body weight. For the pharmaceutical industry it's like having a cake and eating it too: develop new drugs to fight weight gain, weight gain that can be caused by other drugs.


The agriculture, restaurant, and food industry. Quite a bit, actually.


> Fifty years ago, two-thirds of the USA were not obese.

2/3 are not obese now.

(2/3 are overweight, including about 1/3 that are obese.)

> Biology has not changed in that time.

Assumes facts not in evidence, but lets assume that's true.

> What has?

Well, the sharp uptick in obesity (which pretty much drives the overweight including obese upward trend, the overweight-but-not-obese proportion has stayed pretty flat) starts in the late 1970s, immediately following the peak in real hourly wages. Given that (ironically, given that richer countries have higher rates of obesity than poor countries) individual obesity in the United States is correlated with poor economic status, its not entirely implausible that there's a significant economic contribution to the obesity epidemic.


The food has changed a lot - as other commenters have pointed out.

But our lifestyles have changed a lot, too.

Most people in sub/urban areas spend 1-2 mins walking to/from their cars and the rest of their waking hours (12+ hours) sitting/eating.


Easy access to cheap calories.


Impulse control is fundamentally biological, so obviously a "lack of willpower" can't be the explanation.


> Fifty years ago, two-thirds of the USA were not obese. Biology has not changed in that time. What has?

I wish more people would ask this question. It's extremely innocent and straightforward, and replies to it are incredibly revealing of the respondents' understanding of biology . . .


See HN passim "The Sugar Conspiracy" https://news.ycombinator.com/item?id=11444941


>Biology has not changed in that time.

Oh, yeah it has. Changes in food and environment have modified our biologies. The effects of food energy overexposure are semi-permanent.


In the other direction, see the documentary "Why Are Thin People Not Fat" where a group of thin volunteers are overfed by about double their normal calories for 4 weeks:

http://news.bbc.co.uk/2/hi/uk_news/magazine/7838668.stm

http://youtu.be/U1hbPXooB1U

They all easily return to their starting weight, and at least one volunteer gains muscle but not fat. The body is amazing at maintaining homeostasis. Here's an nytimes article from 2011 that discusses much the same thing as the article submitted:

http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...


There's a lot of research being done right now, that suggests your gut microbiome has a lot to do with it. Very interesting stuff.

http://www.scientificamerican.com/article/how-gut-bacteria-h...


Yup, also see this recent research that bariatric surgery causes changes to the gut microbiome which account for some of the weight loss:

http://www.livescience.com/51739-bariatric-surgery-gut-bacte...


Thanks for this; it was completely new to me.


4 weeks may also not be enough time to wreck your insulin/grehlin/etc sensitivity


From the article (emphasis mine):

> Mr. Cahill was one of the worst off. As he regained more than 100 pounds, his metabolism slowed so much that, just to maintain his current weight of 295 pounds, he now has to eat 800 calories a day less than a typical man his size. Anything more turns to fat.

Presenting the numbers like this seems intentionally confusing. Casually reading this seems like he's eating 800 calories a day and still gaining weight.

What they're really saying is that he's eat $AVG_295_LB_MAN_CALORIES - 800 per day. That's probably around 4000 calories a day.


Using the USDA supertracker here (https://www.supertracker.usda.gov/bwp/) with the following data/assumptions:

Weight: 295 lbs Age: 46 Height: 5 feet 10 inches (average height for US male) Work activity: sedentary Leisure activity: sedentary

The normal maintenance calories come out at 3117. Less 800 is 2317.

That is still enough to eat well and feel full, in my experience.


>That is still enough to eat well and feel full, in my experience.

That's because your hormone levels aren't crazily out of whack like the individual you reference. If your hormone levels were changed to reflect the person that lost weight, I doubt you'd say that.


Perhaps that is true.

I have also experienced that if I eat total shit, my hunger is boundless. Whereas if I eat well, my hunger tops out at around where it needs to be to maintain a healthy weight. It is not obvious why this should be the case.


I've had the same experience. My family has a history of heart disease, and for a long while I tried to follow a heart healthy diet. I was always starving, and I had difficulty concentrating. I actually managed to gain weight as well.

A year into this experiment I gave up and started eating foods that I felt help me concentrate the best: red meat, dairy, potatoes, butter, starchy vegetables, deli meats, etc. I suddenly felt much better. I found it much easier to maintain a healthy weight, and I had much more energy throughout the day.

I spoke with my internist and a cardiologist, and they were more than ok with the change. My BMI is exactly where it should be, my cholesterol and blood pressure are incredibly low, and I exercise all the time. I don't want to give the impression that everyone should start eating "unhealthy" foods, but at the very least the foods I'm eating are much healthier than the sugar-laden foods that are prevalent in the average diet.

For what it's worth, my cardiologist, believes "bad" cholesterol is damaging in the absence of "good" cholesterol. His wife, who is a dietitian, disagrees with him entirely.


Even with hormone imbalance, I wonder what exactly Cahill eats day to day. I'd guess he's not eating satiating, nutritious, whole foods. I'm almost certain he'd be eating high-GI, insulin-spiking foods, which are driving his hormones further out of whack.


I had no such confusion. It's strange you would blame others and not your own reading comprehension when it was written pretty clearly.


Let's keep it civil.


I just checked what you're saying here: https://news.ycombinator.com. The amount of calories you need to maintain weight does go up enormously as you weight more. And I didn't know that while reading the article, so I thought the guy who needed 800 fewer calories was needing 800 less than a non-overweight person. Not true. A moderately-active 6'0" male needs 3386 to maintain weight as a baseline. Subtracting 800 gives 2586. Which is about what a person of the same build and activity level who weights 175 needs to maintain his weight. So it doesn't seem like it should be so hard to maintain 295.

But the problem would seem to be that if he does get down to 175, then does he need to take in no more than about 1800 calories to keep from gaining, because the 800-calorie difference remains constant? That seems very difficult but also seems unlikely. Or is the 800 calorie difference reduced proportionally or according to some more complicated formula? In any case, it sounds like it would be hard to maintain a weight of 175 once you've had Mr. Cahill's history.


Nowhere near that.

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