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Overweight and healthy is a big fat lie, obesity study finds (thetimes.co.uk)
199 points by elorant 33 days ago | hide | past | favorite | 223 comments



I got curious about this once and looked up the life expectancy of sumo wrestlers. It anyone is “fit but fat” it would be them.

They have very high bmi’s, ~35. But they’re just barely obese by body fat, about 26%. Result is a life expectancy of 60-65, more than ten years shorter than the Japanese male.

“ The negative health effects of the sumo lifestyle can become apparent later in life. Sumo wrestlers have a life expectancy between 60 and 65, more than 10 years shorter than the average Japanese male, as the diet and sport take a toll on the wrestler's body. Many develop type 2 diabetes or high blood pressure, and they are prone to heart attacks due to the enormous amount of body mass and fat that they accumulate. The excessive intake of alcohol can lead to liver problems and the stress on their joints due to their excess weight can cause arthritis. Recently, the standards of weight gain are becoming less strict, in an effort to improve the overall health of the wrestlers.”

https://en.wikipedia.org/wiki/Sumo

Source on bmi: https://pubmed.ncbi.nlm.nih.gov/10195655/

Note: wiki’s own quote is not well sourced, but there were some paper noting short lifespan. This is the main one cited, but it is in japanese. If anyone wants to track down the actual life expectancy, let me know.

https://www.jstage.jst.go.jp/article/jjh1946/50/3/50_3_730/_...

This one in English discusses bmi as a risk factor for sumo but doesn’t give an age: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761530/#!po=50...


Of course BMI doesn't work for body builders. However only like 1% of the population work out enough to have muscle mass vs fat mass to actually make BMI "worthless" as so many people say. BMI is an "ok" way of determining if you're obese or not with 95-99% of the population. (at least in the USA). Lots of people just don't want to admit they're fat.


BMI works for body builders too, if you carrying 50kg> extra the body doesn’t care as much if it’s fat or muscle your heart still needs to support that body mass.

BMI for people with very high body mass and low fat percentage can be adjusted slightly usually within 10-15% but if you are morbidly obese it’s going to be a problem either way.

Going down from 96kg to 78kg while gaining some body fat from 9-10% to 12-13% reduced my RHR by about 10-15bpm.

And that initial mass gain was just with a decade of exercise not the gain and shred cycles that body builders are going through not to mention the extra “vitamins” they tend take...


I don’t think professional athletes are a good population sample to map onto the general population. Athletes are highly incentivized to burn bright and flare out.

Take NFL players. Yes, an obviously aggressive sport that lends itself to short careers…but even then, the average stint is 3.3 years. (https://www.statista.com/statistics/240102/average-player-ca...) You will do anything, no matter how deleterious, to keep yourself in the game, damn the consequences. And by anything, I mean a steady diet of uppers, downers, and steroids.


I replied to another comment to say that olympic athletes actually live longer than average.

NFl players aren’t a great example. That much traumatic brain injury is seriously harmful to health. Among olympic athletes, those in contact sports did less well.

You do have a point as sumo is grueling and involves contact, but you wouldn’t expect hard playing to take off that much life expectancy all on its own. Sumo wrestlers surely lose some from adiposity.

https://theculturetrip.com/europe/united-kingdom/articles/at...


If I recall correctly the same is not true for professional cyclists [1], a sport with a rich doping history. They seem to live longer than the general population. I believe this is related to the impact on the body versus steroids.

1. https://www.cyclingweekly.com/fitness/cyclists-live-longer-a...


My personal trainer told me that first application of anabolic steroids was in endurance sports like cycling.

One effect of testosterone is to increase red blood cells count, enhancing the oxygen transfer and thus endurance.

(BTW, red wine's quercetin blocks testosterone's drainage by kidneys and indirectly elevates red blood cells count)

The weightlifting also has positive effect on the longevity: https://www.sciencedaily.com/releases/2019/04/190412085247.h...

To counter your article about cycling: https://www.dw.com/en/michael-goolaerts-death-raises-questio...

And obligatory reference to Marko Pantani: https://crushingiron.com/cycling-is-the-toughest-sport/

He was so fit, he has to cycle several times at night to make his heart go faster and not to die.

The article of yours was not about professional cyclists, more about "cycling fitness" approach. I love cycling - it improves deadlift immensely. But professional cycling is different. Very different. And dangerous.


Pantani was in an age where drug testing was not very good so they pushed the limit of hematocrit level to improve performance. Now the tests are much better and so the level of drugs and thus side affects seems to be lower.

You don’t hear of cyclists dying in their sleep really of coagulated blood from EPO.

There are some legal pain killers like tramadol and excessive caffeine that you might not do if you are optimizing for health but not sure how detrimental that is long term.


> He was so fit, he has to cycle several times at night to make his heart go faster and not to die.

That wasn’t because he was “so fit” was it, but rather from being in the middle of a powerful doping regimen (like all top cyclists were, you simply couldn’t compete otherwise) raising your hemocrit level to the point it could kill you?

Vid about it: https://youtu.be/hT8GZlBBv5k


unfortunately I can't get the full text of the cited study but it sounds like baloney to me based on the numbers. TDF cyclists live to 81 vs 73 for the general population. But to be a tdf cyclist you have to first live to (and be healthy in) your 20s. What is the life expectancy of a normal citizen who is in their 20s and healthy? Surely more than the "general population", which includes infant deaths, people with degenerative conditions, etc.


Cycling does have a rich history of doping, but it also has a rich history of critical coverage of its doping.

Does anyone honestly think that international soccer, which is also a sport where athletes would richly benefit from both EPO and steroids, actually has less doping (at least as covered by the press) than cycling, when there is 10x-100x as much money?


Isn’t doping in cycling mostly blood doping, ie. replacing «old» blood with blood collected prior to a competition? I doubt that has any real effect on your body beyond the immediate effect of the new blood binding oxygen better than the old blood.


NFL players have another major issue that greatly shortens lifespans: CTE [1]. I wonder how much sumo wrestlers are affected by it. I could imagine it also being a problem due to the powerful impacts from their heavy bodies slamming against each other.

[1] https://www.mayoclinic.org/diseases-conditions/chronic-traum...


Yeah, for anyone who doesn’t know, everyone in the NFL is on HGH. Their tests are inadequate and they didn’t even test for it whatsoever until 2010.

Even better, if you know you’re going to be injured, you can just take PEDs and laugh right on through your suspension since you weren’t going to be playing anyway (see: Edelman, Branch, others).


yeah, but then again it's probably more deleterious to your health to try to survive in the nfl without juicing so can you blame them?


I'm a sumo fan, and when you think about the daily routine these guys endure it's really amazing that even then it can't overcome their diet. They wake up at 5am, train for 5 hours in the morning, perform the domestic chores that the stable needs them to do, then come back in the afternoon for more 4 hours of training. E-VE-RY day. Other than some rare off season oportunities only the top wrestlers can get, that is it. And they still become diabetic and develop heart disease. There's no escape, other than having amazing genetics, if you eat like a pig, you die like one.


I've also heard it phrased as: You'll never outrun your fork.


Sort of riffing on this subject, since rikishi are nearly all Asian: Asians are more vulnerable to diabetes than people of other ethnicities. Health authorities have recommended screening Asians with a BMI above 23 for diabetes. BMI, of course, is purely a function of weight and height.

> limiting screening at BMI ≥25 kg/m2 would miss 36% of Asian Americans with newly diagnosed type 2 diabetes. In the same study, Araneta et al. (39) found that screening Asian Americans at a BMI cut point of ≥23.5 kg/m2 identified approximately 80% of those with undiagnosed type 2 diabetes. Among Japanese Americans, lowering the BMI screening cut point to ≥22.8 kg/m2 achieved 80% sensitivity.

https://care.diabetesjournals.org/content/38/1/150

https://aadi.joslin.org/en/am-i-at-risk/asian-bmi-calculator


How the fat is distributed is more important than how much there is. In sumo wrestlers almost all their excess fat is subcutaneous fat rather than visceral fat.

Subcutaneous fat is much less harmful than visceral fat.

There was a fair bit about this and sumo wrestlers on the excellent Nova episode "The Truth About Fat" last year [1]. Fat is much more complicated than most people realize, as is long term weight loss. It looks like the episode is available for free streaming [2] until the end of the month. It's worth it.

[1] https://www.pbs.org/video/the-truth-about-fat-xnqm4i/

[2] PBS shows go in and out of free streaming. They can usually be streamed for free for about a month after they first air, then most of them become restricted to people who donate to their local PBS station. The restricted ones do pop back to free streaming for a while now and then, and certain episodes become free for years.


As a corralary has anyone researched the longevity of bodybuilders?

You’d think entering old age with a large surplus of muscle could be beneficial.


Powerlifters or weightlifters might be better because they don't cut to <5% body fat and steroid use is less common.


“steroid use is less common”

Ha. Hahaahahahaaa. Haha. Wow. No. That’s the entire point of untested powerlifing federations. Have you ever been to a powerlifting gym? Those sharps disposal bins aren’t just there for the diabetics.

https://fivethirtyeight.com/features/what-powerlifting-tells...


He said less common than in bodybuilders, not less common than the general population, which would be absurd.


I think their hearts are way more under stress - they lift a lot more weight..


Since it's not like their hearts are overworked the same was with an obese person, I'm not sure if this would be a good thing or a bad thing.


I think it is a bad thing.


At the same time I looked into life expectancy of olympic athletes. Iirc it was higher across the board, but powerlifters had a lower boost compared to runners.

https://theculturetrip.com/europe/united-kingdom/articles/at...

Edit: Fixed typo thanks. Also note that bodybuilders on steroids may not fall into the same group. One report found higher mortality below 50 this group.


>Iirc correctly If I recall correctly correctly?


I thought the olympics would not entertain any sort of event with bodybuilders because they were extremely unhealthy.

(this is different than weightlifting)


Having your cardiovascular and endocrine system taxed by steroids is going to be shit for longevity.

I think from what I've seen in media restricting calories seems beneficial to longevity so bulking and packing muscle mass probably "burns you out" even without steroids.

Having said that I'd rather trade 10 years of the tail end of my life for being jacked and rested in my prime years (testosterone does wonders for energy and recovery), especially compared to being a fat slob.


A good example of why BMI is actually a good indicator. Its a bit of a meme that when you weightlift BMI is inaccurate, but all excess body mass is somewhat unhealthy. Even most people who lift weights are too fat.


These weightlifters below all-inclusive weight category are pretty much not too fat. Look at deadlift records: https://www.youtube.com/watch?v=3zxXQhSvGKY

Upwards 140 kg, there are fat people, but even Konstantinov (below 140kg)is not fat.

Take look at him doing 55 pullups: https://www.youtube.com/watch?v=boLl8rGhJvE

The "most people who lift weights is fat" myth comes from watching too much competition in open-ended weight category (which, for weightlifting, starts at 109kg, I believe).


I’m confused how they have 26% body fat. That’s not all that much. Are you saying they are mostly muscle?


It's still overweight. For men the mid to high 10s is considered healthy.


The normal fat percentage range for men is 15..20%. 26% is overweight but not much. I once pulled up 27 times having 27-28% of fat being 38 years old, weighting 115 kg, which is about as much as I pulled up at my 18yo with 72 kg of body weight and god knows fat percentage (I had sixpack at the time, so it is 10% or less).

3% of fat is death low (thanks to Nazis to find that). To keep anything less than 10% for prolonged time takes very calculated effort or young age and high activity. It is very hard to go lower than 15% for normal men.


yeah it's surprising. But keep in mind they weigh at least twice a normal man, so they have about 4x the total fat of a healthy adult male (12% being close to what I consider ideal).


12% isn't really a sustainable bf% for most people.


Yep.


I remember someone telling me that as soon as sumo wrestlers stop wrestling, they immediately get diabetes.


my scales say i'm in the healthy rang for BMI, but unhealthy for fat and too much muscle mass...

i can tell you i have a desk job and do NOT have too much muscle :-P


Honestly this is more of a systemic failure than an individual failure.

It's extremely hard to eat and live healthy. It's getting harder every day. Why are low sugar alternatives to basic snacks (e.g. Keto friendly) like 3-10x more expensive?

Why does EVERYTHING have sugar in it? Why don't we have cheap and healthy fast food that seems to be common in so many other countries?

We could solve this problem if we actually subsidized and demanded better food standards. If we helped people make the right choices. But hey, we decided that fat is the enemy and everyone should have hundreds of grams of carbs per day.

When I lived in Iran it was so much easier to maintain a proper weight. After moving to the US it's become extremely difficult. I'm still the same person. But what's available to me has changed immensely.


Sometimes the amount of sugar is also completely unnecessary.

Heinz sells ketchup without added sugar and it tastes almost exactly the same as normal, or even slightly better, half the calories though.


Yep. And also usually more expensive. I can't understand, I'm paying more for less.

I didn't belive this before but we need a sugar tax. We also need to have strict dietary guidelines on how much sugar is acceptable per gram of food.


You’re probably paying more for the same weight or volume comprised of ingredients more expensive than sugar.


I know you’re being facetious but on top of the marketing appeal: Less sugar means more tomato?


True, usually the bottles are smaller though. But I'm not sure of this.


Less buyers also means less economy of scale.


It is sweetened with sucralose. Presumably they wouldn't have been able to market a sugar-free version without sugar substitutes.


Wow, I didn't know that. I see "sugar free" I'm expecting the same thing without sugar, not a substitute.

Really more of a "diet ketchup" in that case...

I really don't think tomatoes need to be sweeter than they are naturally to make decent ketchup. I'll be on the lookout for ketchup that is "sweetener free" in the future.


I've found sauces tend to be more vinegary, at least low fat salad sauces. Salt should also be looked out for too.


It’s not hard to eat healthy at all. People are just nutritionally illiterate, and that makes it difficult for them to build proper meals.

The typical person has no idea how big a meal should be to obtain the right quantities of nutrients, because they’ve never bothered to weigh their food. They also have no idea what their daily macro nutrient goals should be.


Its not all on the people though, there are many forces bent on keeping people nutritionally illiterate. Low fat, cholesterol, its all been found to be, at the most charitable, completely wrong. When I grew up, my Mom made sure we ate “healthy” cereal for breakfast instead of eggs. She wasn’t illiterate, she was following the “literacy” of the day.


It’s not true at all. Vietnamese are one of the healthiest nations in terms of weight. They don’t weigh the food or know much more than an average person. Their diet is just culturally diverse and healthy.


I don't really buy the argument that sugar content is to blame. I buy cheap food, I live in the US, I don't eat "healthy" and never have -- and yet I'm thin. People like to hand-wave this away by telling me I must have a high metabolism, but I've never found that to be a convincing explanation.

I think a more probable reason for the obesity epidemic is the rise of food as a self-soothing device. To me, the best indicator of whether you're likely to have a weight problem isn't your activity level or the sugar content of your groceries, it's whether you turn to food as a way to relax.


Yep, I look at food as an escape and my BMI is 44.1


One reason for this is that corn subsidies have created an excess supply of corn-based food derivatives (e.g. corn syrup) for years, driving down costs and creating an incentive to use cheap corn-based ingredients across the entire food supply.


Farming subsidies were originally created in the aftermath of the Great Depression. While they have their place, we probably over-subsidize today. Given the choices of widespread obesity or widespread starvation, I'd choose the former.


Lots of deli meat + wrap or 2 slices of bread + lots of lettuce.

A cheap, portable meal/snack that removes the need for fast food or "Keto snacks". Enough protein and fibre to fill you up.

Eating low calorie is not expensive, it's just not very exciting.

Until recently you could also get something like this at mcdonalds (grilled chicken burger or wrap).

Added sugar is not good, but fat free products are a great choice for dieters who want more variety. You get the same volume of food with a similar taste for much less calories.


Another possible answer is that it's just cheaper to fill snacks with sugar than anything else while keeping them tasting good. Plus sometimes in snacks sugar plays a big role in forming the structure and it's hard to find a proper replacement for it.


I used to drink Dr Pepper 10 instead of regular, it was almost identical, how existing full sugar soda is considered normal blows my mind . Would you drink a cup of coffee with 10+ sugars? Alas it is very difficult to find now.


Sugar substitutes like Monk Fruit Extract aren't as widely produced. (There are other sugar substitutes, but among all of them, Monk Fruit is king: it tastes most like sugar and it is the least likely to cause digestive issues). If they were more popular, perhaps efficiency at scale would drive down prices. Also, carbs tend to be more shelf-stable than proteins and fats (though, beef sticks and nuts are solid exceptions to this generalization). But a long shelf life can help decrease the cost-- which is the case with staple grains like wheat and rice.


Back in the day when we were running around the Savannah foraging, fat and grease would have evolved taste buds to prefer these inputs since they are such concentrated energy sources.

Fast food takes advantage of this, and it would not be too much of an issue if not for preservatives (find a French fry under your car seat from 5 years ago and it looks the same as it did the day you bought it - we should want to eat things that will rot within a week of room temperature).

I sop up all the grease of my homemade dishes ( "Food what nearly all people eat, to me it is harmful and dangerous. Sometimes I visualize that chefs in the world are all in conspiracy against me …" Nikola Tesla thought chefs were conspiring against him [1]) because I refuse to let anything to go to waste, and I welcome all the energy I can get (fuel for the tractor). I also do not clean dishes after every meal (blender included) because I want to see what nature can throw at me tomorrow. So far so good, although my stool once smelt like sulfur after cooking with boiled/stored creek water - duckduckgo tells me giardiasis, waterborne pathogen, which my gut promptly destroyed after one digestive cycle (well rehearsed and diversified, daily probiotic reinforcements).

At this point I have an iron stomach, and I was inspired by quite the lean healthy "homeless" girl I met who was eating out of dumpsters. I refused to partake in the dripping salad offering she presented me, but I could understand that because of this lifestyle - she would be far less of a liability to the healthcare system. Meanwhile, the "housed" people are stuffing themselves with their Precious TV Dinners (Tom Green, Stealing Harvard), sanitizing every surface they can think of, and finding it acceptable and even preferable to sit in their favorite chair with their "free" time to fawn over streaming media that depicts other people living their lives.

We want to blame it on the food, but the propaganda on phones and public wall-mounted screens is orchestrated by those who themselves are fearful of the world around them. The ones that follow suite are going to acquire a gut, high blood pressure (Why Zebras Don't Get Ulcers), and dulled senses.

[1] https://garylite.com/2019/08/21/everything-is-the-light-an-i...


It seems like you made a choice that lowers your life standard. If you want lots of money while living healthy, move to Switzerland. But of course there are many other options.


I'm imagining the Swiss watching in horror as a caravan of thousands of obese American refugees arrives at their frontier...


I mean, if they're gay, moving to the US from Iran probably did not lower their life expectancy.

But more generally - we can't ask everyone in the US to move out of the country, can we? So it seems worth figuring out how to get the US to be healthier.

(And in any case, the linked study happened in Spain.)


It’s not about asking people to do something.

I lived 6 years in Switzerland and a guy who moved from London to Zurich told me that he lost 10kg in a year just because people don’t let him eat crappy food, and on the weekends people go hiking and skiing, not to pubs.

Sometimes changing the situation is the easiest way to change someone’s lifestyle.


>Why does EVERYTHING have sugar in it?

I suspect that added sugar increases sales.


[flagged]


Thanks. This advice is literally useless for millions of working class people.

Fast food can be healthy. We're doing a disservice to our public health by not making it be healthy.


If you're affording to eat out at fast food restaurants, you're probably not as working class as you think you are.

aaomidi 33 days ago [flagged]

You...do realize that around 30% of people in every economic level eat fast food right? It's how a third of the population gets their food.

Stop being a dick.


I agree fast food can be healthy. When you meal prep it ahead of time and throw it in the microwave straight from your lunchbox.


There's nothing wrong with snacking in itself. Arguably, it's better than three or so heavier meals. There's nothing wrong with fast food either, if we encompass, say, a healthy sandwich or salad from Subway, Chipotle, or Panera in it.

These attitudes purely stem from the way these are dominantly present in our society.


> There's nothing wrong with fast food either, if we encompass, say, a healthy sandwich or salad from Subway, Chipotle, or Panera in it.

I don't know what to say apart from this baffles me. These aren't healthy options. They're processed junk food.


What’s wrong with Chipotle?


A typical Chipotle order is 1,000 calories, an entire day's worth of salt, and most of a day's worth of saturated fat. Just for lunch. That's insane. Almost nobody needs that unless you're an athlete.

https://www.nytimes.com/interactive/2015/02/17/upshot/what-d...

https://www.cosmopolitan.com/food-cocktails/news/a36622/chip...

I think it's also pretty gross, greasy, sloppy food in general - they've caused e coli breakouts in the past it's so bad.


The higher-end numbers from the NYT article come from chips and guac. If you're ordering fast food from these places you of course have to watch that you're not ordering calorie-heavy foods like you also have to in restaurants. But their menu also has lighter-calorie options.

What I'd also question is how much of these numbers are due to the portion sizes vs. nutrition per calorie.


Thanks, I didn’t realize this. I appreciate the sources


> There's nothing wrong with snacking in itself. Arguably, it's better than three or so heavier meals.

There have been studies purporting to show benefits from having either more or fewer meals per day and overall there isn't really strong evidence either way.


Regarding the point about cheap and healthy fast food, wouldn’t it be awesome to have the convenience of something like that? No need to be so dismissive.


Easier said than done for some. Many snacks are chemically engineered to subvert your rational mind.


It's yet another thin person thinking they've discovered the magic to life.

It's always this dismissiveness of real issues that has led to obesity becoming such a massive national and international crisis.


That's exactly the response that does not solve systemic problems. It is unconstructive, unhelpful, and most importantly ineffective.


Just don't go to fast food restaurants. Just don't. That's the advice. How much more clear do you want it to be?


"Just don't drink alcohol. Just don't. That's the advice. How much more clear do you want it to be?"

"Just don't use addictive drugs. Just don't. That's the advice. How much more clear do you want it to be?"

"Just don't smoke. Just don't. That's the advice. How much more clear do you want it to be?"

This is how you sound.


What do you think the advice should be?

Snacks and fast food are harmful. So don't do them. The same way we say cigarettes are harmful and tell people to avoid them.

I don't know how else to dress it up? What are you expecting? The advice is 'don't do it'. Seems hard to pretend it's anything else?


what,s wrong with that advice?

we live in an unsafe world...

you either make these hard choices, or you suffer the consequences...


These aren't solutions to systemic problems.

People like doing stuff that is unwise/unsafe/destructive, acting like they don't (ignoring the problem) and then throwing out dismissing quips isn't even an attempt at a solution.

Nudge theory[0] has worked in the past (within the limits of the problems). Dismissing those problems as trivial while waving them away as an individual choice hasn't been and cannot be because it doesn't even attempt to address the underlying issues.

[0] https://en.wikipedia.org/wiki/Nudge_theory#Types_of_nudges


If there are systemic problems, there's nothing an individual can do about it today, apart from following my advice - abstain. That's the best advice there is today, for an individual.

If I was advising a government for how to change things in the next decade I might have some more ideas I could share!


i can,t solve systemic problems. no one can. each of us can only solve problems locally.


If more people thought like you we wouldn't have an obesity problem.

Thank you. Seriously.


Thank you.


> Why does EVERYTHING have sugar in it?

Taste, mainly, because all the fat has been removed.


meh, I think this rant is a little dated. The FDA recently started requiring an "added sugars" line item on nutrition labels, which is a step in the right direction. In my city there's now a tax on sugary drinks. People have never had more options for what to eat and drink, however we (Americans) don't live in a nanny state, thankfully, and some people will make choices that you consider unwise.

To your last point, I live in the US and have a healthy diet and lifestyle and waistline. So don't be so quick to blame your environment.


I live in the US and I have a healthy diet and lifestyle but I definitely spend 3-10 times more than most of my friends that don’t on food and exercising


Good for you.


Source:

Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study

https://doi.org/10.1093/eurjpc/zwaa151


right off the bat I'm suspicious of the methodology, since it seems that active obese people are more likely to develop high cholesterol than less active obese people (doesn't pass the sniff test).

More importantly, I don't think the "active" category is sufficiently discerning, ie it's a pretty low bar to exercise 150 minutes in a week. I know several hardcore endurance athletes who are likely overweight if not obese, who exercise obsessively and achieve those weekly exercise figures every day. If anyone was "fat but fit" it would be them, but this study doesn't measure that kind of person.


This should be the top link not a paywalled times article.

The chart below is pretty clear as to their findings if anyone wants the summary.

https://academic.oup.com/view-large/figure/225496940/zwaa151...


And it always has to come down to either fat shaming or fat acceptance.. It's like we can't have an honest dialogue about abusive relationships with food (be it using food as a coping mechanism for other things going on in their lives or straight up addiction), or the fact people are never taught nutrition, instead just 'winging' it. You can't do that in the US. There's so much food you can buy and eat for cheap that will leave you starving despite being at a caloric surplus.


There are very few overweight people past the age of 80. Anyone telling you otherwise is trying to sell you a bridge. Agenda pushers and idiots who parrot for free what others are selling them are responsible for the “body shaming” nonsense.

Cut back on the ice cream and hit the rack. Your body will thank you, even if your politically minded “friends” don’t.


> There are very few overweight people past the age of 80.

How much of that selection is due to voluntary lifestyle choices, how much is due to genetics or other involuntary factors? The answer has a pretty big influence on how appropriate it is to look down your nose at others for not fitting your ideal.


I don’t think anybody really believed such thing except a loud minority, mainly thanks to social networks and journalists wanting to gain eyeballs with provocative headlines so people get mad at absurd stuff and come back for more.

The formula worked and keeps working very well.


Didn't need a study to know this


Unfortunately, we do. There is a movement dubbed HAES which purports "health at any size".


Please correct me but I always thought HAES meant “you can choose healthy choices no matter your size”, presumably because past a certain point fat people might be like ‘fuck it no point in trying to be better’.


As with every other generic slogan, it probably means different things to different people


HAES is giving yourself permission to give up.


That’s one of those things that I’ve been hearing about for a decade or longer, but literally only from people refuting it and apparently claiming it’s a mainstream view that desperately needs to be refuted.


[1] has quite a good overview of the HAES movement. It is real.

[1] httpss://www.medicaldaily.com/health-every-size-obesity-weight-loss-science-383008


I wonder if the two can't be reconciled. It's probably ideal, from a health perspective, to avoid developing things like metabolic in the first place. But has it been demonstrated that, once you're already there, living the kind of aggressively orthorexic lifestyle it takes to get down to an ostensibly healthy weight does more good than harm?

Even without that, though, I'm sympathetic to HAES because it seems quite likely that, even if absolutely nothing else, focusing on body weight rather than lifestyle factors ultimately does more to discourage than encourage making healthier choices.


And in fact this study totally fails to refute that idea. All it does is it says that, among a half million people, the higher-BMI groups had more cases of high cholesterol, high blood pressure, and diabetes, even when controlling for levels of physical activity. It says nothing about whether adding physical activity to get to a lower-BMI group could work as a treatment for any of those, nor whether there are any consequences of that level of physical activity.


There are many stupid movements. Do you think you’ll change the opinions of anybody with a study? Especially when the solution is losing weight


I do like the focus on health rather than weight though, I think that's valuable.


Indeed, this is stating the obvious. If you are an active fat person, you are still a fat person - which is the important point.


I'd like to agree, but when this was a major magazine front page this month, I don't think I can.https://i.imgur.com/0kQQMcS.png

I personally know too many people who believe this shit. You can't say anything about it though or you're called scum and toxic. That too is healthy to them.



The loons that say "healthy at any size" beg to differ unfortunately. It's just a coping mechanism.


and no amount of studies will get this into the heads of those who need to accept it


The conclusion of the actual study doesn't exactly align with the title here. The title gives the impression being active is pointless which isn't true.

> “Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles.”

For a lot of people, increasing activity is something they can manage even when weight loss is a struggle. Obviously being skinny and active is the ideal, but being heavy and active is vastly better than being heavy and sedentary.


Check out this slide. Shows a big step change in health at every increase in weight level, regardless of activity: https://academic.oup.com/view-large/figure/225496940/zwaa151...

The title seems accurate. If you’re overweight and active, you’re less healthy than normal weight and sedentary, on average. Most people would find this surprising.

The title doesn’t mention activity, so I would not say it gives the impression that “being active is pointless”.


> Most people would find this surprising

Really? I don't understand how people would come to the conclusion of fat + active > normal + sedentary unless they're willfully ignorant.


I could be wrong on the most, but there has been a heavy push towards arguing for fitness rather than weight loss. The healthy at any size movement is a centerpiece: https://en.wikipedia.org/wiki/Health_at_Every_Size

It’s possible the movement is simply loud however and most people think weight matters more than activity. Can’t be sure. I should have edited that to “many”.


The title doesn't mention activity, but the actual study does. That's my point here.

> I would not say it gives the impression that “being active is pointless”.

If the only way to be healthy is to be skinny, what is the point of being active at all?

Being healthy is a sliding scale, not an on/ off toggle. Being active and overweight is significantly better than being sedentary and overweight. Being skinny is an even bigger jump.


The study pretty clearly shows that within each group, activity helps! It’s just that the effect is not as large as weight. You’re arguing against a straw man.

The full argument would be “it is pointless to try to undo the health effects of excess weight through activity alone, as an active overweight person is less healthy than a sedentary normal weight person”


Is anyone possibly surprised by this?


Probably not,but more often than not, there's a bizzare trend to normalise it. Fat becomes plus size, Obese becomes big bones and etc. I've gone bananas with my weight and to be honest it's pretty scary how normalised it is. Nobody really tells you that you are fat and it's time to drop some.


> Nobody really tells you that you are fat and it's time to drop some.

Literally everyone does. I don't know what world you live in. If you're obese its the ONLY thing you hear your doctor say. This has caused hundreds of missed diagnosis for serious issues because it's just "lose some weight".

Thanks. I'm trying. It's not working. And now you've missed an issue that's going to end up being life threatening for me.


> Thanks. I'm trying. It's not working. And now you've missed an issue that's going to end up being life threatening for me

You don't believe that obesity could be an underlying problem that relates to your life threatening issue, plus many other possible issues?

Put another way, if you weren't obese do you think there'd be a good chance your possible life threatening issue would be less life threatening, or not exist in the first place?


> If you're obese its the ONLY thing you hear your doctor say.

Yea because it will kill you early. Do you want your doctor not to talk about your health problems?


"This has caused hundreds of missed diagnosis for serious issues because it's just "lose some weight"."

Are you missing this? Not everything is related to weight.

Again this is what I mean about being dismissive about other health issues when someone is obese.


Doctors are not all seeing gods. They need input from their patients - if you told your doctor that you have been actually dieting and actually exercising but aren't losing weight and wonder if there is some other cause? And if he won't look into it get another doctor. It's not that hard.

> Again this is what I mean about being dismissive about other health issues when someone is obese.

Doctors see the excuses all the time - in most cases it's diet and exercise. You can be mad all you want that someone called you fat and a doctor misdiagnosed you but at the end of the day it's your body and your life, he won't be the one dying from complications due to obesity or your other health problems.


Your doctor counts as "literally everyone"?

I've never heard anyone comment on anyone else's weight. It's just a taboo in my part of America.


> It's just a taboo in my part of America.

in literal face-to-face conversation probably. But beauty ideals are communicated to you on every bill board. In the US probably more so than in many other countries.

Why do you think there's a billion dollars weight loss market? If obesity was actually normalised, there'd probably more obese news anchors.


No. I mean literally everyone. You say you're feeling bad on a normal conversation and people immediately link it to your weight.

This taboo doesn't exist. People keep saying it does. But, as an obese person, it absolutely doesn't.


> You say you're feeling bad on a normal conversation and people immediately link it to your weight.

I've never seen that happen. It sucks that it happens to you, though. We must live in really different social circles.


No there is a movement to increase tolerance so fat people aren't treated like pariahs which is perfectly legitimate pursuit. What is the societal value of acting like a fat person is less valuable than you are? Like it or not it is pretty normal in the USA and a lot of western countries and people need to learn to be tolerant rather than feeling superior because they're at a healthier weight. It can hurt a person as much as racism, ageism, or any number of other improper and unfounded isms.



The Army Sergeant Major of the British Army is 'overweight', for example. The idea that he's unhealthy is an absolute joke. He's done an interview about this.


The BMI is radically oversimplified. I don't think any professional is surprised that well built athletic people fall outside the target audience for that metric.

It really is just a ratio of weight to height, after all. Of course that's going to have its limitations.


So why are we criticising 'overweight' people if we know it's a broken metric?


For the same reason that people use Newtonian physics even though we all know it's a simplification which doesn't apply exactly to all situations. BMI is also obviously not going to work the same for an amputee, but it's an OK heuristic for most people.


It's confusing but let's be honest, we aren't talking about really fit body builders with muscle. We're talking about people with excess fat. Body fat % is a better metric, but you don't really need that if you're a doctor and can tell your patient has too much of it and the scale says so too.


The numbers for obesity in the US and even the world are shocking, and it feels like we are doing almost nothing. Even if you believe we aren’t doing enough to combat COVID, we seem to be doing much less to battle the obesity epidemic.


When I went to see "Body worlds", and saw the comparison between an obese person and a non-obese person, you can tell immediately how unhealthy being obese is.


To those who say BMI is misleading, consider that athletes of average height weigh around 150-160lbs when they have a lot of muscle and very low body fat. If an average man didn’t work out at all (no muscle) and had low body fat, he would probably weigh around 130lbs. A 5’10” 180lbs man that lifts weights regularly could easily lose 30lbs of fat, so the typical 180lb sedentary office worker is actually enormous. The idea that BMI doesnt count is almost always just a coping strategy.


One counter example can be diabetes. Healthy insulin usage often causes weight gain, and withholding it the opposite. It’s a human growth hormone. So it’s entirely possible that one could mistake a thin person suffering from diabulemia for being healthy, and an “overweight” diabetic as unhealthy.


I prefer to refer to it as metabolic syndrome rather than obesity (even though they're not strictly identical) just to reinforce the point that it's going to likely lead to early mortality if left untreated.


Its obesity. Caused by eating too much and probably minimal to no physical activity


> Caused by eating too much and probably minimal to no physical activity

Very often actually it's unrelated to eating to much and doing no physical activity (at least wrt. most obese people I ended up knowing, context: Germany/Berlin).

Most obese people I ended up knowing did had a rather controlled diet and did more sport/physical activity then your average person.

So why where they obese? Some combination of:

- They had problems with their metabolism, potential had to take medicament too.

- In their childhood they ended up getting fat due to a varity of aspects and even with strict diet and sport had a hard time of losing their weight (once you where fat enough for long enough time your body gets used to it and as such is much much more prone to add fat to your body when you eat etc.)

- there are other reasons too for other people but not people I did know close enough.

Either-way I don't know about the US but in Germany/Berlin "minimal to no physical activity" is not often the case and neither is missing discipline or laziness.

For many obese people telling them to just do more sport and eat proper is like telling a depressed person to just stand up in the morning and go out or a person with social anxiety to just leave the house. I.e. impolite, discriminatory, mean and far of reality.


>For many obese people telling them to just do more sport and >eat proper is like telling a depressed person to just stand >up in the morning and go out or a person with social anxiety >to just leave the house. I.e. impolite, discriminatory, mean >and far of reality.

They need to cut calories and therefore must first be able to control their intake (counting calories). Then they can cut 400cals per day, If that does not work, cut 600-800cals. 200cal steps. This always works.


On a healthy person, reducing calories will work fine.

For a person whose body is pumping full of cortisol, thus pumping also with raised glucose and insulin levels, gradually cutting calories can results in even higher stress response, lethargy, disrupted sleep patterns, reduce satiety triggers, changed apatite towards fat and sugar, and a bunch of other problems that all contribute to the opposite desired effect of loosing weight. A body in panic mode will do about everything except loosing weight unless it is actually medically starving.


No it doesn't. Please do proper research on this, biased thinking like that is harmful for the society.

Edit: I also realized that there are major environmental differences, like where I grow up most people which where obese did try to eat less and do sport and as such the ones which are still obese are often not so because they don't eat proper and don't do sport but because they have other health issues.


It ALWAYS work for a person not having severe diabetes. In case of diabetes (at least type 2) it might actually help, but care is needed.


Yeah no. Don't do that. Your body adapts to low caloric intake and make weight loss wayyy harder than it needs to be.

Go on a low carb / ketogenic diet instead. You get to eat lots of protein and fat. You will automatically feel less hungry but also, once ketosis sets in you will have a surplus of power that you can uses for physical activity. Added bonus, your body will react to insulin again.


This adopting metabolic rate is way overblown. Yes it does happen, but somewhat slightly. For someone just aiming to lose weight, you don't have to think about this at all. Just be in caloric deficit, and adjust slightly if needed (usually not).


Doesn't this violate calories in/calories out, or is that model only theoretical?

> Go on a low carb / ketogenic diet instead

Agree, it's the easiest way to lose weight. Cut out processed food, added sugars and rice/potato/bread, and the weight will drop off very easily. No need to count calories because it'll be very hard to eat too much as long as we cut out the above.


> Doesn't this violate calories in/calories out, or is that model only theoretical?

As often understood, the latter. Two factors (there are others): metabolism of fat, sugar, and protein are hormonally (such as insulin) and differentially dependent, as well as the storage of excess calories.


No it doesnt. I lost weight by not eating. It worked just fine.


Just because there are cases where it does work didn't mean it works for everyone, there are more then a few well know well supervised cases which show that it don't work on all cases. Especially not long term.


It guarantees works for everyone. I lost all my excess weight in just 2 months, first time ever in my life going on a diet. And as a physicist I was convinced from the start that a caloric deficit MUST work. It did.

Yes, what I can say it will be harder for some persons than others. The hormonal environment in the body can not be disregarded and can be either disrupted or genetically different. STILL, restricting your eating habit (caloric deficit), will.always.work.


> For many obese people telling them to just do more sport and eat proper is like telling a depressed person to just stand up in the morning and go out or a person with social anxiety to just leave the house. I.e. impolite, discriminatory, mean and far of reality.

... but it's the truth. I guess that would qualify as "hate-facts". Sometime, you need a good kick in the butt to get your shit together, it just happen the US is now a country of mentality inept people.


It's not the truth, far from it please look into the scientific research around this topic.


This is in line with my own observations too.

I think non obese people really look down on people who are obese and have absolutely no idea what we put ourselves through to lose weight.

It's honestly disgusting and extremely damaging to mental health. You can see examples of this in the comment section here.


No. As a person who was extremely obese, I realize that this attitude was exactly what was needed to get me to lose weight. I am now at a reasonably healthy weight and realize that every excuse I ever made as an obese person was incredibly stupid and lazy.


I hope you learn that not everyone thinks the way you do. Shaming (on average) doesn’t help people lose weight, it actually adds to their stressors which can lead to weight gain [1].

So if you continue to do it, fine, but be aware you’re being an ass, and not a helpful one.

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236245/


Thanks. I gave up trying to get this through to people here.

What's even more sad is seeing so many of these comments directed by people who proudly announce where they work and what they do. Not even an ounce of shame to not do this from their identity attached accounts.


As someone who has lost 40 lbs and continues to lose weight, I get it, but at the end of the day you're the one who's going to get heart disease early, get diabetes, die young, etc, not the ones who aren't obese.

Stop worrying so much about what other people think and do what you think is best to take care of yourself. Get help if you need it - there are a lot of real clinical options these days. These are internet commenters who don't know you and won't ever know you, and won't care when you die. That's just life. Don't sweat it.


I was fairly overweight (BMI bordering on obese) and encourage frank and constant discourse around the health consequences of obesity, and disagree with the normalization of obesity in e.g. fashion magazines and advertisements. Seeing such discourse led me to finally take some action.

We shouldn't be intentionally mean (and I agree there's too much of that), but they're literally killing themselves with their lifestyle. It's something that they should be strongly dissuaded from by their peers and by society, for their own sake and society's sake. It must be the leading health crisis in rich countries right now, now that smoking is unpopular.

It's not 100% the obese person's fault: food companies have hacked their dopamine systems with added sugar/salt/MSG/etc (similar to social media companies hacking attention mechanisms), obesity is largely genetic (in terms of the tendency to overeat and ability to satiate hunger), obesity is likely triggered by some underlying mental health issue (e.g. depression), and evolution programmed us to eat us much as we can get our hands on. It's hard to fight biology. But it's not accurate that obesity is just a metabolism issue. Obese people take in too many calories, usually from added sugars and carbohydrates. They may take in 2400 calories a day when their BMR is 1600, and the chronic impact is obesity.


I think part of the problem of this discussion are differences in the country we live in because of how people are treated in the given area.

I.e. in the environment I grew up obesity was not very common and general seen as unhealthy and not good looking. In turn many of the people which are still obese are people where just eating less and doing more sport doesn't really work and in turn telling them to just do so is problematic.

But on the other side going just to a different part of Germany some degree of obesity caused by drinking to much beer, unhealthy food and maybe to little sport is quite common in the idk. 50+ generation.


> where just eating less and doing more sport doesn't really work

I can understand it not working because it's hard to eat less when attempting to lose weight (something I've struggled with for a long time), but I know if I eat less calories, then I reliably lose weight. I can drop 2lb a week very easily by maintaining a deficit, but I regularly fail in my long-term objective and bounce back when I get stressed and overeat back over 2000 calories/day. So at least for me (most/all people?), it's not that eating less doesn't work, it's the inability to do that (genes/depression/stress/environment/whatever) which is the root cause.


>Caused by eating too much and probably minimal to no physical activity.

Eating too much is probably true. Healthy natural food though doesn't make you want to eat often or too much. People eat too much because they eat highly processed food with lots of sugar, salt, and artificial flavoring. Unfortunately, eating good food in North America is not possible without making a special effort. Learning how to cook is part of this effort.


Thats incorrect because theres no problem with their metabolism at all, you are eating too much and your body stores it as fat, working as intended.


That's actually not working as intended. There is a part of the brain that is supposed to monitor body fat percentage and suppress hunger and encourage physical activity in order to get body fat to lower again.

This book[0] goes through how the metabolic system works, how it is supposed to self regulate, and how it can miss-regulate. It also talks about what it is about our food since the late 1970's that has changed to cause this to happen more frequently.

[0] https://www.amazon.ca/Hungry-Brain-Outsmarting-Instincts-Ove...

EDIT: I want to add a bit. This book goes through how the metabolic system of humans is supposed to work, and it can get technical at times. It also goes over the specific traits that certain foods have that can be problematic, which gives enough info to make a self-improved diet. It backs up everything it can with specific citations of scientific experiments.


Metabolic syndrome is the medical name of a disease. It doesn’t mean “slow metabolism”.

https://en.wikipedia.org/wiki/Metabolic_syndrome


Anybody have an actual link to the study? The article is pay-walled.



You can bypass the Times paywall by adding a '/' to the end of the url


Anyone got a link to the specific study in question? The author has 775 publications on researchgate and I haven't a clue which one this article is referring to.



Non-paywalled link to summary of article: https://www.thetimes.co.uk/article/overweight-and-healthy-is...

In the study, the bottom group by activity contains 63% of the population, while the bottom group by obesity contains only 18% of the population. So shifting from bottom to middle by obesity is a bigger move than shifting from bottom to middle by activity level. Not sure the author is comparing apples with apples here.

In reality, we need to be aware of what lifestyle changes we can sustainably make given our particular circumstances, whatever the whole-population results might look like. To quote the author, “Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles".


Does anyone have a link to the actual study? Whatever study they’re referencing is behind the story’s paywall.

I ask because newspaper summaries of nutrition and exercise research studies are, to put it generously, utter horseshit.


Here's a (non-paywalled) press release from the journal: https://www.escardio.org/The-ESC/Press-Office/Press-releases...

> The researchers investigated the associations between each BMI and activity group and the three risk factors. At all BMI levels, any activity (whether it met the WHO minimum or not) was linked with a lower likelihood of diabetes, high blood pressure or high cholesterol compared to no exercise at all. Dr. Lucia said: “This tells us that everyone, irrespective of their body weight, should be physically active to safeguard their health.”

> However, overweight and obese participants were at greater cardiovascular risk than their peers with normal weight, irrespective of activity levels. As an example, compared to inactive normal weight individuals, active obese people were approximately twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure. Dr. Lucia said: “Exercise does not seem to compensate for the negative effects of excess weight. This finding was also observed overall in both men and women when they were analysed separately.”

> He concluded: “Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles.”

I don't totally follow the establishment of causation here - in particular, it would seem to me like the arrow of causation is likely to go from diabetes to inability to lose weight, instead of vice versa? That is, equally active people with diabetes probably weigh more than people without, and the underlying cause is not their weight, it's their diabetes. So the conclusion in the press release that they should lose weight to get rid of their diabetes doesn't obviously make sense to me.


The press release [1] for the paper Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study [2]:

> We retrieved information from medical examinations on the prevalence of diabetes (medicated or glycaemia > 125 mg/dL), hypercholesterolaemia (medicated or total blood cholesterol ≥ 240 mg/dL), and hypertension (medicated or systolic/diastolic blood pressure ≥ 140/90 mmHg).

> Data from 527 662 participants [32% female; age (mean ± SD): 42.3 ± 9.4 years; BMI: 26.2 ± 4.3 kg/m2] were analysed. About 42%, 41%, and 18% of the participants had normal weight, overweight, or obesity, respectively; 63.5%, 12.3%, and 24.2% were inactive, insufficiently active, and regularly active; and 30%, 15%, and 3% had hypercholesterolaemia, hypertension, and diabetes. Being either regularly or insufficiently active conferred protection compared to inactivity against all the studied risk factors within each BMI category, which was evident in a PA dose-response manner for diabetes and hypertension (Figure 1). However, regular/insufficient PA did not compensate for the negative effects of overweight/obesity, as individuals with overweight/obesity were at greater CVD risk than their peers with normal weight, irrespective of PA levels.

The headline is inappropriate and I'm not convinced the study is as useful as it could be. Though large, the study only demonstrates that being overweight or obese is linked to high cholesterol, diabetes, and high blood pressure; all risks for cardio vascular disease (CVD). I'd prefer more direct measures of CVD like the Ankle-Brachial Index (ABI). Regardless, the data has to explain the U-Shaped BMI mortality curve [4] and it does not. There are also well established mortality tables [5] for blood pressure based on age and gender; 140/90 is not reflective of risk.

[1] https://www.escardio.org/The-ESC/Press-Office/Press-releases...

[2] https://academic.oup.com/eurjpc/advance-article/doi/10.1093/...

[3] https://en.wikipedia.org/wiki/Ankle–brachial_pressure_index

[4] https://en.wikipedia.org/wiki/Obesity#Mortality

[5] https://www.sciencedirect.com/science/article/pii/S014067369...


Sry guys, please anyone telling me how to bypass the paywall? Or any link to a full version of this article?


[flagged]


Smells a little trollish to me, but I'll bite.

The HAES (Health at every size) movement that has been gaining in popularity states that people with a marked excess of body fat can still be considered just as healthy as someone with a normal range of body fat (particularly if they're active).

That assertion is fairly shocking to people familiar with the studies on the subject. This study focused specifically on quantifying the measurable health differences between these groups, specifically factoring in activity level. It shows a strong correlation of excess body fat and worse health outcomes. Even among obese people that are active. This is strong data to directly counter the claims of the HAES proponents.

I would think the progressive /"sjw" (as you say) mindset would be to embrace the HAES model, but you're suggesting they're picking on overweight people? That doesn't make sense to me.

My opinion is that we should be honest about the real danger obesity presents (even with exercise), and have that inform our approaches to treatment. I see no value in shaming or picking on people though, those are orthogonal issues.


Sorry if my comment was unclear, I have no objections to the study or article.

My comment was refering to the "Opinions" of other users and the dehumanizing comments that myself and other obese people are subjected to on a regular basis.

I was trolling a bit as I am a sarcastic person in general and deserved the swift condemnation of fellow readers. However I do believe that there is somewhat of a double standard when it comes to the idea that I have chosen to be obese and shaming me is acceptable while...fill in the blank...get a pass on their life choices.


Mate, for your own mental well-being, please get off social media and go outside.


Wish I could. Lockdowns and all ya know? Not to mention the Rona kills fatties like me. :(


You really shouldn't pick on anyone, live your life and don't be an asshole. That's a pretty good rule to live by as a first principal. It's pretty simple.


I find it problematic how they turn overweight != healthy into chubby != healthy. Sure we all know (I think) that over- (or worse under-wight) is not health. But a obsession with forcefully trying to gain a specific wight can easily be much less health then being slightly overweight.


You don't really need to be obsessed though, you just need to be willing to commit to an appropriate caloric intake. You might need to look at boxes for a while to see how many calories are in your favorite foods, and you might even need to cut some of them out, but after a month or two you just kind of know what you can and can't eat, no unhealthy obsession required.


Calories, although the simplicity of the thermodynamics analogy seems simple are not the only factor at play here.

The basic reason is that your body can increase or decreased its energy expenditure drastically in response to increased or decrease consumption of calories.

I'm reading The Obesity Code by Dr. Jason Fung right now and he presents a very strong argument that the cause of obesity is insulin resistance.

In the book he cites both overfeeding studies where subjects were fed very large numbers of calories but did not gain weight, as well underfeeding studies where subjects ate only 500 calories a day but didn't lose weight.

After reading this I'm pretty damn convinced that the diet problems facing us are: highly refined carbohydrates, sugar and sugar substitutes, and alcohol (I haven't come across this in his work, but if you look at the stuff by Dr. Lustig you'll see sugar and alcohol are incredibly similar metabolically)

Think about this: for most of human history we did not count calories and yet we were not obese.

It's the highly processed western diet of breads, cakes, cereals, soda, etc that are the culprit.


I don't know. I read and really enjoyed this book, and even follow a mild version of intermittent fasting for a while. (only ate 12pm-8pm for a while).

Then a few months ago I started following some fitness YouTuber's advice, which mostly boils down to "count calories and consume less calories than your body uses". I started a basic course of counting calories and eating at a deficit, and dropped ~7kg in a few months (and hopefully am still going).

It wasn't even that hard - mostly counting everything and cutting out some of the stuff that is really high in calories. I still ate fairly well, e.g. I'd eat my favorite hamburger - just would skip the fries to be under the calorie count.

Of course I've only done this for a few months and it's hard to say if my body will eventually force me to expend less energy.

I take comfort in the fact that a lot of bodybuilders go to extreme lengths to drop down in body fat, so they've done anecdotal research on this area a lot. And most of them are not following intermittent fasting, or keto, or anything like that - they're just reducing calorie intake when needed, and going up and down in weight fairly consistently.


keep in mind a lot of body builders will also do unhealthy things to reach their aesthetic goals, like steroids.

congratulations on your cut


A great book as well is The Hungry Brain by Stephan J. Guyenet. It looks at the neurology of eating, overweight and obesity, and there is a ton there. Basically, most of the popular theories (insulin, microbiome, willpower, sugar, etc.) are only a tiny bit right, and the truth is predictably holistic, mostly driven by things that are not acting under conscious control. There are of very interesting studies covered in that book.


It is physically impossible to consume 500 calories a day and not lose body weight if you are making even a basic effort to exercise. That might work for a week, it won't for 6 months.

I see he's written a book. I don't see any peer reviewed papers or actual scientific studies that have been reproduced by others.


Yes that is simply incorrect, you will lose crazy amount of weight on 500 kcal a day. Maybe it was for rodents?

I think I saw somewhere on hackernews a calculation that for only maintaining you body temp it takes 800-900 kcal. That is not even taking into account breathing, blood circulation, etc.


The book cites somewhere between 20 and 100 peer reviewed scientific papers, maybe those pages aren't available in the preview you were able to find.

I can't find the exact part of the book where he mentions the guy who ate 500 cal/day and didn't lose weight, but when I find it again I'll note it. This person did have serious hormonal issues, though. Most people of course, 500 cal a day and also exercise weight will come off, how permanently is another question.


I fail to see how in any world underweight is worse unless its a baby.

This is coping, losing weight to a target healthy weight is always good,


Wow, no, stunningly wrong.

Being underweight is highly correlated with poor health outcomes in seniors. (https://pubmed.ncbi.nlm.nih.gov/16886095/) Obesity is obviously bad there, but being underweight is just as dangerous.


"In seniors" would be the key word there. For the average American they'd be far, far better off being slightly underweight than being obese.


The parent comment was “I fail to see how in any world underweight is worse unless its a baby.”

Pretty decent chunk of the world is seniors these days.


"is highly correlated". Correlated, not caused by being underweight.

Studies on actual cause has shown the opposite (eating to the point of being underweight raising lifespan).


I was denied life insurance once because I was underweight. Maybe, statistically, it's true.

I have since gained weight and now have life insurance.


Does anyone know if the thresholds for being "overweight" and "underweight" have changed over time? I mean, with so many people getting heavier and heavier has the standard crept up so that "underweight" isn't even skinny anymore?


Typically BMI (mass/height^2), which hasn't changed.

Excluding the fact that average height has increased gradually over time.


I believe they have changed the cut-offs because they noticed that cardiovascular issues started to occur at lower BMI than previously thought.


I didn't know this. Thanks!

It was lowered in July 1998 ("overweight" was reduced to 25 from men: 27 and women: 28)

https://www.nytimes.com/1998/06/04/us/us-to-widen-its-defini...

https://well.blogs.nytimes.com/2014/04/14/a-number-that-may-...


In fact being slightly underweight is one of the only sure ways to increase your life expectancy. Restrictive calories diet.


For many healthy people, losing weight to reach a government ideal of 'healthy' means dropping useful muscle mass. Which is not good.


What. 90% of people do not have any musculature worth talking about. Where are your sources? For 99% of people losing weight will be the problem


Brings to mind the MRI scans of the thighs of an elderly athlete versus an elderly sedentary man https://www.bettermovement.org/blog/2012/use-or-lose-looks-l...


The Army Sergeant Major of the British Army is 'overweight', for example. (He's done interviews about it.) That's obviously nonsense and he doesn't need to lose any weight at all. The idea of 'overweight' is meaningless.


Is he jacked, or fat?

If he's jacked, then yes of course he doesn't need to lose weight. That is a tiny proportion of the population though.


He's jacked, but the original comment was 'losing weight to a target healthy weight is always [ALWAYS] good'. It sounds like you agree that's a false statement?


The original comment was making a generalization that was pretty fair considering that the proportion of the population that has enough muscle mass to cause them to be 'overweight' is pretty small.

Obviously "always" is wrong. Almost nothing is absolute.


> Obviously "always" is wrong.

Bingo.


Since most people are average, there is an average "healthy weight" target. Of course individually, it's really about the ratio of lean mass to fat.


If you define many as like 2% maybe.


GP said 'losing weight to a target healthy weight is always good'. 'Always' is not true.


Well, encumbering "losing weight" with a bad method like losing muscle or breakfast cocaine or cutting fat off your belly with a knife to do it isn't an attack on losing weight, but a misunderstanding of their claim.


>Sure we all know (I think) that over- (or worse under-wight) is not health.

Anorexic is not healthy. Underweight within reason is. In fact the best way we currently know to live more is to eat much less...

https://gizmodo.com/how-living-near-the-starvation-point-can...


I think there are a few parts that are more problematic:

* Most layman diet advice is awful. There is scientifically backed advice. I think most people could understand it. It seems to not be common knowledge.

* A lot of people "backseat drive" other people's diets. Since most people carry awful advice, this is extremely unhelpful in practice.

* Some people have a crab bucket mentality towards others losing weight, and almost go out of their way to sabotage.




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