I am becoming convinced that sugar, although not exactly a drug to which we could apply the concepts of addiction and withdrawal (like tobacco, alcohol, or opioids), nevertheless creates habits that are really hard to break.
Notice how we train animals with treats: sniffing drugs, attacking robbers, etc. It's a powerful behaviour modulator.
Our brains are no different. In a pavlovian way, we reinforce behaviours that give us a sugary reward. But in our case, the feedback loops are really short. Instead of doing a difficult task, our behaviour to get the reward is simply going to the kitchen and opening a snack.
Do you ever get the feeling, after a meal, that you feel like having "a little something", like a sweet? To me, that's like a learned pavlovian behaviour. And every time we cave, we reinforce that automatic response. It can be anxiety-inducing not to do the behaviour.
The question in my mind is: how do we break this pattern? Because it's easy to do it once, but it's statistically hard to keep it up many times. You will slip up and reinforce the behaviour again.
I am becoming increasingly convinced that we need to change the environment around us, that is, regulate the amount of added sugar in foods.
I have actually become less convinced after learning Buffett his eating habits. He and Munger couldn’t have eaten much worse than they did and exercised less. Still they are both alive in their 90s. What are the chances of that? Also, I’ve had a spare time job driving elderly people around. The fittest pensioner I ever met was in his 90s and he, upon asking, claimed that he never in his life did much exercise.
So what do these three people have in common? I think it’s a lack of chronic stress. Buffett and Munger are living pretty relaxed lives and the pensioner I met was also surprisingly happy. He told me at a random point during the drive that he was very happy. He told me: "I just met a new girlfriend a few months ago. I’m 94. Amazing huh?" and said this with the most cinsere happiness I’ve seen.
Contrast this to books like Why Zebras Don’t Get Ulchers by Sapolski. The book goes into all the ways in which a body under chronic stress starts to break down. Simply put, if you stress a lot then the body is in survival mode and cancels recovery processes.
So that’s why I think that stress levels have more influence on health than food or exercise. As long as stress is reasonably short-lived, the body will just recover from most things. I’m happy to hear counterarguments to this theory of mine
According to themselves, they are wealthy because they are patient and not they other way around. In Buffett’s own words: "The stock market is a device to transfer money from the 'impatient' to the 'patient'." Being patient requires keeping your emotions under control, including stress. Also, keeping a calm mindset is a common topic under value investors such as Monish Pabrai and Guy Spier.
I don't have such a habit. My parents were never into similar stuff, neither our extended family nor was it common generally where I grew up. I could start doing it as adult living away from them but decided not to, after seeing how affection for sweet junkfood messes up with women en masse and how utterly weak they are against these cravings. And there are some guys in same boat too.
Same for sodas btw, we generally didn't have them, and later I've never found sparkling-anything appealing, remove the bubbles and drinks become oversweetened sewage. Same for champange/prosecco compared to good white wine for 1/2 the price. Best beer lagers from the bottle I've tasted are those Bavarian treasures that have comparably little co2, which messes up tastes badly. If I anywhere get over-co2 beer I know they don't care about quality, just cheap filler.
My best friend's parents bought a machine that was putting co2 into tap water, never grokked why the heck do they go through all the effort to make something so bad in taste compared to original.
Do your kids a favor, don't make sweet stuff some great thing deserved after hardship. You may extend their lifespan by a decade or two and make them overall stronger humans.
On a shorter timescale, I also really like using mouthwash to prevent snacking. A well timed rinse leaves a nice minty flavor in my mouth and also somehow completely suppresses the urge to eat carbs.
Sad stuff. One of those affected will be my 6 year old nephew. Poor kid is already 83lbs. He drinks nothing but sprite and juice.
And it’s causing problems in the relationship my wife and I have with him and his mother.
Whenever we go out to dinner with my SIL and nephew, my own son tries to order Sprite to drink after he hears his cousin order it.
Of course he’s only allowed to drink water so it caused a ruckus the first few times it happened. My SIL said that kids need to “live a little” and that’s why he’s allowed to drink 2+ liters of soda each and everyday.
This is pretty heartbreaking in my opinion. I've heard the phrase "Childhood obesity is one of the easiest diseases to avoid, and one of the hardest to cure." Nearly all obese kids will struggle with their weight their entire (usually shortened) lives, so a parent inflicting that on their kids is ensuring they will have to suffer with that problem a very long time.
When I was a kid in the mid 90s, I distinctly remember one of my friend’s parents not letting their kid drink soda. I remember thinking how uncool that was.
What I never understand about the soda thing is why people don't just switch to the zero calorie versions of them. I drink tons of the stuff myself (Sprite Zero being among my favorites), and while I suppose the science is still a bit out on whether non-nutritive sweeteners are a good replacement, they just have to be better than all that sugar.
I don't have links or anything handy, so take this with a bit of a grain of salt, but I _have_ seen things that confirm my anecdata that sugar free drinks are pretty horrible for your gut microbiome. I do still prefer them to their calorie-dense versions when I have one, but I think it's worth being very cautious about drinking tons of the stuff and assuming it's at all "better".
I prefer beer, if I want a carbinated drink. And a full bodied beer, not a light beer. Sure, they have carbs and calories, but they also have nutritional value unlike light beer or a soda.
There are monks that made a stout they could drink for all of lent. Nothing but stout for 40 days. Each serving was enough nutrition-dense to act as a meal replacement without causing alcohol intoxication.
Perhaps they’re better than sugar, but so far isn’t the science showing them to be also detrimental?
After quitting soda and sweetened beverages for a while, my tastes adjusted and now soda of any sort is insipidly sweet and syrupy. Basically the entire history of humanity was spent drinking unsweetened beverages, all of a sudden our species can’t abide to drink plain water?
I don’t drink a ton of soda but I can’t stand the artificially flavored stuff. One kind - aspartame maybe? - gives me a headache. The others just don’t taste very good.
Coke had one out for a while that was half sugar half Stevia. That wasn’t so bad for me. It still had a bit of the aftertaste but it seemed like a good compromise. They discontinued it.
For me the secret is ice coldness. It matters way more for artificial soft drinks than for the sugar based versions, in my opinion. I definitely know what you mean by the aftertaste, and it's minimized by having more ice in the cup than drink.
Not that you should be attempting to drink more of the stuff... but I figure it's a form of harm reduction. Sugar is certainly worse for your health if you have this vice.
For me it's the opposite. I find Diet Coke delicious, but classic coke i find unbearably sweet and syrupy, and it makes me feel awful and gross afterward.
I am a type 2 diabetic. Weight is a factor, but it is not a direct cause always. The issue with type 2 is insulin resistance. That is caused by eating too much foods with high carbohydrate and sugar content. Carbs break down to sugar, sugar is processed by insulin. If you overload your body you start to produce a lot of insulin, after a while it starts becoming less effective - you begin to get insulin resistance, your body produces more insulin to combat the high blood sugar (which is absolutely scarily deadly in pretty low sugar levels) and your hit the point where your blood sugar can no longer be managed correctly via your insulin production and you start getting serious health degradation (eyes, kidney, liver, vascular, and nerve damage.)
Obesity is one of the side effects of high sugar - you can't process all the glucose your body is synthesising, so your body converts what it can to glycogen and the rest is stored as fat. So - being fat can contribute to type 2 diabetes, but type 2 diabetes also has weight gain as part of the process of becoming type 2 diabetic. It is a vicious circle.
Carbs and sugar are the real issue in my opinion and experience. We were sold a lie - that our bodies run on carbs, and carbs are the best fuel. This is not true. Carbs are actually the worse of the options. A better diet is based on less carbs, more natural fats. Our bodies burn fat for fuel more efficiently and insulin levels do not spike after each meal.
The best thing you can do as a Type 2 is cut down carbs and sugar. If you can cut them down to a minimum, you will lose weight quite steadily and as you do your body will effectively have some breathing space to try to get back to a reasonable level ground. I personally use keto and intermittent fasting (this is not an endorsement or recommendation - it works for me) and I've dropped 10 kilos in the last 2 months. Not only do I feel better (less headaches, more energy, more ability to function in the morning, less hunger) I also feel like I don't need the constant carbs and sugar being shovelled in to my body on a daily basis anymore. They are not even all that pleasurable anymore - usually anything "sweet" tastes like pure sugar to me now - and that is the best think I could do for myself - because I don't seem to be craving foods with sugar, I am not caught in the trap of worsening my condition.
This study doesn't consider the very recent advent of weight loss medications that actually no-BS work, like semaglutide and tirzepatide. They're way too expensive right now but that will absolutely change. I wouldn't be surprised if you could buy Flintstones vitamins with peptides included for your kids in 5 years. The health benefits of not being obese are simply extraordinary.
And again I must stress, for those that haven't read up on these drugs, they REALLY work. Like statins for cholesterol. Nothing less than transformative.
Honestly, I expect obesity to be nearly eradicated in wealthy countries in 10 years. It will be like malaria, a problem only in less privileged regions.
Those drugs are not approved for use in children and require subcutaneous injections.
It would probably take more than 10 years just to push it through children approval and it would fail because they are not at all side effect free especially on a growing body.
I think you’re way too optimistic about drug efficacy. The studies I’ve seen on those drugs showed they were less effective then gastric bypass surgery and I’ve seen people who get that surgery and then still struggle to keep weight off.
We need more government propaganda against obesity. We were able to reduce smoking with propaganda we can do the same with obesity. Problem is the majority is overweight or obese already and they’re sensitive about it. There’s even pro obesity people.
> We need more government propaganda against obesity.
What do you think this "government propaganda" would look like in a way that would be effective? We've been shaming people for decades about being fat and it obviously hasn't reduced obesity rates. I remember a survey from the late 90s or early 00s I think where it asked kids about different disabilities, and the majority said they'd rather lose a limb than be fat.
It's only going to get worse as with the rise of smartphones and other tech in the past 15 years there is ample evidence that kids get much less physical activity then they used to.
These peptides work. REALLY work. They just need to get cheaper.
Another poster noted that it takes much longer to approve medications for children, so my 5 year prediction may well have been wildly optimistic, but they are already approved for adults.
As it should be, as shaming has proven entirely ineffective, and long term, durable weight loss is extremely rare in any case. In my opinion, if people are overweight, they might as well try to deal with the issues while being happy than while being depressed.
I also think it's really important to separate "body positivity" from the much rarer (and false) instances of "obesity doesn't matter for health." I associate body positivity with things like "the Richard Simmons mindset", i.e. no matter what your weight is that getting up and moving/dancing can feel great and improve your health and your mood, or the "Michelle Obama mindset", that healthy eating should start with eating fruits and vegetables rather than focus on dieting.
They aren't approved /yet/, no. They do not require injections, there's a formulation already approved called Rybelsus that doesn't.
Tirzepatide is roughly equivalent to gastric bypass.
Most (not all) people that struggle to lose weight after gastric bypass have a psychological issue causing them to continue eating even when they feel full.
Are you suggesting that race and weight are equally immutable? Or that man-made consequences (incarceration) is the same as automatic health consequences (heart problems)?
"The percentage of individuals who lose weight and successfully maintain the loss has been estimated to be as small as 1 to 3 percent."
Every intervention outside of bariatric surgery and maybe these new drugs (we still need to see how those patients are doing in a decade) is virtually guaranteed to fail.
So sounds like, it is even more immutable than race. Because 1-3% is smaller than a ratio of people with 1/8 to 1/32 African blood, to those with >50% African blood, and those people between 1/8 and 1/32 have a fluid racial identity that depends on their circle of contacts, neighbourhood, and personal choice (see https://archive.is/uMVKL). Someone literally has a better chance at changing their race than losing weight.
"Anti-obesity propaganda" is as good as KKK to alienate a large group of people, and will achieve little else.
It causes weight loss, sure, but it doesn't seem like it's actually healthy weight loss - it entails disproportionate loss of lean mass and unfavorable metabolic changes. https://twitter.com/raphaels7/status/1662021374276255746
There are also anecdotes of appetite bouncing back up above the baseline after discontinuation.
It is absolutely magical, and I can say based on extensive blood work and a MRI that the changes were extraordinarily beneficial for me, personally.
"Unhealthy weight loss" is a stupid phrase. When you're morbidly obese and lose a third of your body weight, your life expectancy changes dramatically.
You do need to take it for the rest of your life. But, so what? If you have high blood pressure or cholesterol, you need to take an ACE inhibitor or statin the rest of your life too. These are chronic conditions. Obesity is too.
Skeletal muscle is a very, very important organ, and there's way more to health risks of obesity than having too much fat tissue alone.
Take PPAR-gamma agonists(Pioglitazone, Rosiglitazone, CBD): They cause weight gain but are one of the most effective diabetes treatments. Why? Because they generate healthy, insulin-sensitive subcutaneous fat and increase the insulin sensitivity of other cells in your body.
Saying it doesn't matter how you lose the weight doesn't matter is plain ridiculous. Losing 1kg of visceral fat would be amazing, but 1kg of muscle? That's fucking bad for you.
What I see is yet another expensive(profitable) way to manage symptoms while discouraging healthcare as a field from looking for or treating root causes. Not that it's doing much of that as it is.
These are not anecdotes, that's a fact and clinical trial doesn't attempt to hide that: you are stuck on those injections for the rest of your days or half the weight returns in about 3 months and nearly all of it, in a year.
How will it work, do you just take the pills and then just go on doing whatever you like? I have people in my family who take semaglutide, and they actually had to get off it because it ran out and people with diabetes actually needed it.
I believe they gained weight again but they also have side effects from it so wouldn't it just be better to lose the weight without the pills, as usual?
This is simply not how obesity works. Yes initially it's the person's own fault but when it happens, it is self-reinforcing and sticky and can't really be countered by any (previously) known lifestyle or medical interventions short of yes, stomach surgery or a couple kinds of pills approved in 1980s that turned out to be too harmful to be used and were later retracted.
Nobody knows why some people are obese and some aren't. It may start with willpower and then reinforce metabolism, sure. Or maybe you caught a virus when you were two years old that disposed you to be fat for life. Or for whatever reason, a specific flora of gut bacteria grew in your belly. We just don't know yet.
True. The field of weight loss was so full of bullshit for all the time since William Howard Taft invented it that people just can't believe this time is different - but that will change. Yes, it is an actual scientific fact that before semaglutide, only treatment for weight loss that could pass a clinical trial, was stomach surgery, plus a couple pills from 1980s that turned people into pathetic drug addicts and destroyed their health in several ways at once. So i understand why people are sceptical: WHOLE of this multibillion dollar industry that worldwide, employs millions of people, some of them intentional, criminal charlatans, as well as many more who are just delusional and believe their BS works, WHOLE of it was a scam. What's happening now is a true "creative destruction" as they are all going to lose their jobs, fast.
Effects will be so profound i'm even afraid it can alone result in a recession and social strife: people lose their jobs, healthcare loses their incomes as people become healthier not being obese -> jobs are lost there too, plus those same people will now have a lot of energy and losing their incomes, will have enough vim to rebel. It can be a turbulent time when glp-1 agonists enter mass market!
> healthcare loses their incomes as people become healthier not being obese -> jobs are lost there too, plus those same people will now have a lot of energy and losing their incomes.
In most developed countries, an effect like this would be desperately needed in order to prevent the health care systems from crumbling under the weight of few healthy, young people financing many old and sick people.
Worst case would be Pharma companies making a bit less profit, stable or falling health insurance costs and health care professionals having enough time for their patients. Not exactly a disaster.
I agree with most of this take. Maybe not the whole healthcare crashing down thing, but the rest is spot-on after my personal experience and watching others.
The effectiveness of this drug class cannot be overstated. In fact, I believe most are understating just how damn effective it is due to both personal/social shame, and not quite believing in something "too good to be true". The truth is if you have a modicum of ability to accomplish hard goals in life, but have had issues losing weight, you will find this drug to be too effective. I feel very confident in stating that for the selection of people the first statement is legitimately true for. It is absolutely nothing short of a magic pill for many people who fit this description.
I can only describe the effects comparable to that of opioids or benzos. Literally hours later.
For most folks the side effects are quite trivial. The lean muscle mass loss from what I can tell is entirely a red herring, and occurs in anyone not changing activity levels but losing 15-20% of their body weight due to severe calorie deficit over 3-6mo. No one I know who lost significant weight on these meds lost more lean mass than you would expect via napkin math. Increasing activity level 50% or so (not hard for most obese folks) counteracts much of this.
Short of an unknown severe side effect for long-term use, or it definitely becoming ineffective over time, this will be a society changing drug on the level of antibiotics or painkillers.
It does look like it's much like bariatric surgery - most will "bounce back" after discontinuing use. However, even if that is the case - just the ability for many to now put on 60lbs over the course of a decade and then take if off in 12mo is likely game changing in itself.
I got interested in this drug class when my son was first diagnosed with type 1 diabetes - it just started coming up in news feeds ~5 years ago. I then became more interested as an investor the more I looked into it. If nothing else I firmly believe this will be the most profitable drug class ever invented.
Doesn't ozempic have some pretty bad side effects in a significant portion of people? Remember hearing a news blurb where Amy Schumer said she stopped taking it due to side effects.
The main one is diarrhea/nausea. I took a few doses as someone who isn’t fat for other reasons and it wasn’t great the first two days after injection, but not terrible either.
Notice how we train animals with treats: sniffing drugs, attacking robbers, etc. It's a powerful behaviour modulator.
Our brains are no different. In a pavlovian way, we reinforce behaviours that give us a sugary reward. But in our case, the feedback loops are really short. Instead of doing a difficult task, our behaviour to get the reward is simply going to the kitchen and opening a snack.
Do you ever get the feeling, after a meal, that you feel like having "a little something", like a sweet? To me, that's like a learned pavlovian behaviour. And every time we cave, we reinforce that automatic response. It can be anxiety-inducing not to do the behaviour.
The question in my mind is: how do we break this pattern? Because it's easy to do it once, but it's statistically hard to keep it up many times. You will slip up and reinforce the behaviour again.
I am becoming increasingly convinced that we need to change the environment around us, that is, regulate the amount of added sugar in foods.