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Why Are People Unhealthy? (obito.blog)
15 points by blackzetsu 3 months ago | hide | past | favorite | 53 comments



Underwhelming article that sort of works on the basis that people are unhealthy because they have failed to do the right things to be healthy in some way shape or form (a.k.a: obesity is a moral failure by the person to exercise self-control and make good choices relating to their health). However, the truth of the matter is that obesity is a chronic illness and people are unhealthy actually more so due to a combination of environmental and genetic factors, and this is even more glaringly obvious in light of GLP-1 agonists like liraglutide and semaglutide.


Agree that environmental factors play role, however diet, exercise, sleep, stress, social life are also equally important


Mmm… but I would argue that diet, exercise, sleep, stress and social life are determined by environmental factors more so that personal choices…


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Put the fork down.

It's really easy. The sugar-induced cravings go away in the first couple of days.

It's just, they don't know about carbs vs fats or fasting. They eat 5 meals a day plus snacks.

The majority of people, contrary to what seems to be the article's belief, do NOT have this information. And there are strong parties with interest in keeping it so.


Everything is easy, if you ignore or don't understand any of the nuance of it.


Weight loss is a thermodynamics problem. You eat less you lose weight,


Partially true, it is more complex than that though. Within the parameters of lifestyle it is not as easy since not everyone will burn off fat the same way in a caloric deficit that also allows them to keep functioning in your day to day life. Some people's resting metabolic is simply not that high either and so dieting alone is a slow and unhelpful process.

Someone in that position will find it really hard to make progress if they treat it like a thermodynamics problem. They need a metamorphic change to their body to increase their energy usage; they will need to get fitter as well as diet. Not just excercise but actual fitness progress that changes their body.


> it is more complex than that though

No its not. Eat less and you will lose weight, humans do not ignore the laws of physics.


Dismissive and reductionist advice that was obsolete years ago. Equal amounts true and useless. If it were that simple, we would just stop eating until we were thin, but since we would first get sick and then die before meeting our targets there must be more to it. Unless the entropy of a decaying corpose satisfies your fitness goals?

The human body has a number of separate energy systems, both creation of and consumption of fat only happens in certain circumstances. If those circumstances aren't met, you don't burn fat at a rate that is sufficient for progress in a timeframe that satisfies most people's goals. This is just physiology, stuff we do understand not fitness psuedoscience.

If you don't treat the problem like a human problem, instead of a physics problem, you will have an inefficient weightloss program that makes the human sad and then they quit.


> If those circumstances aren't met, you don't burn fat at a rate that is sufficient for progress in a timeframe that satisfies most people's goals

Irrelevant. Humans obey the laws of physics. An entire post of excuses. Eat less and you WILL lose weight. You can do it by eating nothing but sugar, Twinkies, or Big Macs. It doesn't matter. Many people have done this to disprove the bullshit that its more complicated than Calories In < Calories Out.


> Humans obey the laws of physics.

We agree.

> Eat less and you WILL lose weight.

Over a long enough time period, inevitably yes.

> You can do it by eating nothing but sugar, Twinkies, or Big Macs.

Great I'll eat it all before bed each day. Should feel great.

In the space between your advice, and actually losing weight, is the entirety of the rest of the task. Your advice is not helpful to anyone trying to lose weight. I see it countless times online. It's a pithy one liner people use as a morale high ground, but it's shallow and unhelpful.


> Your advice is not helpful to anyone trying to lose weight

Stop making excuses. Stop eating and you will lose weight. It works pretty well because physics is real.


See what your advicd boils dowm to? "Stop eating". Yeah, no shit.

Everyone understands calories in calories out, it's such a basic concept, it's the base fact almost all diets start from. You are adding nothing to the discussion and yet you think you've cracked the code. This is why seeing this advice touted is so frustrating.

I have been training myself and others for 12 years, there are no excuses here.


More excuses. Humans obey the laws of physics.


Knowing that does not make you lose weight. Everything you do with that knowledge afterwards does.

You are being willfully ignorant, not something I typically expect from your comments.


Yes that is technically correct but its not very helpful. In practice weight loss is a mental health problem. You can explain thermodynamics to fat people all day, it wont help them lose weight.


> In practice weight loss is a mental health problem

We can easily make animal models obese by feeding them a diet rich in rapidly-absorbed carbohydrates. Are they obese due to mental health problems? Or is it the elevated insulin level induced by their diet?


Prove it. Start a diet of 2k/cal a day of gasoline.


Cool, please provide how much gasoline I need to eat to generate 2k calories per day without it also killing me


It's simply thermodynamics, so just drink a few oz of gasoline per day.


For the interested, a gallon of gasoline is somewhere in the area of 31,000 calories, so around 7.6oz should do the trick. As for the second part, turning into a car is suggested.


Were it easy, there wouldn't be any obese people. Now, _that_ is easy.


This is such an over simplification. What about people who have knowledge and are unable to be healthy? There are "food deserts" where due to geography/economics it's difficult to purchase healthy food.

There was an article on HN the other day showing that after you gain weight and lose it, it's difficult to keep it off because you don't feel full easily and feel hungry more often. So if you were fat as a kid, you're at a huge disadvantage later on in life.

It's "easy" to live on a SW engineering salary where you can afford whatever food you want, after being raised by parents that fed you good food and not be fat.

It's much harder when you grew up fat, working a minimum wage job and living in a food desert.


I lived in an area that would be a borderline food desert. Families car pooled to places like sam's club and split the cost of one membership. Years later, I lived in a different area and with only a dollar general in early adulthood. I could never understand the desert. I bought rice and lentils until I could afford more. Dollar general has simple foods like nuts, seeds, etc. It is certainly a problem that people are eating processed junk food, but the desert argument has always been a tough sell for me.


we need an article written from a poor person s perspective on how to afford good food and motivate them to be healthy without blowing their wallets off while they work a minimum wage 12 hr shift, havent come across a post like this ever


> There are "food deserts" where due to geography/economics it's difficult to purchase healthy food.

What is a concrete example of such a place?


Part of my childhood was in West Virginia and visit family occasionally. I can attest to the comment about food deserts.

There's a nearby Dollar General, which is fine for processed food and sodas, but you have to go 20 miles away to a grocery store with proper fresh food.

Here's an article from 2015. Things have seemingly not gotten better:

https://wvpublic.org/whats-an-appalachian-food-desert-and-wh...


I have bought plenty of healthy food from Dollar General. Rice, beans, canned tuna, nuts, seeds, frozen veggies, etc. It's all the same types of things I would recommend someone trying to eat healthier to get from a supermarket


Here's a more recent article (2023): https://mountainstatespotlight.org/2023/01/26/wv-healthy-foo...

Access to fresh fruit and veg in West Virginia is mostly a problem in the rural areas from what I can tell (and by searching for "fruit and vegetable" or "supermarket" on google maps).

Would teaching people how to grow their own fresh produce in the rural areas work?


Maybe, but it's harder. If I had to grow my own fruit and vegetables, I probably wouldn't and just wouldn't eat them.

My argument isn't that it's impossible to be healthy in such places, just that it's harder.


> It's much harder when you grew up fat, working a minimum wage job and living in a food desert.

Need examples. I've lived on 50K for 4 years and it was perfectly manageable.


You could probably boil this while article down to "Will power."

They say men think about sex every 7 seconds. For me it is thinking about eating every 7 seconds. It is all-consuming and short-circuiting within the brain. A constant non-stop drumbeat in my brain telling me to eat eat eat eat eat eat eat. That would be fine if I ever felt full, but I rarely do - it feels like I have no "off switch". At least as an alcoholic you can go cold turkey and do total abstinence, but you can't go cold turkey on food since you need to eat something, and for me eating is a trigger that just makes me want to eat more and more and more. My will power is at its absolute limits keeping me in the "overweight" BMI range rather than obese and above - it's hard! Perhaps I need therapy or surgery.


> At least as an alcoholic you can go cold turkey and do total abstinence

Worth mentioning in case an alcoholic reads this and thinks it's a good idea to try:

It is, in fact, a really bad idea, because it can kill you.

I don't know how to pick a good link, so simply search "alcohol cold turkey lethal" and pick any of the non-blog links you can find. There's plenty.


This is how Kevin Nash's son died a few months back - https://thehill.com/homenews/3703554-wwe-star-kevin-nash-rev...

Alcohol withdrawal should be done under medical supervision.


You don't need to be hungry all the time. You can lose weight without hunger, and without feeling tired and cold either. You don't even need an exercise regimen.

Elevated insulin levels make you store energy in the form of body fat. In order to lose body fat you need the opposite: you need your fat tissue to release its store energy back into your bloodstream. For that to happen you need your insulin to go down low enough, and for long enough.

So what makes your insulin level to be too high? There are four key factors, three of which are under your control.

First, the fatter you are, the higher your insulin level will be. That's why it is so hard for fat people to lose weight in the first place. Nothing we can do about that, but the next three factors you can improve.

Second, the amount of carbohydrates in your diet. Starchy or sugary foods, such as bread, pasta, rice, potatoes and sugar, are very rich in carbohydrates. Carbohydrates raise your insulin levels, so you want to reduce them as much as possible. In order to prevent hunger you still need to eat, so choose foods that will not raise your insulin as much. This means eating above-ground vegetables, eggs, meat, fish and full-fat dairy like butter, heavy cream, and cheese. Choose fatty cuts of meat, instead of lean cuts.

Third, eat less frequently. Insulin levels go down a few hours after each meal. The fatter you are, the longer they take to come down. Every night as you fast during your sleep, your insulin goes down. By having early dinners and/or skipping breakfast, you extend the number of hours a day in which you are in a low-insulin state. When you consume a meal do eat until you are satisfied. Skipping meals isn't about reducing your calories, it's about reducing your insulin. When you eat a low-carbohydrate diet it becomes much easier to skip breakfast because you aren't nearly as hungry.

Fourth, if you can, introduce some exercise into your daily routine. You don't need to go crazy: you can replace some or all of your commute with walking or cycling and it will help. It is not about how many calories you burn exercising in a particular day. Instead, it's about how over a long period of time exercise makes your muscles more insulin sensitive. This means they become more efficient at eliminating excess glucose from your bloodstream, which in turn makes your body release less insulin, and thus reduce the amount of time you will have excess insulin.

Sources: Dr. Benjamin Bikman, Dr. Jason Fung, Gary Taubes, and many others.


This is really solid advice -- changing the idea of losing weight to being less about "calories in calories out" and more about managing insulin is probably worth doing.

The "how" of releasing fat that you've laid out here is a really excellent explanation -- a lot of trends like intermittent fasting gets these results, but there's not enough discussion about the how/why laid out like you just have.

Would you mind sharing some of the resources you built this view from? You noted some sources below, but if you've got some more specific stuff you looked at, would love to read it.


"Why we get sick" by Benjamin Bikman. It talks about the causes and effects of insulin resistance, including how to diagnose it.

"The obesity code" by Jason Fung. It talks about the causes of obesity (spoiler: hyperinsulinemia) and provides practical advice on how how reducing carbohydrates and intermittent fasting can help.

"The case for keto" by Gary Taubes. Is an enjoyable read that not only covers the extensive evidence of how excess insulin leads to gaining body fat, but also how we ended up culturally terrified of dietary fat and dietary cholesterol.

If you have already managed to become lean through a low-carbohydrate diet and/or intermittent fasting, then I do recommend following the peer-reviewed research published by Nicholas Norwitz (he also has a YouTube channel for laypeople).

Ultimately, what leads me to this eating pattern is my own difficulty managing my body weight when I don't. If I could stay lean, healthy and satiated with a mixed diet that included some rice, bread, potatoes and pasta, I would go for it.

Many people do just fine with some carbohydrates in their diet. I used to as well, when I was younger. These days, I can either take significant steps to reduce my insulin levels or I slowly creep towards obesity and metabolic syndrome.


Try liraglutide or semaglutide. You won’t think about food anymore.


GLP1 RAs do reduce "food noise" and cravings, but remember they don't necessarily work for everyone and do have some side effects that can be severe.

Most of the anecdotal data is right on though -- cravings are lessened, you stay full emptier (the result of delayed gastric emptying), and should even think about food less.


Both art and article reek of weak AI prompting.


Metabolic syndrome is largely down to environment and genetics, but personal responsibility isn't totally let off the hook. If one walks briskly for 30-60 minutes several times a week, that will do wonders for insulin resistance.


Completely agree, We can't do much about genetics and environment (to a large extent), however we can focus on whats in our control


“ Everyone knows that sugar is bad for health but a lot of us tend to ignore it.”

This factually incorrect on two counts. 1. Sugar (Glucose) is fundamental to the functioning of the body. 2. Everyone does not know. Nor do they agree.


If we want to be factually correct though, then it is important to note that sugar (table sugar, the tiny white cubes people sometimes add to their drinks or cereal or baking) is not actually glucose, but rather, it is sucrose, a disaccharide made up of two monosaccharides that have been bonded together (fructose + glucose) and so sugar is not actually good for people, but yes, glucose is fundamental to the functioning of the body. The human liver can actually create glucose through a process called gluconeogenesis in the absence of consumption of glucose.


sugar is not actually good for you does not follow from it being a disaccharide. AFAIK when controlling for calories sucrose and fructose are no worse than any other form of carb, and controlling for calories carbs are no worse than fat. In fact they are much better in certain cases (like doing more than minimal amounts of cardio)


While glucose is either used directly or it is stored as glycogen in liver and muscles, fructose is used in a different way.

Fructose is mostly converted by the liver and much of the energy obtained from it is used to synthesize fat.

In moderate quantities, fructose should cause no bad effects, but in excessive quantities it causes various problems, like fatty liver, as it has been known for millennia, because the method of producing foie gras is based on this (i.e. overfeeding geese with sweet fruits, but the same method would also work on humans).

For humans it is recommended to avoid a daily intake of more than 25 g fructose or 50 g sugar (sucrose).

When the main source of sugar are fruits it is not easy to eat more sugar than recommended, because most fruits have only around 10% sugar. Only a few fruits have over 15% sugar, e.g. grapes, (fresh) figs and (fresh) dates, and even with those you have to eat generous amounts before eating too much fructose.

On the other hand, with dried fruits or with food with added sugar or HFCS, it has become extremely easy to eat too much fructose.

The effects of fructose can be compared with those of alcohol, even if they are much less severe. In small quantities, both are sources of energy, but in too large quantities they both damage the liver. Fructose does not have effects on the nervous system and it becomes harmful only at higher daily intakes, but nonetheless it must not be abused.


The metabolic pathways to process fructose and glucose are different. I think they can be bad for you in entirely different ways.


I know sugar is bad for me, yet look at how much corn-syrup or extra sugar is in everything today. The entire market is working against you.


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Thanks for the feedback. I will work on improving it.


* and mineral deficits (calcium, magnesium, manganese, iron, copper, zinc, selenium, cobalt, iodine spring to mind).


A comment : Being obese is not the only form of "unhealthy", One can be in pretty decent shape and still unhealthy..


No, obese is not the only form of “unhealthy” but the picture at the top of the article is a picture of an obese dude stuffing his face with pizza, and the article makes reference to things like weight loss. So, it’s not shocking that people would draw a link between the two and think that the article might be directed towards obesity related unhealthy, rather than say something more like substance abuse unhealthy.

And I wonder if that’s a result of an unconscious bias because what is perceived as attitudes towards eating and exercise related choices, are seen more so as just that, choices. Where as issues relating to something unhealthy like substance abuse is seen as something people have less personal choice over.


I suppose that the reason for the picture may be that obesity is the form of unhealthiness that can be instantly seen just by looking at someone.

Many other forms are either not visible externally or they may be noticed only when someone has to perform some physical task, like running or lifting something.




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