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Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @12:18PM (#18570589)
And that's why weight loss techniques need to be treated like a new lifestyle, instead of a goal you hit and then finish. I lost 60 lbs a couple of years ago and found that 20 of those had recently crept back on, so I went on another shorter diet to get myself back on track. It's totally doable. You have to be aware and keep correcting.
Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by chosenbreed on Friday November 30, 2018 @12:25PM (#18570645)
> And that's why weight loss techniques need to be treated like a new lifestyle, instead of a goal you hit and then finish. I lost 60 lbs a couple of years ago ...

Firstly, fantastic achievement. I'm curious as to what motivated you enough to put in the effort (I'm assuming it required effort).

Secondly, I wonder if the speed/drastic nature of the weight-loss can be counter-productive. When you think about people don't become over-weight overnight. Perhaps a more gradual pace with some time for settling at various stages of the process...I'm thinking losing weight over a couple of years as opposed to over a couple of months.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by overgard on Friday November 30, 2018 @02:44PM (#18571999)
Not a doctor, and this is just anecdotal, but I lost 60 pounds in 3 months, a couple years ago (6'4" -- went from 260lbs to 200). So that was about 0.6lbs a day. (I think that's actually on the low range of metabolism -- some people can do more like 1-2lbs a day fasting).

Honestly, there were no side effects other than my back problems went away, I stopped snoring, and I felt better. Even with fasting, I just think your body has enough time to catch up when it's just a pound a day or whatnot. (Btw, you know what the world record for fasting is? 382 days. I'm not recommending that, I like food, but, as long as you get enough nutrients not to get something like scurvy and you consult with a doctor the human body is a lot more adaptable than people realize)

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @12:30PM (#18570692)
It was my health. My snoring was bothering my wife, and I was exhibiting sleep apnea so I knew I either had to lose weight or go to a doctor, and I hate visiting the doctor.

And the time is certainly a factor - people have to set up weight loss scenarios that are sustainable over the long term. My weight loss goal was 1-2 lbs a week, so that was aggressive, but I am large enough that I can lose weight on enough calories to not feel deprived. By counting calories and making sure I had enough to enjoy myself it was a relatively easy process, once I got used to the counting and accountability.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by therealx on Friday November 30, 2018 @12:49PM (#18570849)
For some people, I think they shouldn't be given the false hope that "enough to lose weight" and "enough to enjoy myself" go together. Part of losing weight is a fundamental rewiring of what is "enjoying myself".
Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @12:53PM (#18570895)
Oh yeah. As a sweet freak, for me "enjoying myself" is a cup of frozen yogurt at the end of a day full of chicken breasts, not a plate of nachos or a whole pizza.
Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by striking on Friday November 30, 2018 @12:28PM (#18570673)
Garry's blog post about this was particularly insightful.[0] He shares a graph of his progress and how it goes both forwards and backwards, as well as the things he's learned along the way.

0: https://garry.tv/2018/10/17/fatty/

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @12:34PM (#18570718)
> When you’re weighing yourself every day you need to understand that you’re creating a weekly/monthly average. What you ate yesterday isn’t going to show up on the scales the next day. If you ran around the park yesterday, don’t expect to have lost weight today.

I only weighed myself once a week for this reason. Every day can be demoralizing if you have a bloat day, but once a week gives enough to have a pretty regular drop. Whatever behaviour you do can't be considered on a day by day basis, it needs to be considered as a week of good behaviour, and then weeks and then months. You gotta stay consistent every day over the long term to expect results.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by tacon on Friday November 30, 2018 @02:04PM (#18571649)
I think daily weighing is important because it is hundreds of daily decisions to not eat that need to be made. Our current society makes food available at all times, and daily weighing is one part in actually thinking about our body and being mindful for at least twenty or thirty seconds each day. With the ridiculous calorie density of modern processed foods, a few minutes of mindless eating can add an enormous calorie load, without even beginning to feel full.

We hackers can geek out on the math in the Hacker's Diet[0], which goes into various smoothing algorithms and plotting styles to show the daily weight and smoothed trends.

[0] https://www.fourmilab.ch/hackdiet/

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @02:44PM (#18571996)
That's fair, if that needs to happen. I found my caloric considerations where my tracking - I built a spreadsheet where I input values so I could track my daily allotment as I ate. I always tracked it before I ate it.

I worry that daily tracking could be discouraging or introduce maldaptive behaviour - you went up a lbs since yesterday, but that's because your morning poop wasn't as productive as it usually is, and now you feel like you need to go more extreme to make up for it the rest of the day.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by quotemstr on Friday November 30, 2018 @01:06PM (#18571036)
Nostrums like "treat it like a new lifestyle" are easy to say, but do they actually address the current public health crisis? Proposing actions that, for whatever reason, people don't actually take isn't a useful way to spend time.

What's good is what works. And honestly, drugs work today. The likes of the FDA considers them too risky, but I think they're deciding wrong.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @01:29PM (#18571290)
>Nostrums

def: A medicine

>drugs work today

....

Seriously though, the problem is that, regardless of cause, we're fat and lazy. Throwing more drugs to take care of diabetes and heart disease is robbing Peter to pay Paul.

I'm watching my boomer parents realize that medicine isn't going to help everything, and they are going to have to be accountable for their help. They've gotten much more physically active and lost weight because they are seeing that my grandfather's heart medication may be stopping the heart attacks but it isn't stopping his diabetes or inability to climb the stairs, and the gamut of surgeries are just making him more and more crippled. A pill won't solve our problems. It may solve the current health crises, but it won't stop the next one. Losing weight, eating better, and being active will solve the whole set of problems.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by quotemstr on Friday November 30, 2018 @01:41PM (#18571395)
One problem afflicting us now is that people eat too much, consequently weigh too much, damage their health, and balloon healthcare expenses society-wide. If a pill can make people eat less, why reject it? If a medication solves a problem, it solves a problem. You can't say "X doesn't work" when X does, in fact, work, and then expect people to take you seriously.

You're adopting a moralizing stance here, one that says that gain without pain is illegitimate. This approach has broad appeal, but it just doesn't work. For decades people have been making the same argument you're making, and it hasn't worked. It's time we try something else.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @01:47PM (#18571453)
> You can't say "X doesn't work" when X does, in fact, work, and then expect people to take you seriously. > You're adopting a moralizing stance here, one that says that gain without pain is illegitimate.

No, I'm saying that a pill won't solve the root problem. You make people skinny with a pill, you just end up with unhealthy, malnourished skinny people who insulin is all out of wack and who will still get heart attacks.

> For decades people have been making the same argument you're making, and it hasn't worked. It's time we try something else.

Are you suggesting that "throw a pill at it" hasn't been a solution for decades? We've had this belief that medical science can cure us of all our ills, and I think we are no realizing we can't. I've seen family members become shells of themselves after surgery after surgery causes them to lose as much as they got back. Pills always have trade offs, surgery always leaves scars. Maybe one day that'll be the case where a pill will solve all our problems, but it's not today.

Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by quotemstr on Friday November 30, 2018 @03:03PM (#18572129)
Nevertheless, telling people they should eat better and exercise more does not convince them to do these things. The approach you're advocating does not work. What is your alternative? More of the same?
Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @03:30PM (#18572342)
And throwing pills at it doesn't seem to help either - we've had weight loss pills for decades, unless THIS round is going to work.
Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by quotemstr on Friday November 30, 2018 @03:55PM (#18572539)
Many of the most effective medications were banned due to medical risks --- for example, DNP. Efficacy isn't in doubt here; safety is. IMHO, given that all other public health interventions have failed, we should relax the safety constraints on these existing medications and mitigate the risks however we can. Demanding perfection in drug development has left us with nothing, and something is better than nothing.
Re:Type 2 diabetes: NHS to offer 800-calorie diet treatment by SketchySeaBeast on Friday November 30, 2018 @04:17PM (#18572697)
"Acute oral exposure to DNP has resulted in increased basal metabolic rate, nausea, vomiting, sweating, dizziness, headache, and loss of weight. Chronic oral exposure to DNP can lead to the formation of cataracts and skin lesions and has caused effects on the bone marrow, central nervous system, and cardiovascular system.

...

Case reports have shown that an acute administration of 20–50 mg per kilogram of body weight in humans can be lethal. The lowest published fatal ingested dose is 4.3 mg/kg. Concerns about dangerous side-effects and rapidly developing cataracts resulted in DNP being discontinued in the United States by the end of 1938. DNP, however, continues to be used by some bodybuilders and athletes to rapidly lose body fat. Fatal overdoses include cases of accidental exposure, suicide, and excessive intentional exposure (overdose). The substance's use as a dieting aid has also led to a number of accidental fatalities."[1]

I would argue that's an entirely unsafe medication. That's not a drug that's short of perfection, it seems to be the sort of medication that will solve the obesity crises by actively killing people instead.

[1] https://en.wikipedia.org/wiki/2,4-Dinitrophenol