If people tried to follow normal dieting advice, and they failed, do we keep telling them to try harder?
I am speaking as someone who had lost a lot of weight and achieved near normal BMI and had prioritized health. I found intermittent fasting to be much easier and less willpower taxing than counting calories, which was way too much work.
People do want to be healthier and a lot of people really tried hard. Problem is, in other societies, it's effortless.
Sorry, but no. The person you're replying to made some spot on points.
If a person wants to maintain some semblance of physical fitness then they are going to have to work for it. It's astounding that this concept gets lost on so many people, as if having a normal-sized physique should come naturally to someone who lives a sedentary yet gluttonous lifestyle.
Also, to their point about being fat having become socially acceptable. Yes, it is true, at least as far as women are concerned. So much that euphemisms are being used all the time: plus size, curvy, thicc, voluptuous, and so on. I've heard people even use the term "athletic" to describe a thicker person's physique.
> If people tried to follow normal dieting advice, and they failed, do we keep telling them to try harder?
Really depends on how hard they "tried". If a person is actually determined to maintain a good physique, then yes they have to work at it AND they need to be honest with themselves about how much food (as well as the type of foods) that they consume. If someone gives up after a week of dieting and exercise because they don't see significant results or because it's just too hard for them to maintain then that's entirely on them. If they want to then view themselves as a victim, then that just shows a lack of accountability.
I am mostly concerned about health, rather than physical fitness.
Really depends on how hard they "tried". If a person is actually determined to maintain a good physique, then yes they have to work at it AND they need to be honest with themselves about how much food (as well as the type of foods) that they consume. If someone gives up after a week of dieting and exercise because they don't see significant results or because it's just too hard for them to maintain then that's entirely on them. If they want to then view themselves as a victim, then that just shows a lack of accountability.
Trust me, I am the first to sign up for accountability and looking over your health. I exercised fairly consistently and lost 30-40 pounds to the point of being almost normal BMI. Just need to lose like 5 more than I'll be happy.
People really do want to get healthy, and they spent prodigious amount of effort, and failed anyway. Maybe it's something wrong with our strategies/approach then it is something's wrong with the victim.
In the end, I don't really think it's an issue of gluttony either. I love food. I still eat a lot when I can, maybe even too much. However, I basically don't drink soda, or even artificially sweet soda, and excluded most sweets thing. Trying to make sure I eat veggies.
Consider this - most people spend 40+ hours at work, 5+ hours in commute, only to go home and spend most of the rest of the waking hours doing house chores or attending to family needs - this is a truly epic investment of human effort, yet almost every adult does it without thinking and nobody thinks it's exceptional, thing is, it's kind of expected of people. Compared to that, the amount of sacrifice needed to get healthy is miniscule - only the lack of boring routine and social expectations make it seem otherwise.
It's much easier to do something you have to do. Much harder to do something that isn't required of you.
The Dutch attitude towards walking, cycling, food and sports makes it extremely easy to manage one's weight, if you buy into it. When I visit my home country, no one in my family / friends circle enjoys walking. Most don't enjoy exercise, but they are truly fond of barbecues, beer, soft drinks and other such hyper palatable foods.
Had I remained in my home country, I would just be one more data point toward the obesity statistic, just by virtue of putting some effort to fit in.
The fact is that multigrain bread, oats, beans, lentils and peanuts are all cheap, filling good sources of fiber and protein. Large animal protein portions are rarely truly needed.
Combine that with some vegetables, a bit of oil, some spices, a modest portion of pork/chicken protein, and you end up with an inexpensive healthy meal. I understand that eating well has other costs (namely, the time and effort it takes to make it and clean up afterwards). For people who value their health, this cost is usually acceptable.
Well, perhaps. If multiple different factors (say: car culture, ease of food delivery, prevalence of tasty-if-unhealthy food, peer prestige via excess, and targeted advertising) -- or perhaps more -- combine, they can actually create an overriding sense of social acceptability that you then cite.
In that sense, the social acceptability becomes a defensive moat for all of the problematic practices that have created the obesity problem in the first place; and rational people will join in defending the moat rather than questioning what is behind it.
https://www.endocrine.org/news-and-advocacy/news-room/2014/r...
People are less active in their work and lives, and not just a little bit.
Rice has a fairly high glycemic index. Nothing wrong with eating some rice in moderation, but getting the majority of your calories from rice isn't healthy.
https://www.health.harvard.edu/healthbeat/a-good-guide-to-go...
McDonalds and their ilk, have created taste formulas that are nearly irresistable. I've seen people from foreign countries come to america who've never tasted anything other than their local cuisines who can't imagine eating anything else. but the second they sink their teeth into a McDon hamburger, they are hooked.
MSG has been shown as a super reliable way to make mice obese: there's even a scientific procedure named after it: "MSG induced Obestity". It's a standard procedure used as a precurser to obesity experiments on rats. If it's that reliable on rats, just imagine what it would do to humans.
https://www.mcdonalds.com/ae/en-ae/your-right-to-know.3807.d...
I don't think fast food restaurant necessarily create delicious superpalatable food.
Of course there are exceptions, but we're a long long way from only having the exceptions left.
People also don't know tricks like meal preps, sous vide, and slow cooking.
In reality, from a very young age people are bombarded with advertisements and other marketing materials that promote foods packed with sugar, carbs, and salt.
Cinnamon Toast Crunch is "part of this complete breakfast." In reality, it should never be a part of any breakfast.
Unhealthy foods are sold as healthy, e.g., the Nutella scandal: https://www.npr.org/sections/thesalt/2012/04/26/151454929/nu...
Another example: sugary, calorie-laden "vitamin" drinks and other "healthy" trends like flavored/sugared Kombucha, juices, etc.
I remember seeing advertisements from Coca-Cola "debunking" the idea that soda doesn't have hydration benefits.
Then you start realizing that doctors and other experts are receiving free materials from food and drug manufacturers. The food pyramid is influenced by food industry lobbyists.
So you're talking about it as if it's all "choice" but that becomes a very complex subject once you start following the money. The nutrition scientist at your local university or the dietician on main street doesn't have a marketing budget, but PepsiCo sure does.
However, despite that, I have a hard time believing that most people think eating at McDonalds is healthy, or that drinking Coca-Cola is healthy, or eating a bag of chips is healthy. They know it's not. Don't they? Am I wrong about that?
But there are a lot of products out there with more grey area than the typical McDonald's menu item.
For example, the Dunkin' "Power Breakfast Sandwich." The marketing sounds healthy without saying the words "healthy:" https://www.dunkindonuts.com/en/menu/sandwiches-and-more/pow...
Notice how this item has almost half your daily value of saturated fat! High cholesterol, high sodium!
A lot of people would see this menu and think "this is a good alternative to McDonald's."
Same deal with Subway. Jared was selling us on weight loss via eating sandwiches, but he himself didn't eat the Sweet Onion Chicken Teryaki – a.k.a. Chicken on Bread with Sugar Sauce. Subway was promoting footlongs (five...five dollar...five dollar footlongs!) specifically, a portion size that is objectively too large for a single meal unless you're skipping a meal or eating with basically no condiments. Everything about Subway is healthy-ish until you get to the end of the line and you have a spread of caloric sauces to choose from (all free) along with a translucent case of cookies, addictive chips, and unlimited-refill soda.
Another example: products labeled "no added sugar" that are largely sugar, such as orange juice. Sure, it's slightly better than added refined sugar, but it's still sugar and it's still calories.
I once dated someone who thought their daily Dunkin' Donuts coffee was a low-calorie menu item. Nope! It's 300+ calories, because it was a latte in a large portion size with sweetener. But it looks really similar to low-calorie items.
Portions are a huge issue, too. A lot of those fast food chains make larger drink and side sizes in the USA compared to the exact same menu items overseas. Why this is, I'm not actually 100% sure – maybe a more competitive fast food market in America where these companies are trying to beat competing restaurants in value?
All of this is to say:
1. We can't assume the average person's nutritional knowledge is very good. It's barely taught in school and the schools themselves are doing basically nothing to promote healthy eating. My public school provided meals like pizza, smiley-face french fries, Little Debbie desserts, and an entire cookie and slushie stand. They actually helped get me addicted to bad food!
2. We can't assume that the general population has any idea what rational portion sizes look like. This has been distorted beyond belief.
3. We can't even assume that the general population knows what a healthy-weight person looks like anymore! I had family members concerned about one family member who lost weight down to a healthy weight. They thought that this person was starving or something like that, even though they were basically the only person in the family who had reached ideal weight.
I know I ranted for a long bit here but I think the USA in particular is long-overdue for some really major reforms surrounding the food industry. There need to be serious restrictions on advertising, portions, and macronutrient transparency. Bad food should be treated a lot more like cigarettes. For example, if I could make all the decisions I'd make it illegal to mass-advertise any food item that exceeded certain daily value macro-nutrients like saturated fat, sugar, calories, etc. Sure, you can sell them, but you can't put them on TV.
That's not our ancestors eat, and that's not how I eat either. Though I did quit drinking half and half after realizing that it's supposed to be a food item rather than something to drink.
A lot of “default” portion sizes are too large.
A lot of companies heavily imply unhealthy products are healthy or beneficial.
A lot of high-calorie items are marketed as something that is okay to eat regularly and not just as an occasional treat.
That’s why in my mind advertising and packaging regulations are being underutilized.
Think of how cigarettes warn you about their unhealthy properties, and aren’t allowed to be advertised on TV. A lot of food products should really have similar restrictions.
E.g.:
“Caution: a full portion of this product provides an elevated level of sodium, increasing risk of heart attack and stroke.”
“This menu item exceeds recommended calorie levels for a single meal, and may cause weight gain and obesity with regular consumption.”
“This item is a high sugar item, increasing the risk of diabetes. Complications of diabetes can include nerve damage and glaucoma.”
Part of what I loved about living in Asia (Taipei, Tokyo, et al.) was that public transit required walking to, between and from stations/stops. It's not much but it's just enough.
Research had came out indicating that exercise doesn't really do much good in losing weight. Might help in maintaining weight.
If the desired outcome is an improved quality of life, exercise has a plethora of mental-health benefits [0], cardiovascular and energy improvements[1], and has negative correlations with some of the risk-factors of obesity, like type 2 diabetes, high blood pressure, and some cancers [1][2].
I would hate for someone to read the common response and conclude that since obesity is causing their problems and weight loss seems more affected by diet changes, that exercise doesn't matter and can be safely skipped. To have a different life a lifestyle change is needed.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172294/ [2] https://www.mayoclinic.org/healthy-lifestyle/fitness/in-dept...
Running a 5k doesn't even burn 500 calories for most people, but you can eat that much in snacks without a second thought. To really make a difference in weight the much more important side of the equation is intake.
Something else is a major contributor to this.
You can eat anything - vegetables, meat, fish, potatoes, pasta, bread - and be pretty thin. If you add 500 calories of dressing to a salad, then no matter what you eat, you are doomed... also, that and spices would bomb out your taste buds, so you wouldn't even be able to enjoy "purer" food anymore.
What would this look like policywise?
One policy choice (amongst many required) could be to stop subsidizing the inputs to junk food.
Another policy I've heard talked about by Joel Salatin is that a lot of low processed foods are getting crushed by regulation because the cost/barriers are very high and demand scale/volume. For example poultry processing is only feasible on a massive scale because of regulation policies like (paraphrased) "there must be a dedicated washroom onsite for the inspector to use". That makes no sense if you only process 10000 birds a year (something like $100k of gross market value).
I really could go on.
I know many would prefer bike lanes, but bicycle infrastructure isn't always safer for cyclists. Often city planners have no concept of what actually goes on, so even when token lines are painted on the street - it does nothing to increase cycling.
It may be best to put aside the issues of investment and which top-down solution is the best. There may be a time and place for that, but in the near term individuals with an interest can develop their skills incrementally.
Disclaimer: I am a self admitted cycling extremist
Most people do not care what form of transportation they take. They do not identify as cyclists, drivers, or anything else. Transportation is an inconvenience in their lives as they travel from A to B. They will do whatever is cheap, fast, and convenient.
Cities need to be built to a human scale and not a car scale. Cities should be designed so that riding a comfortable, durable, upright bicycle is a fast and convenient option for people. That means bicycle paths that are physically separated from other forms of traffic. It means constructing different kinds of buildings and businesses so that bicycle routes are short and convenient.
Most people are never going to risk their lives to ride bicycles on roads where cars, driven by people on their phone, are travelling at speeds exceeding 30 mph. They won't ride their bicycles for an hour over the vast distances that are convenient for cars to travel in a few minutes. And they won't take their bicycle to a big box store with car-parks larger than the store so that they can clumsily chain their bicycle to a street light pole.
If you want normal people to ride bicycles as transportation, you need extensive bicycle infrastructure.
>Most people are never going to risk their lives to ride bicycles on roads where cars, driven by people on their phone, are travelling at speeds exceeding 30 mph
From my admittedly biased or perhaps experienced perspective it really isn't as dangerous as people imagine.
What is clear to me is that no matter what happens, there will always be a contingent of individuals who will never ride a bicycle. Whether that is because of imagined safety reasons or because of infrastructure fantasies, I can't say. I can say with certainty that if you eliminated both of these objections, another excuse would be raised. That's fine. People should choose the lifestyle that suits them and brings them happiness.
At the local level, it is up to you. In my city of Pittsburgh, we are removing parking and expanding transit access and bike lane coverage. But there is still a lot to be done, so I am advocating for change by participating in groups and contacting my city councilman.
Pick a "first world" country with much better BMI. Copy all of their regulations surrounding food and agriculture.
What about rolled oats or steel cut oats? They're clearly "processed", oats don't look like that when they come off the plant.
Potato chips + fries are just cut potatoes dropping into a vat of oil. Oil itself isn't very much processed either. But we all know that potato chips / fries are unhealthy and shouldn't be eaten all the time.
Cheese or butter require incredible amounts of processing to get done. But when properly portioned, they are part of a healthy diet (more so than potato chips anyway).
--------
Is honey any healthier than sugar? Is juice healthier than soda? From an obesity perspective, not really. You really want to be cutting back on these empty calories. (Sure, juice is __slightly__ better than soda cause juice has vitamins in it. But... its actually not that good for you)
Because "unhealthy" is a better starting point than the arbitrary metric "processed".
-------
You're going to do more for your health by cutting back on your rice portions, rather than worrying about what is or isn't processed. (And rice is barely "processed" at all... but its incredibly calorie dense with high glycemic index).
Switching out bread portions (since bread is highly processed) for rice portions won't do you jack diddly squat. Both are high calorie / high glycemic index foods.
And yet Asia has basically no obesity problem. We clearly need better nutrition science.
Citation: I'm Asian-American. Also, Filipino. We're not obese, but erm... Americans might be healthier, no joke. The amount of lechon we consume (incredibly fatty pig) + other fatty foods is a big problem to heart health, despite the fact that it doesn't cause obesity.
Oh, and Filipinos generally eat fresh foods. Fresh fish, fresh pork, fresh chicken. Relatively low processed foods (our Halo-Halo is similar to your "ice cream", except Halo-Halo is just milk poured over shaved ice + fruits + ube mixed in. "Low processing", but we all know its a desert and unhealthy).
That's the thing. Being Filipino gives me more insight into this "processed food" craze going on. Halo-halo has almost no processing involved and is made out of fresh ingredients. That doesn't make Halo-halo any healthier.
> And yet Asia has basically no obesity problem. We clearly need better nutrition science.
We all know beer and soda is bad for us, and yet we drink it all the time as a society. I'm not sure what nutrition science is beneficial when so many people choose to ignore it.
Cut back on high calorie foods. Watch your portion sizes. Count calories. Eat more fibrous meals to fill up your stomach ("tricking" your brain into thinking you're more full). Avoid non-fibrous foods (such as soda) because they miss out on the stomach/brain psychology.
---------
Its hard in America because of stupid little things. Plates are bigger in America, so when you're in America you trick yourself into putting more food into your plates.
Plates are literally smaller in the Philippines. So you end up eating less. Stupid cultural differences like that make a big difference.
Because American culture subtly forces you to overeat (bigger plates, bigger glasses, bigger drinks), you need to explicitly count calories. That's just the facts, if you aren't counting calories in America, you're going to overeat.
NYC's obesity rate is half of the nation's; we could still do better, but it's a starting point.
This is a function of density. We walk more. Look at the boroughs that drive and they're closer to the national average.
Replicating this in e.g. San Francisco would require overcoming the anti-development NIMBYs. That's a hard problem.
- In the documentary Fed Up, it showed how Michelle Obama had to back down to the big food companies over her push for healthier food.
- I worked with bariatric surgeons and some incredibly cited papers stating that people can’t lose weight by diet and exercise alone. The surgeons I knew were incredibly narrow-minded and uninterested in any counter arguments.
- Sleeve gastrectomies are the most effective technology to fight obesity. If someone can’t change on their own in 10 years, then it is a good option. It removes 90% of the stomach including the hunger hormone ghrelin.
- The surgeon I worked with had a sleeve procedure, stretched his stomach out, and had a 2nd sleeve.
- Long term, the food environment has to change. Living expenses are high, work demands are high, people are stressed and all the easy options are terrible for you.
- We should distribute good meats, foods, vegetables and essentials in an entirely new way.
- Our business leaders like Buffett and Gates need to realize the absurdity of respectively owning Coca Cola and selling potatoes to the fast food industry. Buffet also owns DaVita, a dialysis company. Gates promotes global health but earns money from french fries being sold at McDonalds.
It's not obvious, but there are some ways to trade relatively small amounts of inconvenience for food that's healthier and often cheaper.
Some people will cook enough food on a weekend to last the rest of a week with refrigeration, optionally dividing it up into single-serving containers. Since a lot of recipes scale up well, this ends up taking much less cooking time than doing one meal at a time, and the labor is shifted to weekends when you might have more energy. A quality-of-life variation on this idea is to do ingredient preparation for a week on the weekend -- chop the vegetables, measure things out, etc. -- and cook meals for four days, then do a second (much quicker) batch of cooking mid-week so the food doesn't spend too long in the fridge. Googling for "once a week meal prep" will turn up a lot more information on this.
The big problem with the approach above, of course, is the monotony: having only a handful of meal choices each week can get old after a few days. For people who are willing to cook more often but would still like to economize on time, this guide from last year on quarantine meal-planning for people who normally don't make most of their food at home is very good:
https://www.seriouseats.com/our-tips-for-meal-planning-durin...
In particular, the big thing to take from it is the idea of making larger batches of meal components that you can quickly put together in various combinations with different flavors, which lets you save on cooking time (and shift it to when it's more convenient) while also giving more variety in your diet.
Sugar is in everything. Snacks, restaurant food, drinks, sauces. It puts the metabolism into a bad state and desensitizes the body to its deleterious effects. Before you know it you're overweight, mentally foggy, and pre-diabetic. Not a good place to start working out or going for outdoor activities.
People exercise and walk more when they have energy to do so. Sugar saps that away.
Look at people in other "confined" spaces: submarines, ships, the space station. These people are not overweight for lack of walking.
It's diet.
America is pumped full of sugar.
edit to respond to comments (since I'm flagged / rate limited) :
Someone with a healthy body and mind won't "sit on their ass 23 hours a day". They won't consume too many calories, either.
Sugar pushes the body into more lethargy and higher sugar consumption.
His point basically is that Sugar is not in any way except for how it contributes to excess caloric intake. The key here is that sugar contains calories and can attribute to hyper-caloric state. But you can also eat lots of sugar and be in a hypo-caloric state. Therefore sugar has nothing to do with it. Total consumption is everything here (and body fat percent).
Have a watch of these videos:
https://www.youtube.com/watch?v=9JrT84PeTgw
It's true that countries where they don't put sugar in everything—or don't use HFCS at all—don't have this problem.
It's also true that between 1950 and 2000 portion sizes went up. For everything. If you travel in France and Italy, known for butter and pasta heavy cooking, respectively, their servings are half the size of the typical American restaurant.
At the same time, if you go from a walking city in the US to a suburb where it's all cars all the time, the visible difference if you just look around at people is jarring. Sure, cities might eat differently, but not that differently.
I'm not anti-car, but in some places the 100% sedentary lifestyle is a big part of the problem.
Do people want walkable cities? Or do they want single-family dwellings and yards?
Do people want to be healthy? Or do they want sugary foods and television programs?
Fortunately, the U.S. has plenty of each, to accommodate multiple preferences.
Life is trade-offs. It's the conceit of policy makers to force their trade-off preferences on people.
As of 2010, close to 24 million Americans lived in a "food desert"[1], i.e. an area without adequate access to healthy eating choices. These areas are disproportionately lower SES areas, and the people in them don't get to have a "preference"; the decision is being made for them.
Edit: Here's a paper explaining the correlation and absence of choice in detail[2].
[1]: https://en.wikipedia.org/wiki/Food_desert
[2]: https://academic.oup.com/nutritionreviews/article/66/4/216/1...
So, yeah, that's exactly my point.
Average rents indicate that Manhattan is once again the most highly desired place to live in the country, and for good reason.
(A) Emphasis on "onward." There's a massive amount of development since 70 years ago; if it were a fluke there's been ample opportunity for it to change.
(B) Who chooses urban planners?
(C) A large number of people want to live in dense population centers. Also, a large number of people don't.
This isn't forcing people to make a decision, it's including all of the costs in the dollar value of the product on the shelf.
But as much as possible, it's best to reduce decisions to the individual level.
If the average person suffers from what should be an anomaly, perhaps it is less a personal failing than a societal failing and we should try to fix the societal problems generating the poor outcome.