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Re:A flawed paradigm has derailed the science of obesity by perl4ever on Monday September 13, 2021 @09:36PM (#28519149)
As an adult, over about 15 years, I've gone from around 140 lbs (nearly clinically underweight) to almost 200 (slightly overweight), but in my case it's a well known side effect of medication I take. So is diabetes.

I hate reading about this topic. I ask (rhetorically) how can it be that people pretend that normal weight is normally achieved through conscious choice?

I like to think even if I had stayed the same weight my own life, I would have insight enough, but in my position, it's really clear to me. I have a thermostat, and ingesting chemicals changed the set point. People who keep on gaining weight until they die must have a broken thermostat set on "high". It can't be psychological.

I feel like there's an awful conspiracy to gaslight people who are obese, because they can't be sure when someone says it's a matter of willpower, if they've always been that way. What to compare to?

But everyone who has spent much or all of their life at a normal weight, should know it doesn't take supreme effort or fanatical accounting. It doesn't require not eating when you feel like you're starving. Empathy should come from properly understanding yourself, even if you can't be philosophically certain what it's like in others' shoes.

People have free will, but you wouldn't tell a person who had a congenital inability to feel pain that they are responsible for injuring themselves, would you? You wouldn't construct a model of them as a person, as someone that enjoyed hurting themselves, right? Because conscious thought is not a replacement for automatic regulation.

Re:A flawed paradigm has derailed the science of obesity by tarsinge on Tuesday September 14, 2021 @01:14AM (#28520511)
I’m formerly obese, controlling my weight at will with healthy food is relatively easy, with junk food it’s very hard. Sugar, salted and fried foods are basically hacks, your brain and body has no idea which quantity is enough so they can be eaten without limit. Whereas with a plate of vegetable, a protein and no added sugar or fat you naturally can’t eat more calorie than you need. In fact I must usually add olive oil to eat enough calories and not lose weight if I eat too healthy. So it’s not willpower in a vacuum, the kind of food is key.
Re:A flawed paradigm has derailed the science of obesity by kayodelycaon on Monday September 13, 2021 @09:56PM (#28519291)
> you wouldn't tell a person who had a congenital inability to feel pain that they are responsible for injuring themselves, would you?

I know people who absolutely do that. The logic is those people don’t have enough faith or care enough to be healed.

People will go a very long way to blame a person who is suffering because it absolves them of responsibility.

Re:A flawed paradigm has derailed the science of obesity by bitshiftfaced on Tuesday September 14, 2021 @09:27AM (#28524453)
> I have a thermostat, and ingesting chemicals changed the set point. People who keep on gaining weight until they die must have a broken thermostat set on "high". It can't be psychological.

This misses something important. If your weight is the thermostat's setpoint, then your BMR is the A/C unit, and your calorie intake is the ambient outdoor temperature. If your A/C unit is out of whack, then you'll need to move to a cooler climate (lower calorie intake) in order to get to a comfortable temperature. For example, women have a lower BMR than men and must eat less to maintain a healthy weight.

> But everyone who has spent much or all of their life at a normal weight, should know it doesn't take supreme effort or fanatical accounting. It doesn't require not eating when you feel like you're starving.

Only it does sometimes. You can't see how someone can slowly adapt unhealthy eating patterns over time? Or, as perhaps in your case, they need medication which changes their BMR? Once your ghrelin production/cycle no longer matches your BMR + physical activity, you may feel like you're starving even though you've already met you're calorie intake needs. Fortunately, we can change how hungry we feel in the long run just as we can change how much we eat, and there are plenty of examples of that. I don't think it's a gaslighting conspiracy to say that much.

Re:A flawed paradigm has derailed the science of obesity by webmobdev on Tuesday September 14, 2021 @12:21PM (#28527071)
What's BMR?
Re:A flawed paradigm has derailed the science of obesity by bitshiftfaced on Tuesday September 14, 2021 @12:55PM (#28527530)
Basal metabolic rate
Re:A flawed paradigm has derailed the science of obesity by int3 on Monday September 13, 2021 @10:14PM (#28519416)
I don't think it really matters how it's normally achieved. The point is that it can be achieved through conscious choice.

I used to be slightly underweight when I was younger, and could eat endlessly with no consequence. These days I have to consciously watch my calories. It was a bit difficult at first, but I've gotten used to it. Conscious thought is not a replacement for automatic regulation in itself, but you can consciously work to form new habits.

Re:A flawed paradigm has derailed the science of obesity by lkey on Monday September 13, 2021 @11:38PM (#28519952)
Believe it or not, fat people receive this kind of anecdotal lecture unprompted throughout their lives.

It is precisely these attitudes that the article addresses directly. If you assume the problem is simple and easy to solve, then anyone who hasn't solved it has a character defect. Needless to say, receiving this kind of pep-talk is annoying and unpleasant.

I'd encourage you to read the article or study directly and perhaps ponder what it might feel like to not have been able to eat endlessly from the moment you were born before telling someone else how best to handle a medication actively dis-regulating their metabolism.

Re:A flawed paradigm has derailed the science of obesity by int3 on Tuesday September 14, 2021 @11:35AM (#28526388)
You seem to be reading a lot into what I wrote. I never said anything about a "character defect", or that the problem is easy to solve. I'm saying that easy or hard, we do have agency. In particular, I disagree with these two statements from GP:

> People who keep on gaining weight until they die must have a broken thermostat set on "high". It can't be psychological.

> Because conscious thought is not a replacement for automatic regulation.

I skimmed the article, but only because I've already read an entire book on the topic. I understand that there are hormonal effects on weight. That's no reason to throw your hands up and declare that you have no agency in the matter.

Re:A flawed paradigm has derailed the science of obesity by birksherty on Tuesday September 14, 2021 @12:33AM (#28520262)
Are all people obese due to medication? The article from beginning tries to say it's not due to difference in total calorie taken and used. Is it really not the case? People always chose sugary food over fruits, veg and meat whenever they are hungry.

edit: Want to add that people also eat way too frequently, which makes us feel hungry (falsely) whenever not eating in that schedule. This can be averted by practice of eating less frequently few days. It does not mean starving, we just deviated from the normal and trying to go back.

Re:A flawed paradigm has derailed the science of obesity by aaomidi on Tuesday September 14, 2021 @01:38AM (#28520651)
There are things that have fundamentally changed in our bodies as a whole to make us have a different relationship with food and hunger. This change really started in the mid 19th and 20th century.

Food security can't be the only explanation for this because there were dozens of periods in human civilization where food security was just as good or better.

Not investigating this is causing lives lost and mental anguish. It's like we don't want to admit that fat people might have actually been fat because of other reasons other than being a failure.

Re:A flawed paradigm has derailed the science of obesity by danaris on Monday September 13, 2021 @10:59PM (#28519695)
> The point is that it can be achieved through conscious choice.

"It's normal and trivial for me; therefore, anyone who doesn't do it right must be lazy/greedy/insufficiently determined!"

There are so many ways that different people's bodies and brains are different, it is patently clear that the idea that it is realistically possible for every human to achieve and maintain what our current society says is an "ideal weight" over the course of years, no matter their physical, psychological, or financial situation is just another way for certain people to see themselves as more worthy and morally upright than others.

Re:A flawed paradigm has derailed the science of obesity by andreskytt on Tuesday September 14, 2021 @01:17AM (#28520529)
Most people are capable of running the marathon after some training but most don’t. The fact, that, theoretically, it is possible to loose weight by conscious choice (I have), does not mean it is reasonable to expect everyone to do it. I know very well how hard it is. Thus, “it is possible” and “you should have done it” are not equivalent statements
Re:A flawed paradigm has derailed the science of obesity by dvogel on Tuesday September 14, 2021 @01:26AM (#28520577)
You're focusing on the overweight side of the ledger, causing your character judgement to kick into gear. Controlling your weight can be difficult without moral failure. When I was 14 I was desperate to gain weight (5'10" 128lbs) so I was eating nearly 3,000+ calories per day. I was lifting weights a few times per week for maybe 20-30 minutes but not much other exercise. Over the course of 5 years I gained a grand total of 19lbs. Weight gain is definitely not a simple calorie intake vs calories burned formula.
Re:A flawed paradigm has derailed the science of obesity by birksherty on Tuesday September 14, 2021 @03:31AM (#28521478)
> not a simple calorie intake vs calories burned formula

People have lost weight that way. At 14 your body was in growing phase. Clearly fat does not come from air. I gained weight last year and I know how it happened. What kind of food you eat (sugary packaged vs fruit veg meat) and lifestyle matters.

Re:A flawed paradigm has derailed the science of obesity by perl4ever on Monday September 13, 2021 @11:20PM (#28519828)
Surely the experience of it becoming harder can be extrapolated? If it's a little harder for you, then it could be much harder for some people?

Giving up alcohol is way easier for some people than others. Lots of people have written about what alcoholism is like; have you ever read Lawrence Block's Matthew Scudder novels?

Re:A flawed paradigm has derailed the science of obesity by webmobdev on Tuesday September 14, 2021 @12:41PM (#28527335)
I think what the article is trying to say is, yes, there is a behavioural (psychological) component. But there is also a metabolism (physical) component too that is not getting enough attention. (Your own example highlights this well - when you were younger, you could eat more, and / or perhaps lose weight faster too, but now your body's metabolism has changed and you put on weight more easily). For e.g. thyroid imbalances can cause someone to put on weight, and can be addressed medically. The author believes there may be many other similar factors at play behind someone's obesity.

I partly agree with the author. But there is another factor - we also know that processed and / or junk foods definitely contributes to obesity. Yet, many obese people refuse to change their diet. If obese feel that they can't do without 1000 calories in their diet, why can't they eat 1000 calories of vegetables instead of 1000 calories of processed food? If gut bacteria plays a huge role in the kind of food we like to eat, then the author has a solid case ...

Re:A flawed paradigm has derailed the science of obesity by emmanuel_1234 on Monday September 13, 2021 @11:48PM (#28519999)
This is actually a great analogy. I believe what the article is (more or less succesfully) explaining is that the problem is with your thermostat, which drives you to eat too much, and that over-eating carbs screws up said thermostat.

I'll reuse this.

Re:A flawed paradigm has derailed the science of obesity by andreskytt on Tuesday September 14, 2021 @01:13AM (#28520499)
There are two basic mechanism groups defining the weight of a person: one, that adjusts calorie input based on the weight and one that adjusts output based on weight. Some of these mechanisms are physiological (stress eating), some physical (it is harder to walk for a overweight person). System dynamics basically tells us being over-, or underweight comes from these mechanims being unbalanced. For some reason the automated adjustments do not kick in on time and at sufficient volume.