> The three-day meeting was infused with an implicit understanding of what obesity is not: a personal failing.

This weird push that "it's not a moral personal failing" is so strange. Is anybody serious claiming it is? Sure, your weird uncle might.

But I'd hope the actual scientists would focus on finding the causes instead of whatever this is.

Because on a policy level, it's often treated that way.

Do you have an example? Besides banning big gulps and ineffectual ad campaigns I don't recall much policy on the topic.

> Is anybody serious claiming it is?

Most Americans.

https://www.nytimes.com/2016/11/01/health/americans-obesity-...

Ha, ok. On the other hand I'd argue "evidence it's genetic" is also clearly false.

There are certainly genetic factors that make some people vulnerable but our genetics haven't changed that much in the last 30 years. Obesity has.

The combination of genetics with our lifestyle and dietary context is where it's at IMO.

We know what causes obesity...less activity than what's consumed. Yes, there are contributing factors (e.g., gut bacteria, urban food deserts) that can tilt the scale (no pun intended) against you, but at some level it's a lifestyle issue. Why is that politically incorrect to say?

Moral failing? Not really. Cheating on your spouse is a moral failing. But not watching your diet and/or not making an effort to exercise is simply denial.

I'd argue "less activity than what's consumed" is not causal but an accounting of what's already happened. Just like "more money in your bank account" is a mere measurement, whereas "getting paid for your job" is what was causal.

> We know what causes obesity...less activity than what's consumed.

In general, yes, but it's a bit more complex than that.

First, it's not "activity". It's total calories burned, which includes base rate metabolism. Base rate metabolism is something that can be affected by exercise, disease, maybe diet, and certainly by chemicals (weight loss "aids" often work on this route, but can cause some nasty side effects).

Second, it's not quite what's "consumed", it's what's extracted or absorbed. Gut bacteria show up here, but so do enzyme and other digestive issues.

You can eat as much as you want and never gain weight if you have a high enough base metabolism, or if your digestive system is flawed.

I understand all that. That's way I generalized over absolutes. Nonetheless, drink soda, eat foods with low nutritional density, watch TV, play video games...where is the surprise?

Again, there are things that tilt one way or another but to say the individual has no say and no influence is simply no true. And it's a dangerous mindset to normalize.

I agree with all of that.

Food cravings are intense and real. It's like being addicted to drugs...maybe even worse. People will suffer withdrawal-like symptoms when deprived of calorie dense food. Obesity can be prevented by preventing kids from ever tasting this stuff in the first place.

From tasting food?

>Food cravings are intense and real.

Regular fasting recalibrates the mind over body state.

"Personal failure" is a stretch, and in contrast broadly saying it's never about willpower is also a stretch. Humans are capable of accomplishing amazing feats of physical control. Our minds have incredible power over our bodies. Buddhist monks are a testament to this. There is a huge factor of belief becoming a self-fulfilling prophecy when it comes to willpower. If you don't think you can control your own behavior, then it becomes negative reinforcement until it becomes true. Thinking you cannot control yourself from putting food in your mouth is the epitome of a 1st world problem in current times.

Off the top of my head - Sugars and <edit> complex carbohydrates </edit> that break down to derive a lot of fructose - being used in excess in manufactured food. New Scientist had an article in the 90s in regard to tests on fructose free and normal diet on rats. Pretty much tended to show the increase of appetite as well as more storage. In recent years Harvard did further studies why.

However there's a lot more than that going on, iirc didn't Michael Moore produce a doco on some of the tricks big fast food industry use to entice more food consumption.

I don't think there's just one box and everyone is the same, but in my 20s due to an accident I gained a lot of weight where I needed suspenders to keep my jeans and trousers up, and once I was well enough I first walked a few mile every day and eventually using a push bike to travel to my nearest town for further studies about 30 miles (50km) away. Sure those trips moved from taking around 4 hours down to just over 2 and peddled near everywhere at that point, I still had most of that excess fat around the gut. Even after I stopped riding a bike, it was about the same but I still did quite a lot of manual work at that point and ... I tried that experiment more or less they'd done on rats, I used glucose instead of sucrose and maybe it would help ... in a mere matter of weeks instead of months the fat just fell away, and even before much had fell away I'd felt so much better.

I think starch only breaks into glucose, not fructose.

I believe you are right, I did mean complex carbohydrates so I'd better edit that in.

> Sugars and <edit> complex carbohydrates </edit> that break down to derive a lot of fructose

https://twitter.com/sguyenet/status/669638118400749568

Unsure what message you're implying or just sugar consumption in the US has declined more than 15% since 1999.

Though similar decline is reflected at a couple other online areas [1] [2] I am however not going to research and quantify that ... besides I don't trust the big food industry to provide accurate figures, I'd only confidently trust a totally independent facility that confirmed overall sugar and easy to digest carbohydrate levels in each food item and average consumption by the population.

Sugars like sucrose and HFCS rather than regular corn syrup, yield 50% and >42% fructose respectively. It's consumption in great quantity does not seem to have a major impact on some people, but certainly others are prone to the vast amount of fructose consumed. Harvard iirc showed how the extra fructose in diet corresponded to longer villi in the gut.

Obviously there's other factors at play, but excess fructose consumption is nonetheless an obvious change in diet to what those earlier than 60 or 70 years ago.

[1] https://www.healthyfoodamerica.org/sugartoolkit_overview_ori...

[2] https://www.researchgate.net/figure/Sugar-consumption-in-the...

> Unsure what message you're implying or just sugar consumption in the US has declined more than 15% since 1999.

I'm implying excess sugar consumption, including HFCS, is not the cause of the obesity epidemic. No one's telling you to eat it, though.

One thing that is striking is those who have the means to eat well and more diverse foods seem to fare better weight wise, yet those who are poorer and have to rely on processed foods to make up the bulk of their diet as it's cheaper and affordable, where they can not avoid the added sugar with fructose derivatives, don't fare so well even if they try to add in better things to their diet to balance it like a small amount fruit and vegetables.

I for one, noted first hand the very stark difference cutting down the fructose had, not just on weight, but how it modified my mood and appetite. In actual fact the one problem I had with my little self experiment was my diet got worse balance wise. There was no placebo effect to account for IMO, since trying for years on actively planning time to be very active did not help much, though my muscles were better for it, I had expected a mere change in removing fructose to be on a time scale of at best 10 months, and expected more likely if it worked at all, after a year I might be lucky enough to lose 10 kg (approx 20 pounds) ... instead on starting the low fructose diet, my mood notably improved in a week or so (I didn't think I had a mood issue - I am what I am, so that was unexpected,) and I didn't shed 10 kg but 25 kg in two or three months (I no longer recall the exact time frame) ... and while I did that I was no longer push bike riding where I might easily clock 100 km (60 miles) in a day but still moderately active but not that active. Seemed clear to me though a few people would not respond the same, but since I'm not unique, many would also fare similarly as well. The only issue was the tedious nature of introducing and staying true to ensuring that sugar consumed was far more glucose than what broke down into fructose, even though I still ate a small amount of processed food - most sugar was fortunately by way of hot drinks consumed during the day.

To say it was actually something else in my case, equates to blaming eating a pie, a couple boiled whole potatoes or same ration of pumpkin pieces, 3 cups of milk per day for my weight problem back in my 20s ... I really wasn't eating very much, though sugar was powering my days.

Unfortunately I'm with the other guy here.

I think reducing excess sugar consumption is necessary but not sufficient to get lean for some obese individuals like myself.

When I started keto 7 years ago I lost 100lbs. Then I gained it all back - staying pretty strict keto the entire time. I haven't had what you'd call "processed food" or "sugary food" in nearly a decade if you exclude a small % of keto-style things like dark chocolate (85%).

Now back down 45-50lbs (depends on how you count) and hopefully going to continue. But this time I cut out protein, too. It could be that both carbs and protein raise insulin enough to cause obesity in some people. Or maybe seed oils in even the tiniest doses. Those are my two main hypotheses: https://exfatloss.substack.com/p/hypotheses

I don't think fructose is the one shot answer for carrying more fat than is healthy -- but it's consumption or ratio in food consumed by the general population, IMO plays an important role in higher rates of over weight people in a given population nonetheless [1]. Basic foods grown haven't changed that much, but manufactured foods certainly have changed over the last half a century. So too I guess, have our habits of how we eat changed with devices like microwaves that make frozen one serve portions a practical reality for a fast life.

There will of course be a small percentage of people who carry more fat, for different reasons entirely, not directly related to diet or exercise even.

Interesting experiment you're running. Funny thing, one of those years where I never lost much weight push bike riding and other ideas, I landed a 15kg box of dark chocolate buttons - unintentional but I indulged and started bagging up about 3/4 to a full cup in a bag to take with me for the day's travel ... by end of box I'd lost a bit over a kilo (2 pounds) which seemed odd to me.

[1] https://www.ncbi.nlm.nih.gov/books/NBK576428/#_article-14058...