4 ms·

That's true. These plans, properly followed, work as advertised. That's physics. The trouble is that most people do not follow this plans, and after 40 years of

That's true. These plans, properly followed, work as advertised. That's physics. The trouble is that most people do not follow this plans, and after 40 years of trying to show otherwise, we now know that this situation isn't going to change. Why is it that so many people are completely oblivious to the limits of human psychology? Telling people to eat less doesn't work. We need to try other public health measures.

DanBC 11y ago
I just said that these modern plans are not about telling people to just eat less, perhaps I wasn't clear. Modern weight loss plans focus on making sure people feel full, and have tricks to help people feel like nothing is forbidden (you could still eat cheese or chocolate, just controlled small amounts), while helping them make better choices. There's not much evidence, and the evidence is about as good as all the other dietary stuff (not great) but they do seem to work and be maintainable.
- rewqfdsa 11y ago
  Low-carbohydrate diets are supposed to decrease calorie intake without reducing satiation. They've been around for 50 years. They may work for individual people, but they do not work at scale as a public health measure. Why is this concept so difficult to get across? There are _constant_ advertisements in every medium for weight loss programs of every sort. We've already explored the entire parameter space of dieting. Tweaking the food mix and saying, "No. This time we have the perfect mix to keep you health and full!" isn't science. It's quackery that belongs on the cover of Cosmo. You know what works in reality? * Amphetamines * Nicotine * 2,4-Dinitrophenol * Gastric surgery of various sorts * Cancer Of course none of these things is an effective public health measure. (Although there's some evidence that e-cigarettes aren't quite as carcinogenic as regular cigarettes, but might still deliver all of nicotine's benefits.) You know what might actually work? * Pigovian taxes on high glycemic index food and drink * A ban on food advertisement * Portion size regulation * Weight-based airfare But these are all unpopular, because they contravene the pretty little dogma that we all have enough willpower within ourselves to accomplish our goals. Sometimes we need an external kick in the ass. It's time we stop pretending that yelling at people about diet and exercise is going to make a bit of difference. We might as well yell at the sea and tell it to stop rising.
  - TeMPOraL 11y ago
    > Of course none of these things is an effective public health measure. (Although there's some evidence that e-cigarettes aren't quite as carcinogenic as regular cigarettes, but might still deliver all of nicotine's benefits.) N=1 sample, not to prove anything but sharing an anecdote: I'm nicotine-taking non-smoker, consuming it in form of nicotine gums. I haven't noticed any effect of it on my weight over the period of last two years. I did respond to ketogenic diet however, but found it hard to maintain over long periods of time - basically it's a big time and cognitive investment to invent new foods that you won't puke on out of a limited set of ingredients. I do think that a lot of diets would work if they were the only thing people have to think about during the day. Alas, the cognitive demands of our fast-moving, competitive world are strong.
  - DanBC 11y ago
    Bariatric surgery is linked to increased risk of suicide, so if that's what you call working I guess we're not going to agree. http://www.medscape.com/viewarticle/852616?nlid=89075_2052&src=wnl_edit_medn_psyc&uac=197294HK&spon=12&impID=860596&faf=1 http://www.medscape.com/viewarticle/852616?nlid=89075_2052&s... > Suicide attempts increase substantially in morbidly obese patients in the years following bariatric surgery, when the "honeymoon" period of substantial weight loss comes to an end, new research shows. I agree that death does have a slimming effect. > yelling at people about diet and exercise Nothing in my posts can be seen as advocating for yelling at people. Please don't bring your bickering with other people into your replies to me. What I'm talking about is an "Every Contact Counts"[1] style approach of supporting people to access a modern weight loss programme[2], for free if they can't afford it. This will be "prescribed" by their GP, paid for by Public Health[3] or perhaps their Clinical Commissioning Group. I've accepted that the evidence is not great, but if you want to find what's wrong with the evidence[2] used by NICE I'd be interested to hear it. I haven't said anything in this thread about exercise, but I have said in other threads that exercise does not help weight loss. We should be recommending that people do exercise because it has other undeniable health benefits. [1] http://www.makingeverycontactcount.co.uk/ http://www.makingeverycontactcount.co.uk/ [2] http://www.nice.org.uk/guidance/ph53 http://www.nice.org.uk/guidance/ph53 [3] https://www.gov.uk/government/organisations/public-health-england https://www.gov.uk/government/organisations/public-health-en... England's use of generic names is nice, but feels a bit weird sometimes.
TeMPOraL 11y ago
As Scott Alexander puts it, "society is fixed, biology is mutable"[0]. Dieting is only one of many things in which we're shooting ourselves in the foot as civilization by pushing for social solutions and discarding the technical ones because "willpower" and stuff. A quote from the beginning that captures the gist of the article: "[L]ecture on ADHD suggested several reasons for the increasing prevalence of the disease. Of these I remember two: the spiritual desert of modern adolescence, and insufficient iron in the diet. And I remember thinking “Man, I hope it’s the iron one, because that seems a lot easier to fix.”" The same author also wrote an article about when it's better from a practical standpoint to treat something as a disease instead of a failure of character[1]. [0] - http://slatestarcodex.com/2014/09/10/society-is-fixed-biology-is-mutable/ http://slatestarcodex.com/2014/09/10/society-is-fixed-biolog... [1] - http://lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/ http://lesswrong.com/lw/2as/diseased_thinking_dissolving_que...

DanBC 11y ago

I just said that these modern plans are not about telling people to just eat less, perhaps I wasn't clear. Modern weight loss plans focus on making sure people feel full, and have tricks to help people feel like nothing is forbidden (you could still eat cheese or chocolate, just controlled small amounts), while helping them make better choices. There's not much evidence, and the evidence is about as good as all the other dietary stuff (not great) but they do seem to work and be maintainable.

rewqfdsa 11y ago
Low-carbohydrate diets are supposed to decrease calorie intake without reducing satiation. They've been around for 50 years. They may work for individual people, but they do not work at scale as a public health measure. Why is this concept so difficult to get across? There are _constant_ advertisements in every medium for weight loss programs of every sort. We've already explored the entire parameter space of dieting. Tweaking the food mix and saying, "No. This time we have the perfect mix to keep you health and full!" isn't science. It's quackery that belongs on the cover of Cosmo. You know what works in reality? * Amphetamines * Nicotine * 2,4-Dinitrophenol * Gastric surgery of various sorts * Cancer Of course none of these things is an effective public health measure. (Although there's some evidence that e-cigarettes aren't quite as carcinogenic as regular cigarettes, but might still deliver all of nicotine's benefits.) You know what might actually work? * Pigovian taxes on high glycemic index food and drink * A ban on food advertisement * Portion size regulation * Weight-based airfare But these are all unpopular, because they contravene the pretty little dogma that we all have enough willpower within ourselves to accomplish our goals. Sometimes we need an external kick in the ass. It's time we stop pretending that yelling at people about diet and exercise is going to make a bit of difference. We might as well yell at the sea and tell it to stop rising.
- TeMPOraL 11y ago
  > Of course none of these things is an effective public health measure. (Although there's some evidence that e-cigarettes aren't quite as carcinogenic as regular cigarettes, but might still deliver all of nicotine's benefits.) N=1 sample, not to prove anything but sharing an anecdote: I'm nicotine-taking non-smoker, consuming it in form of nicotine gums. I haven't noticed any effect of it on my weight over the period of last two years. I did respond to ketogenic diet however, but found it hard to maintain over long periods of time - basically it's a big time and cognitive investment to invent new foods that you won't puke on out of a limited set of ingredients. I do think that a lot of diets would work if they were the only thing people have to think about during the day. Alas, the cognitive demands of our fast-moving, competitive world are strong.
- DanBC 11y ago
  Bariatric surgery is linked to increased risk of suicide, so if that's what you call working I guess we're not going to agree. http://www.medscape.com/viewarticle/852616?nlid=89075_2052&src=wnl_edit_medn_psyc&uac=197294HK&spon=12&impID=860596&faf=1 http://www.medscape.com/viewarticle/852616?nlid=89075_2052&s... > Suicide attempts increase substantially in morbidly obese patients in the years following bariatric surgery, when the "honeymoon" period of substantial weight loss comes to an end, new research shows. I agree that death does have a slimming effect. > yelling at people about diet and exercise Nothing in my posts can be seen as advocating for yelling at people. Please don't bring your bickering with other people into your replies to me. What I'm talking about is an "Every Contact Counts"[1] style approach of supporting people to access a modern weight loss programme[2], for free if they can't afford it. This will be "prescribed" by their GP, paid for by Public Health[3] or perhaps their Clinical Commissioning Group. I've accepted that the evidence is not great, but if you want to find what's wrong with the evidence[2] used by NICE I'd be interested to hear it. I haven't said anything in this thread about exercise, but I have said in other threads that exercise does not help weight loss. We should be recommending that people do exercise because it has other undeniable health benefits. [1] http://www.makingeverycontactcount.co.uk/ http://www.makingeverycontactcount.co.uk/ [2] http://www.nice.org.uk/guidance/ph53 http://www.nice.org.uk/guidance/ph53 [3] https://www.gov.uk/government/organisations/public-health-england https://www.gov.uk/government/organisations/public-health-en... England's use of generic names is nice, but feels a bit weird sometimes.

TeMPOraL 11y ago

As Scott Alexander puts it, "society is fixed, biology is mutable"[0]. Dieting is only one of many things in which we're shooting ourselves in the foot as civilization by pushing for social solutions and discarding the technical ones because "willpower" and stuff. A quote from the beginning that captures the gist of the article: "[L]ecture on ADHD suggested several reasons for the increasing prevalence of the disease. Of these I remember two: the spiritual desert of modern adolescence, and insufficient iron in the diet. And I remember thinking “Man, I hope it’s the iron one, because that seems a lot easier to fix.”" The same author also wrote an article about when it's better from a practical standpoint to treat something as a disease instead of a failure of character[1]. [0] - http://slatestarcodex.com/2014/09/10/society-is-fixed-biology-is-mutable/ http://slatestarcodex.com/2014/09/10/society-is-fixed-biolog... [1] - http://lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/ http://lesswrong.com/lw/2as/diseased_thinking_dissolving_que...