4 ms·

The entirety of the comments seem to be either saying "This guy is a genius and is 100% right" or "This guy is talking out of his backside". The scientific con

The entirety of the comments seem to be either saying "This guy is a genius and is 100% right" or "This guy is talking out of his backside". The scientific consensus on weight loss is pretty clear: all forms of diets are similarly effective when you control for calorie intake. Low carb diets work, low fat diet work, intermittent fasting works, plain old fasting works, McDonald's diet and Twinkie diets work. This is nothing new and calorie deficit is always the best predictor regardless of the diet type. He seems to make the argument that high insulin causes fat to accumulate and as such reducing carbohydrate lowers insulin and increases weight loss, but I have yet to see any evidence that a high-calorie keto diet will result in weight loss. The general consensus as to why keto works for some people is that it makes hunger management easier, although AFAIK there is no mechanism that has been clearly identified as being the main responsible, people who succeed on keto report higher levels of satiety after meals, but the same can be said of many other diets for people on which they work. There's a paragraph in there about keto being restrictive and he's basically dismissing the claim with "it feels less restrictive for people who feel less hungry on keto", which, fair enough but I don't think that enough evidence to say "promoting the keto diet will address the obesity problem". There may well be tons of people for whom keto is too restrictive, because they won't feel less hungry after meals. In the end, the best diet is the one you can stick to. For some people that's keto, for most people it's portion control, for others it may be intermittent fasting, for others it may be offsetting their food intake with exercise. In the end, I think it's harmful to promote any specific diet as "the cure to obesity", and it's far better to encourage people to try out different diets rather than giving them the idea that "if this diet won't work, nothing will". Try different things out and see what works for you.

MrRiddle 6y ago
My personal experience is that when I eat carbohydrates I enter “berserk” mode, where my appetite is extremely elevated. It usually ends up with overeating and an insulin crash. While when eating no carbohydrates I don’t get that same feeling and can have more self-control.
watwut 6y ago
> all forms of diets are similarly effective when you control for calorie intake. Low carb diets work, low fat diet work, intermittent fasting works, plain old fasting works, McDonald's diet and Twinkie diets work And none of them creates sustainable long term weight loss. Overwhelming majority of people who loose weight, gain it again. Keeping diets long term means that they feel bad all the time, you are tired etc. And you fail the moment keeping diet is not priority number one. Which leads to search for something that will work long term for majority of people.
- hypertele-Xii 6y ago
  Solution: Eat sensible amounts of good food. How do people struggle with such a basic aspect of human existence? Does food packaging in the US not list ingredients or something?
  - friendlybus 6y ago
    Hard to answer that question any better than we can for alcoholism, workaholics and perpetual cheaters.
  - AnIdiotOnTheNet 6y ago
    Yes, the theory behind weight loss and maintenance is very simple. As with many theories, however, it's the application that's the problem. I've lost and maintained 150lb weight loss until recently, when circumstances and stress has caused me to gain back some portion of that I haven't been keen to measure. I can tell you from significant first hand experience that it is very difficult to override your brain when your brain thinks it needs more food.
  - glogla 6y ago
    Next, poor people just should make more money and spend less. Next, all addicts can just ... stop, except for the opiate addicts who can just ... carefully stop. Next, criminals should just stop doing crimes! Congratulations! You solved all societal problems. ... Sorry for being snarky, but if literally billions people struggle with it, isn't that a sign that this really isn't that simple?
aYsY4dDQ2NrcNzA 6y ago
For me, the keto diet was effective because after I stopped eating carbohydrates I also stopped craving them. This produced a tectonic shift in my eating habits.
selfishgene 6y ago
It's the increase in leptin that drives satiety under keto diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244537/#:~:text=Accordingly%2C%20the%20ketogenic%20diet%20increases,the%20increase%20in%20leptin%20could https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244537/#:~:tex.... Healthy weight is also a lot more complicated than just one hormone. Taubes is not discussing, for example, the difference between healthy and unhealthy obesity and the role that dysfunctional adipogenesis plays in the latter by inducing hypertrophic changes in fat cells (distended fat cells) rather than hyperplasia (create more fat cells). A lot of research has focused on finding agonists for PPARgamma to restore healthy adipogenesis and reduce unhealthy inflammation of fat tissue. Some have been taken off the market for suspected toxicities, but piaglitazone is still widely prescribed.
- selfishgene 6y ago
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539070/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539070/ Why the downvotes?
  - kaba0 6y ago
    I didn’t downvote but perhaps the overtly scientific writing. I had trouble understanding it even though I have some background in medicine.
- Kwantuum 6y ago
  Just wanted to let you know, although it's been a few days, that I genuinely appreciate this reply. I am curious why this got downvoted. It adds context to one of my uncertainties (the exact mechanism for increased satiety under keto) and adds more context as to why obesity is unhealthy in the first place and how the original article is extremely reductive. I don't know of any way to enable notifications for replies to my comments (be it via email or on HN itself) so if anyone knows please let me know!

MrRiddle 6y ago

My personal experience is that when I eat carbohydrates I enter “berserk” mode, where my appetite is extremely elevated. It usually ends up with overeating and an insulin crash. While when eating no carbohydrates I don’t get that same feeling and can have more self-control.

watwut 6y ago

> all forms of diets are similarly effective when you control for calorie intake. Low carb diets work, low fat diet work, intermittent fasting works, plain old fasting works, McDonald's diet and Twinkie diets work And none of them creates sustainable long term weight loss. Overwhelming majority of people who loose weight, gain it again. Keeping diets long term means that they feel bad all the time, you are tired etc. And you fail the moment keeping diet is not priority number one. Which leads to search for something that will work long term for majority of people.

hypertele-Xii 6y ago
Solution: Eat sensible amounts of good food. How do people struggle with such a basic aspect of human existence? Does food packaging in the US not list ingredients or something?
- friendlybus 6y ago
  Hard to answer that question any better than we can for alcoholism, workaholics and perpetual cheaters.
- AnIdiotOnTheNet 6y ago
  Yes, the theory behind weight loss and maintenance is very simple. As with many theories, however, it's the application that's the problem. I've lost and maintained 150lb weight loss until recently, when circumstances and stress has caused me to gain back some portion of that I haven't been keen to measure. I can tell you from significant first hand experience that it is very difficult to override your brain when your brain thinks it needs more food.
- glogla 6y ago
  Next, poor people just should make more money and spend less. Next, all addicts can just ... stop, except for the opiate addicts who can just ... carefully stop. Next, criminals should just stop doing crimes! Congratulations! You solved all societal problems. ... Sorry for being snarky, but if literally billions people struggle with it, isn't that a sign that this really isn't that simple?

aYsY4dDQ2NrcNzA 6y ago

For me, the keto diet was effective because after I stopped eating carbohydrates I also stopped craving them. This produced a tectonic shift in my eating habits.

selfishgene 6y ago

It's the increase in leptin that drives satiety under keto diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244537/#:~:text=Accordingly%2C%20the%20ketogenic%20diet%20increases,the%20increase%20in%20leptin%20could https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244537/#:~:tex.... Healthy weight is also a lot more complicated than just one hormone. Taubes is not discussing, for example, the difference between healthy and unhealthy obesity and the role that dysfunctional adipogenesis plays in the latter by inducing hypertrophic changes in fat cells (distended fat cells) rather than hyperplasia (create more fat cells). A lot of research has focused on finding agonists for PPARgamma to restore healthy adipogenesis and reduce unhealthy inflammation of fat tissue. Some have been taken off the market for suspected toxicities, but piaglitazone is still widely prescribed.

selfishgene 6y ago
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539070/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539070/ Why the downvotes?
- kaba0 6y ago
  I didn’t downvote but perhaps the overtly scientific writing. I had trouble understanding it even though I have some background in medicine.
Kwantuum 6y ago
Just wanted to let you know, although it's been a few days, that I genuinely appreciate this reply. I am curious why this got downvoted. It adds context to one of my uncertainties (the exact mechanism for increased satiety under keto) and adds more context as to why obesity is unhealthy in the first place and how the original article is extremely reductive. I don't know of any way to enable notifications for replies to my comments (be it via email or on HN itself) so if anyone knows please let me know!