4 ms·

Many people on this page appear irritated or angry that obesity might be a topic of complexity and nuance, and that simplistic understanding might be at odds wi

Many people on this page appear irritated or angry that obesity might be a topic of complexity and nuance, and that simplistic understanding might be at odds with reality. There are few HN participants who are stunned to find out that quantum physics is counter-intuitive, or who are amazed that proving 1+1=2 might be worth a volume or two of pure logic, but so many are angrily rebutting the idea that obesity might be more than just caloric intake versus caloric expenditure. This speaks volumes.

josephcsible 5y ago
If this article were right and CICO were wrong, then how is the Twinkie diet able to be effective?
- lkey 5y ago
  Not all CI are stored as fat. Not all CO are burned from fat. Obesity specifically, is about excess fat, not bioavailable calories. Imagine, as the article mentions, a person that has a daily calorie excess of exactly 10kcal per day from a potato chip. CICO with a 100% fat conversion dictates that person will gain 8lbs of pure fat every year. Yet this isn't how it works in practice, so we need a better understanding of fat accumulation and loss if we want to address the crisis. Any sufficiently drastic calorie deficit will result in weight loss, and eventually that loss will get to your fat stores. This is how the Twinkie diets works. Most folks, myself included, would like to just stay at a healthy weight without thinking too much about 100 calories plus or minus their perceived BMR. And for lots of folks that works, but clearly for an increasing majority, the 100kcal are stored as fat immediately, and the small 100kcal deficit doesn't burn the fat that was stored. Death by 1000 cuts. Wouldn't it be interesting to discover why that might be and address it directly?
  - josephcsible 5y ago
    > Imagine, as the article mentions, a person that has a daily calorie excess of exactly 10kcal per day from a potato chip. CICO with a 100% fat conversion dictates that person will gain 8lbs of pure fat every year. No it doesn't. One of the factors that determines your BMR is your weight, so adding any constant amount of calories every day only affects your weight by a constant amount. Eating an extra 10kcal every day might give you 2lbs, total, ever in your life.
    - lkey 5y ago
      I apologize, I didn't divide that number by 9, so it's a bit less than a lb a year, but that was meant to illustrate what you ended up pointing out. BMR is variable. It's why when we talk about deficits and surpluses we are actually doing hand-waving around something critical, on any given day, how do you even know what your BMR/RMR is? Contestants that starved themselves on the biggest loser showed a 500kcal reduction in RMR 6 years later. If they'd just plugged themselves into a calculator and eaten the prescribed allotment daily, they'd be gaining the weight back quite rapidly. And that's exactly what happened to most of them as it turns out.
      - josephcsible 5y ago
        > it's a bit less than a lb a year My whole point was that some amount of weight "a year" isn't how that would work. The only way you keep gaining weight every year is that if every year, you eat more and/or exercise less than you did the prior year. If you eat too much, but the same too much, every year, you'll be overweight, but you won't keep gaining weight every year forever. > Contestants that starved themselves on the biggest loser showed a 500kcal reduction in RMR 6 years later. That makes sense, since they lost a bunch of weight and RMR is tied to weight.
        lkey 5y ago
        You misunderstand me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ After 6 years, 41.0±31.3 kg of the lost weight was regained (p=0.0002) while RMR was 704±427 kcal/d below baseline (p<0.0001) and metabolic adaptation was −499±207 kcal/d (p<0.0001) The lower RMR remained and sometimes continued to drop after they regained the weight. Any normal person cannot assume that their RMR is something they get off of a website calculator, or that it will behave like linearly. Speaking as someone formerly fat, the metabolic adaptation did persist for years after I lost all the weight, putting me around 400 below where I should have been on the chart. It is still quite annoying, though it has lessened.
    - belltaco 5y ago
- monkeydreams 5y ago
  If I answer this by saying - well, it's complex - what does that tell you?
  - josephcsible 5y ago
    Isn't "well, it's complex" a fully general counterargument?
greyivy 5y ago
This exactly. I highly recommend the podcast Maintenance Phase to anyone interested in learning more. They cover a lot of that nuance and the science behind them. Leave your biases at the door and it's eye opening.

josephcsible 5y ago

If this article were right and CICO were wrong, then how is the Twinkie diet able to be effective?

lkey 5y ago
Not all CI are stored as fat. Not all CO are burned from fat. Obesity specifically, is about excess fat, not bioavailable calories. Imagine, as the article mentions, a person that has a daily calorie excess of exactly 10kcal per day from a potato chip. CICO with a 100% fat conversion dictates that person will gain 8lbs of pure fat every year. Yet this isn't how it works in practice, so we need a better understanding of fat accumulation and loss if we want to address the crisis. Any sufficiently drastic calorie deficit will result in weight loss, and eventually that loss will get to your fat stores. This is how the Twinkie diets works. Most folks, myself included, would like to just stay at a healthy weight without thinking too much about 100 calories plus or minus their perceived BMR. And for lots of folks that works, but clearly for an increasing majority, the 100kcal are stored as fat immediately, and the small 100kcal deficit doesn't burn the fat that was stored. Death by 1000 cuts. Wouldn't it be interesting to discover why that might be and address it directly?
- josephcsible 5y ago
  > Imagine, as the article mentions, a person that has a daily calorie excess of exactly 10kcal per day from a potato chip. CICO with a 100% fat conversion dictates that person will gain 8lbs of pure fat every year. No it doesn't. One of the factors that determines your BMR is your weight, so adding any constant amount of calories every day only affects your weight by a constant amount. Eating an extra 10kcal every day might give you 2lbs, total, ever in your life.
  - lkey 5y ago
    I apologize, I didn't divide that number by 9, so it's a bit less than a lb a year, but that was meant to illustrate what you ended up pointing out. BMR is variable. It's why when we talk about deficits and surpluses we are actually doing hand-waving around something critical, on any given day, how do you even know what your BMR/RMR is? Contestants that starved themselves on the biggest loser showed a 500kcal reduction in RMR 6 years later. If they'd just plugged themselves into a calculator and eaten the prescribed allotment daily, they'd be gaining the weight back quite rapidly. And that's exactly what happened to most of them as it turns out.
    - josephcsible 5y ago
      > it's a bit less than a lb a year My whole point was that some amount of weight "a year" isn't how that would work. The only way you keep gaining weight every year is that if every year, you eat more and/or exercise less than you did the prior year. If you eat too much, but the same too much, every year, you'll be overweight, but you won't keep gaining weight every year forever. > Contestants that starved themselves on the biggest loser showed a 500kcal reduction in RMR 6 years later. That makes sense, since they lost a bunch of weight and RMR is tied to weight.
      - lkey 5y ago
        You misunderstand me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ After 6 years, 41.0±31.3 kg of the lost weight was regained (p=0.0002) while RMR was 704±427 kcal/d below baseline (p<0.0001) and metabolic adaptation was −499±207 kcal/d (p<0.0001) The lower RMR remained and sometimes continued to drop after they regained the weight. Any normal person cannot assume that their RMR is something they get off of a website calculator, or that it will behave like linearly. Speaking as someone formerly fat, the metabolic adaptation did persist for years after I lost all the weight, putting me around 400 below where I should have been on the chart. It is still quite annoying, though it has lessened.
  - belltaco 5y ago
monkeydreams 5y ago
If I answer this by saying - well, it's complex - what does that tell you?
- josephcsible 5y ago
  Isn't "well, it's complex" a fully general counterargument?

greyivy 5y ago

This exactly. I highly recommend the podcast Maintenance Phase to anyone interested in learning more. They cover a lot of that nuance and the science behind them. Leave your biases at the door and it's eye opening.