8 ms·

I'm a bit more skeptical of the CIM than I was in the past, but the EBM to me just seems hilariously inadequate to explain the obesity crisis. It's like if a p

I'm a bit more skeptical of the CIM than I was in the past, but the EBM to me just seems hilariously inadequate to explain the obesity crisis. It's like if a patient came to their doctor complaining of water retention, and the doctor said "well clearly you're drinking more than you're excreting" and sent the patient home with instructions to drink less and pee more. My hunch with the CIM is that a human in good health can pretty effortlessly maintain a non-obese weight without much regard for things like macronutrient balance, but that some fairly widespread factor has disrupted that regulation mechanism in a large fraction of the population. That in a sense a keto/low-carb diet is a workaround for a mechanism that's broken in a lot of people, rather than some platonic ideal of how everyone should be eating. As to what broke it, there are some interesting hypotheses here [https://slimemoldtimemold.com https://slimemoldtimemold.com] but no clear answers. I do personally feel a bit better eating a lower glycemic diet (from the standpoint of consistent energy levels), but I haven't achieved any weight loss that way (BMI hovers just under 25).

JoeNr76 5y ago
Nah. EBM does explain the obesity crisis. We're just eating more. The average American consumes more than 3,600 calories daily – a 24% increase from 1961, when the average was just 2,880 calories. And that's just the average.
- briHass 5y ago
  Yes, but why are we eating more? It's not like people in 1961 had more willpower than those in 2021. I think there's some truth to the CIH and palatability. It's pretty hard to argue that food engineering hasn't made super tasty snacks designed to get you hooked. Those same snacks just so happen to mostly be high-carb as well.
  - solarmist 5y ago
    Note: This ignores the factors in the article to keep it simple, those affect many things which contribute to or decrease hunger, satiety, etc. I think it's as simple as the availability and quantity of food in front of us at all times. We're eating just as often as in the past, but portions (of everything) are so much larger and our bodies will eat more if it's available. Satiety is always a lagging indicator to stop eating, so by default we'll over eat if we can. Combine this with food always being available and it doesn't take a genius to figure out where the trend is going to go. This feels even more accurate to me as I've started doing alternative day fasting (because I'm about 50 lbs overweight), but I've been tracking my food intake on days I eat and I'm almost always eating 2500-3500 calories. Stuff adds up quickly. * 500 calories for a bowl of cereal with milk * 1,000 calories for a sandwich from a sandwich shop * 1,000 calories for dinner * 500+ calories from drinks And eating all of that doesn't make me feel stuffed. It's what makes me feel full. Which I know is a good bit more than "just enough" which I've done when I was working out a lot and watching every calorie I ate.
    - dTal 5y ago
      Jesus, all of those quantities are shocking to me. A cup of cereal is under a hundred calories, and a cup of milk less than 200, so a bowl of cereal with milk should run about 2-300 calories. 500 calories is a Big Mac. Are you spooning sugar into it? Cream? What the heck kind of sandwich has 1000 calories? Okay, a fully loaded footlong from Subway maybe, but you seriously have that for lunch? A normal sandwich, such as you might make at home, has 300-500 calories. No 6 inch sub has more than 600 calories. Why is your lunch the same size as your dinner? 1000 calories for dinner is more reasonable, but still - that's a huge dinner. That's like a generously large platter of spaghetti bolognese. I don't know how you could be hungry for that after downing an equivalent meal at lunchtime. 500 calories from drinks is truly horrifying because unless you're chugging milkshakes that's probably all high fructose corn syrup. A quarter of your recommended daily caloric intake, in the form of pure refined sugar! That's an express ticket to diabetes-ville right there. 4+ cans of coke daily is not a healthy intake. I'm not trying to lay into you here. I'm glad you're experimenting with fasting. But, reality check - I would physically struggle to eat that quantity of food without being sick. I wonder if all that soda is messing with your appetite?
      - barefoot 5y ago
        I’ll bite, here are a few relevant observations. I like honey bunches of oats cereal. It’s delicious. The variety I like is also ~200 calories _per cup_. That’s before adding milk of any kind. Add a little bit of milk and tip the box a bit more than usual (I imagine a lot of folks are not very precise when measuring breakfast cereal) and we’re easily sailing over 500 calories. I eat a modest 1700 calorie diet most days and I could easily crush 1,000 calories of this cereal without even feeling full. Likewise for sandwiches. The best rated local sandwich shops near me offer a selection of (very likely) 1,000+ calorie sandwiches. They also do not list calories so my estimates are based on casually deconstructing them and plugging in constituent ingredients into MyFitnessPal ensembles with surprising results. It’s surprising because I’ve proven I can eat more than one without feeling full. It doesn’t take a mad genius in an evil food lab somewhere underground to make food that’s guaranteed to derail a diet. The ingredients are cheap, easy, and abundant everywhere. That’s the problem.
      - 5y ago
  - munk-a 5y ago
    Yea - cramming everything full of sugar to encourage over-consumption might be habit forming even for the individuals that try to minimize consuming those sugar laden goods in their adult life. Maybe a big chunk of folks can naturally avoid this but, honestly, modern life is basically about being bombarded continuously with advertising to over-consume while blaming everyone who falls victim to it - whether it be racking up credit card debt or overeating.
  - baggy_trough 5y ago
    We can afford more enticing food.
  - xg15 5y ago
    > It's pretty hard to argue that food engineering hasn't made super tasty snacks designed to get you hooked. Those same snacks just so happen to mostly be high-carb as well. I mean, this pretty much answers the question. Also, I suspect, more hidden fat and sugar. It would be interesting to track the calories of processed food that you generally wouldn't associate with snacks, such as bread or salad dressings. I could imagine those got a higher sugar amount over the decades. The other side of the equation might also be to blame - less energy output: Today, more areas are optimised for cars, not for walking. We also spend more time in front of a screen - both at work and for leisure.
    - ericb 5y ago
      > I mean, this pretty much answers the question. It really doesn't though. Wild animals and lab rats have been gaining weight.
  - deleted 5y ago
    [deleted]
- kortex 5y ago
  EBM is just begging the question. You gain weight when you have a positive energy balance, and you have a positive energy if you eat more than burn. It's trivially true, otherwise you are violating laws of conservation of energy. Therefore, it has no real explanatory power. Biology is all about homeostasis, cybernetics, and feedback loops. People aren't universally overweight in industrialized countries, therefore it suggests something is messing with those feedback loops. These feedback loops are myriad and complex, ranging from the simple control loop that tries to keep blood sugar in range, to the choices you make based on concepts such as self image.
  - ItsMonkk 5y ago
    One of the shocking things I figured out when researching this that no one ever talks about is just how efficient fat is. If you burn 2000 calories a day and eat 2000 calories a day, you are in a steady state. Won't gain or lose any weight. But if you burn 2000 calories a day and eat 2100 calories a day, you have a 100 calorie gain. This should all be obvious. So you do that a month and a few days, and after a month or so you are up 3500 calories, which is one pound. Now that you are one pound of fat heavier, you now burn an additional couple calories per day. If you continue to eat 2100 calories, you will gain 10 pounds before you reach your equilibrium weight from consuming 2100 calories. Every 10 daily calories is worth 1 pound. Every daily apple is worth 10 pounds long-term. The 720 calorie average above is worth 72 pounds of fat. And that's even before we consider if now that you burn more calories, you will start eating more calories to keep the same offset?
  - edanm 5y ago
    > EBM is just begging the question. You gain weight when you have a positive energy balance, and you have a positive energy if you eat more than burn. It's trivially true, otherwise you are violating laws of conservation of energy. Therefore, it has no real explanatory power. That's not true. You can see it's not true by the fact that so many people do in fact dispute consequences of this claim, despite it both being trivially true and proven multiple times in studies with actual humans. If you eat at a calaoric defict, no matter what you are eating, you will lose weight. That is both undeniable and widely denied, and has lots of explanatory power, because at the end of the day, a correct question to ask about the world is "why are people eating more calories?". There are certainly other factors which matter, depending on why you are asking the question: if it's for personal weight loss reasons, a good question to ask is "what kind of diet will allow me to eat less calories in the easiest way". If it's to explain the obesity epidemic, the answers are "why are people in general consuming more calories now than they were in the past". But if you discard the base mechanism by which people are gaining weight, you don't even know what questions to ask.
- deleted 5y ago
  [deleted]
- solarmist 5y ago
  I'd say it's a necessary explanation, but not sufficient.
- inglor_cz 5y ago
  N == 1, but when I eat in certain way (lots of veg + fruit, reduce white bread and pastry, no caloric drinks), my body stays the same weight, as measured by clothing size, without any further conscious effort. I suspect that this is the way how our ancestors in the 1950s-1970s stayed slim (at least compared to us) without calorie counting or even knowing what calories were, even though they held white collar jobs too. Body tries to find an in/out equilibrium, and ultra processed foods disrupt this process. Take any photo of an engineering or academic team from that period and compare it to a photo of people doing similar jobs today. A massive difference in size, though the job's physical demands aren't that different.
- BizarroLand 5y ago
  Why are we eating more though? Normally you would expect what, maybe people get pudgy when they live in a realm of excess availability and little exertion, but the percentage of 300+ lb people rising so dramatically in the last 30 years isn't so simply explained. I would suspect multiple things at play, some combination of processed food, food scientists tweaking flavors so that we don't burn out on eating foods, increased carbohydrate and calorie density, PFAs and endocrine disruptors in the food and water, plastic gloves leaking human analogue hormones into fast food fry grease or some currently unidentified hidden factor is a play here. Somehow these things the combination has to be shorting out the satiation signal so that people don't stop eating when they have enough. Trying to listen to your body when your body is being lied to. It's not as simple as people eat too much. Something is creating the hole that they are trying to fill.
edanm 5y ago
> It's like if a patient came to their doctor complaining of water retention, and the doctor said "well clearly you're drinking more than you're excreting" and sent the patient home with instructions to drink less and pee more. I agree that if that were the only thing the doctor said, they would be a pretty terrible doctor. What would happen in the real world is that the doctor would try to diagnose why the person is drinking more than they're excreting, and help stop that from happening, whether it's a psychological reason, an illness, or some other reason. What the doctor for sure needs to have, though, is a base understanding that if someone is complaining of water retention, the underlying thing that is happening really is that they're drinking more than they're excreting. That's the basis of the diagnosis process. "You drink, then you excrete liquids, and if there's a misbalance there you have a problem" - if the doctor denies that, it's impossible to diagnose anything. > but the EBM to me just seems hilariously inadequate to explain the obesity crisis. I'd just like to point out that people usually talk about diet/nutrition in two contexts. One is the context of "how should I personally eat to lose weight" (or gain weight, but losing is more common). The other context is "how do we explain the society-wide obesity epidemic. Those are very different questions. They both need to start by taking the EBM seriously, since it's completely proven science (both on a theoretical and on a practical level). But I completely agree with you that the model by itself doesn't explain the obesity epidemic. It doesn't even try to, really - it just says that we know for sure people are eating more calories now, and therefore they are becoming obese. Why they are eating more calories is a separate mystery (though, in my mind, it's not very mysterious - far larger access to far more calorically-dense but nutritionally-poor foods).
- cortesoft 5y ago
  > though, in my mind, it's not very mysterious - far larger access to far more calorically-dense but nutritionally-poor foods This doesn’t seem so obvious to me… it seems reasonable to me that any abundance of calorically-dense food would lead to obesity. I don’t think it is obvious without study that the food being nutritionally poor is a requirement for widespread obesity.
  - yetihehe 5y ago
    Body needs more nutrients, so it eats more of food. But to give you enough nutrients, you must now consume too much calories. Hence, obesity crisis.
tharkun__ 5y ago
a keto/low-carb diet is a workaround for a mechanism that's broken in a lot of people I think you're onto something from my own experience. I don't think you are entirely correct though. It's not a workaround as much as cure. This might just be anecdotal evidence but my body was definitely broken. My gut was b0rked and I was in a cycle of eating more and more carb-y food to not feel hungry/cravy/fatigued all the time. What getting on the right probiotics and doing keto did for me was what I think is to restore the natural state human bodies should be in again. I finally am able to feel "full" again and eat when I'm actually hungry vs. just eating three meals a day (plus 'cravings'). Now I don't subscribe to any religion but I do think that any religion that includes a "fast" does right is to basically do something akin to keto. I don't believe in any of the religious aspects of fasting but I do recognize that the easiest way to get a large populace to stay healthy is to subscribe them to a religion and then let the religion dictate things that keep them healthy and happy. E.g. I don't eat breakfast any longer. I just don't need it. I don't feel hungry in the morning any longer. I oftentimes don't even feel hungry at lunch any longer and only do so around maybe 2pm. Not being bound to traditional meals and customs around eating helped me with this. I just go scour the fridge at 2pm to find some cheese and eat some almonds. Maybe some peanut M&Ms (at the office - at home it'd be say raspberries with cream). I can totally recommend peanut M&Ms with cheese actually! Awesome combination! As you can see in my comment history some people have asked before after comments like this one from me. What I did was try a lot of different probiotics but what I think helped in the end is Garden Of Life - Primal Defense. You don't have to use that brand but what I think did it is the Bacillus Subtilis included in it, which wasn't part of any of the other probiotics I tried. I'm sure there are others that have that one. I started off with 1 a day, then 2 a day, then 3 a day and I felt like crap for a few weeks. Then it all went away and I felt awesome. I'm still on those to make sure I maintain a healthy gut flora but I'm down to one in the morning and one in the evening and I also made Sauerkraut from it (i.e. empty a capsule into your Cabbage and let it ferment).
- sinsterizme 5y ago
  I’ve recently learned how important a health gut flora is. I took a course of antibiotics and had a month of severe depression, anxiety, constipation and general sense of hopelessness. It was fucking awful. I’ve completely cut out sugar and processed foods and refined carbs. I’m starting to feel genuinely good. That month was the scariest period of my life. The experience has also shown me how ignorant we still are in terms of nutrition and medicine. My surgeon basically gaslit me, and handed me 5 different prescriptions. Hopefully we get to a place where nutrition is taking seriously, and we get proper tools to evaluate our body’s health
Rd6n6 5y ago
> The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqab270/6369073?login=true https://academic.oup.com/ajcn/advance-article/doi/10.1093/aj... Compare this to the article > A landmark paper proves that obesity is not just energy in and out; the type of food matters. The paper does not say what the article claims. The paper is about proposing a credible alternative model of weight gain and is a call for further research. This article, like most science journalism, is fake news and we need to stop sharing “stories” like this
- throwawayapples 5y ago
  I wish you'd posted this as a top-level comment, so that you could become the highest-ranked comment!
  - Rd6n6 5y ago
    Didn’t think anybody would see it since there were so many pre-existing comments
sleepysysadmin 5y ago
>My hunch with the CIM is that a human in good health can pretty effortlessly maintain a non-obese weight without much regard for things like macronutrient balance, but that some fairly widespread factor has disrupted that regulation mechanism in a large fraction of the population. In the USA, Percent of adults aged 20 and over with overweight, including obesity: 73.6% (2017-2018) >That in a sense a keto/low-carb diet is a workaround for a mechanism that's broken in a lot of people, rather than some platonic ideal of how everyone should be eating. This was studied several times now and they haven't discovered it. Some people assert GI microbiome is broken and there has been success there. Others are asserting that it's glysophate somehow interrupting, that keto avoids the larger concentrations of glysophates in our food. The one that seems simplest is that 100 years ago we didnt eat carbs unless you were poor. For thousands of years we ate game meats. About 75 years ago the governments of the world were fooled by political activists and they started an experiment on us. I have 73.6 reasons that experiment failed.

JoeNr76 5y ago

Nah. EBM does explain the obesity crisis. We're just eating more. The average American consumes more than 3,600 calories daily – a 24% increase from 1961, when the average was just 2,880 calories. And that's just the average.

briHass 5y ago
Yes, but why are we eating more? It's not like people in 1961 had more willpower than those in 2021. I think there's some truth to the CIH and palatability. It's pretty hard to argue that food engineering hasn't made super tasty snacks designed to get you hooked. Those same snacks just so happen to mostly be high-carb as well.
- solarmist 5y ago
  Note: This ignores the factors in the article to keep it simple, those affect many things which contribute to or decrease hunger, satiety, etc. I think it's as simple as the availability and quantity of food in front of us at all times. We're eating just as often as in the past, but portions (of everything) are so much larger and our bodies will eat more if it's available. Satiety is always a lagging indicator to stop eating, so by default we'll over eat if we can. Combine this with food always being available and it doesn't take a genius to figure out where the trend is going to go. This feels even more accurate to me as I've started doing alternative day fasting (because I'm about 50 lbs overweight), but I've been tracking my food intake on days I eat and I'm almost always eating 2500-3500 calories. Stuff adds up quickly. * 500 calories for a bowl of cereal with milk * 1,000 calories for a sandwich from a sandwich shop * 1,000 calories for dinner * 500+ calories from drinks And eating all of that doesn't make me feel stuffed. It's what makes me feel full. Which I know is a good bit more than "just enough" which I've done when I was working out a lot and watching every calorie I ate.
  - dTal 5y ago
    Jesus, all of those quantities are shocking to me. A cup of cereal is under a hundred calories, and a cup of milk less than 200, so a bowl of cereal with milk should run about 2-300 calories. 500 calories is a Big Mac. Are you spooning sugar into it? Cream? What the heck kind of sandwich has 1000 calories? Okay, a fully loaded footlong from Subway maybe, but you seriously have that for lunch? A normal sandwich, such as you might make at home, has 300-500 calories. No 6 inch sub has more than 600 calories. Why is your lunch the same size as your dinner? 1000 calories for dinner is more reasonable, but still - that's a huge dinner. That's like a generously large platter of spaghetti bolognese. I don't know how you could be hungry for that after downing an equivalent meal at lunchtime. 500 calories from drinks is truly horrifying because unless you're chugging milkshakes that's probably all high fructose corn syrup. A quarter of your recommended daily caloric intake, in the form of pure refined sugar! That's an express ticket to diabetes-ville right there. 4+ cans of coke daily is not a healthy intake. I'm not trying to lay into you here. I'm glad you're experimenting with fasting. But, reality check - I would physically struggle to eat that quantity of food without being sick. I wonder if all that soda is messing with your appetite?
    - barefoot 5y ago
      I’ll bite, here are a few relevant observations. I like honey bunches of oats cereal. It’s delicious. The variety I like is also ~200 calories _per cup_. That’s before adding milk of any kind. Add a little bit of milk and tip the box a bit more than usual (I imagine a lot of folks are not very precise when measuring breakfast cereal) and we’re easily sailing over 500 calories. I eat a modest 1700 calorie diet most days and I could easily crush 1,000 calories of this cereal without even feeling full. Likewise for sandwiches. The best rated local sandwich shops near me offer a selection of (very likely) 1,000+ calorie sandwiches. They also do not list calories so my estimates are based on casually deconstructing them and plugging in constituent ingredients into MyFitnessPal ensembles with surprising results. It’s surprising because I’ve proven I can eat more than one without feeling full. It doesn’t take a mad genius in an evil food lab somewhere underground to make food that’s guaranteed to derail a diet. The ingredients are cheap, easy, and abundant everywhere. That’s the problem.
    - 5y ago
- munk-a 5y ago
  Yea - cramming everything full of sugar to encourage over-consumption might be habit forming even for the individuals that try to minimize consuming those sugar laden goods in their adult life. Maybe a big chunk of folks can naturally avoid this but, honestly, modern life is basically about being bombarded continuously with advertising to over-consume while blaming everyone who falls victim to it - whether it be racking up credit card debt or overeating.
- baggy_trough 5y ago
  We can afford more enticing food.
- xg15 5y ago
  > It's pretty hard to argue that food engineering hasn't made super tasty snacks designed to get you hooked. Those same snacks just so happen to mostly be high-carb as well. I mean, this pretty much answers the question. Also, I suspect, more hidden fat and sugar. It would be interesting to track the calories of processed food that you generally wouldn't associate with snacks, such as bread or salad dressings. I could imagine those got a higher sugar amount over the decades. The other side of the equation might also be to blame - less energy output: Today, more areas are optimised for cars, not for walking. We also spend more time in front of a screen - both at work and for leisure.
  - ericb 5y ago
    > I mean, this pretty much answers the question. It really doesn't though. Wild animals and lab rats have been gaining weight.
- deleted 5y ago
  [deleted]
kortex 5y ago
EBM is just begging the question. You gain weight when you have a positive energy balance, and you have a positive energy if you eat more than burn. It's trivially true, otherwise you are violating laws of conservation of energy. Therefore, it has no real explanatory power. Biology is all about homeostasis, cybernetics, and feedback loops. People aren't universally overweight in industrialized countries, therefore it suggests something is messing with those feedback loops. These feedback loops are myriad and complex, ranging from the simple control loop that tries to keep blood sugar in range, to the choices you make based on concepts such as self image.
- ItsMonkk 5y ago
  One of the shocking things I figured out when researching this that no one ever talks about is just how efficient fat is. If you burn 2000 calories a day and eat 2000 calories a day, you are in a steady state. Won't gain or lose any weight. But if you burn 2000 calories a day and eat 2100 calories a day, you have a 100 calorie gain. This should all be obvious. So you do that a month and a few days, and after a month or so you are up 3500 calories, which is one pound. Now that you are one pound of fat heavier, you now burn an additional couple calories per day. If you continue to eat 2100 calories, you will gain 10 pounds before you reach your equilibrium weight from consuming 2100 calories. Every 10 daily calories is worth 1 pound. Every daily apple is worth 10 pounds long-term. The 720 calorie average above is worth 72 pounds of fat. And that's even before we consider if now that you burn more calories, you will start eating more calories to keep the same offset?
- edanm 5y ago
  > EBM is just begging the question. You gain weight when you have a positive energy balance, and you have a positive energy if you eat more than burn. It's trivially true, otherwise you are violating laws of conservation of energy. Therefore, it has no real explanatory power. That's not true. You can see it's not true by the fact that so many people do in fact dispute consequences of this claim, despite it both being trivially true and proven multiple times in studies with actual humans. If you eat at a calaoric defict, no matter what you are eating, you will lose weight. That is both undeniable and widely denied, and has lots of explanatory power, because at the end of the day, a correct question to ask about the world is "why are people eating more calories?". There are certainly other factors which matter, depending on why you are asking the question: if it's for personal weight loss reasons, a good question to ask is "what kind of diet will allow me to eat less calories in the easiest way". If it's to explain the obesity epidemic, the answers are "why are people in general consuming more calories now than they were in the past". But if you discard the base mechanism by which people are gaining weight, you don't even know what questions to ask.
deleted 5y ago
[deleted]
solarmist 5y ago
I'd say it's a necessary explanation, but not sufficient.
inglor_cz 5y ago
N == 1, but when I eat in certain way (lots of veg + fruit, reduce white bread and pastry, no caloric drinks), my body stays the same weight, as measured by clothing size, without any further conscious effort. I suspect that this is the way how our ancestors in the 1950s-1970s stayed slim (at least compared to us) without calorie counting or even knowing what calories were, even though they held white collar jobs too. Body tries to find an in/out equilibrium, and ultra processed foods disrupt this process. Take any photo of an engineering or academic team from that period and compare it to a photo of people doing similar jobs today. A massive difference in size, though the job's physical demands aren't that different.
BizarroLand 5y ago
Why are we eating more though? Normally you would expect what, maybe people get pudgy when they live in a realm of excess availability and little exertion, but the percentage of 300+ lb people rising so dramatically in the last 30 years isn't so simply explained. I would suspect multiple things at play, some combination of processed food, food scientists tweaking flavors so that we don't burn out on eating foods, increased carbohydrate and calorie density, PFAs and endocrine disruptors in the food and water, plastic gloves leaking human analogue hormones into fast food fry grease or some currently unidentified hidden factor is a play here. Somehow these things the combination has to be shorting out the satiation signal so that people don't stop eating when they have enough. Trying to listen to your body when your body is being lied to. It's not as simple as people eat too much. Something is creating the hole that they are trying to fill.

edanm 5y ago

> It's like if a patient came to their doctor complaining of water retention, and the doctor said "well clearly you're drinking more than you're excreting" and sent the patient home with instructions to drink less and pee more. I agree that if that were the only thing the doctor said, they would be a pretty terrible doctor. What would happen in the real world is that the doctor would try to diagnose why the person is drinking more than they're excreting, and help stop that from happening, whether it's a psychological reason, an illness, or some other reason. What the doctor for sure needs to have, though, is a base understanding that if someone is complaining of water retention, the underlying thing that is happening really is that they're drinking more than they're excreting. That's the basis of the diagnosis process. "You drink, then you excrete liquids, and if there's a misbalance there you have a problem" - if the doctor denies that, it's impossible to diagnose anything. > but the EBM to me just seems hilariously inadequate to explain the obesity crisis. I'd just like to point out that people usually talk about diet/nutrition in two contexts. One is the context of "how should I personally eat to lose weight" (or gain weight, but losing is more common). The other context is "how do we explain the society-wide obesity epidemic. Those are very different questions. They both need to start by taking the EBM seriously, since it's completely proven science (both on a theoretical and on a practical level). But I completely agree with you that the model by itself doesn't explain the obesity epidemic. It doesn't even try to, really - it just says that we know for sure people are eating more calories now, and therefore they are becoming obese. Why they are eating more calories is a separate mystery (though, in my mind, it's not very mysterious - far larger access to far more calorically-dense but nutritionally-poor foods).

cortesoft 5y ago
> though, in my mind, it's not very mysterious - far larger access to far more calorically-dense but nutritionally-poor foods This doesn’t seem so obvious to me… it seems reasonable to me that any abundance of calorically-dense food would lead to obesity. I don’t think it is obvious without study that the food being nutritionally poor is a requirement for widespread obesity.
- yetihehe 5y ago
  Body needs more nutrients, so it eats more of food. But to give you enough nutrients, you must now consume too much calories. Hence, obesity crisis.

tharkun__ 5y ago

a keto/low-carb diet is a workaround for a mechanism that's broken in a lot of people I think you're onto something from my own experience. I don't think you are entirely correct though. It's not a workaround as much as cure. This might just be anecdotal evidence but my body was definitely broken. My gut was b0rked and I was in a cycle of eating more and more carb-y food to not feel hungry/cravy/fatigued all the time. What getting on the right probiotics and doing keto did for me was what I think is to restore the natural state human bodies should be in again. I finally am able to feel "full" again and eat when I'm actually hungry vs. just eating three meals a day (plus 'cravings'). Now I don't subscribe to any religion but I do think that any religion that includes a "fast" does right is to basically do something akin to keto. I don't believe in any of the religious aspects of fasting but I do recognize that the easiest way to get a large populace to stay healthy is to subscribe them to a religion and then let the religion dictate things that keep them healthy and happy. E.g. I don't eat breakfast any longer. I just don't need it. I don't feel hungry in the morning any longer. I oftentimes don't even feel hungry at lunch any longer and only do so around maybe 2pm. Not being bound to traditional meals and customs around eating helped me with this. I just go scour the fridge at 2pm to find some cheese and eat some almonds. Maybe some peanut M&Ms (at the office - at home it'd be say raspberries with cream). I can totally recommend peanut M&Ms with cheese actually! Awesome combination! As you can see in my comment history some people have asked before after comments like this one from me. What I did was try a lot of different probiotics but what I think helped in the end is Garden Of Life - Primal Defense. You don't have to use that brand but what I think did it is the Bacillus Subtilis included in it, which wasn't part of any of the other probiotics I tried. I'm sure there are others that have that one. I started off with 1 a day, then 2 a day, then 3 a day and I felt like crap for a few weeks. Then it all went away and I felt awesome. I'm still on those to make sure I maintain a healthy gut flora but I'm down to one in the morning and one in the evening and I also made Sauerkraut from it (i.e. empty a capsule into your Cabbage and let it ferment).

sinsterizme 5y ago
I’ve recently learned how important a health gut flora is. I took a course of antibiotics and had a month of severe depression, anxiety, constipation and general sense of hopelessness. It was fucking awful. I’ve completely cut out sugar and processed foods and refined carbs. I’m starting to feel genuinely good. That month was the scariest period of my life. The experience has also shown me how ignorant we still are in terms of nutrition and medicine. My surgeon basically gaslit me, and handed me 5 different prescriptions. Hopefully we get to a place where nutrition is taking seriously, and we get proper tools to evaluate our body’s health

Rd6n6 5y ago

> The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqab270/6369073?login=true https://academic.oup.com/ajcn/advance-article/doi/10.1093/aj... Compare this to the article > A landmark paper proves that obesity is not just energy in and out; the type of food matters. The paper does not say what the article claims. The paper is about proposing a credible alternative model of weight gain and is a call for further research. This article, like most science journalism, is fake news and we need to stop sharing “stories” like this

throwawayapples 5y ago
I wish you'd posted this as a top-level comment, so that you could become the highest-ranked comment!
- Rd6n6 5y ago
  Didn’t think anybody would see it since there were so many pre-existing comments

sleepysysadmin 5y ago

>My hunch with the CIM is that a human in good health can pretty effortlessly maintain a non-obese weight without much regard for things like macronutrient balance, but that some fairly widespread factor has disrupted that regulation mechanism in a large fraction of the population. In the USA, Percent of adults aged 20 and over with overweight, including obesity: 73.6% (2017-2018) >That in a sense a keto/low-carb diet is a workaround for a mechanism that's broken in a lot of people, rather than some platonic ideal of how everyone should be eating. This was studied several times now and they haven't discovered it. Some people assert GI microbiome is broken and there has been success there. Others are asserting that it's glysophate somehow interrupting, that keto avoids the larger concentrations of glysophates in our food. The one that seems simplest is that 100 years ago we didnt eat carbs unless you were poor. For thousands of years we ate game meats. About 75 years ago the governments of the world were fooled by political activists and they started an experiment on us. I have 73.6 reasons that experiment failed.