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I've been hitting the gym for a few months now, and one thing that completely blew my mind was the existence of hypercalorics. Imagine that, not being able to e

I've been hitting the gym for a few months now, and one thing that completely blew my mind was the existence of hypercalorics. Imagine that, not being able to eat a lot (specially carbs) and having to resort to these solutions. Point being, people like to spew out CICO as if fat people just don't understand thermodynamics. What I've found is that matters is appetite: some people just get full way faster than others. Beyond metabolism differences, NEAT, emotional responses, etc, I think that's actually the major factor. So a hormone like that can be game-changing

bugfix-66 4y ago
We have an old, safe, cheap drug for humans already: Metformin. Most people can get an off-label metformin prescription for anti-aging or appetite suppression. Your interest in food will be reduced to the point you have trouble keeping weight on. Sugar will be repulsive to you. Sweet food tastes "sickly sweet", nauseating. Metformin also interferes with the absorption of carbohydrates in your gut.
- drowsspa 4y ago
  I once heard about one drug that basically works by making you nauseous to food. Is it the one? > Metformin is generally safe, but common side effects do include vomiting, nausea, and diarrhea. Those experiencing these unpleasant side effects might consume less food, resulting in modest weight reductions.
  - bugfix-66 4y ago
    Many foods you used to like (e.g., sweets) will be nauseating. Other foods remain delicious. For example, eggs and cheese and meat. But basically, your interest in food will be drastically reduced, and you will eat just enough. This is an important part of metformin's beneficial effect on lifespan and health.
    - TylerE 4y ago
      Admittedly, I’m on a fairly low dose (500mg x 2), but I can still kill a bag of Haribo when the mood hits. It doesn’t , quite as often, but I’ve noticed no changes in flavor.
      - bugfix-66 4y ago
        Thanks for the anecdote. Biological variation, we're all different!
    - dwaite 4y ago
      Can you point to any studies around this? I've never heard of this effect (let alone experienced it). I do know that Diabetes itself can reduce the efficiency of taste receptors, and metformin will sometimes cause people to have a metallic taste in their mouth (due to metformin in produced saliva)
      - bugfix-66 4y ago
        It's easy to find studies connecting metformin to weight loss and loss of appetite. I'll leave that to you, just use Google and you'll be swamped with evidence. You say you've never heard of metformin affecting food palatability and taste? Did you search the web at all? Just use Google if you want anecdotal examples. For example: https://forum.diabetes.org.uk/boards/threads/loss-of-appetite-on-metformin.97468/ https://forum.diabetes.org.uk/boards/threads/loss-of-appetit... I joined as after 18 months on metformin, my appetite and enjoyment of food is constantly declining. I’ve lost about 10 kg over that time, which is not a problem. But I’ve lost my appetite and, as a keen cook and someone who has always enjoyed good food, I no longer look forward to meals and get little pleasure from food. or https://www.diabetes.co.uk/forum/threads/anyone-experience-loss-of-appetite-with-metformin.86526/ https://www.diabetes.co.uk/forum/threads/anyone-experience-l... Metformin changed the taste of food slowly during the time I took it. It finally got to the point where all vegetables tasted like burnt plastic. This meant that I didn't want to eat them. And so on. Now you've heard of it! All it took was a web search.
  - empiricus 4y ago
    You should not feel anything when you take Metformin. Its effects are subtle and very long term.
- CharlesW 4y ago
  > Most people can get an off-label metformin prescription for anti-aging. Dumb question: How? I'm reasonably certain my GP would not be amenable to being asked to prescribe drugs for off-label use.
  - gruez 4y ago
    Off label use is fine. I'd be more worried about the fact that a patient is bring it up out of the blue (ie. "give me drugs plz"), and the evidence for life extension is shaky >There is some evidence metformin may be helpful in extending lifespan, even in otherwise healthy people. It has received substantial interest as an agent that delays aging, possibly through similar mechanisms as its treatment of diabetes (insulin and carbohydrate regulation). This is controversial, and an area of active research.[61][62]
  - bugfix-66 4y ago
    Just ask your doctor for it. Say: "Please prescribe me Metformin, 2 grams daily." If you're overweight, tell your doctor you want help with your appetite. Otherwise, say you want metformin for its cancer prevention and anti-aging effects. Metformin is safe and it almost universally improves health and well-being. Your doctor knows this, and she'll gladly prescribe it.
    - dylan604 4y ago
      > Your doctor knows this, and she'll gladly prescribe it. If your doctor gladly prescribes anything you just walk in and ask for by name and dosage and doesn't have a green cross symbol outside their office, then I'd highly suggest seeking out a new doctor.
      - bugfix-66 4y ago
        We're talking about a particular drug here (metformin) not just "anything". I'm saying it's likely your doctor will be willing to prescribe METFORMIN (that drug, in particular) for off-label use if you ask.
- anaisbetts 4y ago
  A more appropriate drug for this is probably Ozempic/Wegovy (Semaglutide), or an even more effective version available in the US, Tirzepatide. I've personally been on the former and after 4.5 months, I've lost ~20% of my body weight
  - bugfix-66 4y ago
    Metformin is well-understood, old, safe, and has various health benefits. Surprisingly, metformin seems to be almost a pure win, even for healthy people: https://www.health.harvard.edu/blog/is-metformin-a-wonder-drug-202109222605 https://www.health.harvard.edu/blog/is-metformin-a-wonder-dr... In contrast, GIP analogues like semaglutaide present real risks and are less well understood. For some people, with serious health problems, GIP analogues make sense. But generally you don't want to be taking them if you're healthy.
  - bilsbie 4y ago
    Aren’t those hard to get and then super expensive if you do quality?
    - anaisbetts 4y ago
      No idea, in the EU I pay ~85 EUR/mo
- DontchaKnowit 4y ago
  Yeah tell that to my stress eating family members who all have metformin prescriptions. This may be true for some people but definitely not a universal
  - bugfix-66 4y ago
    Here's a question to consider: How much worse would the situation be if they weren't on metformin?
- tacitusarc 4y ago
  > Because the vast majority of research regarding metformin included only people with diabetes or prediabetes, it’s unclear whether these potential benefits are limited to people with those conditions, or whether people without diabetes may derive benefit as well. https://www.health.harvard.edu/blog/is-metformin-a-wonder-drug-202109222605 https://www.health.harvard.edu/blog/is-metformin-a-wonder-dr...
- smhoff256 4y ago
  I think those kinds of blanket statements about metformin are a little misleading and a bit dangerous. For instance I myself have been on metformin now for almost 2 years and I can assure you I have no repulsion to sugar.
  - bugfix-66 4y ago
    Yes, I see three responses along these lines, already. Some people don't lose weight. Some people's appetite isn't affected. Some people retain their taste for sweets. And so on. But "misleading and a bit dangerous"? Really? Readers can find a summary of metformin's typical effects on Wikipedia, here: https://en.m.wikipedia.org/wiki/Metformin https://en.m.wikipedia.org/wiki/Metformin YMMV: "your mileage may vary"
- bitwize 4y ago
  So Metformin basically reduces to fasting which, as Hackernews knows, is the cure for everything.
dabbledash 4y ago
Appetite differences are almost certainly the primary factor in why some people get heavy and others don't, but that isn't inconsistent with CICO at all.
- adrian_b 4y ago
  In my opinion, the differences in appetite are caused mostly by the differences in the type of food eaten, and not by the differences between humans. In my search for a diet that would allow me to avoid gaining weight, the main successes were achieved by replacing various kinds of food that were tasty, but which did not satiate me before eating huge amounts of them, with other kinds of food that are also tasty, but which satiate me after eating a moderate amount of them.
  - antiterra 4y ago
    I have known plenty of people who ate very small amounts of garbage food (eg only candy & hot pockets) and didn’t gain weight. Some instances this seemed due to an incredibly fast metabolism, others were due to GERD/IBS or some other factor that limits the craving. The differences are real, even if it’s just something like gut biome.
  - drowsspa 4y ago
    But that right there is a difference between you and other humans. The idea of "searching for a diet that allows you to gain weight" is absolutely alien to me. I can easily get to 5000 calories a day without even thinking about it, while you have to make a conscious effort to reach (I assume) much less than that. My sister and I grew up with the same diet. We didn't starve, but neither of us had lots of access to junk food. Yet she could be hungry once she got home and after half a plate to be already satiated. Today she has tons of junk food in her house yet she doesn't feel the compulsion to eat more than a few bytes. I'm down to 71 kg from 83 kg back in June, but I still can't have a single cookie package in my house.
    - adrian_b 4y ago
      I think that you have misread my comment. I have said "a diet to avoid gaining weight", not "a diet that allows gaining weight". If I eat more than 1900 ... 2000 kcal per day, I gain weight rapidly, so the problem was reducing the amount of energy intake so much, while ensuring an adequate daily intake of proteins and of any other essential nutrients, and without feeling that I am starving. I agree that there are differences between people and there are also differences for a single human depending on circumstances, e.g. in many cases when you are ill you lose your appetite. Nevertheless, for the same human, different foods containing the same amount of energy can behave extremely differently from the point of view of causing satiety, both immediately after the meal and some hours later. For remaining satiated many hours after the meal, at equal energy content food with higher content of proteins and/or fat and/or fiber is more effective. For being satiated immediately after the meal, at equal nutrient composition food that is more consistent and requires prolonged chewing causes satiety much faster than soft food such as creams, mashed potatoes, ground meat and the like.
huntertwo 4y ago
Hormones, appetite, metabolic diseases are all orthogonal to CICO. These can have an effect on how many calories you burn or how many calories you crave but at the end of the day, CICO is still law.
- klyrs 4y ago
  > CICO is still law. Calories are a measure chemical energy, not mass. Our digestive systems don't get anywhere near e=mc^2 in their efficiency. The conservation law is MIMO; calories are way more complicated. For example, people who extol CICO rarely take into account the fact that poop has a variable amount of chemical energy, which depends on a huge variety of factors including gut flora, hydration and fiber intake, or that most of our mass output is actually exhaled CO2.
  - AnIdiotOnTheNet 4y ago
    And yet Mark Haub[0] ate a diet of Twinkies (and other convenience store garbage food) to a caloric deficit and lost 27lbs in 10 weeks while all of his health metrics improved. Trying to be super precise about calories may be complicated, but nobody has to do that to reach a caloric deficit anyway so who cares. Eat less than you need by any reasonable ball park metric and you will lose weight, it's that simple. The hard part is that for some reason a large percentage of the population can't regulate their intake naturally because what they require for calories to be a healthy weight is misaligned with what they are compelled to consume. [0] http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/...
    - klyrs 4y ago
      Sure, let's agree that CICO is a decent rule of thumb, not a law. That's a fun anecdote, though.
  - huntertwo 4y ago
    https://en.m.wikipedia.org/wiki/Laws_of_thermodynamics https://en.m.wikipedia.org/wiki/Laws_of_thermodynamics > The laws of thermodynamics define a group of physical quantities, such as temperature, energy, and entropy, that characterize thermodynamic systems in thermodynamic equilibrium. If you eat 2000 calories of food and burn 2000 calories (taking into account inefficiencies in the metabolic processes our bodies undertake to convert molecules to other molecules), there is no source of energy for you to accumulate fat, regardless of anything else. Your metabolic rate and the chemical energy of your excrement and the amount of co2 you exhale can be affected by a myriad of factors, hormonal included. But they just change the CO part of the equation, not the fact that CICO is law.
sigg3 4y ago
> What I've found is that matters is appetite: some people just get full way faster than others. This is a half truth. If you cut down portion size your stomach will shrink over time. I eat a lot less before feeling full now, and I only changed my life a year ago. It's also important that you eat stuff that makes you feel full, fibers and greens. Changing diet also changed my taste, so I crave more healthy things now, while the food I used to eat honestly don't appeal to me any longer or tastes empty. OTOH if you push yourself to eat a little more every meal, your stomach will grown, accommodating room for more before you feel full.
- adrian_b 4y ago
  For increased satiety, even when eating little, an additional factor is that the food should not be too soft, like most of the industrially made food is, but it should need some time of vigorous chewing. There are many vegetables, fruits and nuts that require a decent amount of chewing. There are also some kinds of home-made bread that require much more chewing than the industrial soft bread, while also being much tastier than the commercial bread (when eaten immediately after baking; the commercial bread is optimized for long shelf life).
  - bollu 4y ago
    Got any chewey bread recipes?
    - ljf 4y ago
      My homemade sour dough is always chewy and tough, but I love it! [ ] Thursday [ ] 8am - if starter hasn't been used for 4 weeks or more; feed starter 30g flour and 30g of water [ ] Thursday evening weigh out flour and salt as below into two bowls, and cover. Get water jug, yeast and teaspoon ready. Keep starter in the fridge until needed [ ] Friday: [ ] 1. (8am) Mix 100g of Starter, 200g white flour, 50g wholemeal flour, 200g warm water. Mix and cover. This is the Levain, set aside somewhere room temperature - if you house is very cold you can use extra starter. [ ] 2. (1pm) Five hours later, in a big bowl mix 100 of white flour, 300g of wholemeal flour, 10g of salt and 330g warm water. Stand for 20 minutes, uncovered. [ ] 3. (1.20pm) Add a quarter tea spoon of instant yeast and 300g of the levain made this morning to the big bowl, mix all together (leftover levain add to starter you have in the fridge - save for next time or mix and give half to someone else). [ ] 4.1 (2.30pm) 1st fold. Over the next 2 hours, fold the dough 3 times with wet hands. Roughly mix and blend the dough, no need to kneed. [ ] 4.2 (3.30pm) 2nd fold [ ] 4.3 (4.30pm) 3rd fold [ ] 5. (6pm, approx 5 hours after step 2.) Shape into a ball and place on greaseproof paper in a large bowl. Put in fridge till tomorrow morning. [ ] Saturday: [ ] 6. (8am) Remove from fridge. Preheat oven and a cast-iron pot to 245 deg C [ ] 7. Score top of loaf and place with greaseproof paper in the heated pot and bake for 20 minutes. Remove lid and cook for 25 mins more. Will sound hollow(ish) when tapped once baked. Crust should be a dark brown. [ ] 8. Remove from pot, take off greaseproof paper and place on a rack. Cool for 20 minutes.
newaccount74 4y ago
I agree that appetite is the most important factor. But I think CICO is still helpful. It's not a panacea, lots of people struggle to just eat the right amount (see appetite). But you can use CICO as a check to make sure you aren't bullshitting yourself. If you try a diet (eg. cut sugar, intermittent fasting, low carbs, etc), you will only lose weight if you have a caloric deficit. Eg. if you cut sugar from your diet but eat huge portions of whole grain pasta instead you aren't going to lose any weight.
- matthewdgreen 4y ago
  Other measures are also helpful but we don't generally think about them. For example, carefully counting "water-in, water-out" (WIWO) seems like it'd be necessary to avoid dehydration. However in normal circumstances (i.e., when you're not running marathons or exerting yourself in the desert) we don't need to think about this very much. Your body will manage its own hydration levels by making you thirsty only at the appropriate times. WIWO is still a thing but we don't obsess about it. Now imagine your body couldn't manage its own hydration properly, perhaps because we contaminated our water supplies with something that disregulates the thirst response. Then you'd have a society that spends a lot of time talking about WIWO and it'd be a pretty sick place to live. It's much healthier to treat the underlying disregulation than to force people to constantly be thirsty.
- dwaite 4y ago
  counting calories gives you knowledge of what you are putting in. The problem with people who pitch it as the answer (rather than one line on four full whiteboards) is that calories out is very difficult to control or measure, and will tend to reduce in proportion to calories in. On the flip side, many people find that their base metabolic rate increases when they switch to a very low carb diet - this is both because using the nutrients in their food takes more energy, and because they are no longer suppressing their body's use of energy with overabundant insulin. Low carb aka Atkins are typically hormonally-focused diets, not a caloric deficit diets. Paleo is an autoimmune-friendly diet, not a caloric deficit diet.
flamebreath447 4y ago
What doesn’t make sense about your statement is that CICO evangelists don’t claim that appetite or that satiation isn’t a problem. One of the best examples I know of is Greg Doucette. He specifically preaches CICO because for 95-99% of people it is about putting the fork down. It’s a generalization because, more often than not you aren’t controlling your intake if you are overweight. There will always be the minority that truly have hormonal imbalances and need assistance losing weight. If you have a higher appetite you should have learned about low calorie dense foods, and if you’re serious about losing or maintaining a healthy weight you have to find sustainable foods you like that fill you but are lower in calories. There’s a heirarchy in terms of trouble shooting your weight problems and proper jumping to NEAT and hormonal imbalances is really just trying to take a shortcut for instant gratification. Long term you can lose 1 pound a month, slowly, and keep it off the rest of your life via CICO. Sorry for the rant but I can’t stand people who skip CICO cause they don’t like to hear it and haven’t done research on how to keep themselves full.
- guerrilla 4y ago
  > It’s a generalization because, more often than not you aren’t controlling your intake if you are overweight. There will always be the minority that truly have hormonal imbalances and need assistance losing weight. But we know it's not a minority. Most people who try to eat less fail, repeatedly, for all of their lives.
  - BeetleB 4y ago
    About a decade ago I read an interview with an applied mathematician about how he applied his knowledge of math to practical applications. I don't recall if he was working for the NSF or the NIH at the time, but his work for the past few years had to do with this. He said that of all the contributing factors to being overweight, the factor that was clearly the most significant by a margin was food production per capita. If you produce a lot more food, people will consume a lot more as well. Putting down the fork may not be an effective solution, but the problem definitely is eating too much. Other factors like how our bodies absorb more from the same food than they did 40 years ago pale in comparison.
beebeepka 4y ago
Uh huh. I've heard all the excuses. I am sure fat people understand thermodynamics just fine. What they lack is restraint. Never met a fat person with sane eating habits
- vasco 4y ago
  There are no fat people during famines or in work camps, that's all we need to know to know what is true.
bogota 4y ago
Lol stop making life complex nothing about your comment says CICO is wrong. Self control on the other hand is a problem that a lot of people have. But im sure we will find the .1% of random issues to talk about instead. People love to say its easy for you or make up all kinds of excuses. A person i dated in the pst liked to complain about how she couldn’t lose weight because of all these genetic issues. Both of her parents were fat and she had recently started to get a lot bigger. I said i would diet with her eating the same amount of calories even though i work out 5 times a week and need 2200 calories just to maintain my weight normally i am eating 2400 to 2600 since my goal is muscle gain. She needed likely about 1800 based on sex, height, and activity level. We both targeted 1600 calories a day. I lost close to ten pounds (this is not at all healthy dont do it) she lost 4 pounds. I stopped after a month and she was unable to keep doing it alone without me doing all the meal planning and just generally because she was lazy. I never had to hear about how it was because i was lucky again which was great. I had serious hunger cravings for the entire month but guess what you can decide to not eat. Prepared for my downvotes from all the people “stuck” at unhealthy weight.
- drowsspa 4y ago
  "It's a self-control issue" well, obviously? It's also a completely useless and un-actionable observation, unless your goal is to feel better by pointing fingers, in which case, suit yourself.
- xctr94 4y ago
  You're being downvoted for having a bad attitude, victim-blaming in a system not designed for healthy weight, and for generally not understanding this is a nice forum. This isn't Reddit.
nonrandomstring 4y ago
It seems surprising that almost no progress has been made in appetite suppression since they used to prescribe amphetamines as "diet pills" in the 1950s. I found just a few spoons of stodgy porridge can keep hunger away for 6 - 8 hours.
- ChadNauseam 4y ago
  Tons of progress has been made actually. Semaglutide works amazingly well at appetite suppression, and there are human trials going on now for drugs that seem to be even better. I wrote about it here [0]. [0]: https://chadnauseam.com/random/semaglutide-has-changed-the-world/ https://chadnauseam.com/random/semaglutide-has-changed-the-w...
  - nonrandomstring 4y ago
    That's very interesting thanks for sharing. BTW I used to be exactly like you and could eat enough to feed a regiment without gaining an ounce. My eating for Britain stopped suddenly when I hit 40 and metabolism changed. Hope you are blessed with lifelong good apetite management, but for me I had to start working on it and changing my lifestyle/willpower. It's good to know that advances are happening for those who truly need a helping hand though.
spacemannoslen 4y ago
Over experimenting with my own body with diet through about 20 years I'm always amazed at how big a role habit plays in appetite. When I did intermittent fasting I got into the habit of never needing food until around 4pm. The body adapts fairly quickly to whatever inputs you feed it, and it's amazing how little of diet advice focuses on that, to me
lob_it 4y ago
Being on prescription meds is almost like the junkie paraphernalia with shooting up insulin and popping high bloodpressure meds. Doesn't is sound like a biological crutch for low-quality habits (fake food, cascading health issues, unhealthy environments,etc)? Hormone treatments appear to be guinea pig experiments with lifelong consequences.
- xctr94 4y ago
  Sadly, it's quite hard to fix the environment, since we're communally invested into the current system.
  - lob_it 4y ago
    Happily, individuals always have a choice :) I've laughed several times already at "culture clumping" and "lifestyle clumping". Being a technology native, I had good timing and got to grow up with the "golden library" that was the information superhighway. The kids nowadays have to filter more tabloid info/illiteracy in a day than I had to in the course of years. I got to skip late-stage television too :p Innovation in the 21st century is soooooooo much better than anything fiction has to offer.
AnonCoward42 4y ago
CICO as an assumption is important. It certainly doesn't solve obesity, but it makes the problem measurable. For me it is mostly about the amount of sweet stuff, however in general it is about the appetite/calorie ratio. You can eat "unhealthy" food and still lose weight. My body wants sugar once a week or so, however that's still fine. It's probably obvious, but avoid eating food you don't like, just because it is less calorie/supposedly healthy. This leads to enormous frustration. Experimenting however is a good idea, the more alternatives one has the better.
0x737368 4y ago
Has nothing to do with fat people not understanding thermodynamics and has everything to do with not being able to follow the simple principle and looking for shortcuts instead.
- drowsspa 4y ago
  A diet that doesn't take into account the factors that lead someone to overeat is useless by definition. If "most people can't follow this simple principle" then evidently it's a useless principle. Unless the goal is to point fingers to feel better about yourself, in which case it's pretty useful.
  - 0x737368 4y ago
    What are you talking about? If you eat a diet that has the required number of calories and nutrients designed for a healthy-weight person, your body weight will drop accordingly. The factors that lead someone to overeat is a totally different question the answer to which should be figured out by themselves or maybe their psychologist. In most cases it's not that dire though, once their initial withdrawal from fast food stops people stop having these impulses to reach for a doughnut each time they're inconvenienced. In any case, your problems in life should be treated by dealing with the problems directly and not making themselves feel better by stuffing their face.
    - drowsspa 4y ago
      > If you eat a diet that has the required number of calories and nutrients designed for a healthy-weight person, your body weight will drop accordingly. Thanks for explaining thermodynamics to me, I guess? > once their initial withdrawal from fast food stops people stop having these impulses to reach for a doughnut each time they're inconvenienced Statistically, most people who try to eat less fail to do it. Why do you think you don't you have the impulse to reach for a donut each time you're inconvenienced? I guess it's more comfortable to just call them lazy, but it's utterly useless and un-actionable at a societal and personal level. Diets have to be all about managing the sensation of hunger while maintaining such a caloric deficit. CICO amounts to "Just eat less lol"
jjtheblunt 4y ago
NEAT?
- drowsspa 4y ago
  Non-exercise activity thermogenesis: https://pubmed.ncbi.nlm.nih.gov/12468415/ https://pubmed.ncbi.nlm.nih.gov/12468415/
User23 4y ago
Gym bro science gets a bad rap here for whatever reason, but I’d bet dollars to donuts that you’re better off following a 1970s bodybuilder diet (scaled appropriately) than whatever the latest garbage the FDA and USDA are pushing. Sure plenty of it is nonsense, like eating 6 meals a day, but it’s mostly harmless nonsense. That’s in stark contrast to the food pyramid recommendation to eat a couple loafs of bread each day which is harmful nonsense that has probably played a role in the type 2 diabetes epidemic. Also it’s entirely plausible that various small molecules like artificial sweeteners, preservatives, solvents, and whatever else goes in the process chemistry products called processed food is in some way or another bioactive and alters homeostasis, perhaps by disrupting the endocrine system or perhaps through other pathways.
- hombre_fatal 4y ago
  People hate on the dietary guidelines a lot but adherence is only 50-60% in the US. A slight overconsumption of grains, large overconsumption of meat, and massive under consumption of vegetables and fruits and dairy. I looked this up recently. On my phone but googling “adherence of us population to dietary guidelines” may help.
bradknowles 4y ago
One thing that I've never seen anyone talk about is ulcers. I've had them since I was in grade school, in the 70s and 80s. And I've always eaten to deal with the physical pain of the hunger as represented by the ulcers. It wasn't until high school that the doctors detected and diagnosed the ulcers, and my mom felt horribly bad because I'd always complained about my stomach pain and that I was hungry, and she asked if this is what I had always felt. Unfortunately, the doctors didn't actually cure the ulcers. They came back. But at least now we know what causes them, and I can hopefully get proper treatment for them, once I get other things like my blood pressure and kidney stones dealt with. But I am convinced that ulcers were at least a major contributor in my developing diabetes and obesity. I wonder how many other people who are overweight have also had to deal with ulcers, but may not have realized what was causing that pain, or why it went away with food?
edanm 4y ago
> Point being, people like to spew out CICO as if fat people just don't understand thermodynamics That is certainly what some people do, and they're wrong. But CICO as a model is incredibly important. Mostly because a lot of people don't actually believe it! For years, I had the vague sense that I wanted to lose a bit of weight (for context, I wasn't obese, just a bit overweight.) And for years, my kind of underlying assumption was that I'd have to eat completely differently, mostly have to cut out carbs, etc. Today, people talk about all sorts of different diets - Intermittent fasting, or Keto, low-carb in general, etc. Those are all legit! They all can work for some people. But understanding that the way they work is by making you consume less calories (and most likely making you less hungry) is a critical part of their success, IMO. Otherwise you'll do as I did- I started doing IF, lost a few kilo, then get used to consuming all the sweets I otherwise would've had late at night, but right before my IF window closed. Not helpful in the slightest, and just made my day less flexible.

bugfix-66 4y ago

We have an old, safe, cheap drug for humans already: Metformin. Most people can get an off-label metformin prescription for anti-aging or appetite suppression. Your interest in food will be reduced to the point you have trouble keeping weight on. Sugar will be repulsive to you. Sweet food tastes "sickly sweet", nauseating. Metformin also interferes with the absorption of carbohydrates in your gut.

drowsspa 4y ago
I once heard about one drug that basically works by making you nauseous to food. Is it the one? > Metformin is generally safe, but common side effects do include vomiting, nausea, and diarrhea. Those experiencing these unpleasant side effects might consume less food, resulting in modest weight reductions.
- bugfix-66 4y ago
  Many foods you used to like (e.g., sweets) will be nauseating. Other foods remain delicious. For example, eggs and cheese and meat. But basically, your interest in food will be drastically reduced, and you will eat just enough. This is an important part of metformin's beneficial effect on lifespan and health.
  - TylerE 4y ago
    Admittedly, I’m on a fairly low dose (500mg x 2), but I can still kill a bag of Haribo when the mood hits. It doesn’t , quite as often, but I’ve noticed no changes in flavor.
    - bugfix-66 4y ago
      Thanks for the anecdote. Biological variation, we're all different!
  - dwaite 4y ago
    Can you point to any studies around this? I've never heard of this effect (let alone experienced it). I do know that Diabetes itself can reduce the efficiency of taste receptors, and metformin will sometimes cause people to have a metallic taste in their mouth (due to metformin in produced saliva)
    - bugfix-66 4y ago
      It's easy to find studies connecting metformin to weight loss and loss of appetite. I'll leave that to you, just use Google and you'll be swamped with evidence. You say you've never heard of metformin affecting food palatability and taste? Did you search the web at all? Just use Google if you want anecdotal examples. For example: https://forum.diabetes.org.uk/boards/threads/loss-of-appetite-on-metformin.97468/ https://forum.diabetes.org.uk/boards/threads/loss-of-appetit... I joined as after 18 months on metformin, my appetite and enjoyment of food is constantly declining. I’ve lost about 10 kg over that time, which is not a problem. But I’ve lost my appetite and, as a keen cook and someone who has always enjoyed good food, I no longer look forward to meals and get little pleasure from food. or https://www.diabetes.co.uk/forum/threads/anyone-experience-loss-of-appetite-with-metformin.86526/ https://www.diabetes.co.uk/forum/threads/anyone-experience-l... Metformin changed the taste of food slowly during the time I took it. It finally got to the point where all vegetables tasted like burnt plastic. This meant that I didn't want to eat them. And so on. Now you've heard of it! All it took was a web search.
- empiricus 4y ago
  You should not feel anything when you take Metformin. Its effects are subtle and very long term.
CharlesW 4y ago
> Most people can get an off-label metformin prescription for anti-aging. Dumb question: How? I'm reasonably certain my GP would not be amenable to being asked to prescribe drugs for off-label use.
- gruez 4y ago
  Off label use is fine. I'd be more worried about the fact that a patient is bring it up out of the blue (ie. "give me drugs plz"), and the evidence for life extension is shaky >There is some evidence metformin may be helpful in extending lifespan, even in otherwise healthy people. It has received substantial interest as an agent that delays aging, possibly through similar mechanisms as its treatment of diabetes (insulin and carbohydrate regulation). This is controversial, and an area of active research.[61][62]
- bugfix-66 4y ago
  Just ask your doctor for it. Say: "Please prescribe me Metformin, 2 grams daily." If you're overweight, tell your doctor you want help with your appetite. Otherwise, say you want metformin for its cancer prevention and anti-aging effects. Metformin is safe and it almost universally improves health and well-being. Your doctor knows this, and she'll gladly prescribe it.
  - dylan604 4y ago
    > Your doctor knows this, and she'll gladly prescribe it. If your doctor gladly prescribes anything you just walk in and ask for by name and dosage and doesn't have a green cross symbol outside their office, then I'd highly suggest seeking out a new doctor.
    - bugfix-66 4y ago
      We're talking about a particular drug here (metformin) not just "anything". I'm saying it's likely your doctor will be willing to prescribe METFORMIN (that drug, in particular) for off-label use if you ask.
anaisbetts 4y ago
A more appropriate drug for this is probably Ozempic/Wegovy (Semaglutide), or an even more effective version available in the US, Tirzepatide. I've personally been on the former and after 4.5 months, I've lost ~20% of my body weight
- bugfix-66 4y ago
  Metformin is well-understood, old, safe, and has various health benefits. Surprisingly, metformin seems to be almost a pure win, even for healthy people: https://www.health.harvard.edu/blog/is-metformin-a-wonder-drug-202109222605 https://www.health.harvard.edu/blog/is-metformin-a-wonder-dr... In contrast, GIP analogues like semaglutaide present real risks and are less well understood. For some people, with serious health problems, GIP analogues make sense. But generally you don't want to be taking them if you're healthy.
- bilsbie 4y ago
  Aren’t those hard to get and then super expensive if you do quality?
  - anaisbetts 4y ago
    No idea, in the EU I pay ~85 EUR/mo
DontchaKnowit 4y ago
Yeah tell that to my stress eating family members who all have metformin prescriptions. This may be true for some people but definitely not a universal
- bugfix-66 4y ago
  Here's a question to consider: How much worse would the situation be if they weren't on metformin?
tacitusarc 4y ago
> Because the vast majority of research regarding metformin included only people with diabetes or prediabetes, it’s unclear whether these potential benefits are limited to people with those conditions, or whether people without diabetes may derive benefit as well. https://www.health.harvard.edu/blog/is-metformin-a-wonder-drug-202109222605 https://www.health.harvard.edu/blog/is-metformin-a-wonder-dr...
smhoff256 4y ago
I think those kinds of blanket statements about metformin are a little misleading and a bit dangerous. For instance I myself have been on metformin now for almost 2 years and I can assure you I have no repulsion to sugar.
- bugfix-66 4y ago
  Yes, I see three responses along these lines, already. Some people don't lose weight. Some people's appetite isn't affected. Some people retain their taste for sweets. And so on. But "misleading and a bit dangerous"? Really? Readers can find a summary of metformin's typical effects on Wikipedia, here: https://en.m.wikipedia.org/wiki/Metformin https://en.m.wikipedia.org/wiki/Metformin YMMV: "your mileage may vary"
bitwize 4y ago
So Metformin basically reduces to fasting which, as Hackernews knows, is the cure for everything.

dabbledash 4y ago

Appetite differences are almost certainly the primary factor in why some people get heavy and others don't, but that isn't inconsistent with CICO at all.

adrian_b 4y ago
In my opinion, the differences in appetite are caused mostly by the differences in the type of food eaten, and not by the differences between humans. In my search for a diet that would allow me to avoid gaining weight, the main successes were achieved by replacing various kinds of food that were tasty, but which did not satiate me before eating huge amounts of them, with other kinds of food that are also tasty, but which satiate me after eating a moderate amount of them.
- antiterra 4y ago
  I have known plenty of people who ate very small amounts of garbage food (eg only candy & hot pockets) and didn’t gain weight. Some instances this seemed due to an incredibly fast metabolism, others were due to GERD/IBS or some other factor that limits the craving. The differences are real, even if it’s just something like gut biome.
- drowsspa 4y ago
  But that right there is a difference between you and other humans. The idea of "searching for a diet that allows you to gain weight" is absolutely alien to me. I can easily get to 5000 calories a day without even thinking about it, while you have to make a conscious effort to reach (I assume) much less than that. My sister and I grew up with the same diet. We didn't starve, but neither of us had lots of access to junk food. Yet she could be hungry once she got home and after half a plate to be already satiated. Today she has tons of junk food in her house yet she doesn't feel the compulsion to eat more than a few bytes. I'm down to 71 kg from 83 kg back in June, but I still can't have a single cookie package in my house.
  - adrian_b 4y ago
    I think that you have misread my comment. I have said "a diet to avoid gaining weight", not "a diet that allows gaining weight". If I eat more than 1900 ... 2000 kcal per day, I gain weight rapidly, so the problem was reducing the amount of energy intake so much, while ensuring an adequate daily intake of proteins and of any other essential nutrients, and without feeling that I am starving. I agree that there are differences between people and there are also differences for a single human depending on circumstances, e.g. in many cases when you are ill you lose your appetite. Nevertheless, for the same human, different foods containing the same amount of energy can behave extremely differently from the point of view of causing satiety, both immediately after the meal and some hours later. For remaining satiated many hours after the meal, at equal energy content food with higher content of proteins and/or fat and/or fiber is more effective. For being satiated immediately after the meal, at equal nutrient composition food that is more consistent and requires prolonged chewing causes satiety much faster than soft food such as creams, mashed potatoes, ground meat and the like.

huntertwo 4y ago

Hormones, appetite, metabolic diseases are all orthogonal to CICO. These can have an effect on how many calories you burn or how many calories you crave but at the end of the day, CICO is still law.

klyrs 4y ago
> CICO is still law. Calories are a measure chemical energy, not mass. Our digestive systems don't get anywhere near e=mc^2 in their efficiency. The conservation law is MIMO; calories are way more complicated. For example, people who extol CICO rarely take into account the fact that poop has a variable amount of chemical energy, which depends on a huge variety of factors including gut flora, hydration and fiber intake, or that most of our mass output is actually exhaled CO2.
- AnIdiotOnTheNet 4y ago
  And yet Mark Haub[0] ate a diet of Twinkies (and other convenience store garbage food) to a caloric deficit and lost 27lbs in 10 weeks while all of his health metrics improved. Trying to be super precise about calories may be complicated, but nobody has to do that to reach a caloric deficit anyway so who cares. Eat less than you need by any reasonable ball park metric and you will lose weight, it's that simple. The hard part is that for some reason a large percentage of the population can't regulate their intake naturally because what they require for calories to be a healthy weight is misaligned with what they are compelled to consume. [0] http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/...
  - klyrs 4y ago
    Sure, let's agree that CICO is a decent rule of thumb, not a law. That's a fun anecdote, though.
- huntertwo 4y ago
  https://en.m.wikipedia.org/wiki/Laws_of_thermodynamics https://en.m.wikipedia.org/wiki/Laws_of_thermodynamics > The laws of thermodynamics define a group of physical quantities, such as temperature, energy, and entropy, that characterize thermodynamic systems in thermodynamic equilibrium. If you eat 2000 calories of food and burn 2000 calories (taking into account inefficiencies in the metabolic processes our bodies undertake to convert molecules to other molecules), there is no source of energy for you to accumulate fat, regardless of anything else. Your metabolic rate and the chemical energy of your excrement and the amount of co2 you exhale can be affected by a myriad of factors, hormonal included. But they just change the CO part of the equation, not the fact that CICO is law.

sigg3 4y ago

> What I've found is that matters is appetite: some people just get full way faster than others. This is a half truth. If you cut down portion size your stomach will shrink over time. I eat a lot less before feeling full now, and I only changed my life a year ago. It's also important that you eat stuff that makes you feel full, fibers and greens. Changing diet also changed my taste, so I crave more healthy things now, while the food I used to eat honestly don't appeal to me any longer or tastes empty. OTOH if you push yourself to eat a little more every meal, your stomach will grown, accommodating room for more before you feel full.

adrian_b 4y ago
For increased satiety, even when eating little, an additional factor is that the food should not be too soft, like most of the industrially made food is, but it should need some time of vigorous chewing. There are many vegetables, fruits and nuts that require a decent amount of chewing. There are also some kinds of home-made bread that require much more chewing than the industrial soft bread, while also being much tastier than the commercial bread (when eaten immediately after baking; the commercial bread is optimized for long shelf life).
- bollu 4y ago
  Got any chewey bread recipes?
  - ljf 4y ago
    My homemade sour dough is always chewy and tough, but I love it! [ ] Thursday [ ] 8am - if starter hasn't been used for 4 weeks or more; feed starter 30g flour and 30g of water [ ] Thursday evening weigh out flour and salt as below into two bowls, and cover. Get water jug, yeast and teaspoon ready. Keep starter in the fridge until needed [ ] Friday: [ ] 1. (8am) Mix 100g of Starter, 200g white flour, 50g wholemeal flour, 200g warm water. Mix and cover. This is the Levain, set aside somewhere room temperature - if you house is very cold you can use extra starter. [ ] 2. (1pm) Five hours later, in a big bowl mix 100 of white flour, 300g of wholemeal flour, 10g of salt and 330g warm water. Stand for 20 minutes, uncovered. [ ] 3. (1.20pm) Add a quarter tea spoon of instant yeast and 300g of the levain made this morning to the big bowl, mix all together (leftover levain add to starter you have in the fridge - save for next time or mix and give half to someone else). [ ] 4.1 (2.30pm) 1st fold. Over the next 2 hours, fold the dough 3 times with wet hands. Roughly mix and blend the dough, no need to kneed. [ ] 4.2 (3.30pm) 2nd fold [ ] 4.3 (4.30pm) 3rd fold [ ] 5. (6pm, approx 5 hours after step 2.) Shape into a ball and place on greaseproof paper in a large bowl. Put in fridge till tomorrow morning. [ ] Saturday: [ ] 6. (8am) Remove from fridge. Preheat oven and a cast-iron pot to 245 deg C [ ] 7. Score top of loaf and place with greaseproof paper in the heated pot and bake for 20 minutes. Remove lid and cook for 25 mins more. Will sound hollow(ish) when tapped once baked. Crust should be a dark brown. [ ] 8. Remove from pot, take off greaseproof paper and place on a rack. Cool for 20 minutes.

newaccount74 4y ago

I agree that appetite is the most important factor. But I think CICO is still helpful. It's not a panacea, lots of people struggle to just eat the right amount (see appetite). But you can use CICO as a check to make sure you aren't bullshitting yourself. If you try a diet (eg. cut sugar, intermittent fasting, low carbs, etc), you will only lose weight if you have a caloric deficit. Eg. if you cut sugar from your diet but eat huge portions of whole grain pasta instead you aren't going to lose any weight.

matthewdgreen 4y ago
Other measures are also helpful but we don't generally think about them. For example, carefully counting "water-in, water-out" (WIWO) seems like it'd be necessary to avoid dehydration. However in normal circumstances (i.e., when you're not running marathons or exerting yourself in the desert) we don't need to think about this very much. Your body will manage its own hydration levels by making you thirsty only at the appropriate times. WIWO is still a thing but we don't obsess about it. Now imagine your body couldn't manage its own hydration properly, perhaps because we contaminated our water supplies with something that disregulates the thirst response. Then you'd have a society that spends a lot of time talking about WIWO and it'd be a pretty sick place to live. It's much healthier to treat the underlying disregulation than to force people to constantly be thirsty.
dwaite 4y ago
counting calories gives you knowledge of what you are putting in. The problem with people who pitch it as the answer (rather than one line on four full whiteboards) is that calories out is very difficult to control or measure, and will tend to reduce in proportion to calories in. On the flip side, many people find that their base metabolic rate increases when they switch to a very low carb diet - this is both because using the nutrients in their food takes more energy, and because they are no longer suppressing their body's use of energy with overabundant insulin. Low carb aka Atkins are typically hormonally-focused diets, not a caloric deficit diets. Paleo is an autoimmune-friendly diet, not a caloric deficit diet.

flamebreath447 4y ago

What doesn’t make sense about your statement is that CICO evangelists don’t claim that appetite or that satiation isn’t a problem. One of the best examples I know of is Greg Doucette. He specifically preaches CICO because for 95-99% of people it is about putting the fork down. It’s a generalization because, more often than not you aren’t controlling your intake if you are overweight. There will always be the minority that truly have hormonal imbalances and need assistance losing weight. If you have a higher appetite you should have learned about low calorie dense foods, and if you’re serious about losing or maintaining a healthy weight you have to find sustainable foods you like that fill you but are lower in calories. There’s a heirarchy in terms of trouble shooting your weight problems and proper jumping to NEAT and hormonal imbalances is really just trying to take a shortcut for instant gratification. Long term you can lose 1 pound a month, slowly, and keep it off the rest of your life via CICO. Sorry for the rant but I can’t stand people who skip CICO cause they don’t like to hear it and haven’t done research on how to keep themselves full.

guerrilla 4y ago
> It’s a generalization because, more often than not you aren’t controlling your intake if you are overweight. There will always be the minority that truly have hormonal imbalances and need assistance losing weight. But we know it's not a minority. Most people who try to eat less fail, repeatedly, for all of their lives.
- BeetleB 4y ago
  About a decade ago I read an interview with an applied mathematician about how he applied his knowledge of math to practical applications. I don't recall if he was working for the NSF or the NIH at the time, but his work for the past few years had to do with this. He said that of all the contributing factors to being overweight, the factor that was clearly the most significant by a margin was food production per capita. If you produce a lot more food, people will consume a lot more as well. Putting down the fork may not be an effective solution, but the problem definitely is eating too much. Other factors like how our bodies absorb more from the same food than they did 40 years ago pale in comparison.

beebeepka 4y ago

Uh huh. I've heard all the excuses. I am sure fat people understand thermodynamics just fine. What they lack is restraint. Never met a fat person with sane eating habits

vasco 4y ago
There are no fat people during famines or in work camps, that's all we need to know to know what is true.

bogota 4y ago

Lol stop making life complex nothing about your comment says CICO is wrong. Self control on the other hand is a problem that a lot of people have. But im sure we will find the .1% of random issues to talk about instead. People love to say its easy for you or make up all kinds of excuses. A person i dated in the pst liked to complain about how she couldn’t lose weight because of all these genetic issues. Both of her parents were fat and she had recently started to get a lot bigger. I said i would diet with her eating the same amount of calories even though i work out 5 times a week and need 2200 calories just to maintain my weight normally i am eating 2400 to 2600 since my goal is muscle gain. She needed likely about 1800 based on sex, height, and activity level. We both targeted 1600 calories a day. I lost close to ten pounds (this is not at all healthy dont do it) she lost 4 pounds. I stopped after a month and she was unable to keep doing it alone without me doing all the meal planning and just generally because she was lazy. I never had to hear about how it was because i was lucky again which was great. I had serious hunger cravings for the entire month but guess what you can decide to not eat. Prepared for my downvotes from all the people “stuck” at unhealthy weight.

drowsspa 4y ago
"It's a self-control issue" well, obviously? It's also a completely useless and un-actionable observation, unless your goal is to feel better by pointing fingers, in which case, suit yourself.
xctr94 4y ago
You're being downvoted for having a bad attitude, victim-blaming in a system not designed for healthy weight, and for generally not understanding this is a nice forum. This isn't Reddit.

nonrandomstring 4y ago

It seems surprising that almost no progress has been made in appetite suppression since they used to prescribe amphetamines as "diet pills" in the 1950s. I found just a few spoons of stodgy porridge can keep hunger away for 6 - 8 hours.

ChadNauseam 4y ago
Tons of progress has been made actually. Semaglutide works amazingly well at appetite suppression, and there are human trials going on now for drugs that seem to be even better. I wrote about it here [0]. [0]: https://chadnauseam.com/random/semaglutide-has-changed-the-world/ https://chadnauseam.com/random/semaglutide-has-changed-the-w...
- nonrandomstring 4y ago
  That's very interesting thanks for sharing. BTW I used to be exactly like you and could eat enough to feed a regiment without gaining an ounce. My eating for Britain stopped suddenly when I hit 40 and metabolism changed. Hope you are blessed with lifelong good apetite management, but for me I had to start working on it and changing my lifestyle/willpower. It's good to know that advances are happening for those who truly need a helping hand though.

spacemannoslen 4y ago

Over experimenting with my own body with diet through about 20 years I'm always amazed at how big a role habit plays in appetite. When I did intermittent fasting I got into the habit of never needing food until around 4pm. The body adapts fairly quickly to whatever inputs you feed it, and it's amazing how little of diet advice focuses on that, to me

lob_it 4y ago

Being on prescription meds is almost like the junkie paraphernalia with shooting up insulin and popping high bloodpressure meds. Doesn't is sound like a biological crutch for low-quality habits (fake food, cascading health issues, unhealthy environments,etc)? Hormone treatments appear to be guinea pig experiments with lifelong consequences.

xctr94 4y ago
Sadly, it's quite hard to fix the environment, since we're communally invested into the current system.
- lob_it 4y ago
  Happily, individuals always have a choice :) I've laughed several times already at "culture clumping" and "lifestyle clumping". Being a technology native, I had good timing and got to grow up with the "golden library" that was the information superhighway. The kids nowadays have to filter more tabloid info/illiteracy in a day than I had to in the course of years. I got to skip late-stage television too :p Innovation in the 21st century is soooooooo much better than anything fiction has to offer.

AnonCoward42 4y ago

CICO as an assumption is important. It certainly doesn't solve obesity, but it makes the problem measurable. For me it is mostly about the amount of sweet stuff, however in general it is about the appetite/calorie ratio. You can eat "unhealthy" food and still lose weight. My body wants sugar once a week or so, however that's still fine. It's probably obvious, but avoid eating food you don't like, just because it is less calorie/supposedly healthy. This leads to enormous frustration. Experimenting however is a good idea, the more alternatives one has the better.

0x737368 4y ago

Has nothing to do with fat people not understanding thermodynamics and has everything to do with not being able to follow the simple principle and looking for shortcuts instead.

drowsspa 4y ago
A diet that doesn't take into account the factors that lead someone to overeat is useless by definition. If "most people can't follow this simple principle" then evidently it's a useless principle. Unless the goal is to point fingers to feel better about yourself, in which case it's pretty useful.
- 0x737368 4y ago
  What are you talking about? If you eat a diet that has the required number of calories and nutrients designed for a healthy-weight person, your body weight will drop accordingly. The factors that lead someone to overeat is a totally different question the answer to which should be figured out by themselves or maybe their psychologist. In most cases it's not that dire though, once their initial withdrawal from fast food stops people stop having these impulses to reach for a doughnut each time they're inconvenienced. In any case, your problems in life should be treated by dealing with the problems directly and not making themselves feel better by stuffing their face.
  - drowsspa 4y ago
    > If you eat a diet that has the required number of calories and nutrients designed for a healthy-weight person, your body weight will drop accordingly. Thanks for explaining thermodynamics to me, I guess? > once their initial withdrawal from fast food stops people stop having these impulses to reach for a doughnut each time they're inconvenienced Statistically, most people who try to eat less fail to do it. Why do you think you don't you have the impulse to reach for a donut each time you're inconvenienced? I guess it's more comfortable to just call them lazy, but it's utterly useless and un-actionable at a societal and personal level. Diets have to be all about managing the sensation of hunger while maintaining such a caloric deficit. CICO amounts to "Just eat less lol"

jjtheblunt 4y ago

NEAT?

drowsspa 4y ago
Non-exercise activity thermogenesis: https://pubmed.ncbi.nlm.nih.gov/12468415/ https://pubmed.ncbi.nlm.nih.gov/12468415/

User23 4y ago

Gym bro science gets a bad rap here for whatever reason, but I’d bet dollars to donuts that you’re better off following a 1970s bodybuilder diet (scaled appropriately) than whatever the latest garbage the FDA and USDA are pushing. Sure plenty of it is nonsense, like eating 6 meals a day, but it’s mostly harmless nonsense. That’s in stark contrast to the food pyramid recommendation to eat a couple loafs of bread each day which is harmful nonsense that has probably played a role in the type 2 diabetes epidemic. Also it’s entirely plausible that various small molecules like artificial sweeteners, preservatives, solvents, and whatever else goes in the process chemistry products called processed food is in some way or another bioactive and alters homeostasis, perhaps by disrupting the endocrine system or perhaps through other pathways.

hombre_fatal 4y ago
People hate on the dietary guidelines a lot but adherence is only 50-60% in the US. A slight overconsumption of grains, large overconsumption of meat, and massive under consumption of vegetables and fruits and dairy. I looked this up recently. On my phone but googling “adherence of us population to dietary guidelines” may help.

bradknowles 4y ago

One thing that I've never seen anyone talk about is ulcers. I've had them since I was in grade school, in the 70s and 80s. And I've always eaten to deal with the physical pain of the hunger as represented by the ulcers. It wasn't until high school that the doctors detected and diagnosed the ulcers, and my mom felt horribly bad because I'd always complained about my stomach pain and that I was hungry, and she asked if this is what I had always felt. Unfortunately, the doctors didn't actually cure the ulcers. They came back. But at least now we know what causes them, and I can hopefully get proper treatment for them, once I get other things like my blood pressure and kidney stones dealt with. But I am convinced that ulcers were at least a major contributor in my developing diabetes and obesity. I wonder how many other people who are overweight have also had to deal with ulcers, but may not have realized what was causing that pain, or why it went away with food?

edanm 4y ago

> Point being, people like to spew out CICO as if fat people just don't understand thermodynamics That is certainly what some people do, and they're wrong. But CICO as a model is incredibly important. Mostly because a lot of people don't actually believe it! For years, I had the vague sense that I wanted to lose a bit of weight (for context, I wasn't obese, just a bit overweight.) And for years, my kind of underlying assumption was that I'd have to eat completely differently, mostly have to cut out carbs, etc. Today, people talk about all sorts of different diets - Intermittent fasting, or Keto, low-carb in general, etc. Those are all legit! They all can work for some people. But understanding that the way they work is by making you consume less calories (and most likely making you less hungry) is a critical part of their success, IMO. Otherwise you'll do as I did- I started doing IF, lost a few kilo, then get used to consuming all the sweets I otherwise would've had late at night, but right before my IF window closed. Not helpful in the slightest, and just made my day less flexible.