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> Isn’t obesity a function of calories intake and calories burn rate? In the same way that the economy is a function of people trading things, sure. Why do we

> Isn’t obesity a function of calories intake and calories burn rate? In the same way that the economy is a function of people trading things, sure. Why do we even need economic policy?

iammjm 4y ago
Indeed, we need an economic policy, not an economic drug. I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc.
- ceejayoz 4y ago
  > I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc. So are physicians, and most patients. It's just a lot harder than it sounds to sustain. There's the old adage that "the definition of insanity is trying the same thing over and over expecting different results"; attempting to cure obesity by telling patients "exercise more, eat less" is precisely that.
  - robertlagrant 4y ago
    This is too absolutist. People aren't immutable, unable to control themselves at all without drugs. Anyone who gives up smoking without a patch has to decide to never pick up a cigarette again. They may have "given up" a few times before, and the last time they succeeded. By your logic they shouldn't have tried more than once.
    - ceejayoz 4y ago
      At a population level, we know how effective the various kinds of behavioral interventions for obesity are. The numbers aren't good. https://www.cbc.ca/news/health/obesity-research-confirms-long-term-weight-loss-almost-impossible-1.2663585 https://www.cbc.ca/news/health/obesity-research-confirms-lon... > But if we check back after five or 10 years, there's a good chance they will have put the weight back on. Only about five per cent of people who try to lose weight ultimately succeed, according to the research. Those people are the outliers, but we cling to their stories as proof that losing weight is possible. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ > In a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained. "Just eat right and exercise more" may work for a small number of people, but for most it's setting folks up to fail. It's good that we're starting to get medication options that can help folks achieve those changes; bariatric surgery works, but it's a big deal for the body.
      - robertlagrant 4y ago
        > "Just eat right and exercise more" may work for a small number of people It may work for most people - those studies are performed on a fraction of the remainder.
        ceejayoz 4y ago
        > It may work for most people 70% of adult Americans are overweight, so no, probably not. > those studies are performed on a fraction of the remainder Why would you believe that?
        robertlagrant 4y ago
        Well, to be clearer, the first is just an article, but it talks about obese people, not all people. That's what I mean. Obese people are not all people, and studies of weight loss in obesity are on a few obese people.
        djur 4y ago
        Do you have any reason to think that the sample isn't representative?
      - djur 4y ago
        Bariatric surgery also tends to require a period of weight loss beforehand as well as extensive behavior modification afterward. These new drugs should make that process much easier.
    - pixl97 4y ago
      And you're isn't absolute enough. Take a 'large enough' population of animals and give them an all you can eat buffet for months. What percentage of them becomes overweight? It won't be 100%, but the numbers should be pretty high. I have a very strong feeling (sadly no evidence, they won't let me trap random people in cages for months at a time to test this) that the human numbers and the animal numbers will look very much alike.
      - robertlagrant 4y ago
        > And you're isn't absolute enough. My what? I was countering an absolutist position; I wasn't presenting my own. And yes, animals can be made to starve to death as well, if you give them a bar to push that gives a dopamine hit. That doesn't mean we should shrug and say, "Well, it's inevitable that I'm going to die now, because I failed once" the first time we fail to refrain from getting such a hit.
- medvezhenok 4y ago
  There is some evidence to show that obesity has been rising independently of behavioral changes (even though they do contribute), due to deterioration in the food quality. Look at obesity rates amongst animals for example, especially wild animals that feed off of human food.
  - randomdata 4y ago
    Does this rise correlate with the decline in average body temperature that we've also been seeing? Less heat = fewer calories burned?

> Isn’t obesity a function of calories intake and calories burn rate? In the same way that the economy is a function of people trading things, sure. Why do we even need economic policy?

iammjm 4y ago

Indeed, we need an economic policy, not an economic drug. I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc.

ceejayoz 4y ago
> I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc. So are physicians, and most patients. It's just a lot harder than it sounds to sustain. There's the old adage that "the definition of insanity is trying the same thing over and over expecting different results"; attempting to cure obesity by telling patients "exercise more, eat less" is precisely that.
- robertlagrant 4y ago
  This is too absolutist. People aren't immutable, unable to control themselves at all without drugs. Anyone who gives up smoking without a patch has to decide to never pick up a cigarette again. They may have "given up" a few times before, and the last time they succeeded. By your logic they shouldn't have tried more than once.
  - ceejayoz 4y ago
    At a population level, we know how effective the various kinds of behavioral interventions for obesity are. The numbers aren't good. https://www.cbc.ca/news/health/obesity-research-confirms-long-term-weight-loss-almost-impossible-1.2663585 https://www.cbc.ca/news/health/obesity-research-confirms-lon... > But if we check back after five or 10 years, there's a good chance they will have put the weight back on. Only about five per cent of people who try to lose weight ultimately succeed, according to the research. Those people are the outliers, but we cling to their stories as proof that losing weight is possible. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ > In a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained. "Just eat right and exercise more" may work for a small number of people, but for most it's setting folks up to fail. It's good that we're starting to get medication options that can help folks achieve those changes; bariatric surgery works, but it's a big deal for the body.
    - robertlagrant 4y ago
      > "Just eat right and exercise more" may work for a small number of people It may work for most people - those studies are performed on a fraction of the remainder.
      - ceejayoz 4y ago
        > It may work for most people 70% of adult Americans are overweight, so no, probably not. > those studies are performed on a fraction of the remainder Why would you believe that?
        robertlagrant 4y ago
        Well, to be clearer, the first is just an article, but it talks about obese people, not all people. That's what I mean. Obese people are not all people, and studies of weight loss in obesity are on a few obese people.
      - djur 4y ago
        Do you have any reason to think that the sample isn't representative?
    - djur 4y ago
      Bariatric surgery also tends to require a period of weight loss beforehand as well as extensive behavior modification afterward. These new drugs should make that process much easier.
  - pixl97 4y ago
    And you're isn't absolute enough. Take a 'large enough' population of animals and give them an all you can eat buffet for months. What percentage of them becomes overweight? It won't be 100%, but the numbers should be pretty high. I have a very strong feeling (sadly no evidence, they won't let me trap random people in cages for months at a time to test this) that the human numbers and the animal numbers will look very much alike.
    - robertlagrant 4y ago
      > And you're isn't absolute enough. My what? I was countering an absolutist position; I wasn't presenting my own. And yes, animals can be made to starve to death as well, if you give them a bar to push that gives a dopamine hit. That doesn't mean we should shrug and say, "Well, it's inevitable that I'm going to die now, because I failed once" the first time we fail to refrain from getting such a hit.
medvezhenok 4y ago
There is some evidence to show that obesity has been rising independently of behavioral changes (even though they do contribute), due to deterioration in the food quality. Look at obesity rates amongst animals for example, especially wild animals that feed off of human food.
- randomdata 4y ago
  Does this rise correlate with the decline in average body temperature that we've also been seeing? Less heat = fewer calories burned?