4 ms·

(From a position of significant ignorance) It seems there is not a strong consensus on what has caused the great increase in obesity of the past fifty years, pe

(From a position of significant ignorance) It seems there is not a strong consensus on what has caused the great increase in obesity of the past fifty years, perhaps throwing greater effort in that direction would be a better long term solution ? To my mind it's strange that there seems to be a circular argument which starts with sedentary life style and "bad" foods cause obesity so exercise and diet control seems like a fix but that is countered by exercise doesn't help (much) and dieting has only temporary effects. If my summary is reasonably correct it seems to me what's needed is more understanding of the outcome before using drugs to "fix it". I wonder if a drug is less likely to be lobbied against than the types of changes such investigations might suggest.

luckylion 4y ago
> If my summary is reasonably correct it seems to me what's needed is more understanding of the outcome before using drugs to "fix it". The likely reason is the changes in lifestyle thanks to the changes in technology. Is "let's just get rid of the past 70 years of technological advancement" something that we'll seriously consider?
- glaucon 4y ago
  | The likely reason is the changes in lifestyle Agreed, that's the commonly held reason but when one attempts to reverse what the changes seem to have been, by exercising more and eating less, that doesn't seem to work. My point is that perhaps we need to better understand what the changes have been, that perhaps they are more subtle than they are commonly held to be.
  - luckylion 4y ago
    From what I understand (which is mostly second hand from a health journalist friend), "work out a bit more and eat a bit less" doesn't get you anywhere close to how people lived up until 1950. In 1920, Americans had 8million cars registered (at 106m people), today they have 276 million cars to 330m people, and that's basically the same for every aspect of life.
  - pixl97 4y ago
    To couple on with what the other poster said there are two primary changes... 1. The amount of available cheap calories in convenient easy to eat packaging is orders of magnitudes higher than it was in the past. 2. Work and activity has changed so dramatically that we would not recognize the world of the past. Now the nuance here is understanding all the small ramifications that are far more invisible to us. Think of a coke bottle and how many calories that contains, I mean it's a huge amount. But now think about the convenience of it. You can carry it with you just about anywhere. The vast majority of jobs will let you carry it around work or leave it on your desk to drink from all day. It doesn't matter how much your work out, if you drink one extra coke per day, you've added more calories in than you're working off. But then add in all the small things that keep us from walking/exercising as much. Way fewer of our jobs are 'hard work' and been replaced by machines. We tend not to let our kids run around like wild creatures outside the house all day. Instead they are probably home, on the entertainment system of some kind with a coke in their hand. Kids also consume junk all day that is specifically marketed to them. You have to add all these factors in.
curiousllama 4y ago
I would encourage you to revise your summary. We don't know what the third-order drivers of obesity are, but we absolutely know that caloric surplus is the primary driver, and that surplus is driven by both lower energy expenditure (sedentary lifestyle) and increased caloric intake (junk food). There are other causes for individuals, but not at a population level. The question is much more: why did people start moving less & eating more? Each have complex factors (less physical jobs, increased wealth, food addictiveness, cultural shifts, etc.), and on THOSE, there's lots of debate. But we absolutely know what causes obesity at a population level.
groos 4y ago
It's pretty clear by now that the intake of high amounts of fructose, refined carbohydrates and packaged foods has resulted in obesity. The much maligned fat in a healthy diet was never the culprit. The Chinese on a rice diet were never very obese until they became rich and started consuming packaged foods. Now their obesity rates rival the US's. Uncontrolled insulin levels cause obesity because of insulin's dual role in fat storage. The key is to change one's diet such that insulin levels are lowered and the stored fat can be utilized for metabolic needs. Exercise is important for general health but trying to lose weight by exercising doesn't work if the diet stays the same. Food is just too calorie rich and the body too calorie efficient. The adage 'get fit in the gym, get slim in the kitchen' applies. Genetically, a small number of people might have metabolic issues causing obesity.Drugs might be the right choice for them but for the vast majority of us, we just need to take a hard look at our diet.

luckylion 4y ago

> If my summary is reasonably correct it seems to me what's needed is more understanding of the outcome before using drugs to "fix it". The likely reason is the changes in lifestyle thanks to the changes in technology. Is "let's just get rid of the past 70 years of technological advancement" something that we'll seriously consider?

glaucon 4y ago
| The likely reason is the changes in lifestyle Agreed, that's the commonly held reason but when one attempts to reverse what the changes seem to have been, by exercising more and eating less, that doesn't seem to work. My point is that perhaps we need to better understand what the changes have been, that perhaps they are more subtle than they are commonly held to be.
- luckylion 4y ago
  From what I understand (which is mostly second hand from a health journalist friend), "work out a bit more and eat a bit less" doesn't get you anywhere close to how people lived up until 1950. In 1920, Americans had 8million cars registered (at 106m people), today they have 276 million cars to 330m people, and that's basically the same for every aspect of life.
- pixl97 4y ago
  To couple on with what the other poster said there are two primary changes... 1. The amount of available cheap calories in convenient easy to eat packaging is orders of magnitudes higher than it was in the past. 2. Work and activity has changed so dramatically that we would not recognize the world of the past. Now the nuance here is understanding all the small ramifications that are far more invisible to us. Think of a coke bottle and how many calories that contains, I mean it's a huge amount. But now think about the convenience of it. You can carry it with you just about anywhere. The vast majority of jobs will let you carry it around work or leave it on your desk to drink from all day. It doesn't matter how much your work out, if you drink one extra coke per day, you've added more calories in than you're working off. But then add in all the small things that keep us from walking/exercising as much. Way fewer of our jobs are 'hard work' and been replaced by machines. We tend not to let our kids run around like wild creatures outside the house all day. Instead they are probably home, on the entertainment system of some kind with a coke in their hand. Kids also consume junk all day that is specifically marketed to them. You have to add all these factors in.

curiousllama 4y ago

I would encourage you to revise your summary. We don't know what the third-order drivers of obesity are, but we absolutely know that caloric surplus is the primary driver, and that surplus is driven by both lower energy expenditure (sedentary lifestyle) and increased caloric intake (junk food). There are other causes for individuals, but not at a population level. The question is much more: why did people start moving less & eating more? Each have complex factors (less physical jobs, increased wealth, food addictiveness, cultural shifts, etc.), and on THOSE, there's lots of debate. But we absolutely know what causes obesity at a population level.

groos 4y ago

It's pretty clear by now that the intake of high amounts of fructose, refined carbohydrates and packaged foods has resulted in obesity. The much maligned fat in a healthy diet was never the culprit. The Chinese on a rice diet were never very obese until they became rich and started consuming packaged foods. Now their obesity rates rival the US's. Uncontrolled insulin levels cause obesity because of insulin's dual role in fat storage. The key is to change one's diet such that insulin levels are lowered and the stored fat can be utilized for metabolic needs. Exercise is important for general health but trying to lose weight by exercising doesn't work if the diet stays the same. Food is just too calorie rich and the body too calorie efficient. The adage 'get fit in the gym, get slim in the kitchen' applies. Genetically, a small number of people might have metabolic issues causing obesity.Drugs might be the right choice for them but for the vast majority of us, we just need to take a hard look at our diet.