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It's the same as all diets, no? We know that if you eat less, you will lose weight. You just need to do that for the rest of your life, forever, or you will mos

by doix 2y ago

It's the same as all diets, no? We know that if you eat less, you will lose weight. You just need to do that for the rest of your life, forever, or you will most likely put the weight back on. I am pretty sure there is research that shows "diets don't work" because of that. The same probably applies to diabetes. Yes, if you eat a low carb diet you can improve your A1C, but you would have to do that for the rest of your life (or however long). Sure, part of it is probably _capitalism_, but I'm fairly sure that for a large part of the population, prescribing them diet instead of insulin would result in worse outcomes.

improv 2y ago
It's not so much "low carb" as it is avoiding the sugar junkie culture that pervades the Standard American Diet. Keto can be an effective acute intervention against type 2 diabetes, but then one might add carbs back in to a reasonable level, but not the poisonous level of the Standard American Diet.
abracadaniel 2y ago
Exactly. If you have a 100% effective treatment for a disease, but only 10% are able to maintain the regimen, you have a 10% effective treatment. The distinction is obviously critical at the individual level, but at the policy level you need to know what the actual result of a recommended treatment will be. It’s like how condoms are 87% effective because the rate includes people who don’t use them consistently. Knowing that they’re 98% effective when used properly is important knowledge to the individual, but the effective rate is more important to anyone advising policy of what advice to give.
6510 2y ago
> We know that if you eat less, you will lose weight. not really no, there are several very weird processes that add up to something entirely different. You don't mean weight but body fat. If you just restrict calories you will lose both fat and muscle. You will get more hungry the longer you keep it up until you eventually replace the lost kg with fat alone. Less energy, less muscle mass to burn energy - brilliant plan! To lose fat you need to stop eating long enough to trigger fat burning or the reserves won't be addressed. Might take a few attempts to get used to it. Then you need to do strength training. The ratio carbs and starch is how some people stay skinny while eating a lot while others stay fat eating next to nothing. It also gets hard to move if your heavy. You will adapt your life to avoid moving. It involves dozens of other fascinating processes. Metabolic syndrome lowering testosterone making it hard to grow muscle which lowers testosterone again, nutrition shortages, poor sleep from lack of exercise/activity and lack of activity from poor sleep, not getting any sunlight etc etc
- doix 2y ago
  No, I literally mean weight, I am aware you will lose both muscle and fat. Yes, there are biological processes that can affect that process, but the gist is the same. If you don't eat, you will lose weight.
  - 6510 2y ago
    > It's the same as all diets, no? There is a big difference between them. > We know that if you eat less, you will lose weight. No one is looking to lose weight that generally. (or they shouldn't be) > You just need to do that for the rest of your life, forever, or you will most likely put the weight back on. Not at all. There are several mechanisms by which being fat contributes to getting more fat. > I am pretty sure there is research that shows "diets don't work" because of that. Simply eating less doesn't work. Other diets work. > The same probably applies to diabetes. Yes, if you eat a low carb diet you can improve your A1C, but you would have to do that for the rest of your life (or however long). Excess fat causes insulin resistance and insulin resistance makes you fat. If you have and use more muscles you can (and will) eat more. Your metabolism will also speed up if you are more active. When overweight it is much harder to jump on a bicycle, skate, take a long walk or sign up for a sport. > I'm fairly sure that for a large part of the population, prescribing them diet instead of insulin would result in worse outcomes. Fasting can fix insulin resistance. If you eat plenty of fat and protein between the fasts you will adapt to burn that. The system is quite good, if you don't eat for 12 hours the reserves are addressed. May take a bit of getting used to since the mechanism is quite rusty. You become much more focused and active naturally. It is time to hunt or otherwise find food. When the belly is stuffed there is no need for physical activity.
    - 6510 2y ago
      Just ran into this. Apparently arthritis is caused by overweight and eating to much carbs. It is also a major reason why overweight people avoid exercise. https://www.youtube.com/watch?v=UYj3IROfvV4 https://www.youtube.com/watch?v=UYj3IROfvV4

by doix 2y ago

improv 2y ago

It's not so much "low carb" as it is avoiding the sugar junkie culture that pervades the Standard American Diet. Keto can be an effective acute intervention against type 2 diabetes, but then one might add carbs back in to a reasonable level, but not the poisonous level of the Standard American Diet.

abracadaniel 2y ago

Exactly. If you have a 100% effective treatment for a disease, but only 10% are able to maintain the regimen, you have a 10% effective treatment. The distinction is obviously critical at the individual level, but at the policy level you need to know what the actual result of a recommended treatment will be. It’s like how condoms are 87% effective because the rate includes people who don’t use them consistently. Knowing that they’re 98% effective when used properly is important knowledge to the individual, but the effective rate is more important to anyone advising policy of what advice to give.

6510 2y ago

> We know that if you eat less, you will lose weight. not really no, there are several very weird processes that add up to something entirely different. You don't mean weight but body fat. If you just restrict calories you will lose both fat and muscle. You will get more hungry the longer you keep it up until you eventually replace the lost kg with fat alone. Less energy, less muscle mass to burn energy - brilliant plan! To lose fat you need to stop eating long enough to trigger fat burning or the reserves won't be addressed. Might take a few attempts to get used to it. Then you need to do strength training. The ratio carbs and starch is how some people stay skinny while eating a lot while others stay fat eating next to nothing. It also gets hard to move if your heavy. You will adapt your life to avoid moving. It involves dozens of other fascinating processes. Metabolic syndrome lowering testosterone making it hard to grow muscle which lowers testosterone again, nutrition shortages, poor sleep from lack of exercise/activity and lack of activity from poor sleep, not getting any sunlight etc etc

doix 2y ago
No, I literally mean weight, I am aware you will lose both muscle and fat. Yes, there are biological processes that can affect that process, but the gist is the same. If you don't eat, you will lose weight.
- 6510 2y ago
  > It's the same as all diets, no? There is a big difference between them. > We know that if you eat less, you will lose weight. No one is looking to lose weight that generally. (or they shouldn't be) > You just need to do that for the rest of your life, forever, or you will most likely put the weight back on. Not at all. There are several mechanisms by which being fat contributes to getting more fat. > I am pretty sure there is research that shows "diets don't work" because of that. Simply eating less doesn't work. Other diets work. > The same probably applies to diabetes. Yes, if you eat a low carb diet you can improve your A1C, but you would have to do that for the rest of your life (or however long). Excess fat causes insulin resistance and insulin resistance makes you fat. If you have and use more muscles you can (and will) eat more. Your metabolism will also speed up if you are more active. When overweight it is much harder to jump on a bicycle, skate, take a long walk or sign up for a sport. > I'm fairly sure that for a large part of the population, prescribing them diet instead of insulin would result in worse outcomes. Fasting can fix insulin resistance. If you eat plenty of fat and protein between the fasts you will adapt to burn that. The system is quite good, if you don't eat for 12 hours the reserves are addressed. May take a bit of getting used to since the mechanism is quite rusty. You become much more focused and active naturally. It is time to hunt or otherwise find food. When the belly is stuffed there is no need for physical activity.
  - 6510 2y ago
    Just ran into this. Apparently arthritis is caused by overweight and eating to much carbs. It is also a major reason why overweight people avoid exercise. https://www.youtube.com/watch?v=UYj3IROfvV4 https://www.youtube.com/watch?v=UYj3IROfvV4