27 ms·

Adipose tissue retains an epigenetic memory of obesity after weight loss

263 points by paulpauper 2y ago

olalonde 2y ago
I'm surprised the paper doesn't mention "settling point theory" which was suggested decades ago. This seems to be evidence in favor of the theory.
- bluecheese452 2y ago
  There is not good evidence in favor of that theory.
  - andbberger 2y ago
    there is quite a lot of evidence supporting the existence of homeostatic mechanisms involved in weight regulation eg https://www.nejm.org/doi/full/10.1056/NEJMoa1105816 https://www.nejm.org/doi/full/10.1056/NEJMoa1105816
taeric 2y ago
Doesn't similar happen for strength gain? People that have had larger muscles tend to have an easier time building them back up, as well.
- loeg 2y ago
  > People that have had larger muscles tend to have an easier time building them back up, as well. Yes, although I don't know whether that's epigenetic.
  - taeric 2y ago
    Fair. I'm now curious to know what the different forms of memory things can have. I confess I assumed they were all inter-related.
    - loeg 2y ago
      The mechanism I've heard of (heard proposed?) for skeletal muscle is that muscle cells retain the additional nuclei (myonuclei) developed during strength training, even during detraining periods. Then subsequently re-developing strength is easier because you've still got all of those nuclei.
      - taeric 2y ago
        That sounds similar to the way the fat thing was described to me, in the past. Curious how all of that relates. If anyone has a good read to dive into this, I'd be grateful! It really lends itself to the way I model "training" for stuff. Sucks, as we want to think there are differences from rote practice and learning. But it increasingly seems that any differences there are are much softer than is often taught.
spoiler 2y ago
As someone who's struggled with weight loss, and have known others to struggle with it well, I think we colloquially called this "slow metabolism". It always did feel like it was easier to gain weight than lose it, especially fat weight and not muscle weight for me. I was recently sent a video about fat adaptation (basically teaching your body to be better at burning fat) by a very fit friend, but I wonder how much of that is bro science and how much of it is grounded in reality. Maybe worth looking into more deeply if it can counteract or balance out this.
- skirmish 2y ago
  It is well known that if you gain muscle then lose it, it is easier to regain it than the first time (IIRC, the cells store extra nucleii?). This could be a similar effect but with fat cells.
  - joncrocks 2y ago
    I believe that is the latest theory regarding the mechanism, yes. https://pmc.ncbi.nlm.nih.gov/articles/PMC3892465/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3892465/
  - deleted 2y ago
    [deleted]
  - beejiu 2y ago
    As well as the "cell memory", the total number of fat cells you have in your body is set during adolescence, then it remains constant for the rest of your adult life. (https://www.nature.com/articles/ncpgasthep1189 https://www.nature.com/articles/ncpgasthep1189). During adolescence, if you gain weight, you create new fat cells. During adulthood, the fat cells themselves just get larger. Arguably the best thing you can do is avoid obesity during childhood and adolescence at all costs.
    - BlackFly 2y ago
      Interested parties may want to read the original article https://doi.org/10.1038/nature06902 https://doi.org/10.1038/nature06902 in place of the highlight https://doi.org/10.1038/ncpgasthep1189 https://doi.org/10.1038/ncpgasthep1189.
john_minsk 2y ago
Just went trough Yo-Yo. Any good strategies on how to overcome it for good?
- blitzar 2y ago
  Its a lifestyle change not a diet. Don't stop the diet / exercise when you get to the "target" weight. This idea sucks when you are looking at a plate of lettuce leaves - but you should also avoid extreme diets and extreme exercise as it is unsustainable.
  - hxorr 2y ago
    in addition to this, start by making small, but permanent changes to your lifestyle over time, if you change everything at once then of course you'll revert pretty quickly
- ManBeardPc 2y ago
  Don't try to lose weight fast. Don't do a diet for a limited amount of time. Change your eating habits to something you can live with permanently. Avoid sugar in drinks, it's so easy to get a lot of calories without feeling full. Sugar in general will give you hunger attacks. For me personally I feel best if I have a big part of calories coming from protein, followed by less carbs and some fat. But removing sugar from drinks alone lost me 30kg, without changing any other habits. Better for the general health as well. Going to the gym helped me immensely. Not so much in losing weight directly but in feeling better and fresher.
  - krzat 2y ago
    Exactly, this is a lifestyle change first.
  - vladvasiliu 2y ago
    > Going to the gym helped me immensely. Not so much in losing weight directly but in feeling better and fresher. This. I've found working out has changed the kinds of foods I crave, making it easier to adhere to a diet. I'd usually feel more like a steak with eggs and brocoli rather than a deep-fried burger.
delichon 2y ago
> ...it is plausible that epigenetic memory could also play a role in many other contexts, including addictive diseases. Recent advancements in targeted epigenetic editing global remodelling of the epigenome provide promising new approaches. "Darn, I think I've contracted some alcoholism. Could you order me another bottle of the reset pills?"
- elric 2y ago
  More like "just take these GLP-1 agonists for the rest of your life". Those seem to have an effect on addictions etc. But at least when it comes to weight, people seem to put it back on once they quit. Perhaps the GLP-1 agonist is lacking an epigenetic reset button ...
  - bsder 2y ago
    Fat cells only turn over about 20% per year. You basically need to maintain a reduced weight for 5 years before the fat cells "forget" the higher weight. If you come off it before that 5 years are up, yeah, you are probably expected to bounce back somewhat. You might not need to be on GLP-1 forever, but you might need to be on it longer than people currently think.
    - elric 2y ago
      Oh thanks, that 20% is a super useful statistic to keep in mind.
    - Etheryte 2y ago
      Do you happen to have a reference for that or a specific link to learn more? That sounds oddly specific.
      - senko 2y ago
        Was also interested and a quick search for "human fat cells turnover time years" returned a few research papers that quote 10% a year.
oaxoa 2y ago
[dead]
paulpauper 2y ago
The more you research/learn about obesity, the worse it is, much like smoking. One of the most depressing stats is that dieting does not get easier with time. The probability of eventually regaining all the weight eventually converges to 100%. Even if you're successful for 2 years, people still regain by year 4, 5, etc. The body never resists trying to regain the weight. GLP-1 drugs are the best hope yet.
- agos 2y ago
  absolutely. and yet people will still say "just eat less"! Imagine telling a person who smokes "just smoke less"
  - _Algernon_ 2y ago
    That's... A completely reasonable thing to say..
    - agos 2y ago
      the "just" is doing a lot of work, too much. Most people with an addiction or weight problem are very well aware of what they should be doing (or not doing), but they'll be fighting with their body telling them constantly that they really, really need to eat or smoke. This is the hard part and telling someone "just do it" is not helpful in the least
      - schrectacular 2y ago
        Unfortunately it's also the only advice that works, in a trite and tautological way. You either find the willpower (in the addiction research it seems that some sort of "religious awakening" or "higher purpose" seems to be key) or you struggle with your addiction to the end. The comment elsewhere about HAVING to eat was eye opening to me. For some reason I never made that connection - the cocaine addict doesn't have to do just a tiny line a few times a day. They can kick it permanently. A food addict has to face their temptations every meal...
    - 2y ago
anovikov 2y ago
[flagged]
- rexpop 2y ago
  > How about MAGA? What if it can be treated with some pills, too? I often wonder if anti-psychotics might do the trick. They often seem captivated by paranoid delusions.
squeedles 2y ago
As this article shows, there are incredibly complex feedback mechanisms around weight and metabolism, but thermodynamics are still fundamentally a thing. After he died last year, I ran across this engineering and accounting approach to weight maintenance and loss written up by John Walker (one of the Autodesk founders). It worked very well for him and changed the way I thought about weight and eating. It is interesting reading because he is "one of us" https://www.fourmilab.ch/hackdiet/ Basically, he uses a first level approximation of the body as a control system with a feedback loop, and tries to pin down some techniques to bring the system to a known good state (target weight) and manage that loop for long term stability.
- dorfsmay 2y ago
  The problem with diets based only on calories is that they don't take satiety into account, nor health. Calories is what makes you gain/lose weight, it's basic physics. Satiety is what makes you want to eat more/less. Nutrients are what is making you healthy. Fiber and protein tends to make you feel full. Lack of them allow you to eat large amount of calories without feeling full. You need to keep track of micro and macro nutrient to stay healthy.
  - squeedles 2y ago
    Quite so, and I think he does address that, but those are all second level factors, along with activity level, exercise, and their effect on your caloric requirements. He puts together a bunch of excel spreadsheets for tracking many factors, but I have found the simple discipline of accounting for what I eat in a little txt file on my phone sufficient to align my choices with my desired outcome.
    - dorfsmay 2y ago
      Exercise and activity are contributing to calories (calories out). These days there are apps that make it easy to track calories, macro and nutrients.
    - taeric 2y ago
wonderwonder 2y ago
I always used to think negatively about people that were severely overweight (still do unconsciously if I'm being honest) as I always attributed their obesity to lack of will power. I'm a huge proponent of better living through chemistry (steroids - with frequent blood work, nootropics, whatever) and recently I decided to get my abs back. I hopped on some compounded semiglutide and was blown away by the change in my attitude towards food. I had always snacked at night after the kids went to bed and had built up about 25 pounds over the past decade. I was able to drop it all in 3 months without any sort of dieting, I just ate when I was hungry. Decided to not eat after 6:30pm and just did it, no issues while on the semiglutide. Really changed my attitude about food, and my body and minds interaction with it. A lot of this is subconscious and really hard to get control of. The fact a chemical compound was able to change my mental relationship with food also put an interesting spin on my ideas about consciousness and self control as a whole. We are just slaves to our biological processes.
- monkeycantype 2y ago
  I had this same experience, but I have not continued to take the medication after a short experiment. I found I could get a similar outcome (subjective experience) through my food selection Today I’ve eaten around 2kg of vegetables today (zucchini, capsicum, eggplant, cauliflower, spinach) all of which was under 500 calories, and I’ve eaten fish. If I eat a massive amount of vegetables and get ~200g protein, I don’t feel I’m depriving myself and am satiated on under 2000 calories, previously I would typically eat over 3000 on a normal day. As for people lacking willpower, the genetics of hunger mean all of us experience vastly different levels of hunger. You might be interested to read about the family in Pakistan who could not produce a relevant hormone leptin, and the toddlers driven to fighting by insatiable hunger to steal food from each other, and the dramatic change in their lives after medical intervention with leptin injections
  - wonderwonder 2y ago
    My brother's family has done something similar although in a different direction. They have been strictly carnivore for several years now. Able to eat large amounts of food while keeping calories low and feeling satiated. It's worked well for them. I'll look at that study you mentioned, thank you.
bowsamic 2y ago
Calorie counting is the only truly reliable way to lose weight
- amanaplanacanal 2y ago
  That's clearly not true. Calorie counting can work if you stick to it and aren't shit at estimating the calories in food. Almost any diet can work if you are able to stick with it. Appetite suppressants like amphetamines seen to work too. We've also seen that the new diabetes drugs actually work.
  - laichzeit0 2y ago
    “Any diet” is still putting you at a net caloric deficit. There is no other principle that can explain weight loss that I know of. Whether you’re counting calories to achieve that deficit or following a “diet” it comes down to the exact same thing. Counting calories just demystifies the process of weight loss.
  - escobar_west 2y ago
    The only reliable way to lose weight is through a caloric deficit. And the only reliable way to be on a caloric deficit is through counting your calories. If you're dieting without actually counting your calories, then at best you are only hoping and guessing that your diet is sufficient enough to put you in a caloric deficit.
    - loeg 2y ago
      You don't have to count calories to eat in a caloric deficit. Counting is not the only reliable way to hit a deficit. Tons and tons of people on GLP-1 drugs are not counting calories but are in a deficit.
      - escobar_west 2y ago
        I'd argue that taking a drug to suppress your appetite is way more extreme and unhealthy than simply counting calories, but I guess to each their own. And yes even in that case you're still guessing and hoping you're in a caloric deficit because different foods will satiate your hunger for different caloric cost. If you're not counting calories you could be cutting calories too aggressively or not aggressively enough, or you might not be getting required macronutrient intake with your given diet.
meindnoch 2y ago
Well, yeah. Adipocytes multiply when you get fat. But when you lose weight, they don't apoptose, they just shrink in volume by giving up their lipid stores.
- mkoubaa 2y ago
  I am pretty sure the only way to reduce the number of cells is liposuction
  - rcruzeiro 2y ago
    Worse than that. Subcutaneous fat (which is the one you can trim off with liposuction) usually expands relying more in cell expansion and not in hyperplasia. Visceral fat on the other hand, is way more likely to involve hyperplasia and you cannot use liposuction against this type of fat. This is also the fat that is very hormonally active and increases the risks of diabetes, heart disease, cancers, strokes.
    - gosub100 2y ago
      Is it unremovable because it's inside the core muscles and near internal organs?
      - nradov 2y ago
        Right. A surgeon can't just stick a liposuction tube into the abdominal cavity and poke around. This would be major invasive surgery with a high risk of complications, far worse than leaving the adipose tissue in place.
      - meindnoch 2y ago
        See the second half of this video: https://www.youtube.com/watch?v=Bav_IBsuXEM https://www.youtube.com/watch?v=Bav_IBsuXEM Visceral fat is literally enclosing the intestines, major blood vessels, organs, etc. of the abdomen. Nevertheless, it is possible to surgically remove this sheet of fat that's covering your organs, it's called an omentectomy. But it's a big surgery, and done only in case of cancer, not for weight loss. That is, in humans: https://pubmed.ncbi.nlm.nih.gov/29367725/ https://pubmed.ncbi.nlm.nih.gov/29367725/
BurningFrog 2y ago
Since I had to look it up: "Adipose tissue" means "fat tissue".
- cogburnd02 2y ago
  You should definitely watch the Doctor Who episode Partners in Crime.
  - jermaustin1 2y ago
    This was how I learned this word... It's insane that was almost 20 years ago.
monkfish328 2y ago
I wonder if fasting of some sort is able to reset these effects somehow - shoot any material on that if you know of it!
- smileysteve 2y ago
  The idea is that fasting does encourage aptopsis of cells.
yieldcrv 2y ago
> However, maintaining weight loss is a considerable challenge, especially as the body seems to retain an obesogenic memory that defends against body weight changes This is validating as I’m very skeptical about this when looking for a partner that currently has a physiology I’m interested in but had one I wasn’t interested in at some point before, and this seems to be a shared experience
suyash 2y ago
Can anyone share tips/insights to loose body fat so as to not gain it back?

263 points by paulpauper 2y ago

I'm surprised the paper doesn't mention "settling point theory" which was suggested decades ago. This seems to be evidence in favor of the theory.

bluecheese452 2y ago
There is not good evidence in favor of that theory.
- andbberger 2y ago
  there is quite a lot of evidence supporting the existence of homeostatic mechanisms involved in weight regulation eg https://www.nejm.org/doi/full/10.1056/NEJMoa1105816 https://www.nejm.org/doi/full/10.1056/NEJMoa1105816

taeric 2y ago

Doesn't similar happen for strength gain? People that have had larger muscles tend to have an easier time building them back up, as well.

loeg 2y ago
> People that have had larger muscles tend to have an easier time building them back up, as well. Yes, although I don't know whether that's epigenetic.
- taeric 2y ago
  Fair. I'm now curious to know what the different forms of memory things can have. I confess I assumed they were all inter-related.
  - loeg 2y ago
    The mechanism I've heard of (heard proposed?) for skeletal muscle is that muscle cells retain the additional nuclei (myonuclei) developed during strength training, even during detraining periods. Then subsequently re-developing strength is easier because you've still got all of those nuclei.
    - taeric 2y ago
      That sounds similar to the way the fat thing was described to me, in the past. Curious how all of that relates. If anyone has a good read to dive into this, I'd be grateful! It really lends itself to the way I model "training" for stuff. Sucks, as we want to think there are differences from rote practice and learning. But it increasingly seems that any differences there are are much softer than is often taught.

spoiler 2y ago

As someone who's struggled with weight loss, and have known others to struggle with it well, I think we colloquially called this "slow metabolism". It always did feel like it was easier to gain weight than lose it, especially fat weight and not muscle weight for me. I was recently sent a video about fat adaptation (basically teaching your body to be better at burning fat) by a very fit friend, but I wonder how much of that is bro science and how much of it is grounded in reality. Maybe worth looking into more deeply if it can counteract or balance out this.

skirmish 2y ago
It is well known that if you gain muscle then lose it, it is easier to regain it than the first time (IIRC, the cells store extra nucleii?). This could be a similar effect but with fat cells.
- joncrocks 2y ago
  I believe that is the latest theory regarding the mechanism, yes. https://pmc.ncbi.nlm.nih.gov/articles/PMC3892465/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3892465/
- deleted 2y ago
  [deleted]
- beejiu 2y ago
  As well as the "cell memory", the total number of fat cells you have in your body is set during adolescence, then it remains constant for the rest of your adult life. (https://www.nature.com/articles/ncpgasthep1189 https://www.nature.com/articles/ncpgasthep1189). During adolescence, if you gain weight, you create new fat cells. During adulthood, the fat cells themselves just get larger. Arguably the best thing you can do is avoid obesity during childhood and adolescence at all costs.
  - BlackFly 2y ago
    Interested parties may want to read the original article https://doi.org/10.1038/nature06902 https://doi.org/10.1038/nature06902 in place of the highlight https://doi.org/10.1038/ncpgasthep1189 https://doi.org/10.1038/ncpgasthep1189.

john_minsk 2y ago

Just went trough Yo-Yo. Any good strategies on how to overcome it for good?

blitzar 2y ago
Its a lifestyle change not a diet. Don't stop the diet / exercise when you get to the "target" weight. This idea sucks when you are looking at a plate of lettuce leaves - but you should also avoid extreme diets and extreme exercise as it is unsustainable.
- hxorr 2y ago
  in addition to this, start by making small, but permanent changes to your lifestyle over time, if you change everything at once then of course you'll revert pretty quickly
ManBeardPc 2y ago
Don't try to lose weight fast. Don't do a diet for a limited amount of time. Change your eating habits to something you can live with permanently. Avoid sugar in drinks, it's so easy to get a lot of calories without feeling full. Sugar in general will give you hunger attacks. For me personally I feel best if I have a big part of calories coming from protein, followed by less carbs and some fat. But removing sugar from drinks alone lost me 30kg, without changing any other habits. Better for the general health as well. Going to the gym helped me immensely. Not so much in losing weight directly but in feeling better and fresher.
- krzat 2y ago
  Exactly, this is a lifestyle change first.
- vladvasiliu 2y ago
  > Going to the gym helped me immensely. Not so much in losing weight directly but in feeling better and fresher. This. I've found working out has changed the kinds of foods I crave, making it easier to adhere to a diet. I'd usually feel more like a steak with eggs and brocoli rather than a deep-fried burger.

delichon 2y ago

> ...it is plausible that epigenetic memory could also play a role in many other contexts, including addictive diseases. Recent advancements in targeted epigenetic editing global remodelling of the epigenome provide promising new approaches. "Darn, I think I've contracted some alcoholism. Could you order me another bottle of the reset pills?"

elric 2y ago
More like "just take these GLP-1 agonists for the rest of your life". Those seem to have an effect on addictions etc. But at least when it comes to weight, people seem to put it back on once they quit. Perhaps the GLP-1 agonist is lacking an epigenetic reset button ...
- bsder 2y ago
  Fat cells only turn over about 20% per year. You basically need to maintain a reduced weight for 5 years before the fat cells "forget" the higher weight. If you come off it before that 5 years are up, yeah, you are probably expected to bounce back somewhat. You might not need to be on GLP-1 forever, but you might need to be on it longer than people currently think.
  - elric 2y ago
    Oh thanks, that 20% is a super useful statistic to keep in mind.
  - Etheryte 2y ago
    Do you happen to have a reference for that or a specific link to learn more? That sounds oddly specific.
    - senko 2y ago
      Was also interested and a quick search for "human fat cells turnover time years" returned a few research papers that quote 10% a year.

oaxoa 2y ago

[dead]

paulpauper 2y ago

The more you research/learn about obesity, the worse it is, much like smoking. One of the most depressing stats is that dieting does not get easier with time. The probability of eventually regaining all the weight eventually converges to 100%. Even if you're successful for 2 years, people still regain by year 4, 5, etc. The body never resists trying to regain the weight. GLP-1 drugs are the best hope yet.

agos 2y ago
absolutely. and yet people will still say "just eat less"! Imagine telling a person who smokes "just smoke less"
- _Algernon_ 2y ago
  That's... A completely reasonable thing to say..
  - agos 2y ago
    the "just" is doing a lot of work, too much. Most people with an addiction or weight problem are very well aware of what they should be doing (or not doing), but they'll be fighting with their body telling them constantly that they really, really need to eat or smoke. This is the hard part and telling someone "just do it" is not helpful in the least
    - schrectacular 2y ago
      Unfortunately it's also the only advice that works, in a trite and tautological way. You either find the willpower (in the addiction research it seems that some sort of "religious awakening" or "higher purpose" seems to be key) or you struggle with your addiction to the end. The comment elsewhere about HAVING to eat was eye opening to me. For some reason I never made that connection - the cocaine addict doesn't have to do just a tiny line a few times a day. They can kick it permanently. A food addict has to face their temptations every meal...
  - 2y ago

anovikov 2y ago

[flagged]

rexpop 2y ago
> How about MAGA? What if it can be treated with some pills, too? I often wonder if anti-psychotics might do the trick. They often seem captivated by paranoid delusions.

squeedles 2y ago

As this article shows, there are incredibly complex feedback mechanisms around weight and metabolism, but thermodynamics are still fundamentally a thing. After he died last year, I ran across this engineering and accounting approach to weight maintenance and loss written up by John Walker (one of the Autodesk founders). It worked very well for him and changed the way I thought about weight and eating. It is interesting reading because he is "one of us" https://www.fourmilab.ch/hackdiet/ Basically, he uses a first level approximation of the body as a control system with a feedback loop, and tries to pin down some techniques to bring the system to a known good state (target weight) and manage that loop for long term stability.

dorfsmay 2y ago
The problem with diets based only on calories is that they don't take satiety into account, nor health. Calories is what makes you gain/lose weight, it's basic physics. Satiety is what makes you want to eat more/less. Nutrients are what is making you healthy. Fiber and protein tends to make you feel full. Lack of them allow you to eat large amount of calories without feeling full. You need to keep track of micro and macro nutrient to stay healthy.
- squeedles 2y ago
  Quite so, and I think he does address that, but those are all second level factors, along with activity level, exercise, and their effect on your caloric requirements. He puts together a bunch of excel spreadsheets for tracking many factors, but I have found the simple discipline of accounting for what I eat in a little txt file on my phone sufficient to align my choices with my desired outcome.
  - dorfsmay 2y ago
    Exercise and activity are contributing to calories (calories out). These days there are apps that make it easy to track calories, macro and nutrients.
  - taeric 2y ago

wonderwonder 2y ago

I always used to think negatively about people that were severely overweight (still do unconsciously if I'm being honest) as I always attributed their obesity to lack of will power. I'm a huge proponent of better living through chemistry (steroids - with frequent blood work, nootropics, whatever) and recently I decided to get my abs back. I hopped on some compounded semiglutide and was blown away by the change in my attitude towards food. I had always snacked at night after the kids went to bed and had built up about 25 pounds over the past decade. I was able to drop it all in 3 months without any sort of dieting, I just ate when I was hungry. Decided to not eat after 6:30pm and just did it, no issues while on the semiglutide. Really changed my attitude about food, and my body and minds interaction with it. A lot of this is subconscious and really hard to get control of. The fact a chemical compound was able to change my mental relationship with food also put an interesting spin on my ideas about consciousness and self control as a whole. We are just slaves to our biological processes.

monkeycantype 2y ago
I had this same experience, but I have not continued to take the medication after a short experiment. I found I could get a similar outcome (subjective experience) through my food selection Today I’ve eaten around 2kg of vegetables today (zucchini, capsicum, eggplant, cauliflower, spinach) all of which was under 500 calories, and I’ve eaten fish. If I eat a massive amount of vegetables and get ~200g protein, I don’t feel I’m depriving myself and am satiated on under 2000 calories, previously I would typically eat over 3000 on a normal day. As for people lacking willpower, the genetics of hunger mean all of us experience vastly different levels of hunger. You might be interested to read about the family in Pakistan who could not produce a relevant hormone leptin, and the toddlers driven to fighting by insatiable hunger to steal food from each other, and the dramatic change in their lives after medical intervention with leptin injections
- wonderwonder 2y ago
  My brother's family has done something similar although in a different direction. They have been strictly carnivore for several years now. Able to eat large amounts of food while keeping calories low and feeling satiated. It's worked well for them. I'll look at that study you mentioned, thank you.

bowsamic 2y ago

Calorie counting is the only truly reliable way to lose weight

amanaplanacanal 2y ago
That's clearly not true. Calorie counting can work if you stick to it and aren't shit at estimating the calories in food. Almost any diet can work if you are able to stick with it. Appetite suppressants like amphetamines seen to work too. We've also seen that the new diabetes drugs actually work.
- laichzeit0 2y ago
  “Any diet” is still putting you at a net caloric deficit. There is no other principle that can explain weight loss that I know of. Whether you’re counting calories to achieve that deficit or following a “diet” it comes down to the exact same thing. Counting calories just demystifies the process of weight loss.
- escobar_west 2y ago
  The only reliable way to lose weight is through a caloric deficit. And the only reliable way to be on a caloric deficit is through counting your calories. If you're dieting without actually counting your calories, then at best you are only hoping and guessing that your diet is sufficient enough to put you in a caloric deficit.
  - loeg 2y ago
    You don't have to count calories to eat in a caloric deficit. Counting is not the only reliable way to hit a deficit. Tons and tons of people on GLP-1 drugs are not counting calories but are in a deficit.
    - escobar_west 2y ago
      I'd argue that taking a drug to suppress your appetite is way more extreme and unhealthy than simply counting calories, but I guess to each their own. And yes even in that case you're still guessing and hoping you're in a caloric deficit because different foods will satiate your hunger for different caloric cost. If you're not counting calories you could be cutting calories too aggressively or not aggressively enough, or you might not be getting required macronutrient intake with your given diet.

meindnoch 2y ago

Well, yeah. Adipocytes multiply when you get fat. But when you lose weight, they don't apoptose, they just shrink in volume by giving up their lipid stores.

mkoubaa 2y ago
I am pretty sure the only way to reduce the number of cells is liposuction
- rcruzeiro 2y ago
  Worse than that. Subcutaneous fat (which is the one you can trim off with liposuction) usually expands relying more in cell expansion and not in hyperplasia. Visceral fat on the other hand, is way more likely to involve hyperplasia and you cannot use liposuction against this type of fat. This is also the fat that is very hormonally active and increases the risks of diabetes, heart disease, cancers, strokes.
  - gosub100 2y ago
    Is it unremovable because it's inside the core muscles and near internal organs?
    - nradov 2y ago
      Right. A surgeon can't just stick a liposuction tube into the abdominal cavity and poke around. This would be major invasive surgery with a high risk of complications, far worse than leaving the adipose tissue in place.
    - meindnoch 2y ago
      See the second half of this video: https://www.youtube.com/watch?v=Bav_IBsuXEM https://www.youtube.com/watch?v=Bav_IBsuXEM Visceral fat is literally enclosing the intestines, major blood vessels, organs, etc. of the abdomen. Nevertheless, it is possible to surgically remove this sheet of fat that's covering your organs, it's called an omentectomy. But it's a big surgery, and done only in case of cancer, not for weight loss. That is, in humans: https://pubmed.ncbi.nlm.nih.gov/29367725/ https://pubmed.ncbi.nlm.nih.gov/29367725/

BurningFrog 2y ago

Since I had to look it up: "Adipose tissue" means "fat tissue".

cogburnd02 2y ago
You should definitely watch the Doctor Who episode Partners in Crime.
- jermaustin1 2y ago
  This was how I learned this word... It's insane that was almost 20 years ago.

monkfish328 2y ago

I wonder if fasting of some sort is able to reset these effects somehow - shoot any material on that if you know of it!

smileysteve 2y ago
The idea is that fasting does encourage aptopsis of cells.

yieldcrv 2y ago

> However, maintaining weight loss is a considerable challenge, especially as the body seems to retain an obesogenic memory that defends against body weight changes This is validating as I’m very skeptical about this when looking for a partner that currently has a physiology I’m interested in but had one I wasn’t interested in at some point before, and this seems to be a shared experience

suyash 2y ago

Can anyone share tips/insights to loose body fat so as to not gain it back?