It’s a subject where I have a hard time being sane, and I’m not aiming for charitable. It’s possible that I should cut people more slack for meaning well, or at least not knowing how much damage they’re doing and not wanting to know how much damage they’re doing, but it’s beyond me at the moment.
People who have cancer are congratulated on losing weight. People in depths of dangerous eating disorders are told how good they look, and the compliments dry up when they get healthier. People who use weight-increasing anti-depressants to not be suicidal are told to give up the drugs.
I grant that it’s easier to prove that the culture is insane on the subject than to prove that losing fat isn’t a good health strategy.
You haven’t addressed the question of how urgent it is for people to lose weight.
“Iterating through strategies” is only a good idea if the strategies are low cost—and a fair number of them aren’t.
I grant that it’s easier to prove that the culture is insane on the subject than to prove that losing fat isn’t a good health strategy.
The culture is insane on the subject, and losing fat is very good for you. That’s what makes it tricky—if you start fighting the cultural insanity and meanness to fat people in a naive way, you wind up with the reversed stupidity that is Healthy At Every Size and This Is Thin Privilege. Personally, the answer for me was to get my life together—I moved across the country away from my parents, moved in with much more emotionally healthy sister, went on a keto diet and lost fifty pounds (5″10′ male, ended high school at 160, went from roughly 220 to 170). Getting my shit together happened first—and then the weight loss was almost an afterthought.
You haven’t addressed the question of how urgent it is for people to lose weight.
You can lead a horse to water, but you can’t make them drink. Fat loss is fine and all, but most people got fat for a reason. I know I did—an extraordinarily stressful college environment combined with social isolation. I could deal with leaving those emotional needs unmet—for a time—if I was meeting at least some of my needs with comfort foods.
More generally, people in an unhealthy environment and state of mind do unhealthy things. It’s really difficult to fix the specific way it gets expressed without simply pushing people into their next best alternative.
“Iterating through strategies” is only a good idea if the strategies are low cost—and a fair number of them aren’t.
I’m not sure the right way to express this idea, so I’ll unpack it a bit more. There are a number of weight loss strategies, and they each work for some people and not for others. Use some research time to figure out what’s likely to work best, try it, and collect data about how it is going. Evaluate it when you expect to have noticeable results. If it’s working, keep going—otherwise, pick a new strategy that’s far enough away in solution space that you don’t expect it to fail for the same reasons.
I got pretty lucky by having keto work for me as the first method—although perhaps my success is more about fixing issues in my life and less about the specific diet.
What is your evidence that losing fat is very good for people?
I’m going to ask for a pretty high standard—at least five years of fairly stable fat loss, outcome-based evidence of improvement, and a reason to think that the improvement isn’t from exercise and/or a low glycemic diet. Some people don’t lose a lot of fat doing those things, but they do get healthier.
Strategies aren’t just about what works and what doesn’t. Some strategies make things worse for some people, and it’s hard to get information about that and harder (impossible?) to get statistics.
What is your evidence that losing fat is very good for people?
I may have inverted the whole cause-effect thing—after all, I did just admit that doing better in your life makes it much easier to lose fat. So it’s entirely plausible that doing better means that you simultaneously lose fat and do other things that make your life better/healthier.
Overall, body fat isn’t the node you want to target anyways, but rather the vague overall level of healthiness and life satisfaction. I believe there’s influence going both ways—that is, losing fat helps many people live healthier and more fulfilled lives, and that having a healthy and emotionally fulfilling life makes it easier to lose fat. I don’t know enough to make an analysis of the relative merits of telling people how to change eating habits X, Y, and Z, as compared to teaching them strategies to deal with their emotions and interpersonal relationships in a healthy way. I do know that they’re both vaguely good ideas with obvious benefits and opportunity costs, and definitely better than meandering along the same kind of strategies that lead them to want to make changes in their life in the first place.
at least five years of fairly stable fat loss, outcome-based evidence of improvement, and a reason to think that the improvement isn’t from exercise and/or a low glycemic diet.
Gastric bypass patients are an example of a population where there is reason to think that the stable weight loss is due mostly to fewer total calories, and they do seem to experience positive effects.
Liposuction, on the other hand, does not seem to share this positive health profile. (Of course, the “fat loss” in liposuction is very location specific)
What is your evidence that losing fat is very good for people?
I doubt there is any direct evidence since it’s pretty unusual for people to lose weight and keep it off for at least 5 years. And probably a lot of those people adopted lifestyle changes which would have been very good for them regardless of whether they lost the weight or not.
Still, I think it’s reasonable to believe that losing fat and keeping it off (assuming that you were obese to begin with) is a healthy thing for a couple reasons. First, one can analogize obesity to cigarette smoking. Evidently, both things cause harm to your body. But it’s well known that if you quit smoking, over time the excess health risks due to smoking go down and after 15 or 20 years your risks are pretty close to those of the never-smoked population. Common sense says that it should work in a similar manner for weight loss.
Second, I believe that there is research showing that objective measures of metabolic health such as cholesterol levels; blood sugar levels; and blood pressure tend to improve in obese people who lose weight. Again, this is suggestive that losing fat is good. This is also consistent with common sense. If excess fat increases your risk of health problems, then losing that fat ought to reduce those risks.
By the way, here is an excerpt from the blog of an obesity researcher:
First, the data on yo-yo diets, otherwise known as weight cycling. Looking at the most recent and robust data, one set from than Cancer Prevention Study II Nutrition Cohort which followed 55,983 men and 66,655 women from 1992-2008, and the other set from the Nurses Health Study which followed 44,882 women from 1972-1994, neither demonstrated any relationship between weight cycling and mortality. Other studies have exonerated weight cycling from increasing the risk of hypertension, and type 2 diabetes, and there’s a mixed bag of studies suggesting both protective and causal effects of weight cycling on various forms of cancer.
When you think about it, there’s some sense to this. It’s reasonably to hypothesize that the human body is adapted to weight cycling (at least to some degree).
Reduced weight seems obviously helpful if you have bad knees or some other joint problems.
“Seems” is the operative word. There are a fair number of people who say that losing weight helps their knee and/or hip joints.
However, I’ve also read accounts by people who found that losing weight didn’t help, but getting medical attention for specific problems did.
Ragen Chastain, a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they’d get if a thin person had the same knee problems.
I didn’t downvote, but “Ragen Chastain, a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they’d get if a thin person had the same knee problems” is not relevant to the discussion. I’m aware that it’s pretty common for doctors to suggest weight loss as a sole solution when this is inappropriate and other treatment is needed. But by “helpful” I did not mean “sufficient” or “a complete cure” or anything like that, or even “helpful in all possible particular types of joint problems”, and I think this should have been clear from a reasonably charitable reading of my comment.
That losing weight will help joint problems seems obvious, not just to doctors, but to the general public—I’ve talked with people who don’t seek other care for joint problems because they assume that weight loss is the one correct solution.
The belief that weight loss is the one and only approach can occasionally be deadly. The comments to the Chastain article include an account of a woman whose doctor told her that her back pain was caused by her being fat. The bone cancer wasn’t noticed in time.
You did say “seems helpful” rather than “the one and only cure”, but I’m honestly not sure how careful I should have been. It does seem reasonable to me to point it out when something that commonly seems reasonable is actually not reliably true, especially when the stakes are high.
The stakes aren’t usually life and death, but years of pain from a joint problem isn’t a small thing.
“I once even had a doctor prescribe blood pressure medication before my blood pressure was taken.” Sorry, but that’s not very believable. At best it’s a self-serving uncorroborated statement.
By the way, I don’t think there’s much rhyme or reason to a lot of the upvoting and downvoting which goes on here.
It doesn’t look at the effect on mortality (if I read it correctly, it’s at least using actual deaths rather than an estimate) of losing fat or trying to lose fat.
I moved across the country away from my parents, moved in with much more emotionally healthy sister, went on a keto diet and lost fifty pounds (5″10′ male, ended high school at 160, went from roughly 220 to 170). Getting my shit together happened first—and then the weight loss was almost an afterthought.
That anecdote doesn’t even separate cause and effect. Maybe you lose weight because you moved, and the diet had no effect. Or maybe your emotional state improved because you lost weight, and moving had no effect—big changes in weight are known to cause or at least correlate with emotional changes.
Fat loss is fine and all, but most people got fat for a reason.
Everything happens for a reason, but most events have many complexly interacting causes, not a single unentangled one. So your claim needs a lot of evidence, and as far as I can see you’re not explicitly presenting any.
Maybe you lose weight because you moved, and the diet had no effect.
It was the diet, full stop. The diet was months after moving, and I stayed at the old weight before starting the diet, and I stopped losing weight when I went off the diet.
Or maybe your emotional state improved because you lost weight, and moving had no effect
I wouldn’t have lost weight without the diet, which wouldn’t have happened without moving. It’s really the difference between A->C and A->B->C. The counterfactual where I successfully go on a keto diet without the social support of my sister isn’t something that would have happened.
Everything happens for a reason, but most events have many complexly interacting causes, not a single unentangled one.
Let me be more specific in the counterfactuals I’m envisioning. You tell a person with a comfort eating problem to go on a specific diet, and they wind up saying they’re on a diet but end up hiding their comfort eating. Any amount of diet advice is not going to work for them because dieting is solving the wrong problem. The right solution is teaching emotional awareness, alternative strategies for meeting your emotional needs, and general skills for improving your life.
I’ll retract the “most” part of “most people got fat for a reason”, because even if it’s true I don’t have the data to say that—all I really have is a story about how diets fail for people with certain issues.
People in depths of dangerous eating disorders are told how good they look, and the compliments dry up when they get healthier.
That’s people engaged in activities that someone has seen fit to classify as “dangerous eating disorders”.
People who use weight-increasing anti-depressants to not be suicidal are told to give up the drugs.
From what I know about the anti-depressants in question, weight gain is by no means their only negative side effect. And yes, I am willing to say that the majority of people on anti-depressants would be better of without them.
It’s a subject where I have a hard time being sane, and I’m not aiming for charitable. It’s possible that I should cut people more slack for meaning well, or at least not knowing how much damage they’re doing and not wanting to know how much damage they’re doing, but it’s beyond me at the moment.
People who have cancer are congratulated on losing weight. People in depths of dangerous eating disorders are told how good they look, and the compliments dry up when they get healthier. People who use weight-increasing anti-depressants to not be suicidal are told to give up the drugs.
I grant that it’s easier to prove that the culture is insane on the subject than to prove that losing fat isn’t a good health strategy.
You haven’t addressed the question of how urgent it is for people to lose weight.
“Iterating through strategies” is only a good idea if the strategies are low cost—and a fair number of them aren’t.
The culture is insane on the subject, and losing fat is very good for you. That’s what makes it tricky—if you start fighting the cultural insanity and meanness to fat people in a naive way, you wind up with the reversed stupidity that is Healthy At Every Size and This Is Thin Privilege. Personally, the answer for me was to get my life together—I moved across the country away from my parents, moved in with much more emotionally healthy sister, went on a keto diet and lost fifty pounds (5″10′ male, ended high school at 160, went from roughly 220 to 170). Getting my shit together happened first—and then the weight loss was almost an afterthought.
You can lead a horse to water, but you can’t make them drink. Fat loss is fine and all, but most people got fat for a reason. I know I did—an extraordinarily stressful college environment combined with social isolation. I could deal with leaving those emotional needs unmet—for a time—if I was meeting at least some of my needs with comfort foods.
More generally, people in an unhealthy environment and state of mind do unhealthy things. It’s really difficult to fix the specific way it gets expressed without simply pushing people into their next best alternative.
I’m not sure the right way to express this idea, so I’ll unpack it a bit more. There are a number of weight loss strategies, and they each work for some people and not for others. Use some research time to figure out what’s likely to work best, try it, and collect data about how it is going. Evaluate it when you expect to have noticeable results. If it’s working, keep going—otherwise, pick a new strategy that’s far enough away in solution space that you don’t expect it to fail for the same reasons.
I got pretty lucky by having keto work for me as the first method—although perhaps my success is more about fixing issues in my life and less about the specific diet.
What is your evidence that losing fat is very good for people?
I’m going to ask for a pretty high standard—at least five years of fairly stable fat loss, outcome-based evidence of improvement, and a reason to think that the improvement isn’t from exercise and/or a low glycemic diet. Some people don’t lose a lot of fat doing those things, but they do get healthier.
Strategies aren’t just about what works and what doesn’t. Some strategies make things worse for some people, and it’s hard to get information about that and harder (impossible?) to get statistics.
I may have inverted the whole cause-effect thing—after all, I did just admit that doing better in your life makes it much easier to lose fat. So it’s entirely plausible that doing better means that you simultaneously lose fat and do other things that make your life better/healthier.
Overall, body fat isn’t the node you want to target anyways, but rather the vague overall level of healthiness and life satisfaction. I believe there’s influence going both ways—that is, losing fat helps many people live healthier and more fulfilled lives, and that having a healthy and emotionally fulfilling life makes it easier to lose fat. I don’t know enough to make an analysis of the relative merits of telling people how to change eating habits X, Y, and Z, as compared to teaching them strategies to deal with their emotions and interpersonal relationships in a healthy way. I do know that they’re both vaguely good ideas with obvious benefits and opportunity costs, and definitely better than meandering along the same kind of strategies that lead them to want to make changes in their life in the first place.
Gastric bypass patients are an example of a population where there is reason to think that the stable weight loss is due mostly to fewer total calories, and they do seem to experience positive effects.
Liposuction, on the other hand, does not seem to share this positive health profile. (Of course, the “fat loss” in liposuction is very location specific)
I doubt there is any direct evidence since it’s pretty unusual for people to lose weight and keep it off for at least 5 years. And probably a lot of those people adopted lifestyle changes which would have been very good for them regardless of whether they lost the weight or not.
Still, I think it’s reasonable to believe that losing fat and keeping it off (assuming that you were obese to begin with) is a healthy thing for a couple reasons. First, one can analogize obesity to cigarette smoking. Evidently, both things cause harm to your body. But it’s well known that if you quit smoking, over time the excess health risks due to smoking go down and after 15 or 20 years your risks are pretty close to those of the never-smoked population. Common sense says that it should work in a similar manner for weight loss.
Second, I believe that there is research showing that objective measures of metabolic health such as cholesterol levels; blood sugar levels; and blood pressure tend to improve in obese people who lose weight. Again, this is suggestive that losing fat is good. This is also consistent with common sense. If excess fat increases your risk of health problems, then losing that fat ought to reduce those risks.
However, if very few people keep the fat off, then the effects of regaining it also need to be considered.
By the way, here is an excerpt from the blog of an obesity researcher:
http://www.weightymatters.ca/2012/03/why-haes-may-never-go-mainstream.html
When you think about it, there’s some sense to this. It’s reasonably to hypothesize that the human body is adapted to weight cycling (at least to some degree).
Yes, I completely agree.
Reduced weight seems obviously helpful if you have bad knees or some other joint problems. As for general overall health, I haven’t a clue.
“Seems” is the operative word. There are a fair number of people who say that losing weight helps their knee and/or hip joints.
However, I’ve also read accounts by people who found that losing weight didn’t help, but getting medical attention for specific problems did.
Ragen Chastain, a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they’d get if a thin person had the same knee problems.
Why the down votes?
The comment doesn’t seem especially different to me than my usual.
I didn’t downvote, but “Ragen Chastain, a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they’d get if a thin person had the same knee problems” is not relevant to the discussion. I’m aware that it’s pretty common for doctors to suggest weight loss as a sole solution when this is inappropriate and other treatment is needed. But by “helpful” I did not mean “sufficient” or “a complete cure” or anything like that, or even “helpful in all possible particular types of joint problems”, and I think this should have been clear from a reasonably charitable reading of my comment.
That losing weight will help joint problems seems obvious, not just to doctors, but to the general public—I’ve talked with people who don’t seek other care for joint problems because they assume that weight loss is the one correct solution.
The belief that weight loss is the one and only approach can occasionally be deadly. The comments to the Chastain article include an account of a woman whose doctor told her that her back pain was caused by her being fat. The bone cancer wasn’t noticed in time.
You did say “seems helpful” rather than “the one and only cure”, but I’m honestly not sure how careful I should have been. It does seem reasonable to me to point it out when something that commonly seems reasonable is actually not reliably true, especially when the stakes are high.
The stakes aren’t usually life and death, but years of pain from a joint problem isn’t a small thing.
I didn’t downvote your comment, but I would point out that Ragen Chastain is not a very credible source.
For example, check out this video:
http://www.youtube.com/watch?v=xwzz6STWp8g
“I once even had a doctor prescribe blood pressure medication before my blood pressure was taken.” Sorry, but that’s not very believable. At best it’s a self-serving uncorroborated statement.
By the way, I don’t think there’s much rhyme or reason to a lot of the upvoting and downvoting which goes on here.
(Of course it depends on how much fat those people had before.)
Admittedly not terribly strong evidence, but see Figure 1 in this study.
It doesn’t look at the effect on mortality (if I read it correctly, it’s at least using actual deaths rather than an estimate) of losing fat or trying to lose fat.
That anecdote doesn’t even separate cause and effect. Maybe you lose weight because you moved, and the diet had no effect. Or maybe your emotional state improved because you lost weight, and moving had no effect—big changes in weight are known to cause or at least correlate with emotional changes.
Everything happens for a reason, but most events have many complexly interacting causes, not a single unentangled one. So your claim needs a lot of evidence, and as far as I can see you’re not explicitly presenting any.
It was the diet, full stop. The diet was months after moving, and I stayed at the old weight before starting the diet, and I stopped losing weight when I went off the diet.
I wouldn’t have lost weight without the diet, which wouldn’t have happened without moving. It’s really the difference between A->C and A->B->C. The counterfactual where I successfully go on a keto diet without the social support of my sister isn’t something that would have happened.
Let me be more specific in the counterfactuals I’m envisioning. You tell a person with a comfort eating problem to go on a specific diet, and they wind up saying they’re on a diet but end up hiding their comfort eating. Any amount of diet advice is not going to work for them because dieting is solving the wrong problem. The right solution is teaching emotional awareness, alternative strategies for meeting your emotional needs, and general skills for improving your life.
I’ll retract the “most” part of “most people got fat for a reason”, because even if it’s true I don’t have the data to say that—all I really have is a story about how diets fail for people with certain issues.
That’s people engaged in activities that someone has seen fit to classify as “dangerous eating disorders”.
From what I know about the anti-depressants in question, weight gain is by no means their only negative side effect. And yes, I am willing to say that the majority of people on anti-depressants would be better of without them.
I’m talking about people who were ending up in the emergency room because of malnutrition-induced fainting and/or heart problems.
Would you care to expand on why you think anti-depressants are more likely to be a net detriment than not?
I can’t get your point.