Obesity Epidemic Explained in 0.9 Subway Cookies
If we’re going to be talking about the obesity epidemic, it might be useful to actually look at some numbers to see how much change it takes to explain the increase in average weight. Given people keep talking about the 1980 inflection point I’m going to use a typical person from that time period as my starting point and track him for five years with minor behavioral changes.
Starting as a 1980′s 165lb 5′8 35 y/o man who goes out swing dancing twice a week
As you can see, it doesn’t take much behavioral change to account for the change in average weight we’ve seen over the last 40 years. A little more sedentary or a little less satiating food per calorie which would lead to eating more. We don’t need fancy contamination theories.
I’ve seen some really smart people overcomplicate this. Eliezer made a Facebook post asking for advice losing weight saying not to bother telling him to eat less because it doesn’t work. A few years later he made a LessWrong post saying he lost weight by eating less. The simple things are the answer, the question is just how to eat less and move more without making yourself miserable.
Some things that will help if you are trying to lose weight and find that you’re hungry and miserable all the time:
High fiber foods are often very satiating per calorie (veggies)
Low calorie density per volume/weight tend to be very satiating per calorie (veggies, lean meats)
Sugary and oily food tend to have high calorie density and shouldn’t make up the bulk of your diet
Nonnutritive sweeteners can help you satisfy your sweet tooth without breaking the bank on calories
You don’t have to lift/run, you can find the activity that you find fun
Time restricted feeding (often called intermittent fasting) tends to vastly increase satiety
You don’t have to track calories forever, you can track things for a few months to build more of an intuition for calorie content and then stop
Pick habits you’ll actually stick to. No point in driving yourself crazy for 6 days until you snap and eat a whole cake on day 7
I find this post naive, like much writing on weight management.
I have struggled with my weight for 40 years (BMI currently 26, slightly overweight but strangely enough the level at which death rates are lowest). And I have read just about every book on the subject and cubic meters of academic papers. Perhaps I have learned something.
> things that will help
I tried all, yes all, those things over the years. Some worked, a bit, temporarily and none worked permanently. I agree that they are plausible stories but they are nothing more.
What this and most writing on diet ignore is that weight management is tightly controlled by the body and lower brain, almost entirely out of conscious control. Yes you can eat less for a while, just as you can consciously stop breathing for a while. But in the end willpower has almost zero effect.
Feedback mechanisms operate through many mechanisms—by regulating appetite. by downregulating metabolism, willingness to expend energy, feelings of fatigue, sleepiness etc. If you have not woken at night having been dreaming about eating, with the only thought in your head being “I don’t care what happens I must eat now” you have not experienced hunger. In Ancel Keys’ WWII study on starvation subjects were found literally eating from garbage cans after a while.
When people are young they find it far easier to control weight. As you get older it gets harder. BY 50-60 virtually everyone is struggling. So don’t declare victory too soon. https://politicaldictionary.com/wp-content/uploads/2020/03/mission-accomplished-moment.jpg
The idea that eating one extra cookie a day voluntarily will have the results predicted by a simplistic mathematical model is not even wrong. You see this in studies where they try to get people to gain weight—it is just as hard for many people to gain weight as it is for others to lose weight. the nody adapts and counters any destablizing inputs.
As Ey pointed out no-one thinks that weight loss is worth the price if it means you effectively lose 15-20 points of IQ because your body has decided to economize on energy supplies to the brain. And no-one thinks that weight loss is good if you mostly lose lean body mass, bone mass and your immune system is weakened. What people want to lose is fat. This is a very different thing from weight loss.
So what is the solution? I have lost 15kg of fat over the years (10 kg of weight when you take into account +5kg muscle).
I do not claim any of the things below are a magic bullet. Such a thing does not exist. But these things have helped me.
1. Eat a nutritionally rich diet. If you are lacking nutrients you will be hungry. Something like the diet recommended in “Eat Rich Live Long”. Just ignore the author’s views on covid19. Protein is often the nutrient in short supply.
1a. In general try to avoid empty calories. Sorry this includes wine and beer, even ‘craft’ beer.
2. Limit carbohydrates to the lowest level consistent with feeling OK. Note that a period of adaption is needed. Especially avoid sugar/fructose. You do not need keto but low carb changed the game for me.
3. Limit polyunsaturated fats especially Omega 6 “vegetable oils”. Like sugars they are nutritionally barren and do not provide satiety commensurate with calories. They are essential but only to 2-3% of calories and it is virtually impossible on a diet with real food to go under this. In contrast saturated fat produces great feelings of satiety and is IMO metabolically benign.
4. Eat seldom e.g. once or twice a day. This helps your body learn to burn fat.
5. A combination of small amounts of intense exercise and large amounts of light exercise such as walking. I walk about 6km/day and do weightlifting. But rest days are important too.
6. It seems to take about 2 years for the body to adapt to your new level of fat. In the meantime you will be hungry. But after the adaption (IMHO due to a reduction in the number of fat cells—contrary to medical orthodoxy) things get a lot better.
7. Get plenty of sleep and limit stress and have pleasure in your life. If you are miserable and stressed you are far more likely to overeat comfort food.
8. Avoid toxic environments like fast food outlets, most cafes, restaurants etc. The focus on hyper-palatability combined with hyper-calories and hypo-nutrition is terrible.
9. Be aware that much nutritional advice, including that delivered by captured regulatory agencies, is warped out of recognition by financial agendas, and various other ideological agendas (e.g. that coming out of the College of Nutritional Evangelism, now renamed Loma Linda University, whose doctrines seem to be inspired by 19th century religious fantasies that held that everyone including the lions were vegans in the Garden of Eden). The whole medical field is also very prone to capture by “Great Men” who dominate the field for decades for reasons utterly removed from the correctness of their theories.
This matches my experience very closely as well, though I’m only about halfway to my goal (dropped from 238 to 215, want to get down to the low 190s) after 4 years of trying a bunch of different things.
What the OP is suggesting doesn’t work in practice for rats and mice, let alone humans who have many more levers with which to confound simple interventions through behavior, conscious or not.
It took me eight years to gain 40 pounds. That’s a difference of about 50-200 calories per day (increasing as base weight rises and it takes more food to generate a sustained weight gain), on average, by pure calorie math. AKA initially no more than the difference between standing vs sitting for one hour, walking an extra 0.5 mile vs not, or eating half an apple vs not. Seems like it should be a breeze to fix! Just a few minutes a day, or one simple action! And yet the years in which I switched to a standing desk (and extra 4-6 hours standing daily) I didn’t lose any weight, nor did I gain any when I stopped. The year I hiked 300 miles more than I normally do as part of a challenge, no weight loss. And all of that is in line with the research that exercise is not that helpful for controlling weight most of the time.
Eating keto (for me, <10% carbs, <20% protein) did help me lose weight steadily, and gave me more energy, but it just wasn’t sustainable for me. I basically lost the ability to eat with other people in many circumstances. 1) That’s very isolating, 2) I tend to eat more when eating alone, 3) it’s not feasible when eating is tied to work events or travel, and 4) on days when I did eat carbs I got significant temporary side effects, I couldn’t just take a one day break for Thanksgiving and Christmas (and birthdays, and Easter, and anniversaries, and...). I managed it for all of 2017, then stopped. Lost 20 pounds, gained 10 back. Then in early 2020 I cut out almost all refined oils and sugar and reduced refined grains my more than half, and lost that 10 again. This January I started 16:8 IF and lost another 5. I’d need to lose another 25 to hit an officially healthy BMI. With IF, as with keto previously, I have more energy, better mood, and less hunger between meals. Also, with cutting out refined ingredients, I don’t even enjoy most fast food and sweets anymore, they taste fake and have no depth of flavor.
I also notice that I never fidget anymore when sitting still. I noticed this change during grad school, which is about when I started gaining most of the weight, when for most of my life before that I tapped my foot to the point of regularly needing to be told to stop shaking the car. This is apparently equivalent to hundreds of extra calories burned per day according to some studies, and if I could somehow upregulate fidgeting I would apparently lose my remaining 20 pounds in under a year, without any other changes! But of course I can’t do that, and I have no idea why this changed, or if there’s any meaningful causal relation between that and my weight. Just one of many unconscious factors I’ve noticed.
Do you expect agave to be worse and glucose syrup (Karo) to be less bad as a sweetener than table sugar (sucrose) or high-fructose corn syrup?
I expect agave to be generally preferred over table sugar and HFCS due to having a significantly lower glycemic index. I’m unfamiliar with Karo.
Agave syrup has a lower glycemic index (than sucrose), and it’s marketed as a “health food” for this reason. But this is because it’s mostly fructose, which has to be metabolized in the liver. So it doesn’t cause the (maybe dangerous) blood sugar spikes, which means you also miss out on the satiety that would normally cause, and may thus overeat and get non-alcoholic fatty liver disease instead. Fructose is more intensely sweet than sucrose, so there is some additional concern that you could develop tolerance to the sweeter taste when it doesn’t cause satiety and thus train yourself overeat food containing sucrose as well. If all these reasons are true, then agave is very bad for you, and possibly worse than glucose syrup or sucrose (which is a disaccharide molecule made of fructose bonded to glucose).
HFCS is not the same thing as corn syrup. Cornstarch is made into corn syrup by breaking down the starches into their component glucose molecules (originally using heat, pressure, and acid, but it’s now mostly done with enzymes), thus corn syrup is mostly glucose and water. It’s also the primary ingredient in Karo-brand syrup. Corn syrup is made into HFCS (high-fructose corn syrup) by enzymatically converting some portion of the glucose into fructose (commonly about half, to make it a substitute for sucrose), which gives it very different metabolic properties compared to the corn syrup it started from.
I’ll throw in with you here, I think calories fundamentally is missing something. Not sure what it is yet, but I argued for suspecting vegetable oils. For anyone who naturally keeps a healthy weight, my intuition is: how hard would it be to lose 10 lbs from here? That would be hard as hell for me, and I have no reason to disbelieve people who have trouble getting to a healthy weight—especially in light of the contents of this post—it would only take a slight surplus to start getting really bad.
My question for you—could you elaborate just how useful avoiding vegetable oils is for you? And you wouldn’t have happened to have run an experiment where you just avoided them but nothing else? A man can hope!
There’s pretty strong evidence that the rise in obesity is not primarily behavioral. For example, here. If obesity is the result of a collective depletion of willpower, than why is obesity increasing in animals? Why does it depend on elevation?
Furthermore, the curves that you present are way too steep. The average American puts on about 1 pound/year, which suggests that our bodies are more or less in homeostasis. The question is, what long-term trend is pushing this homeostasis upwards?
>Furthermore, the curves that you present are way too steep. The average American puts on about 1 pound/year,
Because they’re already in their higher weight state. The graph was a hypothetical 1980 person being moved to 2010 and upping their intake. When we see studies putting people in metabolic wards we find that a 500 calorie a day surplus corresponds to a 1 lb a week weight gain, which is consistent with my curves
>There’s pretty strong evidence that the rise in obesity is not primarily behavioral
How are you defining behavioral? The body is pretty efficient at turning extra calories into weight, a disease can’t make you gain 20lbs by processing the food more. It can make you lose weight by processing the food less. The only mechanism a contaminant would have to raise your weight is by influencing your behavior so you spend less calories or intake more. There is no other mechanism by which a contaminant would work. It /must/ include an intermediate behavioral step
This seems like a strange claim to make, considering the results of various controlled overfeeding studies. (It’s also a strange framing on top of that.) Do you have any sources backing up the quoted claim?
By “not primarily behavioral” I mean the exact opposite of
While “eat less exercise more” may be fine advice at a personal level, it isn’t a sufficient answer to the society-wide epidemic of obesity that we currently face. If the root cause turns out to be pollution or microplastics or vegetable oil or whatever it is, calls to collectively increase our will-power instead of addressing this root cause are largely counterproductive virtue-signaling.
I disagree, although I found the evidence in the linked posts to be rather weak. When I think of “calories in, calories out” I don’t immediately think, “Therefore we should push for voluntary dieting changes.” There are likely involuntary and external factors related to our consumption, which act through the CICO mechanism, driving the obesity crisis.
It’s a bit like if we were debating the “income minus spending theory of wealth.” One hand, you’re right that “just spend less” is unhelpful advice for people. However, the theory is not actually an incorrect one. If people are actually getting poorer, then it’s either because their incomes went down, or their spending went up, or both. Denying the basic mechanism won’t lead to a solution. It will just make you confused forever.
FWIW, I also think the “income minus spending theory of wealth” works great for individuals and literally backwards for economies as a whole.
I don’t quite understand what you mean. National wealth works just like individual wealth. You linked to the Wikipedia page on “Austerity” (presumably because you think such policies do not work) but I don’t understand your point. Do you think either spending cuts or tax increases usually never increase national wealth? I also don’t think those things are equivalent to national income or expenses.
Yes, cutting spending/raising taxes (aka austerity) is anti-correlated with GDP growth.
My point is more so that micro vs macro policy (whether economic or health-related) cannot be reduced to simply “add up the parts”. To take a specific example, the push to make us all eat margarine instead of butter because it contains less saturated fat was almost certainly a mistake.
The “income minus spending theory of wealth” when applied to states implies that if the state cuts spending then the economy would be better. But that’s definitely not true always (for example, research spending), but in the general sense it’s also not true according to some macroeconomic models (like Modern Monetary Theory). Since the state’s wealth is the economy as a whole, not it’s balance sheet, modeling income as taxes and spending as government expenditures doesn’t line up. Increasing taxes decreases the size of the economy but prevents inflation from occurring. Government expenditures increases the size of the economy by stimulating it but can cause inflation. A state increases its wealth by having expenditures and taxes work together correctly to stimulate the economy without unreasonable levels of inflation. That’s leaving aside trade with foreign countries, but it works fairly similarly.
You have not explained why a vast population should mystically choose to eat 0.9 more cookies per day or to replace dancing with Netflix. Yet we see that something equivalent in effect has in fact happened.
And you are assuming a deeply unrealistic model in which each person exercises unlimited long-term control not only over specific behaviors (which are in fact hard to control), but over the total ensemble of all their actions. Not only are you assuming that a person can feasibly cause themselves to eat 0.9 fewer cookies per day for many years, but that, given that they have done so, they will also somehow prevent themselves from switching from dancing to Netflix without even noticing that they have made that switch.
Fair point that I didn’t include as much detail as I could.
My belief is that most people react to “the average weight went up over 20lbs between 1980 and 2010” with “wow that’s a lot, there must be something really weird going on we need a complex thesis with a scary name” but react to “the average calorie budget per day went up 200 calories” with “wow that’s it? I’d expect it to be more given, ya know, everything”.
My post was mostly just meant to put the magnitude of the change in perspective for them.
It would have taken me a lot longer than the 20 minutes I spent on the post if I wanted to find sources on the prevalence of low-satiety foods sedentary entertainment to talk about how they’re more common. I was trying to nail an effort:usefulness sweet spot
I think it’s interesting that you label protein and vegetables as high-satiety foods, when that just isn’t the case for me. Lean meats and veggies satiate me for longer than refined grains, but nor nearly as long as food higher in fat, as long as they’re relatively healthy fats (olive or avocado oil, grass fed butter and cream, cheese, nuts and seeds, things like that). That result definitely varies somewhat between people, but my experience isn’t out of the ordinary. Eating veggies or protein without fat just leaves me feeling full but unsatisfied, waiting until my stomach will let me eat more.
I agree with your point about the magnitude of the change. People didn’t suddenly start eating vastly more food after 1980. But that potentially cuts both ways: most of the other trends in diet and exercise were gradual and started much earlier, yet weight wasn’t increasing at a population level then. So why would slight reductions reverse the trend now, when slight increases didn’t generate it before? Why this recommend this specific slight intervention when so many other things have changed in our lives and environments, especially when you know that it just will come off as insulting to most people who’ve actually struggled to lose weight?
Yes, sometimes it is that simple. I know people who’ve just cut our soda and/or started walking for half an hour a day and lost tens of pounds in a year. And I’m glad for them! But not everyone’s body responds that way, and that’s kinda the point.
Edit to add: also, if the amount of calorie variation needed to lose 20 pounds really were as small as you say, at the level of a single cookie weighing less than 50 grams, then no, intuition for portion sizes would not be sufficient for controlling food intake, and you really would have to measure things. That would mean that being off by a teaspoon of oil when grilling a chicken breast in a pan each day is worth 5 pounds of body fat over time, and that’s just one part of one meal. Ditto for replacing a cup of strawberries with the same volume of apple or melon, or a cup of apple or melon with the same volume of banana—which are the kinds of things that over time just take way too much mindshare to keep up with for every single food decision, even for smart people who like math and measuring things.
Unless the alternative is to eat the whole cake every day, of course. Then, eating the whole cake only 1 day out of 7 is a huge improvement.
This seems to be ignoring the set point hypothesis- was that deliberate?
To steelman this (I haven’t seen the Facebook post), just getting told to “eat less” is not helpful advice. There is a sense where it’s the solution: there are two variables, calories in and calories out, and “eat less” decreases the calories in. However, it’s not good advice because people don’t generally have enough long term commitment power to just cut out food. Your suggestions at the end of the post are ways to make eating less easier, but you need to have those intermediate solutions.
I agree getting told to eat less is not helpful advice. Here is the Facebook post, which I don’t think your steelman applies to.