It occurs to me that there are two separate questions:
Do low carb diets work better than other diets?
Do low carb diets work at all?
Even if the answer to the first question is “yes,” the answer to the second question is clearly “no.” In the sense that the vast majority of people end up regaining weight regardless of the diet they are on.
That’s a big problem for Taubes’ nutritionistic theory. Let’s assume for the moment that Taubes is correct, that if you simply eliminate “refined carbohydrates” (whatever that means) from your diet, you can eat anything else ad libitum and get and stay thin. The fact that low-carb dieters experience weight regain must then mean that they are experiencing difficult-to-resist urges to consume refined carbohydrates. But if you find some way to resist difficult-to-resist urges, then arguably you don’t need low carb dieting in the first place.
I imagine Taubes’ supporters would respond that a low-carb dieter’s difficult-to-resist urges are less difficult to resist than those of other dieter’s. Which may be true, but it doesn’t change the fact that—any way you slice it --
(1) The central and essential problem of successful dieting is dealing with the problem of difficult-to-resist urges;
Preponderance of research indicates that high carb meals (especially in form of starches) are more satiating for the same calories than high fat meals, so it is probably not even true that the urges are lessened. There are some counter-intuitive immediate effects (loss of water) and certain psychological factors (it’s more fun for some people to believe that mainstream is completely wrong) which can explain the appeal of the low carb dieting.
Another issue is that of health. There’s no reason what so ever that the easiest to resist diet would be the healthiest one. If anything, we ought to expect ourselves to naturally avoid at least some highly unhealthy meals, and so a diet that is very unhealthy may be easier to resist overeating on.
Preponderance of research indicates that high carb meals (especially in form of starches) are more satiating for the same calories than high fat meals, so it is probably not even true that the urges are lessened.
Well I suppose that Taubes’ supporters would argue that protein provides extra satiation. Not that it really matters, because there doesn’t seem to be a magic balance of macronutrients which lets you eat ad libitum; get and stay thin; and avoid the problem of difficult-to-resist eating urges.
There are some counter-intuitive immediate effects (loss of water) and certain psychological factors (it’s more fun for some people to believe that mainstream is completely wrong) which can explain the appeal of the low carb dieting.
Yes. You know, I have wondered about the chart which shows an average long term weight loss of 5 extra pounds among low-carb dieters. How much of that 5 pounds is water?
Another issue is that of health. There’s no reason what so ever that the easiest to resist diet would be the healthiest one.
I think you mean the “easiest to stick to diet.” But anyway, we need to be clear about what “healthiest” means. It occurs to me that “healthy” is multi-dimensional when it comes to food. That said, if your point is that on balance, being a few pounds lighter from low-carb dieting is not necessarily a net benefit in terms of cardiovascular health; metabolic health; etc., I would have to agree with you.
Not that it really matters, because there doesn’t seem to be a magic balance of macronutrients which lets you eat ad libitum; get and stay thin; and avoid the problem of difficult-to-resist eating urges.
Obesity is a very recent problem, though, so there’s something that could be done for majority of people—if anything, rolling back a few decades on as many things as you can (within reason of course) should work well.
I think you mean the “easiest to stick to diet.”
Sorry, I wasn’t clear. I meant, easiest to resist eating too much with. On normal diets, sticking to the diet is all about resisting the slippery slope of eating more of the same things, but on a very weird diet, sticking to the diet is about merely not buying things proclaimed ‘bad’, which may be easier. After all we all have mechanisms for resisting the urge to eat colourful, tasty looking berries that are known to be poisonous. It could be psychologically easier to label some things as “poisons” and not eat them, than to limit the amounts.
Obesity is a very recent problem, though, so there’s something that could be done for majority of people—if anything, rolling back a few decades on as many things as you can (within reason of course) should work well.
Agreed, although that sort of subsumes the problem of difficult-to-resist urges. A few decades ago, there were not jumbo slices of pizza available for a dollar on every street corner; there were not hot dogs for a dollar at gas stations and movie theaters; and so on.
It’s probably also worth noting that a few decades ago, cigarette smoking was a much more acceptable diet strategy.
On normal diets, sticking to the diet is all about resisting the slippery slope of eating more of the same things, but on a very weird diet, sticking to the diet is about merely not buying things proclaimed ‘bad’, which may be easier
I agree, except that I might quibble with your definition of “normal diet.”
It could be psychologically easier to label some things as “poisons” and not eat them, than to limit the amounts.
Yes, and then the next questions are (1) what foods or types of foods are, if treated as “poison,” likely to lead to an effective diet; and (2) what is the health cost to eliminating such foods.
In my non-professional opinion, the answer to the first question is the foods which are normally referred to as “junk food” or “comfort food.” The answer to the second question is (again in my non-professional opinion) that there is no health cost at all and in fact you are better off without such food in your life.
It’s probably also worth noting that a few decades ago, cigarette smoking was a much more acceptable diet strategy.
A lot of people didn’t smoke but didn’t get overweight either. And today people routinely consume far more potent stimulants (ADHD medications).
In my non-professional opinion, the answer to the first question is the foods which are normally referred to as “junk food” or “comfort food.” The answer to the second question is (again in my non-professional opinion) that there is no health cost at all and in fact you are better off without such food in your life.
Yeah, agreed. Ethics also works—e.g. there’s hardly any overweight vegetarians. (At least none that I know)
A lot of people didn’t smoke but didn’t get overweight either.
I agree, I’m not saying that smoking is the main reason people were thinner a few decades ago but surely it played a roll. It was very common back in the 70s and 80s for people to take up smoking as a weight control measure, either intentionally or unintentionally—it was inexpensive and no prescription was necessary. It was really common to see thin guys walking around with a pack of cigarettes tucked into their shirt sleeve.
Ethics also works—e.g. there’s hardly any overweight vegetarians
Assuming that’s the case, one can ask why such an approach might be effective. Is it because meat makes you fat? Is it because eliminating meat and meat derived food from one’s diet is a good way to cut out junk food? (I wouldn’t think so; how hard is it to make vegetarian french fries and donuts?)
I’m inclined to believe that identity is a good way to motivate oneself. If you think to yourself “I’m a vegetarian and vegetarians don’t eat that kind of food” or “I’m a foodie and foodies don’t eat processed crap” or “I’m a fitness buff and fitness buffs don’t pig out on nachos” it seems pretty effective.
It reminds me of the story of the Jewish girl who had a hard time resisting milk chocolate treats in the evening; so what she would do is eat a small piece of meat every night after dinner so that it would be non-kosher to eat the chocolate.
It’s plain difficult to consume a lot of calories if you cut out meat and dairy products, I think (I tried to go vegetarian but couldn’t manage to get enough calories, it’s just too much work to eat enough not to go underweight. I don’t eat junk food). Plus if you are changing your habits for some ethical reasons, you are not a hedonist to begin with.
It seems to me that huge majority of people who are successful at maintaining their weight never subscribe to any defined diets or calorie counting. I think that works like this—as you eat, you feel more and more full. You can just stop eating at an earlier point (when you don’t feel entirely full) or at a later point. Also, for the dieters slowly gaining back everything—they still succeed to maintain the weight below the level that makes them take a drastic measure. It’s just that this level is quite high, probably because only a level that high can justify a measure so drastic.
It’s plain difficult to consume a lot of calories if you cut out meat and dairy products,
Is that so? What about french fries, donuts, and soda? Those things can be made without animal products, no?
Plus if you are changing your habits for some ethical reasons, you are not a hedonist to begin with.
Well that may be part of it. Perhaps part of it is that vegetarians spend a lot of mental energy thinking about what they are eating. My impression is that fat people tend to consume a lot of food without being fully consciously aware of it.
It seems to me that huge majority of people who are successful at maintaining their weight never subscribe to any defined diets or calorie counting.
Are you talking about former fat people or never fat people?
Is that so? What about french fries, donuts, and soda? Those things can be made without animal products, no?
Haven’t got a deep frier, not a fan of french fries anyhow (not to the point of eating, what, 600 grams of them a day plus other stuff), prefer to eat at home. Also, sweets are a dessert. edit: and correct me if i’m wrong but with french fries something like half the calories come from fat, which is too much fat. Then, there’s silicone oil, trans fats, a wide variety of carcinogenic chemicals produced at high temperatures....
Are you talking about former fat people or never fat people?
Never fat or only ever fat due to a depression or the like.
edit: with the presently obese, if they are to lose weight and keep it low, that would imply future behaviour inconsistent with past behaviour under same conditions, i.e. simply is not going to happen without significant psychological changes or the like.
Haven’t got a deep frier, not a fan of french fries anyhow (not to the point of eating, what, 600 grams of them a day plus other stuff), prefer to eat at home. Also, sweets are a dessert. edit: and correct me if i’m wrong but with french fries something like half the calories come from fat, which is too much fat. Then, there’s silicone oil, trans fats, a wide variety of carcinogenic chemicals produced at high temperatures....
That suggests to me that convenience and identity are playing important roles. One of the things which has changed over the last 20 or 30 years is that it’s become a lot more convenient to eat junk food. At least that’s my impression. As to the latter, it’s hard to imagine a vegetarian walking into a typical fast food joint and ordering french fries—even if the fries are cooked in vegetable oil.
Never fat or only ever fat due to a depression or the like.
Then I agree with you. Having studied this stuff pretty carefully, I’ve come to the conclusion that everyone has an internal system which regulates his urges to eat or not eat. For people who are naturally thin, the system works well even in the modern obesogenic environment. If that system does not work well, then conscious effort must be applied to override that system. Which is very difficult to do day after day after day. Which is why most weight loss attempts ultimately fail.
i.e. simply is not going to happen without significant psychological changes or the like.
Yes, I agree with this. The fantasy is that one can make a few simple changes like reducing carbohydrate intake or eating oil every morning and thinness will naturally and easily follow. The reality is that one’s psychology—broadly defined—must change.
If that system does not work well, then conscious effort must be applied to override that system. Which is very difficult to do day after day after day. Which is why most weight loss attempts ultimately fail.
I think you’re looking wrong at it. Say, someone reaches the weight of X and then diets down to Y<X . At X they self regulated (consciously), at Y they didn’t before, and won’t in the future. There wasn’t a complete failure to self regulate at all, the set point was set very high though.
edit: that is to say, it is when at the weight X that they want to be at the weight Y. At the weight Y, from prior history, they don’t care to be at the weight Y . I’m looking at it from the point of trying to deduce control system’s properties, and it seems we can explain it by modelling the control as stateless (except for the controlled variable) over long periods of time. edit2: i.e. I see the dieting behaviour as caused by weight; the weight drops, after some time the habits are lost and the behaviour ceases.
edit: that is to say, it is when at the weight X that they want to be at the weight Y. At the weight Y, from prior history, they don’t care to be at the weight Y
Want is a quite tricky word.
A week ago I exposed my body to physical stress. Then I ate a fat meal and didn’t drink anything.
When I layed down to sleep.
I felt a lot of movement around my intestines and I noticed my swollen belly. It wasn’t like me belly hurt but it wasn’t a state in which I could sleep. After a while I went to the toilet and had diarrhea.
That went for around half an hour and I was thinking about what has to happen to come to a state where I could sleep reasonably well. The idea that there was still foot in my stomach and that would probably be part of the problem popped into my mind.
Shortly after that idea popped into my mind I got nauseous. Even through my reaction was “No, I don’t want to throw up”, my body didn’t care at the point. The process was set in motion and there was nothing I could do to stop it.
I did make a conscious judgement that my stomach should be empty, but I can’t say that I wanted to throw up.
I think you’re looking wrong at it. Say, someone reaches the weight of X and then diets down to Y<X . At X they self regulated (consciously), at Y they didn’t before, and won’t in the future. There wasn’t a complete failure to self regulate at all, the set point was set very high though.
Well then why do a lot of diets fail after only a few weeks when the person has lost just a couple pounds? It’s hard to believe that a small change in weight would have a big impact on preferences.
It’s hard to believe that a small change in weight would have a big impact on preferences.
Indeed, but that also applies to starting on the diet as a response to increased weight in the first place. Some combination of the last few pounds and environmental change makes people decide on a diet, then the pounds are lost plus the environment restores (e.g. it was newyear and there was a newyear resolution, cultural pressure, which ceased).
Indeed, but that also applies to starting on the diet as a response to increased weight in the first place. Some combination of the last few pounds and environmental change makes people decide on a diet, then the pounds are lost plus the environment restores (e.g. it was newyear and there was a newyear resolution, cultural pressure, which ceased).
Well can we agree that in late January, after our hypothetical fatty has lost a few pounds, he still wants to lose more weight?
And that under your model, in late January that desire has become diminished compared to some other drive?
And that under your model, in late January that desire has become diminished compared to some other drive?
Yes. In my model, an action is a response to the current conditions (Markov process), meaning that in same conditions, same actions tend to be taken.
I think I see the disparity between my model and conventional model. The conventional model seems to be that the individual formed a strong desire on new year, then this desire inexplicably waned a lot. My model is that usually the individual had a strong desire in early December, which got a little stronger in January, exceeding a threshold, and got a little weaker in February, dropping back below threshold.
Yes. In my model, an action is a response to the current conditions (Markov process), meaning that in same conditions, same actions tend to be taken.
In that case, your model does not seem to contradict my position. I assert that it’s difficult to use conscious effort for an extended period of time to override intuitive eating urges. I do not dispute that various factors such as loss of initial enthusiasm; initial success; opportunities to break one’s diet; stressful events; etc. are what proximately cause this breakdown of willpower.
Even if the answer to the first question is “yes,” the answer to the second question is clearly “no.” In the sense that the vast majority of people end up regaining weight regardless of the diet they are on.
I’m just now seeing this discussion, and don’t have time to read earlier posts.
Has it already been worked into the model that there are different sub-types of people? Some members of my family have successfully managed our weight, but it definitely wasn’t the same solution for each of us, while other members of the family are still needing a better solution. (How useful could it be to look at average results, except to determine that there is no ‘one size fits all’ strategy?)
...curiously, if I did look, would I find that this had been addressed?
I’m not saying you should look. I’m just saying, time spent is not so often rewarded, whereas anyone that has kept with the discussion would readily know.
Furthermore, it helps to keep track of and repeat one’s assumptions. To write, “doesn’t work at all” doesn’t sound right without some qualifications.
That’s very funny. I meant that I hadn’t read the previous posts:
Previously: Mainstream Nutrition Science on Obesity, Atkins Redux, Did the US Government Give Us Absurd Advice About Sugar?, What Causes Obesity?
At some point, it was probably discussed in which context it was appropriate to look at averaged data...I was hoping for a recap. I have composed a comment about whether I should have read the previous posts in the open thread.
[...] the answer to the [...] question is clearly “no.” In the sense that the vast majority of people end up regaining weight regardless of the diet they are on.
If the diet should work for some people, but not most people, why should you say it doesn’t work at all?
There appears to be some substance in the disagreement.
Suppose that there are many different ‘metabolic’ types of people, and different diets work with different efficacies for these different types. Perhaps any diet works well with a small subset of people (we already know some people don’t need to diet). Perhaps particular diets work well with certain subsets of people. Maybe a particular diet works extremely well for one subset, in that they lose weight and keep it off, whereas it only works moderately well for others (they gain the weight back or must combine different diets). This model—which seems quite likely anyway—would imply two things:
the effectiveness of a diet for small subsets of people would be completely obfuscated by averaging the data—for example, in all groups in Figure 2, dieters kept off some of the weight on average. This might mean that some people gained all the weight back, whereas some kept it off, or it might mean that everyone gained some back. (Note that showing standard error, rather than standard deviation, especially hides the role of individual variation.)
it would not be reasonable to expect a diet to work by working for everyone; instead, each person must find which diet, if any, works for them, and then we would say that a diet “works” if it works for any subset of people that would otherwise be overweight
I’m pretty certain that this paradigm is mainstream. Increasingly, we’re recognizing that medical solutions (for example, blood pressure medications or cancer therapies) need to be tailored to individual people.
Here’s what the authors of the 2008 paper (Figure 2) have to say about individual differences:
We enrolled few women; however, we observed a significant interaction between the effects of diet group and sex on weight loss (women tended to lose more weight on the Mediterranean diet), and this difference between men and women was also reflected in the changes in leptin levels. This possible sex-specific difference should be explored in further studies. The data from the few participants with diabetes are of interest, but we recognize that measurement of HOMA-IR is not an optimal method to assess insulin resistance among persons with diabetes.
Gender and diabetes are individual differences that are easy to recognize. Who knows (yet) how many characteristics are relevant for diet. If someone is sensitive to sugar like me (can’t go long periods without eating, tends to put on weight on their belly), the low-carb diet might work for them. Another complication is that changes in gut-bacteria populations over longer time-scales might result in long-term changes in your diet type. For example, over-weight people have different gut bacteria, diets change gut bacteria and gut bacteria might change your equilibrium weight. (The media is dominated by these studies recently.) I find a positive effect—once I’ve been on the low-carb diet for a few months, I’m not as sugar-sensitive and can maintain my ideal weight with a higher level of carbs than before I began the diet. Over time I lose the effect (too many holiday parties?) and need to return to a stricter low-carb diet.
I don’t fault the discussion for not accounting for gut bacteria yet (the diet science literature is huge, and you have to begin somewhere)...but would you agree that it is complicated enough that we can not infer much of anything from average responses to a diet, other than that a particular diet doesn’t work for everyone?
There appears to be some substance in the disagreement.
Suppose that there are many different ‘metabolic’ types of people, and different diets work with different efficacies for these different types. Perhaps any diet works well with a small subset of people (we already know some people don’t need to diet). Perhaps particular diets work well with certain subsets of people. Maybe a particular diet works extremely well for one subset, in that they lose weight and keep it off, whereas it only works moderately well for others (they gain the weight back or must combine different diets).
Assuming this is true, I don’t see how it contradicts anything I have said.
Do you dispute any of the following:
The vast majority of people end up regaining regardless of the diet they are on;
In general, the central and essential problem of successful dieting is dealing with the problem of difficult-to-resist urges;
Taubes’ approach is not a general solution to this problem.
Yes, I dispute with the first point. In any case, you can’t infer this from figure 2.
But that wasn’t my initial point. My initial point, asked in a different way, is what fraction of people would a diet have to be effective for, for you to say that it works “at all”? This is a substantive question, not just semantics, because I would like to convince that an expectation of 100% is not reasonable—rather 20 or even 10% would be quite good.
But that wasn’t my initial point. My initial point, asked in a different way, is what fraction of people would a diet have to be effective for, for you to say that it works “at all”?
I’m not sure, since I generally don’t use “at all” in positive sentences. Besides, it’s just a question of semantics.
This is a substantive question, not just semantics, because I would like to convince that an expectation of 100% is not reasonable—rather 20 or even 10% would be quite good.
Well it depends on how you define “reasonable” or “good.” In terms of deciding whether a diet is worth trying, a 10% success rate might make it worthwhile. But that’s not what we’re talking about—we’re talking about whether Taubes’ underlying model is correct or not. If his model is correct, one would expect a substantially higher success rate.
Yes, I dispute with the first point.
Well let’s quantify things. I assert that weight loss recidivism rates are well over 80%. What’s your estimate of the percentage?
I assert that weight loss recidivism rates are well over 80%. What’s your estimate of the percentage?
I expect that it is very high also. I think the situation could be better if we understood more.
-- we’re talking about whether Taubes’ underlying model is correct or not. If his model is correct, one would expect a substantially higher success rate.
From skimming through the posts, I’m not sure what Taubes’ underlying model is. Would you summarize it in a couple sentences?
In general, the central and essential problem of successful dieting is dealing with the problem of difficult-to-resist urges;
In your opinion, are these urges physical or cultural/psychological? (I think that a diet that does “work” must handle the ones that are physically based.)
I’m not sure, since I generally don’t use “at all” in positive sentences. Besides, it’s just a question of semantics.
You’re right, it works better to consider the negative context. How many people would the diet need to be effective for before you would not say that the diet does not work at all?
I expect that it is very high also. I think the situation could be better if we understood more.
Then why do you dispute my assertion that the vast majority of people end up regaining regardless of the diet they are on?
From skimming through the posts, I’m not sure what Taubes’ underlying model is. Would you summarize it in a couple sentences?
According to Jack, Taubes’ position is that generally speaking, if people eliminate refined carbohydrates (whatever that means) from their diet, they can eat other foods ad libitum and get and stay thin. Apparently Taubes believes that there is some important and dominant interplay between refined carbohydrates, insulin, and body fat. I don’t know the details of his model.
In your opinion, are these urges physical or cultural/psychological?
Physical.
How many people would the diet need to be effective for before you would not say that the diet does not work at all?
Now that I know what Taube’s model is, roughly, I think that it is probably correct, for some small subset of people (but not vanishingly small). I think a softer version, the effectiveness of a low-carb diet, is true for a larger, significant, but still minority subset of the population. It doesn’t matter what I think though – my point is the qualifier: that a model can be true (or a diet can be effective) for a population subset.
This is why I agree with you that the majority of people will regain their weight—if they are trying a diet at random (like in the study) rather than systematically, and without a working model of how a diet is not a one size fits all type of thing.
It occurs to me that you consider the regaining of weight as evidence that his model doesn’t work, because he also said you could eat as much as you want and stay thin. But there may be some people for whom this is true, even within the study sample. It would be useful to see the individual data.
Now that I know what Taube’s model is, roughly, I think that it is probably correct, for some small subset of people (but not vanishingly small).
Assuming that’s true, it doesn’t contradict what I have said. In fact, now that you concede that the vast majority of people end up regaining regardless of the diet they are on, it seems you do not dispute any of my basic points.
I rather suspect that what’s been presented to you has been made out of straw.
Take that up with Jack.
Me:
But anyway, you seem to be saying that, according to Taubes, if you simply avoid eating refined carbohydrates, you can eat other foods ad libitum and avoid obesity. Is that pretty much it?
If the criteria is that over half won’t benefit, almost every drug on the planet. I wasn’t exaggerating.
Here’s a paper that explains NNT, and on page four there are some examples. NNT under 10 is pretty good no matter what time span or endpoint of interest we’re looking at. Then there’s also NNH.
I see, I guess when I think of ‘most drugs’, I think of common drugs like aspirin and Tylenol that work pretty much for everyone. (But ‘most’ drugs (and treatments) doesn’t mean most ubiquitously used.) I’ve updated, thanks.
I think of common drugs like aspirin and Tylenol that work pretty much for everyone.
That’s not true either. I know a person who on occasion has headaches. They respond well to Tylenol and don’t respond to Ibuprofen or Advil. The latter two are common drugs which do not work for her.
It occurs to me that there are two separate questions:
Do low carb diets work better than other diets?
Do low carb diets work at all?
Even if the answer to the first question is “yes,” the answer to the second question is clearly “no.” In the sense that the vast majority of people end up regaining weight regardless of the diet they are on.
That’s a big problem for Taubes’ nutritionistic theory. Let’s assume for the moment that Taubes is correct, that if you simply eliminate “refined carbohydrates” (whatever that means) from your diet, you can eat anything else ad libitum and get and stay thin. The fact that low-carb dieters experience weight regain must then mean that they are experiencing difficult-to-resist urges to consume refined carbohydrates. But if you find some way to resist difficult-to-resist urges, then arguably you don’t need low carb dieting in the first place.
I imagine Taubes’ supporters would respond that a low-carb dieter’s difficult-to-resist urges are less difficult to resist than those of other dieter’s. Which may be true, but it doesn’t change the fact that—any way you slice it --
(1) The central and essential problem of successful dieting is dealing with the problem of difficult-to-resist urges;
(2) Taubes’ approach does not solve this problem.
Preponderance of research indicates that high carb meals (especially in form of starches) are more satiating for the same calories than high fat meals, so it is probably not even true that the urges are lessened. There are some counter-intuitive immediate effects (loss of water) and certain psychological factors (it’s more fun for some people to believe that mainstream is completely wrong) which can explain the appeal of the low carb dieting.
Another issue is that of health. There’s no reason what so ever that the easiest to resist diet would be the healthiest one. If anything, we ought to expect ourselves to naturally avoid at least some highly unhealthy meals, and so a diet that is very unhealthy may be easier to resist overeating on.
On the satiation research:
http://www.ncbi.nlm.nih.gov/pubmed/17539869
http://www.ncbi.nlm.nih.gov/pubmed/10435117
http://www.ncbi.nlm.nih.gov/pubmed/7900695
and so on and so forth.
Well I suppose that Taubes’ supporters would argue that protein provides extra satiation. Not that it really matters, because there doesn’t seem to be a magic balance of macronutrients which lets you eat ad libitum; get and stay thin; and avoid the problem of difficult-to-resist eating urges.
Yes. You know, I have wondered about the chart which shows an average long term weight loss of 5 extra pounds among low-carb dieters. How much of that 5 pounds is water?
I think you mean the “easiest to stick to diet.” But anyway, we need to be clear about what “healthiest” means. It occurs to me that “healthy” is multi-dimensional when it comes to food. That said, if your point is that on balance, being a few pounds lighter from low-carb dieting is not necessarily a net benefit in terms of cardiovascular health; metabolic health; etc., I would have to agree with you.
Obesity is a very recent problem, though, so there’s something that could be done for majority of people—if anything, rolling back a few decades on as many things as you can (within reason of course) should work well.
Sorry, I wasn’t clear. I meant, easiest to resist eating too much with. On normal diets, sticking to the diet is all about resisting the slippery slope of eating more of the same things, but on a very weird diet, sticking to the diet is about merely not buying things proclaimed ‘bad’, which may be easier. After all we all have mechanisms for resisting the urge to eat colourful, tasty looking berries that are known to be poisonous. It could be psychologically easier to label some things as “poisons” and not eat them, than to limit the amounts.
Agreed, although that sort of subsumes the problem of difficult-to-resist urges. A few decades ago, there were not jumbo slices of pizza available for a dollar on every street corner; there were not hot dogs for a dollar at gas stations and movie theaters; and so on.
It’s probably also worth noting that a few decades ago, cigarette smoking was a much more acceptable diet strategy.
I agree, except that I might quibble with your definition of “normal diet.”
Yes, and then the next questions are (1) what foods or types of foods are, if treated as “poison,” likely to lead to an effective diet; and (2) what is the health cost to eliminating such foods.
In my non-professional opinion, the answer to the first question is the foods which are normally referred to as “junk food” or “comfort food.” The answer to the second question is (again in my non-professional opinion) that there is no health cost at all and in fact you are better off without such food in your life.
A lot of people didn’t smoke but didn’t get overweight either. And today people routinely consume far more potent stimulants (ADHD medications).
Yeah, agreed. Ethics also works—e.g. there’s hardly any overweight vegetarians. (At least none that I know)
I agree, I’m not saying that smoking is the main reason people were thinner a few decades ago but surely it played a roll. It was very common back in the 70s and 80s for people to take up smoking as a weight control measure, either intentionally or unintentionally—it was inexpensive and no prescription was necessary. It was really common to see thin guys walking around with a pack of cigarettes tucked into their shirt sleeve.
Assuming that’s the case, one can ask why such an approach might be effective. Is it because meat makes you fat? Is it because eliminating meat and meat derived food from one’s diet is a good way to cut out junk food? (I wouldn’t think so; how hard is it to make vegetarian french fries and donuts?)
I’m inclined to believe that identity is a good way to motivate oneself. If you think to yourself “I’m a vegetarian and vegetarians don’t eat that kind of food” or “I’m a foodie and foodies don’t eat processed crap” or “I’m a fitness buff and fitness buffs don’t pig out on nachos” it seems pretty effective.
It reminds me of the story of the Jewish girl who had a hard time resisting milk chocolate treats in the evening; so what she would do is eat a small piece of meat every night after dinner so that it would be non-kosher to eat the chocolate.
It’s plain difficult to consume a lot of calories if you cut out meat and dairy products, I think (I tried to go vegetarian but couldn’t manage to get enough calories, it’s just too much work to eat enough not to go underweight. I don’t eat junk food). Plus if you are changing your habits for some ethical reasons, you are not a hedonist to begin with.
It seems to me that huge majority of people who are successful at maintaining their weight never subscribe to any defined diets or calorie counting. I think that works like this—as you eat, you feel more and more full. You can just stop eating at an earlier point (when you don’t feel entirely full) or at a later point. Also, for the dieters slowly gaining back everything—they still succeed to maintain the weight below the level that makes them take a drastic measure. It’s just that this level is quite high, probably because only a level that high can justify a measure so drastic.
Is that so? What about french fries, donuts, and soda? Those things can be made without animal products, no?
Well that may be part of it. Perhaps part of it is that vegetarians spend a lot of mental energy thinking about what they are eating. My impression is that fat people tend to consume a lot of food without being fully consciously aware of it.
Are you talking about former fat people or never fat people?
Haven’t got a deep frier, not a fan of french fries anyhow (not to the point of eating, what, 600 grams of them a day plus other stuff), prefer to eat at home. Also, sweets are a dessert. edit: and correct me if i’m wrong but with french fries something like half the calories come from fat, which is too much fat. Then, there’s silicone oil, trans fats, a wide variety of carcinogenic chemicals produced at high temperatures....
Apparently, it is a common experience
Though I do cook baked potatoes quite often.
Never fat or only ever fat due to a depression or the like.
edit: with the presently obese, if they are to lose weight and keep it low, that would imply future behaviour inconsistent with past behaviour under same conditions, i.e. simply is not going to happen without significant psychological changes or the like.
That suggests to me that convenience and identity are playing important roles. One of the things which has changed over the last 20 or 30 years is that it’s become a lot more convenient to eat junk food. At least that’s my impression. As to the latter, it’s hard to imagine a vegetarian walking into a typical fast food joint and ordering french fries—even if the fries are cooked in vegetable oil.
Then I agree with you. Having studied this stuff pretty carefully, I’ve come to the conclusion that everyone has an internal system which regulates his urges to eat or not eat. For people who are naturally thin, the system works well even in the modern obesogenic environment. If that system does not work well, then conscious effort must be applied to override that system. Which is very difficult to do day after day after day. Which is why most weight loss attempts ultimately fail.
Yes, I agree with this. The fantasy is that one can make a few simple changes like reducing carbohydrate intake or eating oil every morning and thinness will naturally and easily follow. The reality is that one’s psychology—broadly defined—must change.
I think you’re looking wrong at it. Say, someone reaches the weight of X and then diets down to Y<X . At X they self regulated (consciously), at Y they didn’t before, and won’t in the future. There wasn’t a complete failure to self regulate at all, the set point was set very high though.
edit: that is to say, it is when at the weight X that they want to be at the weight Y. At the weight Y, from prior history, they don’t care to be at the weight Y . I’m looking at it from the point of trying to deduce control system’s properties, and it seems we can explain it by modelling the control as stateless (except for the controlled variable) over long periods of time. edit2: i.e. I see the dieting behaviour as caused by weight; the weight drops, after some time the habits are lost and the behaviour ceases.
Want is a quite tricky word.
A week ago I exposed my body to physical stress. Then I ate a fat meal and didn’t drink anything. When I layed down to sleep.
I felt a lot of movement around my intestines and I noticed my swollen belly. It wasn’t like me belly hurt but it wasn’t a state in which I could sleep. After a while I went to the toilet and had diarrhea.
That went for around half an hour and I was thinking about what has to happen to come to a state where I could sleep reasonably well. The idea that there was still foot in my stomach and that would probably be part of the problem popped into my mind.
Shortly after that idea popped into my mind I got nauseous. Even through my reaction was “No, I don’t want to throw up”, my body didn’t care at the point. The process was set in motion and there was nothing I could do to stop it.
I did make a conscious judgement that my stomach should be empty, but I can’t say that I wanted to throw up.
Well then why do a lot of diets fail after only a few weeks when the person has lost just a couple pounds? It’s hard to believe that a small change in weight would have a big impact on preferences.
Indeed, but that also applies to starting on the diet as a response to increased weight in the first place. Some combination of the last few pounds and environmental change makes people decide on a diet, then the pounds are lost plus the environment restores (e.g. it was newyear and there was a newyear resolution, cultural pressure, which ceased).
Well can we agree that in late January, after our hypothetical fatty has lost a few pounds, he still wants to lose more weight?
And that under your model, in late January that desire has become diminished compared to some other drive?
Yes. In my model, an action is a response to the current conditions (Markov process), meaning that in same conditions, same actions tend to be taken.
I think I see the disparity between my model and conventional model. The conventional model seems to be that the individual formed a strong desire on new year, then this desire inexplicably waned a lot. My model is that usually the individual had a strong desire in early December, which got a little stronger in January, exceeding a threshold, and got a little weaker in February, dropping back below threshold.
In that case, your model does not seem to contradict my position. I assert that it’s difficult to use conscious effort for an extended period of time to override intuitive eating urges. I do not dispute that various factors such as loss of initial enthusiasm; initial success; opportunities to break one’s diet; stressful events; etc. are what proximately cause this breakdown of willpower.
OTOH a sizeable fraction of the ones I’ve met are visibly underweight.
Which fraction of the population takes such medications?
I’m just now seeing this discussion, and don’t have time to read earlier posts.
Has it already been worked into the model that there are different sub-types of people? Some members of my family have successfully managed our weight, but it definitely wasn’t the same solution for each of us, while other members of the family are still needing a better solution. (How useful could it be to look at average results, except to determine that there is no ‘one size fits all’ strategy?)
Maybe you can hire someone to read them for you and prepare an executive summary :)
Sure, that’s fair. :)
...curiously, if I did look, would I find that this had been addressed?
I’m not saying you should look. I’m just saying, time spent is not so often rewarded, whereas anyone that has kept with the discussion would readily know.
Furthermore, it helps to keep track of and repeat one’s assumptions. To write, “doesn’t work at all” doesn’t sound right without some qualifications.
Dude, the thread has 39 comments at the moment, two of which are yours. If you are too busy to read 37 comments, then I doubt it is worth engaging.
That’s very funny. I meant that I hadn’t read the previous posts:
At some point, it was probably discussed in which context it was appropriate to look at averaged data...I was hoping for a recap. I have composed a comment about whether I should have read the previous posts in the open thread.
Whatever, if there’s anything I said which you disagree with or would otherwise like to discuss with me, feel free to quote it and respond.
Ok, I wanted to ask about this bit:
If the diet should work for some people, but not most people, why should you say it doesn’t work at all?
To emphasize the fact that even though it might work better than some other diet, it still (generally speaking) does not work.
Anyway, your question is simply about my word choice, right? You do not dispute my substantive point?
There appears to be some substance in the disagreement.
Suppose that there are many different ‘metabolic’ types of people, and different diets work with different efficacies for these different types. Perhaps any diet works well with a small subset of people (we already know some people don’t need to diet). Perhaps particular diets work well with certain subsets of people. Maybe a particular diet works extremely well for one subset, in that they lose weight and keep it off, whereas it only works moderately well for others (they gain the weight back or must combine different diets). This model—which seems quite likely anyway—would imply two things:
the effectiveness of a diet for small subsets of people would be completely obfuscated by averaging the data—for example, in all groups in Figure 2, dieters kept off some of the weight on average. This might mean that some people gained all the weight back, whereas some kept it off, or it might mean that everyone gained some back. (Note that showing standard error, rather than standard deviation, especially hides the role of individual variation.)
it would not be reasonable to expect a diet to work by working for everyone; instead, each person must find which diet, if any, works for them, and then we would say that a diet “works” if it works for any subset of people that would otherwise be overweight
I’m pretty certain that this paradigm is mainstream. Increasingly, we’re recognizing that medical solutions (for example, blood pressure medications or cancer therapies) need to be tailored to individual people.
Here’s what the authors of the 2008 paper (Figure 2) have to say about individual differences:
Gender and diabetes are individual differences that are easy to recognize. Who knows (yet) how many characteristics are relevant for diet. If someone is sensitive to sugar like me (can’t go long periods without eating, tends to put on weight on their belly), the low-carb diet might work for them. Another complication is that changes in gut-bacteria populations over longer time-scales might result in long-term changes in your diet type. For example, over-weight people have different gut bacteria, diets change gut bacteria and gut bacteria might change your equilibrium weight. (The media is dominated by these studies recently.) I find a positive effect—once I’ve been on the low-carb diet for a few months, I’m not as sugar-sensitive and can maintain my ideal weight with a higher level of carbs than before I began the diet. Over time I lose the effect (too many holiday parties?) and need to return to a stricter low-carb diet.
I don’t fault the discussion for not accounting for gut bacteria yet (the diet science literature is huge, and you have to begin somewhere)...but would you agree that it is complicated enough that we can not infer much of anything from average responses to a diet, other than that a particular diet doesn’t work for everyone?
Assuming this is true, I don’t see how it contradicts anything I have said.
Do you dispute any of the following:
The vast majority of people end up regaining regardless of the diet they are on;
In general, the central and essential problem of successful dieting is dealing with the problem of difficult-to-resist urges;
Taubes’ approach is not a general solution to this problem.
Yes, I dispute with the first point. In any case, you can’t infer this from figure 2.
But that wasn’t my initial point. My initial point, asked in a different way, is what fraction of people would a diet have to be effective for, for you to say that it works “at all”? This is a substantive question, not just semantics, because I would like to convince that an expectation of 100% is not reasonable—rather 20 or even 10% would be quite good.
I’m not sure, since I generally don’t use “at all” in positive sentences. Besides, it’s just a question of semantics.
Well it depends on how you define “reasonable” or “good.” In terms of deciding whether a diet is worth trying, a 10% success rate might make it worthwhile. But that’s not what we’re talking about—we’re talking about whether Taubes’ underlying model is correct or not. If his model is correct, one would expect a substantially higher success rate.
Well let’s quantify things. I assert that weight loss recidivism rates are well over 80%. What’s your estimate of the percentage?
I expect that it is very high also. I think the situation could be better if we understood more.
From skimming through the posts, I’m not sure what Taubes’ underlying model is. Would you summarize it in a couple sentences?
In your opinion, are these urges physical or cultural/psychological? (I think that a diet that does “work” must handle the ones that are physically based.)
You’re right, it works better to consider the negative context. How many people would the diet need to be effective for before you would not say that the diet does not work at all?
Then why do you dispute my assertion that the vast majority of people end up regaining regardless of the diet they are on?
According to Jack, Taubes’ position is that generally speaking, if people eliminate refined carbohydrates (whatever that means) from their diet, they can eat other foods ad libitum and get and stay thin. Apparently Taubes believes that there is some important and dominant interplay between refined carbohydrates, insulin, and body fat. I don’t know the details of his model.
Physical.
In what context?
Now that I know what Taube’s model is, roughly, I think that it is probably correct, for some small subset of people (but not vanishingly small). I think a softer version, the effectiveness of a low-carb diet, is true for a larger, significant, but still minority subset of the population. It doesn’t matter what I think though – my point is the qualifier: that a model can be true (or a diet can be effective) for a population subset.
This is why I agree with you that the majority of people will regain their weight—if they are trying a diet at random (like in the study) rather than systematically, and without a working model of how a diet is not a one size fits all type of thing.
It occurs to me that you consider the regaining of weight as evidence that his model doesn’t work, because he also said you could eat as much as you want and stay thin. But there may be some people for whom this is true, even within the study sample. It would be useful to see the individual data.
Assuming that’s true, it doesn’t contradict what I have said. In fact, now that you concede that the vast majority of people end up regaining regardless of the diet they are on, it seems you do not dispute any of my basic points.
I rather suspect that what’s been presented to you has been made out of straw.
Take that up with Jack.
Me:
Jack:
Link:
http://lesswrong.com/lw/je4/critiquing_gary_taubes_part_2_atkins_redux/abjs?context=1#comments
Good point. If we applied the same principle to drugs, very few of them would be used at all.
What examples were you thinking of?
If the criteria is that over half won’t benefit, almost every drug on the planet. I wasn’t exaggerating.
Here’s a paper that explains NNT, and on page four there are some examples. NNT under 10 is pretty good no matter what time span or endpoint of interest we’re looking at. Then there’s also NNH.
I see, I guess when I think of ‘most drugs’, I think of common drugs like aspirin and Tylenol that work pretty much for everyone. (But ‘most’ drugs (and treatments) doesn’t mean most ubiquitously used.) I’ve updated, thanks.
That’s not true either. I know a person who on occasion has headaches. They respond well to Tylenol and don’t respond to Ibuprofen or Advil. The latter two are common drugs which do not work for her.
Advil == ibuprofen. The latter is the active ingredient in the former.
You’re right—I’ve meant Aleve (naproxen), not Advil.
I haven’t looked at their NNTs, but if you compare them to placebo and also take into account the harm, they might seem less amazing.
Interesting, yes, I found in one place that aspirin had an NNT of about 5 for headache.