This seems useful and I liked the author’s book but I wouldn’t call it “well-understood reasons that are entirely accounted for by mainstream obesity science”. If anything, the fact that we’ve known about it for >10 years and it hasn’t spread widely suggests to me that it’s unlikely to be a silver bullet.
ETA: I’d completely misunderstood Elizabeth’s comment. This comment I wrote does not make sense as a reply to it. I’m keeping my comment here with this disclaimer on the top because I wanted to make these points somewhere, but keep that in mind.
the fact that we’ve known about it for >10 years and it hasn’t spread widely suggests to me that it’s unlikely to be a silver bullet.
I don’t know exactly what you mean by “unlikely to be a silver bullet,” but I want to outline the reasons I think this diet is nowhere close to being a $20 bill lying on the sidewalk, as some people seem to think it is:
very restrictive diets are very socially costly to follow. If you regularly eat from college dining halls, cafeterias at work, restaurants, other people’s homes, etc. you’ll have a very hard time following an all-potato diet. Compare it to being vegan — outside of vegan-friendly places, it can be quite inconvenient to be one, and following an all-potato diet seems like it would be significantly worse than that.
very restrictive diets might cause weight loss that is too rapid to be healthy. Losing weight too quickly increases your chances of getting refeeding syndrome (if/when you go back to eating normally) and gallstone formation by quite a lot.
It is unclear that this diet doesn’t have the same exact problems as all other diets, that is, a high attrition rate[1] and weight regain upon cessation.
Investigating diets seems relatively uninteresting when (1) diets have a huge attrition+weight regain problem and (2) semaglutide and tirzepatide alone would massively reduce obesity rates if they were more popular, and there are drugs in preclinical trials that seem even more promising
I hope no one is taking the attrition rates calculated in their post at face value, given that all of their data is from people who literally signed up for a potato diet and hence there is a very obvious selection effect at play. Even if you do take them at face value, however, the attrition rate was like 40%-60% after 4 weeks, depending on how you slice it, compared to 18.8% after 3 months in this study that they mentioned[2], and ~30-50% per year in general in the diet studies they talked about.
They cited this study as having a “56.3%” attrition rate. I think they were probably referring to the fact that the attrition rate was 53.6% (not 56.3%) after 12 months. I don’t know why they chose to report that number, when the study also reported a 3-month attrition rate, which is much closer to the timescale of their own diet.
I think I used “silver bullet” to use the same thing you mean by “$20 bill”, so we’re in broad agreement. I also don’t personally know anyone who thought this was definitely a slam dunk; everyone I’ve talked to has had the attitude “sounds crazy, generally good to try things”.
I agree with you that the weight loss may be too rapid to be healthy, and that the data is basically worthless without knowing what the rebound rate is. I also dislike the emphasis on weight loss over 24 hours, when it’s impossible to have one-day weight loss that is both noticeable above the noise in the measurement and healthy.
I disagree that it being prohibitively restrictive for many people is a reason not to investigate. The restrictiveness and social costs aren’t secret harms people won’t notice until it’s too late; people will naturally notice those costs and change their behavior if it’s not worth it. SMTM claims the diet tolerates a lot of deviance, so the costs may be quite low. Maybe that slows the weight loss, but people can make their own choices on that. It seems much more forgiving than keto, where one carb too many breaks the diet for days, and despite a very high attrition rate there’s a substantial number of people sticking to keto long term. The high attrition rate is irrelevant to knowing if the diet works when you stick to it.
I would feel differently if they were charging a large up front fee and blaming people for not sticking to it, but that is not at all happening. They’re suggesting people eat a very cheap food and stop if they don’t like it. This might change if potato fat camp happens, at which point I do hope they highlight the drop out rate, but I really don’t see “you might quit” as a reason not to try.
I also disagree that we should wait for drugs. Those are definitely worth investigating, but the history of weight loss drugs and especially drugs in trials is really bad, not to mention none of them are as widely available as potatoes.
I still think the potential silent risks are a reason to be concerned. I doubt their reports that potatoes have enough protein, especially for highly active people, and expect micronutrient shortages as well. I hope a more formal study checks those. I didn’t try the diet because there was absolutely no chance “100% potatoes” would be healthy for me, and I advised the friend who asked to wait on the data. I put an extremely large probability on “this is just another fad monodiet and it’s bad in the ways they are all bad”. But trying it out, especially in the extremely flexible way they are, still seems good to me.
very restrictive diets are very socially costly to follow. If you regularly eat from college dining halls, cafeterias at work, restaurants, other people’s homes, etc. you’ll have a very hard time following an all-potato diet.
To be fair to SMTM’s potato diet, the idea is that it still works even if you cheat a lot.
That was somewhat my experience with the diet though, it makes social interaction a lot more awkward
semaglutide and tirzepatide alone would massively reduce obesity rates if they were more popular
I mean, the idea of a cheap, not very effortful and efficient life intervention still appeals to me. It might not be the most pressing problem, and it might not solve global obesity, but if it indeed does give a boost of energy in a safe and reliable way, that is already worth knowing.
The reasons are well-understood. It hasn’t taken off because eating nothing but potatoes seems extreme and weird to most people, and even less appealing than other diets
But people try lots of weird fad diets. Moreover popular wisdom seems to be capable of having different reactions to different fad diets- grapefruit diet is considered dangerous and you’ll regain the weight immediately anyway, but keto is considered to sometimes work if you can stick to it, which is pretty hard. It’s not clear to me keto started off obviously distinguishable from other fad diets of the time- but it worked for some people and was sustainable for some people, and so grew in prominence,
TBC I don’t think eating only potatoes is long term healthy. If the weak form of potato diet- where you eat some potatoes every day but are otherwise unrestricted- works, that is substantially easier to follow and less weird than a lot of popular diets people stay on for years.
I am highly skeptical because that’s the correct default stance to have towards monodiets claiming dramatic levels of weight loss, but if it worked in a healthy sustainable way I don’t expect weirdness to kill it.
This seems useful and I liked the author’s book but I wouldn’t call it “well-understood reasons that are entirely accounted for by mainstream obesity science”. If anything, the fact that we’ve known about it for >10 years and it hasn’t spread widely suggests to me that it’s unlikely to be a silver bullet.
ETA: I’d completely misunderstood Elizabeth’s comment. This comment I wrote does not make sense as a reply to it. I’m keeping my comment here with this disclaimer on the top because I wanted to make these points somewhere, but keep that in mind.
I don’t know exactly what you mean by “unlikely to be a silver bullet,” but I want to outline the reasons I think this diet is nowhere close to being a $20 bill lying on the sidewalk, as some people seem to think it is:
very restrictive diets are very socially costly to follow. If you regularly eat from college dining halls, cafeterias at work, restaurants, other people’s homes, etc. you’ll have a very hard time following an all-potato diet. Compare it to being vegan — outside of vegan-friendly places, it can be quite inconvenient to be one, and following an all-potato diet seems like it would be significantly worse than that.
very restrictive diets might cause weight loss that is too rapid to be healthy. Losing weight too quickly increases your chances of getting refeeding syndrome (if/when you go back to eating normally) and gallstone formation by quite a lot.
It is unclear that this diet doesn’t have the same exact problems as all other diets, that is, a high attrition rate[1] and weight regain upon cessation.
Investigating diets seems relatively uninteresting when (1) diets have a huge attrition+weight regain problem and (2) semaglutide and tirzepatide alone would massively reduce obesity rates if they were more popular, and there are drugs in preclinical trials that seem even more promising
I hope no one is taking the attrition rates calculated in their post at face value, given that all of their data is from people who literally signed up for a potato diet and hence there is a very obvious selection effect at play. Even if you do take them at face value, however, the attrition rate was like 40%-60% after 4 weeks, depending on how you slice it, compared to 18.8% after 3 months in this study that they mentioned[2], and ~30-50% per year in general in the diet studies they talked about.
They cited this study as having a “56.3%” attrition rate. I think they were probably referring to the fact that the attrition rate was 53.6% (not 56.3%) after 12 months. I don’t know why they chose to report that number, when the study also reported a 3-month attrition rate, which is much closer to the timescale of their own diet.
I think I used “silver bullet” to use the same thing you mean by “$20 bill”, so we’re in broad agreement. I also don’t personally know anyone who thought this was definitely a slam dunk; everyone I’ve talked to has had the attitude “sounds crazy, generally good to try things”.
I agree with you that the weight loss may be too rapid to be healthy, and that the data is basically worthless without knowing what the rebound rate is. I also dislike the emphasis on weight loss over 24 hours, when it’s impossible to have one-day weight loss that is both noticeable above the noise in the measurement and healthy.
I disagree that it being prohibitively restrictive for many people is a reason not to investigate. The restrictiveness and social costs aren’t secret harms people won’t notice until it’s too late; people will naturally notice those costs and change their behavior if it’s not worth it. SMTM claims the diet tolerates a lot of deviance, so the costs may be quite low. Maybe that slows the weight loss, but people can make their own choices on that. It seems much more forgiving than keto, where one carb too many breaks the diet for days, and despite a very high attrition rate there’s a substantial number of people sticking to keto long term. The high attrition rate is irrelevant to knowing if the diet works when you stick to it.
I would feel differently if they were charging a large up front fee and blaming people for not sticking to it, but that is not at all happening. They’re suggesting people eat a very cheap food and stop if they don’t like it. This might change if potato fat camp happens, at which point I do hope they highlight the drop out rate, but I really don’t see “you might quit” as a reason not to try.
I also disagree that we should wait for drugs. Those are definitely worth investigating, but the history of weight loss drugs and especially drugs in trials is really bad, not to mention none of them are as widely available as potatoes.
I still think the potential silent risks are a reason to be concerned. I doubt their reports that potatoes have enough protein, especially for highly active people, and expect micronutrient shortages as well. I hope a more formal study checks those. I didn’t try the diet because there was absolutely no chance “100% potatoes” would be healthy for me, and I advised the friend who asked to wait on the data. I put an extremely large probability on “this is just another fad monodiet and it’s bad in the ways they are all bad”. But trying it out, especially in the extremely flexible way they are, still seems good to me.
Oh my, I completely misunderstood your previous comment. I apologize.
To be fair to SMTM’s potato diet, the idea is that it still works even if you cheat a lot.
That was somewhat my experience with the diet though, it makes social interaction a lot more awkward
I mean, the idea of a cheap, not very effortful and efficient life intervention still appeals to me. It might not be the most pressing problem, and it might not solve global obesity, but if it indeed does give a boost of energy in a safe and reliable way, that is already worth knowing.
The reasons are well-understood. It hasn’t taken off because eating nothing but potatoes seems extreme and weird to most people, and even less appealing than other diets
But people try lots of weird fad diets. Moreover popular wisdom seems to be capable of having different reactions to different fad diets- grapefruit diet is considered dangerous and you’ll regain the weight immediately anyway, but keto is considered to sometimes work if you can stick to it, which is pretty hard. It’s not clear to me keto started off obviously distinguishable from other fad diets of the time- but it worked for some people and was sustainable for some people, and so grew in prominence,
TBC I don’t think eating only potatoes is long term healthy. If the weak form of potato diet- where you eat some potatoes every day but are otherwise unrestricted- works, that is substantially easier to follow and less weird than a lot of popular diets people stay on for years.
I am highly skeptical because that’s the correct default stance to have towards monodiets claiming dramatic levels of weight loss, but if it worked in a healthy sustainable way I don’t expect weirdness to kill it.