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I agree that there's a lot of magic wand thinking, but as I alluded to, I think this is aided by an absolutely abhorrent culture on the topic. You have the people trying to sell you something, so they're going to promise the moon. Then, when people give up, they turn to a different magic thinking (e.g., @jeroboem's "There's something else going on, IMO") and just imagine that it must be some magic chemical or something. Even when my wife agreed that we would track our calories and see how it went, she would repeatedly have times where her weekly windowed average weight wasn't visibly going down for like a single data point (maybe even two points) and would go off on "MAYBE IT'S NOT WORKING ANYMORE" with no real rational explanation of why it would suddenly stop working. Just some sort of unknown magic. Spoiler: it always kept working. After enough time and then seeing the summary data over a year or two, she said, "I knew, but I didn't know know." Now she "know knows". Before, there was always a gap, a gnawing hole, where magic could constantly sneak in and make her default to thinking that it's just too weird and complicated and that there's probably "something else going on".
Perhaps ozempic will actually be a magic wand for a lot of people. It seems genuinely useful for a lot of folks. I don't think I've seen any indication that ozempic magically causes people to exercise more, though, and exercise has significant bodily benefits beyond just caloric balance.
There clearly is something else going on. People didn't just suddenly lose willpower. Nor did they suddenly lose the knowledge that diet and exercise were important. More importantly, people 50 years didn't have to try to be skinny, they just were.
No one has a compelling theory, supported by evidence, for why the obesity epidemic happened. You might not agree with SlimeMoldTimeMold, but they do a good job of explaining why all the various folk theories are wrong. If you think the problem is simple, then I'd argue you just don't understand it.
Of course this doesn't mean an individual person can't use diet and exercise to lose weight. It just means that, when measured across the population, few will be able to.
To solve the obesity crisis we have to stop trying the same failed ideas from the 1990s that only made the problem worse.
The superpalable foods and people overeating is the best theory and the truth because it fits available evidence. It is also the main scientific theory.
Also fat people genuinely have less willpower to resist overeating because they have greater appetite.
It is EASIER to stay thin that to become thin after becoming obese. But it isnt impossible and there are other societal problems too due to a culture of less discipline.
So, outside of ozembic, the best intervention would have been to try to stop people from becoming fat in the first place, focusing more on ingraining the right habits to children and target the food culture.
The reality a lot of people go along with what is the default. The default changed for whatever reason (because people like eating tasty food with calories, and because people selling food like making more money over people consuming more food being a big reason, and such food became more available and cheaper), and then obesity increased and as it increased it became more acceptable and people mimicked each other.
Now, sure people don't like the results of being fat, but they do like eating in the way that makes them fat, and there is copying of each other. This conformism and copying others habits then leads to escalation of trends. If there is a rising trend to overeat, people increasingly overeat.
Discipline is not everything about it, because a facet of it is careless overeating due to the rise of hyperpalable food. At some point of making mistakes of judgement, it does require more discipline to get out of it. But the level of discipline in the initial stage would be less, and less so if the default food culture was less obesogenic with less high calorie hyperpalable foods around.
Fundamentally, there is a trend in general, not talking about motte specifically, of people talking about such issues who don't want to do something about it. Obviously you are going to have rising drug abuse, obesity, crime epidemic, or other problems (i.e. cultural far leftism, putting such groups on pedestal), if you promote that such issues are unsolvable mysteries, and exaggerate the difficulty and the harm of doing something about it. Same even with fertility issue. Modernity has come along with some problems which do have their difficulties, and also simultaneously there is an ideological trend which is part of the problem which exaggerates the difficulty of solving them, and is in fact against trying to do so.
The problem I have with this is that foods in the U.S. seem no more superpalatable in 2024 than in 1990. Yet obesity has risen quite a bit. I also think words like superpalatable and hyperprocessed tend to become pretty mushy when we start to examine them.
I hope you don't put me in that bucket. It's true I think these problems are extremely difficult to solve. But rather than advocating surrender (as I feel Scott did on his homelessness article), I advocate stronger action. That said, it's important that we not merely just double down on solutions that we know don't work. For example, if we want to solve housing affordability (another of those intractable issues) we can't do it by using failed solutions like rent control. And if you want to solve obesity, then telling people to simply diet and exercise won't work. We tried it for 50 years. It failed miserably.
Above all, we should adopt epistemic humility and try a variety of solutions, ideally letting natural experiments play out at state and municipal levels.
This seems wrong, the difference between the average restaurant in Plano Texas from then to now is staggering, and not just in terms of quality, but variety of cuisine as well. This might be controversial, but I think the expected quality you would get from a high-end restaurant in 1990 is what you can expect from basically any restaurant today(controlling for location). Cooking knowledge seems to have really been spread through the information age, and a base line expectation of quality ingredients also spread through the country during this time window. Do you remember when people used to advertise that they used arabica coffee beans, before it just became the standard? Dominos pizza is a particular stark example, and that change happened in 2010, in part because they had fallen behind, because all the other pizza places had been upping their game for years. I think the idea that, because on the surface you could go to a Wendy's and get a burger and fries in 1990 and in 2024, the 'superpalatability' of the food has not changed, is wrong (Wendy's is another place that seriously improved and is constantly tweaking and improving, a few years ago they drastically improved their fries).
I will agree that it is not super cleanly defined, but in general I think the availability of good food has improved pretty significantly since the 90s.
Can you expand on that? I haven't been following trends in American style pizza, but the idea of "upping the game" on pizza seems absurd. The thing has been perfected decades ago. It's yeast dough, tomatoes, meat and cheese.
What could you even change to make it more calorie dense? More cheese? That's called pizza quattro formaggi and has been a classic since basically forever.
The idea behind 'superpalatable' is not necessarily that it is more unhealthy (calorie dense), but that it is more delicious, so you over eat more, or are more likely to want to eat it instead of something else(something healthier). 'Upping the game' here, means tastier sauces, better crust recipes, perfecting baking time/and delivery/heat retention, quality of cheese, cheese blends, herbs, spices. Making more palatable food does not require making it more calorie dense. Can you imagine a world where room-temperature school-cafeteria pizza is the best possible delivery pizza, and how that would effect the frequency with which you order pizza?
Although, you can almost always add calories, one of the headline changes of their 2010 recipe was an herb and garlic butter glaze on the crust.
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There's also entirely new categories of commonly consumed foods. How many people in 1995 started their day with a coffee-like milkshake? Even those that don't, energy drinks have more calories than a cup of coffee, even with milk and sugar(and portion sizes were smaller back then, too).
On the other hand, every gas station has sugar-free energy drinks for sale as well. The white Monster is at least iconic enough that Boomerjak is always depicted with one.
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There's also limitless and ubiquitous digital entertainment. Reddit, X, TikTok, YouTube, PornHub, streaming services, video games, if you get tired of one thing you can switch to another. And just like that, your whole day is gone, and you've been mindlessly snacking on junk food the whole time. Yes, there were people that watched the TV the whole day in the 90's. And these people were morbidly obese, shaped like their armchairs.
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Food got cheaper, especially superpalatable food (count calories that can be bought by median wage).
People in the 1970s weren't skinny because food was too expensive.
The fattest countries in the world aren't the richest countries in the world, nor the countries where food is the cheapest. Look at this list, the fattest countries are Pacific islands (where the necessity of importing food makes it expensive) and Middle Eastern countries (which can be poor like Libya or rich like Qatar). Whatever's causing obesity, it isn't cheap calories.
I personally think that the global obesity epidemic has something to do with the fact that we replaced animal fats with an agricultural waste product that is evolutionarily novel.
Last time I checked Pacific islanders were eating ultra processed food and meager amount of fruits and vegetables, with high caloric intake. And food is still cheap enough there given incomes to easily eat yourself to death.
Is it wrong?
May depend on location. In Poland it WAS and obesity was far less widespread than nowadays.
Which countries you wanted to use as counterexamples here?
Cheap calories are at least prerequisite and part of the puzzle. Without that you will not get hordes of fat people
Is there any country where you could spend less than 20% of median income on tasty snacks providing more calories than you need, without obesity epidemic?
France and the high income East Asian countries have low obesity rates despite people being easily able to gorge themselves on food that is generally regarded as quite good by outside observers.
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This is a bad strawman, and you should feel bad.
SMTM acknowledges that calories have something to do with it. He just thinks there's some magic 'nonlinearity' somewhere in the middle. Fine, whatever. Give me a model. Tell me how we can design an experiment to confirm or falsify your belief. Imagine that we have enough resources to run a lab-controlled study with a double digit number of subjects for a year or two. What do you do?
You're asking me to explain the obesity epidemic. I can't.
But I can disprove standard medical advice. Honestly, I don't even need to because we are already running the experiment and the results are overwhelming.
But anyway, here's my experiment. We have a control group and an experimental group. The experimental group goes to a location once a week, for one hour, where they receive diet and exercise information provided by you. You can also do anything you want during that hour, including exercise. However, you may not recommend or mention any pharmaceutical intervention. To ensure compliance, each person is paid $50 per hour but people who drop out still count in the experimental group. After 8 weeks, the intervention ends.
Then we check back in 2 years to see how the BMI of the control group and experimental group has changed. I predict with a high degree of confidence that there is no significant difference.
No, I'm not. It would be simple enough for you to just propose an experiment to show that CICO doesn't work. You know, to demonstrate that "something else is going on". For example, you could propose an experiment where subjects are fed maintenance level calories, but gain weight. Or where they're fed deficit level calories, but maintain weight. You could show something specific about a weird nonlinearity that actually contributes to a claim that "something else must be going on". Anything. Literally anything at all that contributes to that. In any way whatsoever.
But I don't think you want to even try to demonstrate that "something else must be going on". You simply want to say that many people don't choose to do a thing, even given extremely mild informational content. That has never been contested, nor does it imply that "something else must be going on".
Who is saying that CICO doesn't work? No one is saying this.
What do you mean when you say, "There's something else going on"? What is the "something other than X"? Please speak plainly and directly about what you are meaning to say. Also, please take into account SMTM's writing on CICO in your description, as that appears to be related to one of the "folk theories" that you said were wrong, according to his explanation.
Sure. Something in our natural environment is causing us to eat more food than we need, thus gaining weight. Throughout most of history (and even today in countries like Vietnam and Japan) people were able to effortlessly stay thin. They eat when they're hungry. Some days, they eat excess calories. Other days they have a deficit. But overall, there is an almost EXACT match between calories eaten and consumed. Being off by even 200 calories a day would lead to serious weight gain over time.
This is homeostatis. And, importantly, it does not require CONSCIOUS thought.
The mistake most people make is the assumption that thin people are thin because they continuously monitor their weight and exert willpower to maintain it. This is the same flawed mental model as the closeted gay who thinks that straight men want to bang other dudes but just resist it. No, straight men don't want to bang other dudes. Likewise, skinny people don't have to RESIST eating that second donut. They simply don't want to. Because they are full.
Something in our diet or environment has disrupted this homeostasis. This "something else" causes our bodies to send signals to eat more than we need. It might be sugar, it might be seed oils, it might be pesticides, it might be lithium. It could even be hyperpalatable foods. But it's causing people to continue to eat when they should feel full.
What I perhaps was not clear on was that I was wanting you to describe what you think X is. What is the foil that has been shown to be wrong, such that "something else" must be going on? What is that something that is separate from the something else? Note that this question goes all the way back to here, where presumably, the X that is wrong was already presented in the conversation.
I'd also note that you did not mention anything about how to reconcile your views with what SMTM has written about CICO. Is this not one of the "folk theories" that he demonstrated was wrong?
Though, to go ahead and discuss the question of homeostasis, consider historical examples of obese people, some going all the way back to antiquity (often rich folks). Did they lack homeostasis? Were those people exposed to this "something else" in their diet or environment, disrupting their homeostasis?
(FYI, SMTM says it's not sugar, so you might want to update. That's one of the "folk theories" that he's proven wrong, too.)
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No one claims that consistent diet change is easy or that people are easily controlled.
Okay but the problem is that if it's not frictionless enough then it's not a good enough solution for the masses which means not a good enough solution overall for society.
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Massive increase in easily available food combined with a decrease in the amount of physical effort required to live seems like a perfectly sufficient explanation to explain the obesity epidemic.
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My crackpot theory: In the beginning, there was scarcity to keep people thin. Rich people tended to fat if they weren't careful. Then food got fairly cheap, but lead and cigarettes (and sometimes amphetamines) kept people's weight down. Now food is still cheap but the lead and cigarettes are gone, so... boom.
That... actually makes a lot of sense. The insane growth in marijuana consumption can't have helped either.
It still doesn't really explain why Japanese women are skinny, given that they don't really smoke.
Comprehensive and massive fatshaming affecting the meme-gender in a conformist culture?
Everything I've ever heard about fatshaming in other times and places reinforces the idea that American fatshaming is ineffective because there's not nearly enough of it.
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Smoking is very common in Japan, even among women. And even if you don't smoke, there's a lot of second hand smoke there.
But it's probably more to do with genetics, rice, and walking a lot there.
Could secondhand smoke deliver enough nicotine to meaningfully suppress appetite though?
(I agree that the smoking is probably small potatoes compared to the other factors you mentioned)
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Notably, weights were rising that entire time even with lead and cigarettes. The thing is, that was a good thing for the first half of the 20th century because quite a few people were undernourished and underweight.
This is also why I find the simplest theory the best - food got cheap, people got rich, and the people that aren't rich get a bunch of money from the government to buy food. You don't need a complicated story, just a super-rich country that doesn't require much physical labor combined with the human inclination to eat a lot in times of plenty.
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