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One of my guilty pleasures is trash TV, including My 600 Pound Life.
Your observations are generally true for the people on that show. But I think you're being rather uncharitable.
First of all, the patients on that show are extraordinarily obese and unhealthy. They are not your "usual" fat person, but people who've literally reached the point of "lose weight or die." They are also, of course, selected for dramatic and disagreeable personalities who will make for good TV. (You can even see viewers complaining when the season is "too boring" because the patients are cooperative and not dramatic enough.)
You also neglected to mention that most of them are suffering from severe mental illness. The food addiction that has rendered them nearly immobile is clearly a mental illness in itself, but most of them have all kinds of other problems. Most of them are impoverished and come from abusive backgrounds. Childhood sexual abuse is a very common theme. You say they are stupid, entitled, and ignorant; there's a reason you don't see many of them who come from stable and supportive middle class families. Most of the time, when we see family members, they are as fucked up as the patient, if not as fat.
And it's a reality TV show! You know that shit is heavily edited, right? My 600 Pound Life, like most such shows, has been accused of staging confrontations, feeding the "participants" their lines, crafting "storylines" to make them more dramatic, and so on. The patients may be real and their issues are too, but I would not trust the show to be giving you a really accurate picture.
Now, more generally I agree that fat people (even "normal" fat people) have a strong tendency to be in denial about how much they eat and how little exercise they do, or about the health effects of obesity. But it should be obvious that making broad generalizations based on the personalities who appear on a reality TV show is just taking cheap swings at easy targets.
No, I know exactly how much I eat and how little I exercise. I'm lazy and depressive; exercise sucks compared to eating delicious food and reading a good book or playing a wargame in a comfy chair.
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I'm not in denial about anything; I'm just not willing to spend the rest of my life fighting against my set point by suffering from starvation neurosis and working a part-time job at the gym in order to maintain a healthy weight.
The set point is not set. It might be harder to adjust it downwards than upwards, and going from 80kg to 70kg is transformative and empowering the way going from 130kg to 120kg is not, but pushing down on your set point is quite possible.
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Set point theory is very popular among fat activists, yes.
People's metabolisms do vary (which is why "CICO" is both true and simplistic - the "burn rate" is not the same for every person). But nobody weighs 400 pounds because that's what their "set point" says they should weigh, and I have only ever met two kinds of severely obese people: those who admit they eat too much, and those who make up reasons why somehow normal rules of biology and physics are different for them.
For the most part, pro-CICO people seem to reject the idea of fast or slow metabolisms.
I don't know what pile of straw you've found your "pro-CICO people" from, but in my experience, they are happy to point you directly to places where you can see the variability for yourself. I'll even preempt any digging in the straw you might do to claim that "pro-CICO people" simply reject the concept of metabolic adaptation, because they actually write entire articles about it, what it is, what it isn't, and what it practically means for people.
At the end of the day, they say things like that the Cunningham equation (or a few others) actually do a pretty good job of getting you to the right ballpark, but then you probably need direct observation if you want to really nail down where you are with precision. My wife and I proceeded with direct observation, and sure enough, the population-based equation estimates got us pretty darn close, but what was really incredible was that even though the data was insanely noisy (which was expected, and I have enough background in numerical analysis to know how awful that noise would be for estimating derivatives), the trend line over a couple years of tracking (through periods of cutting, periods of maintaining, and periods of gaining) was bang on at exactly 500cal/day = 1lb/wk... for both of us. The "pro-CICO people" that you strawman are actually doing things like putting direct observation into an app rather than making ridiculous claims like there being no variability whatsoever.
The thesis of CICO is that it's not just a useful guide, but literally an iron law of the universe. Ever heard of something called thermodynamics? So it's not obvious to me how a "metabolism" (whatever that is) can conjure up, or delete, energy or mass.
Personally I found CICO useful for losing weight and not useful for gaining weight. But, based on my own direct observation, you'll probably just call me a liar or say that I was tracking wrong. That is of course, what every CICO advocate does immediately. After all, CICO is (apparently) totally perfect and based on thermodynamics.
Perhaps you should read the link, discussing variability in the calories out portion. Saying that CICO is thermodynamics and that there is variability at least in CO is perfectly consistent. I'm not sure what windmill you think you've slain.
I will not call you a liar, but this is indicative of the mindset with which you are entering this conversation. You have tarred the people you hate with a scarlet letter and then simply closed your mind to any meaningful discussion. Very bad epistemic hygiene.
I don't hate CICO advocates, I just don't know if there's a constructive conversation to be had with people who consistently respond to everything with "you're lying" or "you must have missed something". This is also epistemic closure - anyone who struggles with CICO is always accused of lying.
As I've already said I did get some benefit from calorie tracking. I think it's useful even just to learn how many calories are in your food. So of course, I don't hate CICO, but of course this kind of defensiveness is also very typical of CICO advocates.
If the defense of CICO epicycles is that "uh, actually sometimes people just burn extra calories for no reason", that's not that compelling. Isn't the point of CICO that it should always give you predictable results, and that if your results are wrong, it's because you made a mistake or are lying?
The fact that CO is difficult to accurately assess in the real world - even moreso than CI, which is itself very difficult to accurately assess - isn't some epicycle of CICO, it's just a component of it. CICO does always give you predictable results, as long as your predictions are based on actual fact, i.e. the simple fact that you can't accurately assess CO in the real world.
In practice, the vast majority of CICO is directed at weight loss, which means simply making CI < CO. This can be accomplished consistently even without accurate measurements of either, by making them accurate enough such that the error bars don't overlap. That is, you can get a somewhat reasonable estimate for upper bound of CI by taking the nutrition label of every food you eat and then doubling it. And you can get a somewhat reasonable estimate for lower bound of CO by calculating your BMR and adding on half of what those caloric expenditure tables for exercise or your fitness band or smartwatch or your stationary bike says. Make the upper bound estimate of CI lower than the lower bound estimate of CO, then you can have fairly high confidence that you've gotten actual CI lower than CO.
For weight gain, the fact that the body has ways of physically refusing to take in more food or causing the food to pass through without nutrition being extracted makes things trickier, I believe, but that's an area that I've not had the privilege of needing to explore.
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You're mashing up two different things which should be clearly distinct at this point in the conversation. There is no epicycle that there is variability in CO. There is just variability in CO, given the things we are generally able to control for. That's just the data and the labels we have to go with it. I've seen some attempts to quantify things like calories consumed by individual organs and how that correlates to their sizes and such, but on a population scale, we're basically never going to have measurements like that to control for, nor is an individual likely to go to the effort of taking precise measurements that could, in theory, more precisely predict individualized CO. So, absent that, we take a few factors that are easily measurable, fit the curves, see that they work pretty well, with some variability. Before, you had been claiming that this population-level variability was flatly denied by your enemies. Now, you think it's an epicycle. These are both Obvious Nonsense claims. This is just data and empirics.
Now, what you're stuck on is the second part, given that the population-level curves aren't able to precisely control for everything, how do these curves and the variability they contain provide predictable results for individuals? Well, you need individualized observational data to figure out where you are within that variability. The population-level curves get you close, but if you want precision, you need good individualized observational data. My experience with tracking for my wife and I is that the data is extremely noisy and must be handled with care. But after that care, the trend line is, indeed, 500cal/day = 1lb/wk, only with very noisy measurements. I don't think either of our maintenance levels from the trend line were precisely what the population-level data predicted, but they were both pretty close, and our tracking decisions were probably suitable to explain the minor deviation. It's this part, after you've already gotten a lot of individual observational data to avoid the population-level variability problem, where the vast majority of people (and all tightly-controlled lab experiments) get predictable results. The population-level variability doesn't magically jump into this part as an epicycle.
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Well, yes. The problem is that CO is not directly measurable outside of a metabolic ward. That's why successful CICO approaches dial in CI (which is measurable) to hit a certain rate of weight change (also measurable).
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It exists. But I think the CICO denial position puts way too much variability on metabolism and hunger cues and so on. Yes people do vary at bit in how much they burn. But I’d be surprised if the difference was more than 10% or so at normal levels of activity. Likewise with hunger it’s a fairly small variation unless you have a disease of some sort. It’s not going to make you gain fifty pounds over your normal weight range for someone your height. 20 lbs maybe, but that’s about it. If you’re conscious of your diet at all, those 20 lbs are preventable.
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Of course I eat too much; looking at the people around me, I eat approximately 2-3 times what a non-fat person does. Even though almost everything I eat is healthy home-cooked food, I am obviously going to be fat at that rate.
But what can I do? If I don't eat that amount, I just go around feeling hungry all day, unable to enjoy anything or focus on any kind of productive work, until my willpower finally snaps and I scarf down whatever is at hand.
Which is exactly what set point theory predicts. Set point theory doesn't posit some kind of supernatural physical or biological mechanism; it merely argues that your brain will defend a given weight by making you hungry, cold, and lethargic (or, alternatively, full, sweaty, and hyperactive) until you reach that weight.
I'm just curious, what's the longest consecutive time you've gone of eating less than that amount? This very thing used to be my experience - i.e. painful hunger pangs, unable to enjoy anything or focus on anything, not even entertainment, much less productive work - when I was obese until I decided to just try following a strict caloric deficit (in retrospect, it was probably an unhealthily severe sudden deficit, going from around 2,500-3,500 Calories/day to under 1,200 Calories/day, as a physically active early-20s 5' 9" male) for a week to see if there was any acclimation long-term, and I found that, after that week, keeping that deficit was almost trivially easy, to the extent that I just decided to keep at it for the next 4 months. I've seen enough examples of other people that I know that my experience isn't uncommon, but it certainly could be atypical, and I was wondering what, if anything, was your experience with such an experiment.
Not him, but I did basically the same thing you did, except I was less physically active, for about 15 months. The hunger pangs got less severe after a month or so, but never fully went away, and the cognitive problems (lack of focus, slower reasoning, less ability to subconsciously understand references) started half a week in and didn't stop until I started gaining the weight back.
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I used to be like this. Until I intentionally fasted. And I'm not even talking about serious fasting; 16:8 plus some minor daily exercise.
It was shocking how negotiable what seemed like a command was after a while.
I still glutton out, but I'm never in doubt now that I don't have to. It's an extremely useful exercise. You see it's just compulsion like with weed, porn or anything else except it's much better at fooling you that you're gonna die.
Something to consider trying. At least in my case, I build bad habits (no exercise, eating awful, non-satiating food) and then convinced myself this was some natural condition. It was "natural" in the same way my inability to deadlift or sprint is natural.
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Note that if you substituted food for any other substance or activity (alcohol, heroin, tobacco, masturbating to pornography) your reasoning would sound preposterous. It's very easy to tell yourself stories about how "this is just the way I am, so it's cruel to expect me to change". Probably every human defense mechanism is some variant upon this.
No, actually, I think I that's correct? In my experience, people who are addicted to alcohol or smoking or porn almost never stop, and the best defense is to avoid become addicted in the first place by not even trying the addictive habit in the first place (trivial for heroin and tobacco, harder for alcohol and porn, impossible for food).
Like, if you expect an alcoholic or drug addict or a masturbator to give up their vices, you are going to have a bad time; very few do. You are much better off deciding if you are willing to accept that person addiction and all or if you would rather cut them off from your life. Same for expecting a fat person to lose weight. Ignoring morality/desert, it requires a nearly superhuman level of willpower that the vast majority of people empirically do not have.
I find your motivated defeatism rather depressing. "Woe is me - through no fault of my own I was born with a metabolic set point incompatible with maintaining a healthy BMI AND developed an addiction to shitty fast food AND was born without the willpower necessary to overcome said addiction. Nothing I can do to change my lifestyle for the better, I just have to resign myself to my fate."
Look, I'm not going to claim that there's no hereditary component to willpower and everyone can do anything they choose to if they put their mind to it. But by your account, it doesn't sound like you've put a humongous effort into changing your lifestyle and finally decided it's not possible for you personally. Not "tried and found wanting" but "found difficult and left untried", as G.K. Chesterton would say.
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I’m a competitive bodybuilder and spend 4-6 months of the year in a bulking phase where I’m consuming around 6000 calories per day. And 8 to 10 weeks prior to competitions in extremely rigid diets.
And from this experience, I can tell you there is no doubt in my mind that food is 100% addictive, with a higher and higher level of caloric richness needing to reach satiety. When I’m on a restrictive diet pre-completion, I’d treat myself to chewing on a piece of seed bread before spitting it out — and it tastes so delicious.
And, on the other extreme, when I am bulking with no dietary restrictions (other than hitting minimum macronutrient amounts), I’d do things order a 12 piece bucket of KFC chicken, simply because I become so addicted to highly satiating food than I’m unable to force myself through the amount of lean chicken, tuna or whatever I’d need to meet my macro goals.
My experience from when I cut over between diets — bulking, cutting, maintenance — is how I know food is an addiction. When I begin cutting, the first 2-3 weeks is hell. I am lethargic, my head hurts, constantly starving, I have very bad breath, irritable, etc. But like clockwork I get used to the diet and go from choking down cans of tuna and steamed vegetables to actually craving the food I’m eating, and at that point I’m mostly on auto-pilot. The reason I am able to consistently do it is not because i have extreme willpower. Rather I’ve done it so many times before, I know the switch is going to flip and so in that sense it’s a huge bargain: you can get a 12 week diet for the price of only a couple weeks of actual grind up front.
I am not a competitive bodybuilder and do not care at all about size or cosmetics (other than not being a fatass).
But I do like to lift heavier and heavier weights.
Do I really need 1g of protein per 1-lb lean bodyweight?
Also, I'd love a hot take on rep ranges.
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That's not addiction. You literally ARE starving; you are taking far less in terms of calories than you're burning. That's what cutting is.
But those feelings go away after the first few weeks of the cut and I can continue in a similar caloric deficit without those effects. I also begin to find the bland cutting food — boiled eggs, chicken breasts, steamed vegetables, rice, etc — much more enjoyable. Which interpret as breaking the addiction to the much more satiating cutting/maintenance foods.
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What would you do if you were an adherent of a religious tradition that called for fasting? The restriction isn't for the benefit of your own health, but rather divinely commanded, and mandates not less food permenantely, but no food for a day here and there, or when the sun is shining one month per year.
Eat as much as possible before the fasting period starts to tide me over. If that failed, I would just have to sneak food in while no one was watching and hope that G-d/Allah/Heavenly Father is merciful, much the same way I watched porn while I was still a Catholic and then prayed for forgiveness and the strength not to do it again (funny how that never worked).
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Why do you think some people are able to lose weight, then?
Eating a lot is a habit. It is probably closer to an addiction. Eating less is very unpleasant and your body will fight you unless you satisfy it. Just like your body will fight you when you try to stop smoking.
I don't think you have a set point that demands you eat 2-3 times what a normal person does. I think you have a habit of eating that much, and if you stopped doing it, yes, you would feel like you are "starving" until either you give in, or your body adjusts to a lower intake.
I am not speaking hypothetically. I am a former fat person.
Independent upper and lower set points?
The more I hear about set point theory the more it sounds like just-so stories to explain why they can lose weight but I can't.
There may be something to it, but it looks as rigorous as most pseudoscientific theories, and I am suspicious of a theory that happens to be embraced mostly by fat acceptance activists.
I am suspicious of any hypothesis which allows people to think their cruellest instincts justifiable.
CICO wasn't invented as an excuse to be cruel to fat people and blame them for being fat. Cruelty is how you treat people, not what you believe about them.
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What is "cruel" about finding set point theory hard to believe?
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It may well be embraced by fat acceptance activists, but it is also embraced by most of the field of nutrition science.
CICO, meanwhile, is only popular with laymen (who very often pair it with moral condemnation of fat people).
I don't think it's possible to look at a chart like this and conclude that what's really going on is a linear increase in laziness starting in the mid-C20th for no reason. Pick any profession full of intelligent, hardworking people (medicine, law, programming, high-level business) and you'll see similar proportions of fat people to the general population. While there are entire premodern cultures where nobody is fat at all.
CICO feels better than set-point theory in the same way that complaining about greedy landlords feels better than campaigning for YIMBY zoning reform. Most people will choose righteous outrage over real explanations if given the choice.
I work at a software firm. You don't. I don't think we have a single obese person at the main office, and definitely no morbidly obese. I used to work at Google NYC, and obese people were few and far between there. For all the years I've been working, I've worked with few obese people. Go take public transportation (especially in Philadelphia), and they're everywhere. Same at the WalMart. Or many other "general public" places.
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Sorry, there's actually nothing in that blog post about independent upper and lower set points. Or even really about set point theory, broadly speaking, at all.
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I think adherents of both theories can be accused of motivated reasoning. But I don't attribute the rise in obesity to a lack of willpower. I think any society in the past suddenly presented with an overabundance of tasty fattening food would see skyrocketing obesity rates. We see this now with primitive societies suddenly exposed to Western diets.
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Oh my, the epicycles keep on coming. How would one design an experimental protocol in order to verify/falsify such a hypothesis?
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Malfunctioning set point regulator? Not sure. But as far as I know, the overwhelming majority of people fail to lose weight in the long-term.
The food addiction hypothesis fails to explain why skinny people find it just as hard to gain weight as fat people find it to lose weight. The set point model explains both.
But no. Lift according to a good program and track your macros. You'll put on weight. It will happen.
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Yes, because they fail to change their CICO equation long term. They diet and/or exercise, lose some weight, then resume eating like they used to and stop exercising.
And yet in a post above you claimed that it's just like an addiction to smoking or porn or drugs, which we should not expect people to stop because it takes "superhuman willpower."
You are right that most people will not break their addictions, and most people will not lose weight. Because it's hard and unpleasant, and people do not like to do hard and unpleasant things. That doesn't mean it's impossible.
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Me personally having mental illness makes me profoundly unsympathetic to others in that regard. I admit it is a personal flaw that I judge such people without the characteristic liberal softness: I have seen too many people get away with baldly unsympathetic behaviour because of trauma and I never feel more sympathy when it is brought up.
Even with the caprice of reality TV, the shit they do boggles the mind. (Stranger than fiction comes to mind.) And the food addictions on display (even when they know they are being observed and filmed, like in Secret Eaters) are so shameless, it is depicting the real thing, baldly and unsympathetically.
I don't think mental illness is an excuse - you are still responsible for getting yourself fixed. But people who literally aren't in control of themselves can't be expected to act "rationally."
Well, yes, if you screen people for their high levels of craziness, they will do crazy things on camera. My 600 Pound Life, for all that it purports to be "helping" its patients (Dr. Now probably really does care about his patients, at least somewhat) is very much a modern freakshow. "Point and laugh at the freaks and then wonder why they don't just stop stuffing their fat faces..."
If the threat of their imminent approaching deaths isn't enough to establish even a modicum of self control they're not really human beings, but automata who have lost their will to live. But it doesn't matter, in any case: because although they claim to have no self autonomy, they are very good at wheedling out benefits and favors from the people around them. It all smacks of bullshit in the end.
The number of people who weigh more than 600lbs is a vanishingly small number. It's not like in the Jersey Shore, where fake tanned sluts and himbos compete to be the stupidest on camera. Being very fat is comorbid with something very wrong with you and it's a pathology that is rapidly spreading in the Western world. They don't need to pick out the crazies and the exhibitionists: they just need to turn on the cameras and watch them do their distorted routines.
If it makes you feel very superior thinking that, okay. But people who are severely depressed, delusional, schizophrenic, and suffering from various other mental illnesses often do, in fact, lack even a modicum of self control. They are human beings. Broken human beings are still responsible for their actions. Yes, they can also be abusive and manipulative.
The reason we have more morbidly obese people is that (a) we have the medical technology to keep people alive in conditions that would have killed them sooner in earlier times; (b) we have a hyperabundance of extremely cheap, calorie-dense food made to be hyperpalatable; (c) we have no real mechanism to force people to stop self-harming in this way except in the most extreme circumstances.
And here's where I have a fundamentally different worldview than yours. There's a turn of phrase... 'makes you feel superior'. That would be incorrect.
That would imply that it is a subjective, egotistic feeling rather than objective fact.
There's nothing wrong with judging people better or worse than others. That may be a mortal sin to a progressive, liberal worldview, but to me it is simply the basis of any ideology that makes meritocratic judgement of worth. If you're a fat person because you were sexually abused or have some sort of mental illness or what have you... that's a sad story, but in the end, you're still being pushed off the bridge into the path of the runaway trolley.
I probably would not survive in the governing ethics of which I prefer... and that's fine with me. But that's probably too personal to debate on, so I'll chalk this one up to a disagreement of values.
We do have different worldviews, but not in the way you think.
Objectively, yes, you and I are probably "superior" to people who are eating themselves to death, at least on most axes.
What I think is a character flaw is feeling some kind of gratification at being such a superior person. Admit it is what it is; you like watching human trainwrecks. (That's why I watch the show.) You don't have to feel sorry for them or have empathy. But I wouldn't take pride in how superior I am or how it makes me a clear-eyed rationalist that I can deny them sympathy.
We wouldn't watch a show called '160 lb people eat healthy food in regular amounts', now, would we? :P
I believe what the West gets wrong is that it attempts to shift the pride of superiority to obviously inadequate people (and eliminate any pesky shame that came along with it.) But that fundamentally misunderstands the purpose of such emotions. You should feel pride in doing something good (and shame when you do something bad.) When you give pride to the weak-willed and shame the strong you upset the incentive structure of society and chaos ensues.
Or, to put it simply, false modesty benefits no one, and false pride harms everyone. To do otherwise to spare feelings is no good.
Why not? I watch a few YT channels that are like that. They are more of "160 lb people cook and eat healthy food in regular amounts", but still.
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