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Culture War Roundup for the week of September 23, 2024

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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.

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.

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.

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

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.

My actual experience of CICO was exactly the opposite. It worked initially but when I tried to bulk, I found it predicted weight gain very poorly. Since CICO is of course, perfect and never wrong, it must have been a mistake I was making, and since I couldn't find my mistake, I decided to spare myself the stress and anxiety and stopped tracking.

I am sorry you had that experience. Unfortunately, it is probably unlikely that I will be able to figure out whatever was going on in your individual case through comments. But I'm not sure what is supposed to change about my understanding of the published literature from your example.

FYI, my personal experience included periods of gaining, and my trend line from the noisy data was bang on at 500cal/day = 1lb/wk on that side, too (and my wife's). But I'm not sure how you might/might not want to update your understanding of the published literature based on my example, either.

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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?

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

Why do you think some people are able to lose weight, then?

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 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.

What is "cruel" about finding set point theory hard to believe?

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.

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.

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.

This study suggests that in 2011, about 31% of white men working in 'computing and mathematics' were obese, which is actually higher than the obesity rate for white men overall (28%).

But that's missing the point that it isn't just individual groups of people getting fat, it's the entire developed world. Look at a list of the fattest countries, does this look like a list of laziest to most disciplined countries? Are the Italians really skinny because they work harder than Chileans or Finns?

One metric that does vary massively is the proportion of the diet that consists of processed food, which is another name for food that is full of vegetable oil.

I can believe your link, or my lying eyes.

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.

This was the part I was referencing:

But there's a third model, not mentioned by Ludwig or Taubes, which is the one that predominates in my field. It acknowledges the fact that body weight is regulated, but the regulation happens in the brain, in response to signals from the body that indicate its energy status. Chief among these signals is the hormone leptin, but many others play a role (insulin, ghrelin, glucagon, CCK, GLP-1, glucose, amino acids, etc.).

Sure, but that's pretty generic and not really making any claims about set point theory. Just that there are some feedback pathways. You might be interested in my old lengthy comment about the gap between simply observing that there are some feedback pathways somewhere and something that could properly be called "set point theory" with all of the features that many of its proponents would like. There are some significant theoretical and empirical challenges that would need to be overcome in order to close that gap.

I've seen a lot of control theory models for a lot of biological systems in my professional career, and there is a wide range in terms of quality. I would not bin what I've seen of set point theory in the high end of that range.

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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.

I think our positions are pretty close, although I'd be more specific. After all, tasty food existed before the mid-20th century, and any food is 'fattening' tautologically if eating it leads to obesity. People in the past ate vast amounts of calories, but their bodies handled it. Even processed food existed for hundreds of years before the obesity epidemic.

What distinguishes the modern western diet is vegetable oil. All the data on 'processed' or 'junk' food is really just looking at foods with lots of vegetable oils. Consider a big mac meal with a shake from McDonalds. There is nothing modern about minced beef, bread or pickles, nor about fried potatoes, milk or sugar. What defines it as fast food the fact that everything is fried in, or contains vegetable oils. The same is true of essentially all processed food.

The fact that vegetable oil turned up at the exact time that the obesity epidemic kicked off makes it the most plausible candidate in my mind.

Oh my, the epicycles keep on coming. How would one design an experimental protocol in order to verify/falsify such a hypothesis?

Why do you think some people are able to lose weight, then?

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.

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.

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.

why skinny people find it just as hard to gain weight

But no. Lift according to a good program and track your macros. You'll put on weight. It will happen.

But as far as I know, the overwhelming majority of people fail to lose weight in the long-term.

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.

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.

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.