Weight loss - some honest data to consider

[Laurie4b]

I don't equate CICO with fat-shaming. But I do think it gives *some* people a sense of feeling justified in blaming people for their own obesity. This can even happen with doctors. Here's a really good TED Talk in which one doctor very bravely admits to having treated an obese patient with less compassion, because he felt that she brought her diseases upon herself.

 

 

I think that this happens frequently with doctors. I know a woman whose OBGYN told her basically that there was no point in doing testing (maybe a Pap) because it was her weight that was going to kill her. (She (dr) didn't refuse the test; she was just commenting that she thought it was pointless.) :glare:  Patient is still obese and she's also 81, so so far, so good. No longer a patient of that particular doctor. 

Another young male morbidly obese patient went to a doctor to get ADHD meds. Dr. said, "No point prescribing until you've lost some weight," and refused. :huh:

 

http://ruddctr-dev.port200.com/resources/upload/docs/what/bias/Weight-Bias-Among-Health-Professionals.pdf

http://www.amednews.com/article/20130902/profession/130909988/4/

http://www.aaos.org/news/aaosnow/jun13/clinical7.asp

[SproutMamaK]

Or you could add beans, eggs, vegetables and fruits. The veg and fruit would have to be in season, or basic frozen, or you have to up your budget or garden. Usually your local cooperative extension has the affordable menu plans.

 

Not to pick on this too much, because I know you mean well here, but most people on very low card diets will definitely not eat beans, and most fruits and many vegetables are out as well. Leafy greens and eggs are great, though... but that's only two simple/cheap things you can grow yourself and work in to your diet, and eating only those two things does not make for make a balanced diet.

 

[leeannpal]

I absolutely agree with this.

 

So given that we all know that because of metabolic differences, one person can eat 2000 calories per day and be skinny, while another person of the same sex and frame-size can eat 1200 calories per day and be fat, and given that we are also discovering just how little exercise may affect the "CO" part of the equation, WHY do we (not you personally regentrude! we as a culture) still insist that CICO is a valid and helpfull weight loss philosophy. I'm not doubting its truth in terms of thermodynamics. But as a treatment option.

 

I'm sure that CICO is a fantastic treatment option for people who:

have healthy hormone levels

have not developed insulin resistance

have healthy gut flora

don't suffer from severe food allergies or intolerances

have normally functioning appetite and satiety mechanisms

don't have chronic inflammation issues

have never been morbidly obese (which often seems to permanently alter a person's fat storage mechanisms)

are not on any medications which affect appetite, metabsolism, etc.

and so on

 

But for the rest of us, it falls short.

 

As someone wiser than me put it, CICO tells us what is happening, but it doesn't tell us why.

This is exactly what I wanted to say but Greta said it so much better!

[albeto.]

I think it is very nice of you to defend Joanne. I like Joanne, too, and I don't care how much she or anyone else weighs. I think it's terrible that people judge others based on their weight, and I think it's fine that Joanne discusses it here and talks about her personal experiences with being shamed about her weight. But I'm not seeing that shaming from the posters in this thread.

 

I'm not defending Joanne, I'm joining her argument that reason and information is more valuable than experiential thinking. It's valuable in that one can gain and therefore apply knowledge more readily this way, and it's valuable with regard to promoting and maintaining desired social relationships. She's pointing out how erroneous arguments contribute to a mythology that includes shame, and for her troubles, she's being told she's too defensive and intolerant of other people's ideas. 

[Bluegoat]

I absolutely agree with this.

 

So given that we all know that because of metabolic differences, one person can eat 2000 calories per day and be skinny, while another person of the same sex and frame-size can eat 1200 calories per day and be fat, and given that we are also discovering just how little exercise may affect the "CO" part of the equation, WHY do we (not you personally regentrude! we as a culture) still insist that CICO is a valid and helpfull weight loss philosophy. I'm not doubting its truth in terms of thermodynamics. But as a treatment option.

 

I'm sure that CICO is a fantastic treatment option for people who:

have healthy hormone levels

have not developed insulin resistance

have healthy gut flora

don't suffer from severe food allergies or intolerances

have normally functioning appetite and satiety mechanisms

don't have chronic inflammation issues

have never been morbidly obese (which often seems to permanently alter a person's fat storage mechanisms)

are not on any medications which affect appetite, metabsolism, etc.

and so on

 

But for the rest of us, it falls short.

 

As someone wiser than me put it, CICO tells us what is happening, but it doesn't tell us why.

 

I don't know that I would say it is totally useless.  It seems like its more that it is just not enough - it requires fleshing out, for the individuals particular circumstances.  Most people are probably going to have to reduce calories to some extent if they want to lose weight - its just not a simple equation.

 

As far as advice, I guess lots of people just give generalized advice about things a lot of the time.  It's a sometimes annoying aspect of human nature.  Though with weight loss, there are actually a fair number of people who aren't even covering the basics - they don't even have the basics of healthy eating down, and probably would get some good out of just eating less, and less nasty food - even if they didn't actually lose weight.

 

 

[Murphy101]

I don't equate CICO with fat-shaming. But I do think it gives *some* people a sense of feeling justified in blaming people for their own obesity. This can even happen with doctors. Here's a really good TED Talk in which one doctor very bravely admits to having treated an obese patient with less compassion, because he felt that she brought her diseases upon herself.

 

This. And also? *Some* people (general reference, not targeted to anyone here) are just turdy like that.

 

They are nurses who are condescending to pregnant women in pain.

 

Or cancer patients who smoked.

 

Or any other number of things.

 

It makes them feel superior, smarter, assures them they won't end up in the same situation, because they are better people who make better choices.

 

They aren't. It's a lie they tell themselves and unfortunately it's a lie that too many believe.

 

The thing I didn't like about the TED talk was he still justifies his condescending behavior to that obese patient. He seems to think it was wrong bc he was in error about her illness, rather than simply bc that's not how he should think of or treat a person. idk. I hope not. But that's the impression I got from the talk. Which was otherwise interesting.

[PeachyDoodle]

I think maybe that's why I do feel qualified to speak on this subject.  I did lose a very large amount of weight.  And I kept most of it off for 27 years and through two pregnancies.  Until that darn wonky thyroid .  .  ;)

 

Do I think that makes me an expert?  No.  Not on anything but my own body.  But I do know that before I first lost weight I went through all the denial that many on here are voicing -- I thought my body was somehow special, that I wasn't eating that much, that CICO didn't work for me.  I have so totally BTDT this thread has been like a walk down memory lane.

 

This was absolutely me as well. And it is excruciatingly painful to feel like you are trying EVERYTHING, putting in just as much effort as you possibly can, and getting nowhere (or, in my case, gaining). I have nothing but compassion for those who are going through that. For me, I later discovered that for all that time, emotions were clouding my ability to see myself objectively. I WAS eating more that I admitted, I was moving less than I thought, and I wasn't the hopeless case I thought I was. I don't know why one day I was able to see it. I wish I could figure it out and share it.

 

CICO means simply the net energy balance. The person who stays skinny while eating junk food an not exercising has a metabolism that burns these calories. The net balance is still the same - otherwise that person would store an excess of energy on the form of fat.

It can only either be burned or stored. Metabolism and hormones affect how much energy is burned ("fast metabolism " means calories out is very large), but basic thermodynamics cannot be overruled.

 

The misconception lies in the assumption that "calories out" refers only to exercise. this is incorrect. A huge amount of energy goes into maintaining body temperature. It is difficult to increase intrinsic resting metabolism - but all the "other" weight loss techniques do just that, so that CICO works on a sustainable level. When you go low carb or paleo or whatever to lose weight, you alter you body's response so that  more calories are burned, or, in other words, "calories out" increase. But you don't overrule thermodynamics.

 

This is so important to understand. I think it's becoming clear, as others have pointed out, that it's on the "calories out" end of things that there's such a difference from person to person. For me, it turned out that I not only have to reduce the number of calories I take in, I also had to SERIOUSLY increase the intensity and amount of my exercise in order to see any effect at all. Way, way more than other women with my same age/build. Sucks to be me. But it is what it is. Griping about it doesn't help -- ask me how I know.

[goldberry]

Yes, and I stand by that. The assumption that fat people are fat due to over-eating and undermoving moralizes obesity and aligns with assumptions and stereotypes.  It is also,.....false scientifically.

 

I don't hear anyone saying this applies to everyone, so are you saying you don't think it applies to anyone?  There are, in fact, plenty of overweight people became overweight because of over-eating and undermoving. (Just a note, even that I don't think deserves a moral judgment.)

 

Because something doesn't apply to everyone doesn't make it false scientifically.  The fact that people use it to support stereotypes and judgment is wrong.  But that doesn't change the fact that for some people it is true, not false.  Facts don't have inherent judgment or moral value bound up in them, people add the judgment and moral value.

[Bluegoat]

I'm not defending Joanne, I'm joining her argument that reason and information is more valuable than experiential thinking. It's valuable in that one can gain and therefore apply knowledge more readily this way, and it's valuable with regard to promoting and maintaining desired social relationships. She's pointing out how erroneous arguments contribute to a mythology that includes shame, and for her troubles, she's being told she's too defensive and intolerant of other people's ideas. 

 

You are assuming her view that some arguments is erroneous is correct.  Not everyone agrees that those arguments are incorrect.  They have read the same research, and their conclusions and interpretations are different.  And Joanne if you'll notice is also referring to her own experience, fairly heavily, to support her perspective - that's fine, but it sure isn't a rejection of experiential thinking.

 

To equate disagreement about facts or the most accurate way to talk about them with shaming is irrational.

[LucyStoner]

I think that this happens frequently with doctors. I know a woman whose OBGYN told her basically that there was no point in doing testing (maybe a Pap) because it was her weight that was going to kill her. (She (dr) didn't refuse the test; she was just commenting that she thought it was pointless.) :glare: Patient is still obese and she's also 81, so so far, so good. No longer a patient of that particular doctor.

Another young male morbidly obese patient went to a doctor to get ADHD meds. Dr. said, "No point prescribing until you've lost some weight," and refused. :huh:

 

http://ruddctr-dev.port200.com/resources/upload/docs/what/bias/Weight-Bias-Among-Health-Professionals.pdf

http://www.amednews.com/article/20130902/profession/130909988/4/

http://www.aaos.org/news/aaosnow/jun13/clinical7.asp

This happened to my mother. She was in remission for leukemia and started to report signs of lung cancer. Her doctor told her full stop there was no point in him referring her for an MRI and evaluation because she would probably die soon anyways. Her weight definitely influenced his statements. I took her elsewhere, she got good treatment and she lived to see my wedding, my brother's commitment ceremony and the birth of FIVE grandchildren. No point indeedy. She died at 55 but those final years were valuable ones. Her oncologists were not at all like that first doctor. She had solid quality of life until just prior to death.

[Joanne]

 

 

 

This is so important to understand. I think it's becoming clear, as others have pointed out, that it's on the "calories out" end of things that there's such a difference from person to person. For me, it turned out that I not only have to reduce the number of calories I take in, I also had to SERIOUSLY increase the intensity and amount of my exercise in order to see any effect at all. Way, way more than other women with my same age/build. Sucks to be me. But it is what it is. Griping about it doesn't help -- ask me how I know.

 

This kind of supports my point.

 

It is not intuitive, natural, or logical (given our typical nutritional science advice) to have to go that extreme. It takes an exceptional amount of time, planning, and willpower to execute and sustain.

Trite, cryptic suggestions for "balance" and "fitness" and "healthy eating" do not apply. If they "worked," the situation you describe would not exist.

 

We are imposing a (moralized) remedy onto a disease we do not understand nor care to invest adequately in researching.

 

(Again, don't worry about me. I'm not living in this head space. The only time I actually think about and care about what WTM posters think of me and my weight is when I am reading and posting. Otherwise, I am engaged in my quite full life.)

[Carol in Cal.]

It's appalling when doctors apply triage like that.  It's wrong, too.  Triage is supposed to be for ERs, and it doesn't mean 'denial of care' but rather 'prioritization based on urgency'.

[goldberry]

Just for the record, I do agree that people can be woefully ignorant of how complex of an issue obesity is.  I think it is sad and in some cases (such as the doctors mentioned) downright immoral for supposedly professional people not to recognize their own biases and take the time to become educated on such an important issue. 

[Joanne]

I don't hear anyone saying this applies to everyone, so are you saying you don't think it applies to anyone?  There are, in fact, plenty of overweight people became overweight because of over-eating and undermoving. (Just a note, even that I don't think deserves a moral judgment.)

 

Because something doesn't apply to everyone doesn't make it false scientifically.  The fact that people use it to support stereotypes and judgment is wrong.  But that doesn't change the fact that for some people it is true, not false.  Facts don't have inherent judgment or moral value bound up in them, people add the judgment and moral value.

 

I am saying that the cultural attitude about fat and the shaming and assumption that correlates is impossible to remove from this discussion. I am saying that 1) the science most of us were brought up to adopt with regard to weight is increasingly shown to be invalid and 2) fat shaming exists in abundance and is so entrenched in our culture that we don't see it.

 

Eat less, move more as advice is part of that.

[Joanne]

Just for the record, I do agree that people can be woefully ignorant of how complex of an issue obesity is.  I think it is sad and in some cases (such as the doctors mentioned) downright immoral for supposedly professional people not to recognize their own biases and take the time to become educated on such an important issue. 

 

I wish there was more research and more "care" about the need for it.

 

[TranquilMind]

I've known for years that "calories in/calories out" was not a viable weight loss theory for me. "Eat less and move more" and its infinite variations are insulting.

 

I'm inclined to believe these articles:

 

http://www.dailymail.co.uk/health/article-2134162/Research-shows-trying-lose-weight-alters-brain-hormones-youre-doomed-pile-again.html

 

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/diets_do_not_work_the_thin_evidence_that_losing_weight_makes_you_healthier.html

 

http://www.washingtonpost.com/news/wonkblog/wp/2015/07/18/one-chart-shows-why-its-nearly-impossible-to-lose-weight-and-keep-it-off/

 

https://www.psychologytoday.com/blog/evolutionary-psychiatry/201103/dieting-can-make-you-lose-your-mind

 

"Maybe a calorie isn't just a calorie. Maybe novel food products cause inflammation and irritation, leading to changes with insulin, leptin, and other appetite hormones. Perhaps that explanation would make more sense than the current one that, somehow, in a few generations, the majority of Americans have become hopeless gluttonous sloths."

I agree with you.  Something isn't right.  Our foods are loaded with crap and it is having effects, I think. 

Hardly anyone was overweight in my youth. 

[albeto.]

You are assuming her view that some arguments is erroneous is correct.  Not everyone agrees that those arguments are incorrect.  They have read the same research, and their conclusions and interpretations are different.  And Joanne if you'll notice is also referring to her own experience, fairly heavily, to support her perspective - that's fine, but it sure isn't a rejection of experiential thinking.

 

To equate disagreement about facts or the most accurate way to talk about them with shaming is irrational.

 

One's agreement or disagreement does not effect this kind of data. 

 

The data shows diets are demonstrably an unreliable way to achieve weight loss goals. Surprisingly unreliable.

 

Some posters responded with diet tips. 

 

Joanne's attempt to share the hurtful effect of such behavior has been met with predictable responses (ie, "no it's not" or "you're overreacting" or "it's not intentional," all of which lead to the same conclusion - shush). 

 

I asked Cat and Gold, why should the onus not on the individual to consider objective data? It seems your answer to that question is, "one can consider it, disagree, and their argument ought to hold equal persuasion in an argument." Why? Why should someone's opinion be considered with equal weight to a plethora of objective data that suggests the opposite?

[TranquilMind]

I am saying that the cultural attitude about fat and the shaming and assumption that correlates is impossible to remove from this discussion. I am saying that 1) the science most of us were brought up to adopt with regard to weight is increasingly shown to be invalid and 2) fat shaming exists in abundance and is so entrenched in our culture that we don't see it.

 

Eat less, move more as advice is part of that.

Eat less, move more is not wrong.  It's just insufficient in many cases.

Sometimes it does work, for the right kind of person who also isn't having other physical issues. 

[Greta]

I think that this happens frequently with doctors. I know a woman whose OBGYN told her basically that there was no point in doing testing (maybe a Pap) because it was her weight that was going to kill her. (She (dr) didn't refuse the test; she was just commenting that she thought it was pointless.) :glare: Patient is still obese and she's also 81, so so far, so good. No longer a patient of that particular doctor.

Another young male morbidly obese patient went to a doctor to get ADHD meds. Dr. said, "No point prescribing until you've lost some weight," and refused. :huh:

 

http://ruddctr-dev.port200.com/resources/upload/docs/what/bias/Weight-Bias-Among-Health-Professionals.pdf

http://www.amednews.com/article/20130902/profession/130909988/4/

http://www.aaos.org/news/aaosnow/jun13/clinical7.asp

Good grief. :(

 

BTW, I liked your post to thank you for providing the interesting links. Obviously I don't "like" this sad topic.

[Greta]

I don't know that I would say it is totally useless. It seems like its more that it is just not enough - it requires fleshing out, for the individuals particular circumstances. Most people are probably going to have to reduce calories to some extent if they want to lose weight - its just not a simple equation.

 

As far as advice, I guess lots of people just give generalized advice about things a lot of the time. It's a sometimes annoying aspect of human nature. Though with weight loss, there are actually a fair number of people who aren't even covering the basics - they don't even have the basics of healthy eating down, and probably would get some good out of just eating less, and less nasty food - even if they didn't actually lose weight.

 

 

No, I agree, not totally useless. Just limited in its usefulness. And certainly not the panacea it is often promoted to be.

[Joanne]

I agree with you.  Something isn't right.  Our foods are loaded with crap and it is having effects, I think. 

Hardly anyone was overweight in my youth. 

 

Yea, I absolutely think changes to our food supply is part of the problem (and solution.)

[albeto.]

I agree with you.  Something isn't right.  Our foods are loaded with crap and it is having effects, I think. 

Hardly anyone was overweight in my youth. 

 

Last year, though, a team of Israeli scientists put together a stronger case. The researchers concluded from studies of mice that ingesting artificial sweeteners might lead to—of all things—obesity and related ailments such as diabetes. This study was not the first to note this link in animals, but it was the first to find evidence of a plausible cause: the sweeteners appear to change the population of intestinal bacteria that direct metabolism, the conversion of food to energy or stored fuel. And this result suggests the connection might also exist in humans.

 

http://www.scientificamerican.com/article/artificial-sweeteners-may-change-our-gut-bacteria-in-dangerous-ways/

 

But when immunologist Andrew Gewirtz at Georgia State University in Atlanta and his colleagues fed common emulsifiers carboxymethylcellulose and polysorbate-80 to mice, they found evidence that the chemicals affected the animals' health. Although their diet was not otherwise changed, healthy mice whose water contained the chemicals became obese and developed metabolic problems such as glucose intolerance. In mice genetically engineered to be prone to inflammatory gut diseases, emulsifiers also seemed to increase the severity and frequency with which the animals developed inflammatory bowel disease.

 

http://www.nature.com/news/food-preservatives-linked-to-obesity-and-gut-disease-1.16984

 

 

Slowly but surely, I think we're starting to find concrete pieces to this puzzle. 

[goldberry]

I asked Cat and Gold, why should the onus not on the individual to consider objective data? It seems your answer to that question is, "one can consider it, disagree, and their argument ought to hold equal persuasion in an argument." Why? Why should someone's opinion be considered with equal weight to a plethora of objective data that suggests the opposite?

The data to me does not "suggest the opposite" but suggests that there are other sometimes significant factors in play that should be considered.  There is already a broad base of data supporting the fact that CICO is real. The fact that other factors can affect that, also that it is more complex than "food in/exercise out" does not make CICO become false.

 

Also, the data was not being debated.  What is being debated is that it somehow makes CICO invalid or "false" as was claimed, and that CICO is inherently fat-shaming or moralizing.  That topic is most certainly open to opinion and not a data-based argument.

[regentrude]

Yea, I absolutely think changes to our food supply is part of the problem (and solution.)

 

Would you care to elaborate?

 

I see a vastly larger variety of foods in stores available now than as a kid. Whereas, growing up, we had apples, carrots and cabbage in winter, there is now a tremendous variety of produce to select from. Where my parents and grandparents went through periods of famine during their lives, there is now an immense supply of food available to most people (yes, I know about poverty, that's why I said "most"). Compared to most places in the world, the variety of foods available to an American is absolutely staggering.

So, our food supply should allow us to choose, and make it much easier, to be better and more healthfully nourished than generations before.

 

 

 

[PeachyDoodle]

This kind of supports my point.

 

It is not intuitive, natural, or logical (given our typical nutritional science advice) to have to go that extreme. It takes an exceptional amount of time, planning, and willpower to execute and sustain.

Trite, cryptic suggestions for "balance" and "fitness" and "healthy eating" do not apply. If they "worked," the situation you describe would not exist.

 

We are imposing a (moralized) remedy onto a disease we do not understand nor care to invest adequately in researching.

 

(Again, don't worry about me. I'm not living in this head space. The only time I actually think about and care about what WTM posters think of me and my weight is when I am reading and posting. Otherwise, I am engaged in my quite full life.)

 

Yes, I do have to spend more time thinking and working on my weight than other people do. My mother, for example, who maintained a healthy weight with hardly any effort at all until she hit menopause. She still makes almost no effort and, even with the weight gain, isn't significantly overweight. Both my sisters, same way (except neither has gone through menopause). But -- part of what makes it easy for them is that they naturally gravitate towards healthier choices. They naturally want to eat healthier food, in small amounts, and be active. They don't know how to sit still, actually. I tend to crave sweets, have very little regulatory ability when it comes to fullness/hunger, and naturally prefer to think rather than move. If mental activity burned the number of calories that physical activity does, I could eat my weight in ice cream every single day! :drool5:

 

I do not consider what I have to do extreme, though. It is certainly more effort than my mom and sisters have ever put in -- precisely because IT IS HARD AND UNNATURAL FOR ME. I have to be much more intentional about it. And I spent a considerable number of years bemoaning the fact that I wasn't like them. My point is that whining about it got me nowhere. It's not fair, but I had to come to terms with the fact that I was going to have to make choices I didn't like, or else I was going to have to deal with consequences I didn't like.

 

Is it moralizing to ascribe the terms "lazy" and "lack of self-control" to the choices I was making? I don't know. But I can tell you that I was (am!) both lazy and lacking in self-control. I have to actively fight those personality attributes (flaws?) every single day. Of course that doesn't mean that everyone with weight problems is like me. But it doesn't mean that no one is, either. And it did me no good when others (like dh) commiserated with me. I needed the truth. But I can only judge myself.

 

I do agree with you that clearly something else is at play when it's so easy for my mom and sisters and so hard for me. And I do hope that research continues to advance so we can understand why that is the case. Because I see a lot of myself in my dd, and I am doing everything I can to give her the tools to deal with her challenges, hopefully before they become the extreme challenges that they did for me.

 

In the end, though, everybody has something they have to deal with. I wish we could come to a point where we all extend a little more grace to others for their flaws and accept a little more responsibility for our own. The world would be a nicer place.

[Katy]

I don't equate CICO with fat-shaming. But I do think it gives *some* people a sense of feeling justified in blaming people for their own obesity. This can even happen with doctors. Here's a really good TED Talk in which one doctor very bravely admits to having treated an obese patient with less compassion, because he felt that she brought her diseases upon herself.

 

 

 

 

I judged patients with type 2 diabetes.  I essentially thought they were eating themselves to death, they were a waste of taxpayer money, and that most of them would be better off in nursing homes than in acute hospital beds all the time.  And all the while I was struggling with my weight.

 

I judged my family members with diabetes too.  I believed you could just follow one of the programs to reverse diabetes and you would do so, with just a little bit of effort.

 

I can also say for sure that those in my family with adult onset diabetes who were the most lean were also the youngest ones to die.  The ones who are obese basically just got fat, and that's the extent of it. No heart disease.  No strokes.  All still alive.

 

ETA:  I forgot to add that all of that changed when I got diagnosed, and when even doing everything perfectly my numbers got worse.

[Joanne]

Would you care to elaborate?

 

I see a vastly larger variety of foods in stores available now than as a kid. Whereas, growing up, we had apples, carrots and cabbage in winter, there is now a tremendous variety of produce to select from. Where my parents and grandparents went through periods of famine during their lives, there is now an immense supply of food available to most people (yes, I know about poverty, that's why I said "most"). Compared to most places in the world, the variety of foods available to an American is absolutely staggering.

So, our food supply should allow us to choose, and make it much easier, to be better and more healthfully nourished than generations before.

 

I think the apples, carrots and cabbage we eat now are different than those we ate in earlier decades. And I know for certain that the milk we drink with it and the protein we serve is very, very different.

 

(And don't get me started on the food products that emerged in the late 60's through current)

[Pawz4me]

If mental activity burned the number of calories that physical activity does, I could eat my weight in ice cream every single day! :drool5:

 

:iagree: :iagree:

[Greta]

The thing I didn't like about the TED talk was he still justifies his condescending behavior to that obese patient. He seems to think it was wrong bc he was in error about her illness, rather than simply bc that's not how he should think of or treat a person. idk. I hope not. But that's the impression I got from the talk. Which was otherwise interesting.

I didn't think of it that way when I watched it, but you could be right. I certainly agree that doctors should treat their patients with respect and compassion always, even if the patient did make mistakes that led to their condition, because their role is to heal and to treat, not to judge and condemn. Not blaming diabetic patients for their obesity is probably a step in the right direction.

[Carrie12345]

Yes, and I stand by that. The assumption that fat people are fat due to over-eating and undermoving moralizes obesity and aligns with assumptions and stereotypes.  It is also, as evidenced by recent research and anecdotally this thread, false scientifically.

 

I promise I'm really trying to wrap my head around this.

To avoid lung cancer, don't smoke.

To avoid skin cancer, wear sunblock.

To avoid pregnancy, use birth control.

To avoid bankruptcy, use a budget.

I could go on and on. Some things are just true... except when they aren't. Is it wrong for people to assume someone has "failed" when they get a commonly caused cancer, knocked up, or knocked down?  YES.  Does that make the general advice something we should all avoid saying? NO.

[Joanne]

I promise I'm really trying to wrap my head around this.

To avoid lung cancer, don't smoke.

To avoid skin cancer, wear sunblock.

To avoid pregnancy, use birth control.

To avoid bankruptcy, use a budget.

I could go on and on. Some things are just true... except when they aren't. Is it wrong for people to assume someone has "failed" when they get a commonly caused cancer, knocked up, or knocked down?  YES.  Does that make the general advice something we should all avoid saying? NO.

 

But it's not that simple - not from a science or psychological or sociological standpoint. Increasing numbers of people are discovering that CICO is not how they got fat, and even more are discovering how eat less/move more are not their solution.

 

And the psychological and sociological response to skin cancer is =/= to being a fat female. I see the point you are making with your list. I get it. I think its application is limited to the whole of being obese in the US in 2015.

[Bluegoat]

One's agreement or disagreement does not effect this kind of data. 

 

The data shows diets are demonstrably an unreliable way to achieve weight loss goals. Surprisingly unreliable.

 

Some posters responded with diet tips. 

 

Joanne's attempt to share the hurtful effect of such behavior has been met with predictable responses (ie, "no it's not" or "you're overreacting" or "it's not intentional," all of which lead to the same conclusion - shush). 

 

I asked Cat and Gold, why should the onus not on the individual to consider objective data? It seems your answer to that question is, "one can consider it, disagree, and their argument ought to hold equal persuasion in an argument." Why? Why should someone's opinion be considered with equal weight to a plethora of objective data that suggests the opposite?

 

All data has to be interpreted.  All of it. There is no such thing as objective data, and even the stuff that comes closest is only meaningful when interpreted, which brings in subjectivity.   And please keep in mind that articles in popular sources like Slate are not academic studies they are presentations of them with a further level of subjectivity, and even plain old academic studies are interpreted - they are not pure data.

 

If you have read the thread, you can see all kinds of intelligent people, including ones who work with scientific data in their jobs, having different points of view about what this is saying, and what it means to the idea of CICO.  Joanne's view (and I don't mean to pick on you here Joanne) is no more objective than many other views that have been expressed.  I am not saying that some arguments cannot be worse or better than others - I am saying that on this topic, in this discussion, there are not any that are clearly the only right way to look at it.  People are working from the same data to come up with different conclusions.

 

You have made an assumption - perhaps because it agrees with your view, or you have a tendency to take descriptions of emotional pain as definitive - that the view Joanne hold is the only one that can be rationally taken from that data, and so others must simply be ignoring it.  Your assumption is wrong - quite possibly because you seem to have a naive view that data will always lead to a single clear conclusion.

[Carrie12345]

But it's not that simple - not from a science or psychological or sociological standpoint. Increasing numbers of people are discovering that CICO is not how they got fat, and even more are discovering how eat less/move more are not their solution.

 

And the psychological and sociological response to skin cancer is =/= to being a fat female. I see the point you are making with your list. I get it. I think its application is limited to the whole of being obese in the US in 2015.

Do you have any suggestions for what we *should be telling people who want to lose weight? Genuine question from someone who hopes to help people down that path someday.  My credentials will be in fitness and nutrition (not professional nutritionist or dietitian.) If CICO/eat less move more is taboo, what is the conversation?

[Pawz4me]

But it's not that simple - not from a science or psychological or sociological standpoint. Increasing numbers of people are discovering that CICO is not how they got fat, and even more are discovering how eat less/move more are not their solution.

 

And the psychological and sociological response to skin cancer is =/= to being a fat female. I see the point you are making with your list. I get it. I think its application is limited to the whole of being obese in the US in 2015.

 

 

But you keep ignoring a key piece of data that we do know from objective studies -- that people are notoriously bad about accurately self reporting their food intake and exercise.  Across the spectrum -- from the normal weight to the morbidly obese.  It's a widespread issue that no "shaming" label can accurately or honestly be attached to.  Almost all humans do it, if the studies are to be believed.

 

So taking that into consideration saying things like "increasing numbers of people are discovering that CICO is not how they got fat . . ." may or may not be true.  We just don't know.  Because the hard, objective data says we can't believe food or exercise information is true just because someone says it is.  And that's one of the main reasons why it is so incredibly difficult to get good, solid data on dieting and weight loss.

[Greta]

I judged patients with type 2 diabetes. I essentially thought they were eating themselves to death, they were a waste of taxpayer money, and that most of them would be better off in nursing homes than in acute hospital beds all the time. And all the while I was struggling with my weight.

 

I judged my family members with diabetes too. I believed you could just follow one of the programs to reverse diabetes and you would do so, with just a little bit of effort.

 

I can also say for sure that those in my family with adult onset diabetes who were the most lean were also the youngest ones to die. The ones who are obese basically just got fat, and that's the extent of it. No heart disease. No strokes. All still alive.

 

ETA: I forgot to add that all of that changed when I got diagnosed, and when even doing everything perfectly my numbers got worse.

I've done it too. Not openly, but in my own mind wondered why they wouldn't do something to help themselves. Well, actually, I have known one diabetic who refused to do anything to help himself, and he died young. But most have tried. And tried, and tried. And some of them have tried following really bad advice, and gotten worse. Some of them have tried following that bad advice, and simply given up because it didn't help much for the amount of effort it required.

 

:grouphug: You mentioned that your numbers got worse when doing everything right. Have you found something that works?

[Joanne]

Do you have any suggestions for what we *should be telling people who want to lose weight? Genuine question from someone who hopes to help people down that path someday.  My credentials will be in fitness and nutrition (not professional nutritionist or dietitian.) If CICO/eat less move more is taboo, what is the conversation?

 

 

My own personal research and experience leads me to say:

 

1. Research by far supports that people who write down everything they eat are more "successful" in losing weight and keeping it off.
2. Making sure a diet style has abundant leafy greens and non starchy veggies is important.
3. Discourage fat phobia. Good fats are satiating and needed.
4. (intentional) Exercise is important for health, but may not relate to losing weight.
5. Fresh, whole foods are needed and important. Many people report that increasing these decreases cravings for other less nutritionally dense foods.
6. Fast food should be minimum from a health standpoint.
7. Tell them making changes that stay is more about knowing about habits than exercising willpower.
8. (ETA) Emphasize health and fitness vs. weight.
9. (ETA) Teach habit building.
10. (ETA) Help client move *towards* something positive rather than away from something negative.

 

 

And, I'd encourage you (specific AND general) to believe people if they tell you they have tried "x, y, z" and it doesn't work. Or, even if they tell you they have tried x, y, z and it DOES work. Believe their self report, even if it "goes against" what you think should happen.

 

[Bluegoat]

I've done it too. Not openly, but in my own mind wondered why they wouldn't do something to help themselves. Well, actually, I have known one diabetic who refused to do anything to help himself, and he died young. But most have tried. And tried, and tried. And some of them have tried following really bad advice, and gotten worse. Some of them have tried following that bad advice, and simply given up because it didn't help much for the amount of effort it required.

 

:grouphug: You mentioned that your numbers got worse when doing everything right. Have you found something that works?

 

This is my dad, he wants to take a pill that means he can eat what he wants.

 

He says he gave up booze, cigs, and sex, so he is darn well not giving up immoderate eating.  Well, I am ok with that, I am all for weighing what is important to you.

 

But - then you need to live with the effects and not wonder why you are getting problems with your feet or ending up in the ER.

[Joanne]

 

What I hear from my m.o. relatives is that they have no intention of eating like a poor person did when they grew up....less red meat, more fish, more greens, fruit instead of sugar, beans, etc. Food is a sensory pleasure, and they especially like processed food. There is no waiting on a hunger pain...even at Thanksgiving, they dive in before everyone has filled their plate from the buffet and joined the table. Rich people don't cook, and since they are richer than their parents they qualify..and their SS payments are high enough to support eating out if they paid the house off before retirement. When they are in the hospital, they constantly remark how amazing it is that they dont feel hungry at their normal snack times...the hospital and rehab places here make them take the metformin on schedule, and adjust the meal and its timing based on the fingertest results. The meal has fiber, unlike what they consume normally. It is also calorie restricted, sugar restricted, and nutrient dense. They cant drink soda or sugar sweetened drinks/yogurt all day either.

 

 

 

This, in my lived experience, is an outlying circumstance.

 

Although I do believe that something, metabolically and chemically, happens with regard to processed (and fast) food that functions similar to a substance abuse issue.

[Carrie12345]

My own personal research and experience leads me to say:

 

1. Research by far supports that people who write down everything they eat are more "successful" in losing weight and keeping it off.
2. Making sure a diet style has abundant leafy greens and non starchy veggies is important.
3. Discourage fat phobia. Good fats are satiating and needed.
4. (intentional) Exercise is important for health, but may not relate to losing weight.
5. Fresh, whole foods are needed and important. Many people report that increasing these decreases cravings for other less nutritionally dense foods.
6. Fast food should be minimum from a health standpoint.
7. Tell them making changes that stay is more about knowing about habits than exercising willpower.

 

 

And, I'd encourage you (specific AND general) to believe people if they tell you they have tried "x, y, z" and it doesn't work. Or, even if they tell you they have tried x, y, z and it DOES work. Believe their self report, even if it "goes against" what you think should happen.

That's a very interesting response to me, because those points make up the bulk of the weight and lifestyle management program.  :)  Designed under the premise of CICO.

[Joanne]

That's a very interesting response to me, because those points make up the bulk of the weight and lifestyle management program.  :)  Designed under the premise of CICO.

 

They increase health. They may (or may not) result in weight loss.

 

It reminds me of when I was approaching 40. I went to WW. I followed the program *exactly.* Wrote everything down. Planned, Used a whole foods approach and declined WW products.

 

I didn't lose weight. I gained. If "you" doubt me, please read the above paragraph. I promise you, I was accurate in my measurements, I didn't cheat. I didn't slip. I was diligent and compliant.

 

The Leader didn't believe me either.

[Greta]

This is my dad, he wants to take a pill that means he can eat what he wants.

 

He says he gave up booze, cigs, and sex, so he is darn well not giving up immoderate eating. Well, I am ok with that, I am all for weighing what is important to you.

 

But - then you need to live with the effects and not wonder why you are getting problems with your feet or ending up in the ER.

That's tough - I think you're very gracious to be so accepting. Yes, he has the right to decide what he eats, certainly! But his decisions affect his loved ones too. The man I knew who refused to treat his diabetes left behind a wife and two small children. :(

[Pawz4me]

They increase health. They may (or may not) result in weight loss.

 

It reminds me of when I was approaching 40. I went to WW. I followed the program *exactly.* Wrote everything down. Planned, Used a whole foods approach and declined WW products.

 

I didn't lose weight. I gained. If "you" doubt me, please read the above paragraph. I promise you, I was accurate in my measurements, I didn't cheat. I didn't slip. I was diligent and compliant.

 

The Leader didn't believe me either.

 

It's not a matter of believing you or not.

 

It's not a moral judgment.

 

Go back and read the things several of us have posted about our own reporting.  We've read the studies.  We realize we aren't likely to be exceptions. So we don't even believe ourselves! We tack on extra calories each day to help compensate for what are apparently unavoidable failures in reporting.

 

I ask this sincerely, because I'd like to know for my own use and to help my own self doubt (and because I'd really, really like to eat those extra calories!) -- What makes you so sure you were accurately reporting?  Why do you think you were an exception to the data that says almost all of us aren't accurate, even when we believe we are?

[SproutMamaK]

Why do you think you were an exception to the data that says almost all of us aren't accurate, even when we believe we are?

 

If everyone makes these reporting mistakes in calories, I would assume that nutrition and weightloss programs would account for those reporting mistakes when coming up with programs for people. If everyone under reports and WW tells everyone to eat 1800 calories and they all eat 2000, the numbers should tell them that their program is ineffective and everyone is eating 200 calories too much, therefore they should tell people to eat 1600 instead. The program is, after all, supposed to be designed to work for the average person, not just the apparently 1% of people who accurately report calories.

 

So what I'm saying is... what does it matter if, despite one's best efforts, they are accidentally under-reporting their calories? If they're doing the program as designed and seeing the opposite of the intended results, that's not the result of accidental under-reporting (the same accidental under-reporting that everyone else is also doing), there's obviously a much bigger issue at play.

[Joanne]

It's not a matter of believing you or not.

 

It's not a moral judgment.

 

Go back and read the things several of us have posted about our own reporting.  We've read the studies.  We realize we aren't likely to be exceptions. So we don't even believe ourselves! We tack on extra calories each day to help compensate for what are apparently unavoidable failures in reporting.

 

I ask this sincerely, because I'd like to know for my own use and to help my own self doubt (and because I'd really, really like to eat those extra calories!) -- What makes you so sure you were accurately reporting?  Why do you think you were an exception to the data that says almost all of us aren't accurate, even when we believe we are?

 

Pawz4me, I do not think that discussing this with you will be an experience I enjoy.

 

I have repeatedly reported that I tracked, and was compliant. That's fine you don't believe me; I, however, do not wish to spend time convincing you.

 

And, yes, for the Leader it WAS a matter of not believing me.

 

And, yes, much of the reaction to people who are fat is a moral judgment.

[Murphy101]

Well I was thinking of my own experience, but I assume most people can't eat much under extreme stress. I don't have the statistics on it, but I guess it isn't true for everyon.

The opposite is actually well known. People in pain seek comfort. For you it wasn't food. (Me either usually, btw, I tend to seek work when upset.) Where you and I might dig into making casseroles for the memorial ceremony or gathering pictures or whatever, someone else might seek the comfort of food. My sister confessed to me that the night our mother died, she stayed up late making mom's famous dessert breads that she served at holiday gatherings and then proceeded to eat all of the loaf herself. I don't know why she did that. I have plenty of theory.

 

People can be down right crazy when in pain. They say and do things that don't make sense. And sometimes that aren't healthy for them either. Some people have more acceptable means of coping than others. And some just have better means to cover up how they cope so that they won't be judged for it.

[Carol in Cal.]

They increase health. They may (or may not) result in weight loss.

 

I got quite obese following ideas like this--be healthy, don't worry about weight loss.

 

The fact is, if I had done WW or something similar when I started to gain weight I might not ever have gotten to the fairly intractable point that I'm at right now.

I wish that I had gotten that advice--to take it seriously and to take care and pains to move back to a thinner setpoint while I still could--back then.  The science that I have seen supports the idea that that likely would have been effective.

 

It wouldn't be all that helpful now, and now I have to work extremely hard to lose weight, and have (probably permanently) adjusted my setpoint much higher.  So now the idea of at least increasing health by doing more of those choices (which I am, in fact following) might be the best I will ever do.  I'm kind of OK with that, but would caution those who are thinnish to try to maintain their weight if it starts to creep up, using the standard weight loss strategies that seem to work best when your setpoint is not yet shifted.

[Pawz4me]

If everyone makes these reporting mistakes in calories, I would assume that nutrition and weightloss programs would account for those reporting mistakes when coming up with programs for people. If everyone under reports and WW tells everyone to eat 1800 calories and they all eat 2000, the numbers should tell them that their program is ineffective and everyone is eating 200 calories too much, therefore they should tell people to eat 1600 instead. The program is, after all, supposed to be designed to work for the average person, not just the apparently 1% of people who accurately report calories.

 

So what I'm saying is... what does it matter if, despite one's best efforts, they are accidentally under-reporting their calories? If they're doing the program as designed and seeing the opposite of the intended results, that's not the result of accidental under-reporting (the same accidental under-reporting that everyone else is also doing), there's obviously a much bigger issue at play.

 

I don't think that would fly.

 

I don't know a lot about WW (groups of any kind are not my thing), but although people certainly appear to under report food and activity level . . . they aren't stupid.  It wouldn't be difficult to figure out what WW or any other diet group/plan was doing if they fudged on basic calorie information that's available on quite a few highly accurate online calculators.  And their customers would likely either be highly offended or they'd game the system to add those calories back in.  And since a goodly percentage of their customers would probably be in the offended camp it probably wouldn't be good for business!

 

 

Pawz4me, I do not think that discussing this with you will be an experience I enjoy.

 

I have repeatedly reported that I tracked, and was compliant. That's fine you don't believe me; I, however, do not wish to spend time convincing you.

 

And, yes, for the Leader it WAS a matter of not believing me.

 

And, yes, much of the reaction to people who are fat is a moral judgment.

 

Fair enough.

 

But FWIW my comment about it not being a moral judgment applied to that one particular post.  That's all.  If you want to get offended by it when I took pains to point out that many of us who've posted don't even trust our own tracking because of those studies . .  . no, we likely won't be able to find any common ground.

[Annie G]

Well I was thinking of my own experience, but I assume most people can't eat much under extreme stress. I don't have the statistics on it, but I guess it isn't true for everyon.

 

No, it's not. I just lost a friend to cancer and her two daughters are 16 and 18. Over her two year battle, those girls were under some incredible stress. One is now rail thin- quite unhealthy looking. The other has put on a lot of weight.  Sisters, going through the same stressful situation, but it sure impacted their appetites differently.  

[Guest]

Beats me. That would be terrible. i am talking about extreme stress though.....like someone is dying or you find out your husband of 26 years is having an affair. I literally could. Ot eat two bites during those times.

I eat and eat and eat. For me it's an anesthetic during stress. I've never been too stressed to eat. In fact stress ratchets up my appetite horribly.

 

We are not all the same. And bodies don't respond the same to the same stimuli. I wish I went anorexic with stress, but I'm the opposite. I've never experienced that in my life - the worst traumas made me a bottomless pit :(

[albeto.]

All data has to be interpreted.  All of it. There is no such thing as objective data, and even the stuff that comes closest is only meaningful when interpreted, which brings in subjectivity.   And please keep in mind that articles in popular sources like Slate are not academic studies they are presentations of them with a further level of subjectivity, and even plain old academic studies are interpreted - they are not pure data.

 

If you have read the thread, you can see all kinds of intelligent people, including ones who work with scientific data in their jobs, having different points of view about what this is saying, and what it means to the idea of CICO.  Joanne's view (and I don't mean to pick on you here Joanne) is no more objective than many other views that have been expressed.  I am not saying that some arguments cannot be worse or better than others - I am saying that on this topic, in this discussion, there are not any that are clearly the only right way to look at it.  People are working from the same data to come up with different conclusions.

 

You have made an assumption - perhaps because it agrees with your view, or you have a tendency to take descriptions of emotional pain as definitive - that the view Joanne hold is the only one that can be rationally taken from that data, and so others must simply be ignoring it.  Your assumption is wrong - quite possibly because you seem to have a naive view that data will always lead to a single clear conclusion.

 

The condescending rhetoric aside, I agree with you up to the point where you tell me what assumptions I've supposedly made. Additionally, the arm-chair psychology you use to explain these assumptions are bizarre (albeit, not unpredictably so). As I've not suggested, supported, or even implied such things, I doubt any reply would be of any use anyway as there seems to be a trend to respond to what might be read in between the lines, whether or not it corresponds to what I actually say. Not to mention, it's yet another distraction that results in talking about a person's unrelated behavior, rather than the topic at hand.