Yeah, I’d stop after two stalks, and start looking for some actual food. 
A. How many times have you gone on a diet? What worked for longest, or for good?
I’ve gone on diets a few times. “Worked” is a vague word. If my goal was to lose weight, what worked best was stopping eating while I was still a little hungry. If my goal was to maintain a healthy weight/body, what worked was to stay active. Even though staying active is not a diet, things like portion control and eating healthy foods became a lot more intuitive if I was active, because I could sense what nutrients my body needed and when it needed more or less calories.
B. Have you felt your weight led to lower quality medical care?
No, although your OP says that many obese people are unhappy with their medical care, and I’ve never been obese.
C. For you, what pound or percent weight loss would be a success, if any?
Ooh, this is a really tricky one to answer. I am a woman, and I can do about ten pull-ups, but my BMI is slightly above 25. If I lost any amount of weight, and my strength-to-body weight ratio went down substantially, I wouldn’t consider that a success. If I lost weight and maintained that strength, then I probably would consider it a success. I wouldn’t consider it necessary (my health is totally fine the way it is), but if it increased my speed and made me a more competitive athlete, and particularly if it increased my strength-to-body weight ratio, then I’d consider it a success. But that would hinge upon athletic performance rather than pounds lost.
D. How often do you think about weight or dieting?
Not that much. For probably about twenty years of my life, I thought about it almost constantly. Then a few things changed:
(1) I went through a divorce, lost my appetite, and lost weight as a result. People complimented me on my weight loss, which horrified me and made me realize that most people don’t even understand what a healthy human body should look like. I was relieved when I re-gained my appetite, and also began to associate being thin with an unhealthy mental state, and being not-thin with a healthy mental state.
(2) I realized that when I was obsessing over my weight, I was pouring most of my focus into my physical appearance. By prioritizing it in my own mind, I was essentially acting as though my physical appearance was the most important thing I had to contribute to any conversation or experience. I realized that if I stopped depriving myself, then I could sit in a meeting and focus on the thread of conversation better. If I wasn’t daydreaming about brownies and macaroni and cheese, or obsessing over how my legs looked in my skirt, I could instead focus on coming across as intelligent, tactful, skilled, and kind.
E. Do you believe obesity is unhealthy if diet, exercise and medical care are decent?
Yes. When I went through my training to be an EMT, we learned comorbidities for a bunch of different illnesses. Smoking and obesity were listed as a comorbidity for just about everything in the textbook.
A. In terms of formal dieting, twice. The first time with Weight Watchers, in 1993 for several months, and the second time following the Atkins Diet, in 2002 or 2003 for several months. I would say that both were different but equally effective for me in their own respective ways.
B. No
C. I’m 6’ 3" and I once weighed 236 lbs in 2018. I now float around 215 to 225. I would really like to get to a solid 190 to 200 lbs. So, so close
D. If I wasn’t so bloody busy at work right now I would be cycling a 39 km route every day or two, and I always keep what I ate and what I eat in mind (not in some obsessive calorie-counting way) and try to make sure that I eat a lot of salad and try to get a ride in every few days with maybe a walk/jog interval thing in fairly regularly. I much prefer the cycling but there’s a bigger time investment for a 39 km ride (2 hrs, not including a stop at my favourite licensed coffee place in the middle of it) than their is for the 7 km walk/jog thing (50-ish minutes).
E. Yes I do.
I am extraordinarily fortunate that I simply love the sensation of riding a bicycle, whether it’s a European-style city bike, my road bike, or my winter bike. I also really enjoy walking. I don’t do exercising from any great self-discipline. I also can whip up a salad that I can enjoy eating. Otherwise I could eat meat-lover’s pizzas, ramen noodles, chocolate milkshakes, beer and wine (in fact I was doing that when I joined WW, and I was also cycling about 60 km daily; I lost 50 lbs).
The author was thought of highly enough to be invited by NASA to study an astronaut problem. In a fairly short space flight, most astronauts unintentionally lose five to seven pounds. They are busy, stressed, dehydrated food is not always delicious, and smelling food is an important part of enjoying it. How to overcome this for long journeys to Mars?
They wanted to see if comfort foods would help. But the conclusion that people enjoy and eat more of their top three comfort foods is so obvious they could not find studies on it. So they studied it. And it is not true. If someone springs your favourite packaged comfort food on you (the researchers could not supply ‘Mom’s meatloaf’), study participants did not rate their happiness, etc. higher than with regular foods. Who knew? The effect of mood on appetite is twofold. When you are depressed, you might eat a donut - ‘I need this’. But also when you are happy - ‘I deserve this donut’.
BMI, a weak measure of obesity, has an independent effect on mortality, just at much higher levels than you would think - above 35 to 40. Waist circumference may be a better measure.
The study to gain weight meant giving prisoners up to 10,000 calories a day in areas with limited exercise opportunities. (Normal diet is 2500 calories.). Doing this for months led to increase in weight smaller than 20%, and they could not keep the weight on, losing it all after returning to regular diets. Many could not gain much weight on purpose when trying to do so, even at very high calorie levels. They just could not eat enough, and again their body acted to keep weight in their given range.
Improbably, I am actually also currently reading a book that addresses astronaut weight loss in space. However, the statistic I read is that “astronauts in the gravity-free environment of space can lose 20 percent of their muscle mass in just a week or two.” (This is from the book Exercised by Daniel E. Lieberman, and he cites three separate articles in medical journals to support this assertion.)
Seems to me that if you can lose that much muscle mass, it is possible that the 5-7 lbs. these astronauts are losing are all muscle. For an astronaut to gorge on comfort foods while losing significant muscle mass strikes me as an awful idea.
agreed. and I wonder if they don’t re-gain that muscle mass quickly, when they return to holding up their body in gravity.
But it’s a lower percentage than it used to be.
And it appears that, up to a certain point, income is correlated with obesity.
At a gross domestic product (GDP) per capita of $8,000, the prevalence of obesity is no longer the highest among those in the top wealth decile ($10,000 for overweight), and at $30,000, obesity prevalence among those in the poorest decile is higher than among the wealthiest ($50,000 for overweight). The transition is driven by increasing obesity among the poor without appreciable decreasing obesity among the wealthy.
That also supports the point I was making: namely, that it’s oversimplistic to claim that “bodies are not naturally built to ignore food” as an explanation for obesity in food-abundant societies.
Because (a) a high percentage of people even in food-abundant societies are non-obese, and (b) that percentage can change significantly in a relatively short period of time while the basic “nature” of “bodies” stays the same.
A. God only knows.
B. Not especially.
C. I did eventually lose about 30% of my body weight.
D. Not any more.
E. I do believe that.
I weighed about 280. Around 2000, I dieted and lost 30 lb in a year Then gained 10 over the next couple years. Then started taking metformin and lost 20 lb, down to 240. Then over a 2 year period, 2010–2012, I dieted by cutting out eating between meals I lost 40 lb. I have hovered between 195 and 205 ever since. My doctor says I should not lose any more, although my BMI is around 27.
Some respected researchers claim obesity causes an excess 300,000 US deaths each year.
That is a significantly higher figure than I have previously seen reported or what I see doing my own searches. Can you point me to your source for these respected experts please? Thanks.
A good summary of where the current data is on “fat but fit” -
Yes. The quote is from the excellent book Emotional by Leonard Mlodinow. I do not personally agree with this number for reasons stated earlier, but admittedly did not read the paper. It is from:
KM Flegal et al, “Estimating Deaths Attributable to Obesity in the United States”, *American Journal of Public Health 94(2004):1486-1489.
Thank you for the source. The source article is easy to find online and that excellent book apparently horribly misrepresents what it says. It starts off saying that that number is claimed by others in the past (articles dated 1999 to 2002) and proceeds to rip those claims apart.
https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.94.9.1486
The same author, Flegal, then did the research that has been the standard estimate since, 112,000 with decent error bars. There was no increased mortality (actually possibly decreased) in the overweight group.
A good illustration of why following to the source material is often required!
I was wondering if there was some newer work that you were referencing that I could not find. My WAG is that there will be blip over the last few years associated with COVID.
Sorry for multi-posting but following the thread from those Flegal articles is fascinating.
Here is her take on the reactions to her work.
The scientific community did not do itself proud.
I haven’t yet listened but even unheard I suspect you’ll find this recent interview with her to be interesting.
In fact I am glad to hear this. My personal opinion is it is quite possible to have, say, a BMI of 35 and excellent health. I do not doubt the quote is dated and quite mistaken. I am aware of the studies showing decreased mortality in certain segments.
Although it really is an excellent book, and one I would still recommend. The book is about neuropsychology and not obesity at all; and the quote and reference are very tangential to the thesis. A lot of great works describing good science falter when they go too far outside their balliwicks and seneschals.
Agreed. In my experience, the elderly, for example, tend to do worse when frail and thin than if they are overweight by BMI. Someone with a BMI of say, 25-35 might not necessarily be at increased risk of disease due solely to their weight. On the other hand, I think it would be extremely rare for someone with, say, a BMI over 50, to not be having problems due to their weight.
Exercise is probably one of the biggest factors. Another newer study shows if you can do thirty or forty normal consecutive pushups, even at a wide range of ages, this alone reduces the risk of cardiovascular concerns by eighty percent. These non-traditional considerations can be very significant. Exercise reduces stress, increases pleasure, has many positive health benefits.
Diet is obviously important, probably getting enough fiber and vegetables is huge. Sleeping well, not smoking, drinking modestly, addressing diabetes and blood pressure, “choosing your parents well” (I don’t care for that phrase)…
“Yes, yes, yes. (Dismissive wave.)… It’s all a rich tapestry…”
Speaking strictly as an obese person struggling to lose weight and not as a physician, one of the biggest factors (for me at least) in not being able to lose weight is a certain mindset encapsulated in a saying I read once. “Eat right, exercise, still die.” I read that in a book of sayings I was browsing through one day at Barnes & Noble, but couldn’t tell you who the quote was attributed to or the name of the book. Whenever cravings for unhealthy food pop into my head, that’s the saying that goes along with those cravings.
There are a number of references to BMI upthread. The Canadian military went through a bad experiment with BMI as a retention vs release criterion in the late '80s - early '90s and ultimately it didn’t last beyond that. A civilian doctor I was telling about this at the time wasn’t overly impressed, though I don’t recall why.
A lot of people still use BMI as a guideline, however. About ten years later I mentioned my BMI to my then military doctor and he blew off my concerns, saying that BMI was developed for insurance purposes (or something along those lines) and really shouldn’t be taken too seriously.