Thank you!
I hope my doc has some similar positive feedback when I see him tomorrow.
Lots of smart people don’t believe set point theory, but that sure seemed to be the case for me. I didn’t know anything about it when I went on a diet and lost 40 pounds in 3.5 months, but the moment I stopped severe caloric restriction my body fought long and hard to get back the weight I had lost.
My BMR quickly dropped and my hunger rapidly increased, and there was nothing I could do, short of starving myself, to keep from gaining back the weight. I figured I would have to go back on my diet and stay there the rest of my life, which was not what I wanted.
I talked to a dietician and she said I had lost too much weight too fast and I had to now convince my body that I wasn’t going to starve it anymore. I adjusted my macros and increased my calories and in only three days I stopped gaining weight. I was then able to adjust my energy balance to either gain or lose weight as I saw fit.
Once ever. (It was hyperbole - I’ve had a few salads. I like Caprese and Greek salad, for instance. It’s the lettuce I don’t like.)
~Max
Actually we do know; some GLP-1 agonists have been in use as diabetes medications since 2005, and many for a decade or more. Even semaglutide has seven years of use.
Why not? It’s been pretty well conclusively proven that obesity is a chronic disease, and not a question of willpower, habit, or personal failings. Just like plenty of other chronic diseases have lifelong medication needs, obesity does too.
You’re smoking something good if you think that healthy eating and exercise is all it takes, and that obese people are lacking willpower, etc… and that’s why they’re fat. It’s a lot more complicated than that. I’d even argue that the effects of these drugs essentially prove that- something is awry with people’s sensations of hunger, etc… and these drugs level that out.
I believe many folks perceive an individual’s outward “acceptance” of who they are to mean that the individual isn’t "concerned,’ and often that’s not true. For most, there is simply no point in openly moaning and groaning about their concerns when many of those who aren’t overweight will simply say something snarky or offer the brilliant advice to “eat less, exercise more.”
Regardless as to why or how an individual became overweight, losing significant weight for most without medication ain’t easy (and it gets tougher as one ages). The old “eat less, exercise more” will work for a few who are really driven but mostly works long term only if one is part of that relatively small percentage of individuals who have really good to exceptional metabolisms due to the whims of the universe.
Seven years of use is not a long time. We don’t know the long term effects. I’m not saying it’s bad for someone to take it, only that I wouldn’t since there’s a risk in taking any drug that has only been around for a relatively short amount of time. If someone wants to take that risk they can go ahead. It’s their choice, and if it helps them permanently lose weight, so be it
Who said anything about will power or personal failings? People become obese because they have a problem with their metabolism, a medication they are taking is causing them to gain weight, or because they are eating too much of the wrong foods and aren’t moving enough.Perhaps they picked up bad habits growing up that has caused them to steadily gain weight, and they can’t or won’t do anything to change that.
Eating healthy and exercise is all it takes for many people who don’t have a metabolic disease. Countless millions of people have lived their whole lives not being obese and without taking obesity drugs. They eat an appropriate amount of calories and stay away from food that is addictive and leads to overeating. Millions of people have changed their diets and lost weight only to revert back to their old eating habits and gain it all back. It’s not about will power etc., it’s about permanent lifestyle changes.
Even if you are not smart, the “set point” always being the level of what you’d like to be eating, never less, is a bit of a giveaway.
CICO is all you need.
I’ve always found the “just eat properly and exercise” advice similar to that Monty Python bit where a chat show host teaches us how to play the flute: “You blow in this end and move your fingers about on the holes to make notes. There!” IOW, technically accurate but not terribly helpful. Former heavies are often the worst, which is interesting.
For those who struggle to maintain a healthy weight (my peeps!), it is really, really difficult. It’s hard to describe to someone who doesn’t struggle, but as someone who knows, it’s similar to alcoholism. It’s just so, so easy, such a relief, to pick up the drink, history be damned.
I’ll add one more thing. I wonder if there’s a generational aspect to this (sorry if this was covered). I’m 63 and most of my male peers seem largely unconcerned with their bellies. I’m sure if you gave them a pill that would zap them into a buff bod, they’d take it. But no one hides their bellies at the pool or beach. Women of our generation sadly don’t seem to share that lack of concern.
I get the (perhaps false) impression that this doesn’t apply to younger generations of men.
I think a greater percentage of large men seem to lack any inhibitions about exposing their bodies. But whether on the beach - or wearing short/tight skirts/leggings, plenty of oversized women seem comfortable wearing revealing clothes.
Plenty of women? Perhaps. But there are certainly plenty who will not. And the body positivity movement was in large part created because of the scorn larger women receive, especially (but not limited to) when they dare to wear clothing they like that the deplorables find objectionable.
I don’t know any men, at least in my circles, who give a shit what anybody thinks about their bellies. And for the most part, nobody reacts that way re: larger guys.
My husband lost about forty pounds in the last few months taking Ozempic or Mounjaro and using Noom. We’ll have to see what happens if he goes off the meds, but he does talk up Noom as having made a real difference in his thinking.
Whether someone believes in set point or not, homeostasis is a real thing.
Homeostasis is defined as a self-regulating process by which a living organism can maintain internal stability while adjusting to changing external conditions. IOW, you tend to maintain the same weight regardless of how many calories you consume on any given day, which is set point theory by another name.
While CICO can be a useful tool, a calorie is not a calorie with regard to food intake. 200 calories of chocolate brownies is processed differently than 200 calories of broccoli, even though they provide the same amount of heat when burned. As I have heard many times, nobody ever got fat eating too much broccoli.
It’s hard to break habits developed over a lifetime. Most people enjoy eating and dislike exercise, and weight management hasn’t been a priority in their lives. As we get older, and see how excess weight can lead to diabetes and metabolic syndrome, we think about getting down to a healthy weight, which is often more difficult the older we get.
For some, overeating has become an addiction, one of many eating disorders, and some people opt for addiction treatments to curb compulsive eating, however, if someone continues to live a sedentary lifestyle, and eats high calorie snacks in addition to three large large meals a day, they will almost invariably gain weight over time.
Lifestyle changes are hard, and require sacrifices that we sometimes don’t want to make. Semaglutide does curb appetite and may help someone lose those stubborn pounds, but you need to be prepared for when you stop taking it and your appetite comes roaring back.
It does seem silly that the male body some consider ideal can essentially only be achieved through the use of diuretics and steroids and similar unhealthy practices. I never personally liked this look, however, nor am I told do many women. You are right this is often featured in some film genres. Men’s Health is not Muscle & Fitness magazine, but has still played some role in perpetuating these ridiculous ideals, so is not without hypocrisy. Women might compare these extreme measures to plastic surgery.
I am trying to think of examples where very fat men were portrayed in a sexy way without condescension. Maybe that Megan Trainor video of a big dude dancing. I struggle to think of a full length movie, but movie expertise is not really my thing.
This is key and bears re-reading.
Both my parents were large and unhealthy, never exercised, and had a bad relationship with food. My mother didn’t make it out of her 60s before diabetes and cancer took her. And my father made it to his mid-70s before the diabetes and cancer took him, too. They both got very sick toward the end of their lives.
They tried to turn the corner on their health with better eating, but it was much too late. You have to make the changes early enough in your life for them to make a difference - that has been a key learning for me. When my mom told me she had diabetes, she also said I dont have to get it, and so far I haven’t. So, I encourage men to start small, maybe start walking, and stop having seconds, and cut back on the soda, and see how you feel and then go from there. They say it’s never too late to do something about your health, but sometimes it is.
About the closest I can come is someone like John Goodman (not thinking of a specific role) playing a powerful/wealthy individual - who might be portrayed as attractive to certain persons for reasons other than physical.
But not sure very large women are often portrayed as sexy either.
Maybe in music videos more than movies?
Ironically my mom died of cancer in her early 70s and was in pretty good shape and ate healthy while my inlaws are in horrible physical and mental shape in their 80s and yet they don’t die.
To me, almost as important as “not dying” is being able to maintain a high quality of life. My MIL can barely get around because she never exercised and is way overweight. And she’s had a few injuries from falling and whatnot which makes it worse because it becomes a cycle of injuries and weakness from lack of activity, leading to more injuries, leading to more inactivity.
My dad who is 80 OTOH has been an athlete all his life and leads a very active life. He had both hips replaced but because he was already in good shape, he recovered very quickly.
Good for you to make the changes you needed to make, and to stay healthy. Starting small is great advice for men. Men often feel it’s too late to make any real changes, or it’s too hard and not worth the effort.
As an aside, my father was 50 pounds overweight most of his adult life, and I never saw him exercise even once. He would sit and read in his spare time, as opposed to going for a walk outside. He had terrible eating habits, for example I never saw him eat a piece of fruit or eat a salad… and he lived a relatively healthy life until age 91, when he died. He didn’t get diabetes, probably because he didn’t eat sugary foods, but he did have a treatable bout of skin cancer. His mind was sharp as a tack until the day he died.
I think genetics may have something to do with it for some lucky people. They seem immune to disease no matter how much they abuse their bodies. However, these people are rare, and I wouldn’t tempt fate like he did. When he turned 75 he said he never thought he would live that long, and the entire family agreed with that.