The role of satiety in obesity

[Aeschines]

Inspired by this Cracked article, which has some pretty damning stats:

How rare? Well, this person did the math, and as far as they could tell, two out of 1,000 Weight Watchers customers actually maintain large weight losses permanently.

Ouch. Plus, how has the whole low-fat diet thing worked out for America? “Two ounces of chicken breast, a side of broccoli, a glass of skim milk…” Yeah, do you know anyone who has permanently lost and kept off weight because they started “eating right”? I do not mean someone who has screwed up the willpower to drastically reduce calories and start a hard-core exercise program. I’m talking about someone who started to follow a low-fat diet and found it “just worked” to lose weight. I have never heard of a single such person.

And here’s the no-brainer part, it seems to me. The part that is almost never talked about (outside the gluten-free and/or low-carb and/or Primal community, but more on that below):

“Eating right” doesn’t change how hungry you get.

I’m saying “eating right” as opposed to “low-fat,” since the CW on fat seems (as it should be) changing right now. Fill in whatever standard dieting advice is out there USDA, shit doctors talk about, etc.

Whether one is the weight one wants to be, I think the way it works for almost all people is this: You have your meals and snacks and whatever, and you eat such that you are not hungry. At the end of the day, some people doing this end up fat.

I know because I’ve been on both sides of the equation. Until about age 24, I ate all I frickin’ wanted, never thought about the consequences, and never was fat. At age 24 or so, the metabolism seemed to change: I could now not eat like a hog. But if I ate to basic satiety, I would be in the normal range. At about age 29, my metabolism again changed: if I ate to satiety and not even in that great a volume, I would go above the weight I was comfortable with. Obviously, a lot of people have experienced this. You get older, you get fatter.

Sure, there are some fat people who comfort-eat beyond satiety all the time. In theory, they could lose some weight by simply eating to satiety. They could probably even lose some more pounds by eating something else (whether that’s “eating right,” or lower carbs, or whatever).

What seems manifestly untrue for most people is that “eating right” per the Conventional Wisdom will change how satiety works. It does not. And the reason you’ll keep on those extra 20-30 pounds is not because you binge eat but because you go a few hundred calories over a certain point, day after day, and that puts the weight on and keeps it on.

So why does the CW ignore this point? Is it just because it’s an inconvenient truth?

I think once we recognize the importance of satiety we can start to figure out the whole issue of why people used to be thinner than they are now, and what we can do about it going forward.

The approach I’ve taken since 2012 has been thus:

1. Quit eating wheat. This has definitely affected hunger and satiety in a positive direction. Although IMHO Dr. Davis of Wheat Belly goes way overboard on the low-carb thing (recommending 50 g of carb or less a day for everyone), I think he is right about wheat.

2. Mostly quit drinking alcohol.

3. Regularly exercised. I’ve done Pilates and mat springboard.

4. Gone half-assed Paleo. I read marksdailyapple.com. He’s got a very nuanced approach to this lifestyle–far from a B&W thinker. I still eat sugar though mostly in the form of chocolate, but I rarely eat out and avoid grains and seed oils. Aside from the vice of chocolate, my diet is pretty healthy and doesn’t even veer that far from the “eating right” CW (it just happens to overlap with Paleo pretty well).

So what have my results been? I currently weigh 200 (at 5’11") and fit in clothes I wore when I was around 180. I actually have gained weight over the past two years, but obviously a lot of that is muscle. Perhaps all of it, and I’ve lost fat (otherwise, my clothes wouldn’t fit better). I look and feel pretty good. But even so, I wish I were 180: those final 20 lbs. are a whore to lose. Even for someone doing things mostly right.

By the way, I have tried to cut sugar and carbs more, but that didn’t work for me. I get insane carb cravings if I do that. Like a junkie needing a fix.

So, here’s my thought at this point. I think cutting wheat out of the diet can have a genuine effect. It certainly reduced my hunger throughout the day. It has absolutely had a big effect. I think quitting wheat and eliminating shitty oils delivers, oh, 80-85% of the benefit of going Paleo. I think a confounding factor is the effect of low-carb if people do that at the same time they start Paleo. Low-carb works to a certain extent, and certainly not being a carb hob over the long term is possible. But my research says to me that being really low-carb does not work over the long term. It can deliver dynamite results over the first 6 months or so, but after that it messes with your hormones (or the messing with the hormones stops working, rather), and you start to feel like shit and gain weight back.

So the big question remains: Can going Paleo help someone morbidly obese cut 150 lbs. and keep it off while not feeling hungry all the time? Or is a more likely scenario someone like me, who puts on muscle and loses a bit of fat but is still at 20-25% body fat over the long term? The jury is out, I think. That said, I think it’s definitely helpful.

But I think the jury is in on CW “eating right”: it does nothing to correct the satiety issue.

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As an aside, I have also given thought to why people used to be thinner. I think this is also related to the issue of why Asians like the Japanese are thinner than the average American. “If they can be skinny, so can we!” being the thought. Well, I lived in Japan for 8 years and was able to think about this issue while looking at a lot of Japanese people. I also heard a statistic that a lot of Asians are skinny-fat: i.e., they look thin but actually have pretty crappy body fat percentages. I also heard a stat recently that 10% of Chinese people have diabetes. Yeah, wow. So there are plenty of myths as well about Asians and their weight. There are also plenty of Japanese people with your basic pudge.

I think to a certain extent we overestimate how thin people used to be. There is the same skinny-fat issue. Sometimes you’ll see men take off their shirts in movies from the 50s and 60s. For example, I saw Dean Martin take off his shirt in the movie Artists and Models (1955). Or maybe, it was Jerry Lewis. Doesn’t matter. The point is that he didn’t look very good. Almost certainly skinny-fat.

A lot of people in past decades were in horrible shape and smoked. Smoking provided oral satisfaction and acted as an appetite suppressant. When I was first in Japan, in the 90s, I read a stat that 67% of men were smokers.

That said, people in previous decades were on average thinner, and we don’t have a full explanation for that. I just think over-romanticizing the past–“Everyone was so skinny!”–isn’t helpful.

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OK, that’s my set of thoughts, not very succinctly expressed. I look forward to yours!

[iljitsch]

In the relatively short time I’ve been a member of this forum we’ve discussed this at least a couple of times before, but hey, why not do it again.

So the idea is: stop eating when you’re full and you’ll end up at a good weight without effort. Wouldn’t it be nice if things worked that way. First of all, there’s the difference between being full and not wanting to eat. Those are not the same thing. I find that if I eat “bad” food I can get full and still feel hungry. That really sucks, because in that case both eating and not eating are bad options (getting overstuffed or going hungry, nice choice).

I’ve also read about studies that show that fat people have different levels of hunger/satiety from normal weight people: when they don’t eat, they don’t feel as hungry, but when they do eat, they don’t feel as satiated. I always used to laugh when people said they were starving around lunch time. But since I started losing weight nearly two years ago, I’m the same: I get pretty hungry around meal times, but (usually) eating also makes the hunger go away.

However, the trouble is that it takes some time for the hunger to go away. If you eat until you’re satisfied, you’ve eaten too much. I had to learn to stop eating and then wait 10 or 15 minutes to judge whether I’ve really had enough. Before I started losing the weight, I was scared that I’d be hungry the rest of my life. It doesn’t work that way. Yes, I’m hungry sometimes, but I’ll be eating soon enough and then nearly always the hunger goes away. Once in a while I have a day where the hunger doesn’t go away no matter how much I eat. Those are bad days, but they’re fairly rare.

As for the success rates: they’re not great. But it’s hard to say how good or bad they really are, for a variety of reasons. First of all, nobody can afford to take a large group of people, put them on a diet and keep that study going for 10 years. And even if that were possible, that still only measures people who are part of a study, not what people do in the real world. Then there’s the issue of the denominator. If 100 people go on a diet and fail 9 times and then the 10th time they’re successful, is that a 100% success rate or a 10% success rate?

Also, lots of people kinda sorta want to magically lose weight, but they’re not serious about changing their eating habits permanently, so they keep “failing”. Last but not least, there’s a group of people heavily invested in the notion that losing weight permanently is impossible so they’re off the hook and don’t have to try, and they will inject fear, uncertainty and doubt into any discussion.

Personally, I weigh about 35% less than I did two years ago and I want to lose another 15 or so percent of my original weight and then stay there the rest of my life. I think it’s doable.

The thing your “eating to satiety” approach doesn’t account for is that some food is so delicious that you’ll want to eat it even if you’re not hungry. That makes perfect sense for a primate roaming the savannas who won’t run into whatever it is that they love to eat all that often, so if you find a pile of delicious ripe mangos, by all means, eat them until you’re stuffed. But we can avail ourselves of incredibly tasty and calorie-dense food every moment of the day, so that strategy doesn’t work so well for us. So either ban those food out of your life completely or learn to eat them in moderation. It’s not the broccoli and the boiled potatoes that people are going to overeat on.

[Aeschines]

@iljitsch

In the relatively short time I’ve been a member of this forum we’ve discussed this at least a couple of times before, but hey, why not do it again.

If you have links to posts that dealt with the failure of conventional nutritional science to produce successes, please post those, as I’d be interested in reading them. I want to talk more than about our personal successes and failures.

I find that if I eat “bad” food I can get full and still feel hungry. That really sucks, because in that case both eating and not eating are bad options (getting overstuffed or going hungry, nice choice).

Yes, one thing I think Paleo does well is emphasize the need to eat good, nutrient-dense foods.

However, the trouble is that it takes some time for the hunger to go away. If you eat until you’re satisfied, you’ve eaten too much.

I agree. One cardinal rule is to always stop eating when you’re full, and probably well before that point. There is a Japanese saying: “Hara hachibu,” or, “stomach 80%.” It’s good advice overall. That’s another reason I don’t eat out much: the portion sizes are too much. It becomes a money thing. I don’t want to have to spend for two meals’ worth of food and pay higher tax and then tip on all that. I think it’s another reason why Chipotle and other fast cuisine places are succeeding. It’s cheaper, sure, but you don’t have to buy more food than you want, either.

As for the success rates: they’re not great. But it’s hard to say how good or bad they really are, for a variety of reasons. First of all, nobody can afford to take a large group of people, put them on a diet and keep that study going for 10 years. And even if that were possible, that still only measures people who are part of a study, not what people do in the real world. Then there’s the issue of the denominator. If 100 people go on a diet and fail 9 times and then the 10th time they’re successful, is that a 100% success rate or a 10% success rate?

These things are famously hard to measure, but I think our own experience tells us that the vast majority of people who try to lose weight fail over the long term. I have never known someone who was truly “fat” who lost the weight and kept it off through diet alone (i.e., not surgery, etc.)

Also, lots of people kinda sorta want to magically lose weight, but they’re not serious about changing their eating habits permanently, so they keep “failing”.

I think the reason is pretty obvious: except for maybe wheat-free/paleo (and these are not totally proven in my book, either), there isn’t an eating pattern that resets one’s satiety point so that people can eat just a certain thing and know they won’t gain the weight back. Thus, people lose weight because they are willing to put up with hunger for a certain period of time. After they reach their target weight, they say, “OK, I’ll just eat right, according to this prescribed pattern, and I’ll be OK.” But in fact, even if they follow the pattern, they gain small amounts of weight back gradually or not so gradually. Now one can always accuse them of not following the pattern well enough, but usually that’s not really it.

Last but not least, there’s a group of people heavily invested in the notion that losing weight permanently is impossible so they’re off the hook and don’t have to try, and they will inject fear, uncertainty and doubt into any discussion.

This is true, but it’s understandable people get so frustrated, since really nothing works all that well. There is certainly nothing that is easy. If people follow CW “eating right,” at best they are really going to have to watch what they eat including the calories, since such a diet doesn’t change the satiety point. It doesn’t even address the issue, per my OP.

Personally, I weigh about 35% less than I did two years ago and I want to lose another 15 or so percent of my original weight and then stay there the rest of my life. I think it’s doable.

I don’t know if even what I think is the best and most effective approach, paleo, has the power to nuke the final 20 pounds, and almost certainly not the final 10.

The thing your “eating to satiety” approach doesn’t account for is that some food is so delicious that you’ll want to eat it even if you’re not hungry.

I hope you do not think that is my “approach” and that you actually read my OP! I am saying the opposite: that when we eat to satiety, most of us will end up more than we want to weigh.

That makes perfect sense for a primate roaming the savannas who won’t run into whatever it is that they love to eat all that often, so if you find a pile of delicious ripe mangos, by all means, eat them until you’re stuffed. But we can avail ourselves of incredibly tasty and calorie-dense food every moment of the day, so that strategy doesn’t work so well for us. So either ban those food out of your life completely or learn to eat them in moderation. It’s not the broccoli and the boiled potatoes that people are going to overeat on.

The question is: Are there food we can eliminate (or at least greatly restrict) such that we reset our satiety point and lose weight? I think the answer is definitely “yes.” I think eliminating wheat helps a large number of people feel less hungry throughout the day and at individual meals. I think eliminating junk and processed foods per the paleo diet also helps. I think lowering carbs can help. My guess is that this can help the average kinda chunky person drop, depending on where they start, 10, 20, 50, maybe even a greater number of pounds and keep it off. It resets the satiety point, so that if you don’t cheat on the program, you won’t be any hungrier, either. But I don’t know if it can produce miracles for the truly morbidly obese (maybe–I just haven’t seen the proof yet). And I doubt it can guarantee a six-pack.

[Telemark]

How rare? Well, this person did the math, and as far as they could tell, two out of 1,000 Weight Watchers customers actually maintain large weight losses permanently.

I guess I’m one of the two then. I’m still down 40 lbs after 5 years. I don’t think there’s a single approach that works for everyone, but some basics (sensible choices, portion control, don’t drink your calories, exercise, eat slower, routine) seem to have pretty good success.

[elbows]

Can we end the meme, “get older, get heavier”. It’s not true. It’s just a crutch people who put on weight use to avoid looking at/for the real causes.

Both my hubby and I, and most of our friends are the same weight we were 30 yrs ago. I don’t believe it because the majority of people I know don’t seem to fit at all. But the people who have put on weight mention it all the freaking time like it’s gospel!

I’m not buying it, sorry.

[Aeschines]

@elbows

Can we end the meme, “get older, get heavier”. It’s not true. It’s just a crutch people who put on weight use to avoid looking at/for the real causes.

You don’t think metabolism can change over time? Well, you’re wrong.

Both my hubby and I, and most of our friends are the same weight we were 30 yrs ago. I don’t believe it because the majority of people I know don’t seem to fit at all. But the people who have put on weight mention it all the freaking time like it’s gospel!

Good for you. Some people never have an issue with weight their entire lives. I dated someone who ate like a horse and drank like a fish at age 38 and had a flat stomach. I’ve dated people who ate a lot less than she did and were chunky.

If it weren’t true, why is it I could eat anything I wanted until I was 24?

[Aeschines]

@Telemark

I guess I’m one of the two then. I’m still down 40 lbs after 5 years. I don’t think there’s a single approach that works for everyone, but some basics (sensible choices, portion control, don’t drink your calories, exercise, eat slower, routine) seem to have pretty good success.

How much effort do you have to put into it?

I think there is a small percentage of people who, if they were to adjust their bad habits, would find themselves on the right side of the equation. I think they’re pretty rare, however.

[Telemark]

@Aeschines

How much effort do you have to put into it?

How do you measure that? It’s part of my daily routine - I don’t really consider it effort.

[Aeschines]

@Telemark

How do you measure that? It’s part of my daily routine - I don’t really consider it effort.

What did you have to change, and what was the pain level involved?

I think it is pretty rare that someone could lose 40 lbs. just by changing their routine with no pain involved (i.e., feeling hunger, managing calories, etc.). But I would guess that there is some very small percentage that could do that.

[elbows]

That it ‘can’, I accept, that it’s an automatic given, is bullshit in my opinion.

But people never tire of repeating it like it’s a fact, when really, it’s just a convenient excuse. Like being “big boned”!

Older does not = heavier.

[Aeschines]

@elbows

That it ‘can’, I accept, that it’s an automatic given, is bullshit in my opinion.

But people never tire of repeating it like it’s a fact, when really, it’s just a convenient excuse. Like being “big boned”!

Older does not = heavier.

I agree that it’s not an automatic given. It still happens to a large percentage of people, however.

[chiroptera]

@elbows

That it ‘can’, I accept, that it’s an automatic given, is bullshit in my opinion.

But people never tire of repeating it like it’s a fact, when really, it’s just a convenient excuse. Like being “big boned”!

Older does not = heavier.

I agree, and same here. Except make that 40 years+ since my teens! I do eat less than I used to though. If I still ate like I did in my 20s I’d be a blimp.

To the satiety issue - an anecdote from a super-morbidly obese friend (BMI over 60) who finally had bariatric surgery done 3 1/2 weeks ago. She’s still on a very restricted diet - is now eating high-protein pureed foods. But here’s the thing - she tells me she has never in her life experienced the feeling of satiety until now. Since her stomach size has been so drastically reduced, she’s actually having a hard time taking in the recommended amount of food and water.

[HoneyBadgerDC]

I would like to see more extensive studies done on food “triggers”. If I eat a slice of cheese cake for instance it tends to tigger a pleasure zone kind of like a drink and I keep going back and cutting small slices until the dam cheese cake is gone.

If I eat a slice of salty pizza it seems to trigger something that just keeps me hungry all night. 

If I have a sweet roll for breakfast it kills my appetiite for the day. I lost 30# one time without trying because I started going to the donut shop each morning for a cinnamon roll and coffee.

 I have read quite a bit about eating different food at different times but it is really hard to seperate the fact from the bullshit because there is so much conflicting information. But I do believe this is one of the keys if we can get this aspect right. Concentrate more on making sure we eat certain things instead of what not to eat.

I alos believe that our emotional state is proably the biggest single factor in obesity. Find out where we our having problems and deal with it. Creative outlets with opportunities for social validation seem to have some merit here.

[monstro]

A metabolism that slows with age certainly makes sense. The energetic needs of a growing adolescent are different from the needs of a 40 year old. We all know that babies eat eat eat because they’re growing growing growing. It wouldn’t make any sense for a person’s metabolism to stay constant throughout their life. Does this mean that some don’t people put too much blame on their metabolisms? Of course not. But let’s not throw the fat baby out with the bathwater.

As long as we’re trading anecdotes, I don’t feel the same intensity of hunger that I used to feel when I was younger. Which is why I don’t eat as much as I did when I was a kid, despite being more physically active now. I imagine that if I felt the same hunger pangs, I’d be overweight, even WITH my elevated physical activity. Appetite is an incredibly hard force to overcome. I would not be surprised if appetite/satiety can be influenced by the kinds of foods we eat. Maybe wheat is the trigger for folks like the OP. But it may be something else for others. That’s why I think people need to try whatever balance of foods works for them.

[amaguri]

@elbows

Can we end the meme, “get older, get heavier”. It’s not true. It’s just a crutch people who put on weight use to avoid looking at/for the real causes.

Both my hubby and I, and most of our friends are the same weight we were 30 yrs ago. I don’t believe it because the majority of people I know don’t seem to fit at all. But the people who have put on weight mention it all the freaking time like it’s gospel!

I’m not buying it, sorry.

Wouldn’t this mean that you and your husband are the exception, then? I think it’s generally accepted (no cite, sorry) that your metabolism changes as you get older. For many people, the desire and/or ability to eat a lot also changes as you get older, which may or may not be a balancing factor.

[GrumpyBunny]

I lost 40 pounds in the past year on the “eat less crap” diet, which is basically what WW tries to get ppl to do.

If you eat a diet of real food, you will be much less hungry. You don’t have to eat boring food (I rarely eat goddamn chicken breast, I got sick of them in the fat-free 90s), you just eat real food. A lean steak (not a giant one), broccoli, and baked potato or salad will fill you up and keep you full. It’s easy to cook. I make myself stews, soup, chili. No one needs to live on tuna fish, cottage cheese, and chicken breasts to lose weight.

And no, I haven’t been hungry or had cravings. If I want something “bad”, I eat a little bit. It is possible to eat just one piece of candy, or to replace it with fruit. I’ve had the same package of cookies in the cupboard for about a month.

YMMV, of course. People who are really craving foods should probably have bloodwork done to rule out vitamin deficiencies, as well as being screened for depression.

[iljitsch]

People tend to lose lean mass as they get older because of reduced activity and possibly hormonal changes. This explains why they need less food. I’m not sure if people who remain equally active and keep their lean mass as they get older also see a reduction in energy need. (“Slower metabolism.”)

I also keep cookies (and sometimes even chocolate bars) in the cupboard without overeating on them, but there are also foods that I know I shouldn’t buy or only in small quantities because I know I don’t have the willpower to eat only eat a small portion once a day like I do with those cookies.

It’s important to recognize the difference between craving and hunger: when you’re hungry, anything will do. When you have a craving, you want something because it tastes good and something bland but filling isn’t an acceptable substitute.

[Eva_Luna]

Can someone please explain to me this “shitty oils” concept, and provide some kind of citations? I am seeing it more and more, but almost never with any kind of attribution.

[RickJay]

@Aeschines

Ouch. Plus, how has the whole low-fat diet thing worked out for America? “Two ounces of chicken breast, a side of broccoli, a glass of skim milk…” Yeah, do you know anyone who has permanently lost and kept off weight because they started “eating right”?

Yeah, me. That was easy.

[iljitsch]

@Aeschines

If you have links to posts that dealt with the failure of conventional nutritional science to produce successes, please post those, as I’d be interested in reading them. I want to talk more than about our personal successes and failures.

I didn’t save any links, but when I joined I used the search feature and found some good discussions about all of this.

Yes, one thing I think Paleo does well is emphasize the need to eat good, nutrient-dense foods.

I’m not a believer in paleo for several reasons: first, we don’t know how our ancestors back then ate, and it’s probably not what paleo people eat today. There’s evidence that early humans started relying on cooking a few million years ago. Second, paleo is not a sustainable way to eat for a world with 7 billion people.
But like any diet, if you restrict the types of food that can be eaten people will lose weight.

I have never known someone who was truly “fat” who lost the weight and kept it off through diet alone (i.e., not surgery, etc.)

I think the reason is pretty obvious: except for maybe wheat-free/paleo (and these are not totally proven in my book, either), there isn’t an eating pattern that resets one’s satiety point so that people can eat just a certain thing and know they won’t gain the weight back.

Hm, wouldn’t it be because people don’t wait to attempt to lose weight until they’re morbidly obese? I.e., the people who are morbidly obese are the ones that can’t follow a weight loss regime successfully, the ones who can never got that big in the first place.

I hope you do not think that is my “approach” and that you actually read my OP! I am saying the opposite: that when we eat to satiety, most of us will end up more than we want to weigh.

Sorry! It was a long story.

The question is: Are there food we can eliminate (or at least greatly restrict) such that we reset our satiety point and lose weight? I think the answer is definitely “yes.” I think eliminating wheat helps a large number of people feel less hungry throughout the day and at individual meals. I think eliminating junk and processed foods per the paleo diet also helps. I think lowering carbs can help. My guess is that this can help the average kinda chunky person drop, depending on where they start, 10, 20, 50, maybe even a greater number of pounds and keep it off. It resets the satiety point, so that if you don’t cheat on the program, you won’t be any hungrier, either. But I don’t know if it can produce miracles for the truly morbidly obese (maybe–I just haven’t seen the proof yet). And I doubt it can guarantee a six-pack.
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