What message would it take to make obesity rates plummet dramatically?

Assuming we don’t count fiber as a carbohydrate (and we shouldn’t) this is incorrect. It is true that our cells need glucose for metabolism, but we can produce that glucose without having to consume it in our diets. Even a minimal amount suffices, and even then it’s more like that minimal amount of carbs is along for the ride rather than being necessary.

Picture a diet consisting of meat (a variety of fish as well as grass feed beef, chicken, bison, etc.), healthy non-meat fats such as coconut and olive oil and avocado, a diversity of very low carb vegetables (broccoli, cauliflower, leafy greens, mushrooms, onions, garlic, cabbage, etc.) and some low carb fruits like blueberries, raspberries, and blackberries. It’s possible to eat such a diet and get less than 20 grams of carbs per day while consuming enough of all the required vitamins and minerals. No need for sugar, corn, wheat, rice, potatoes, legumes, oats, barley, and things of that sort.

The problem? The stuff at the end of my list that I say there is no need for is highly addictive, and many of us, myself included, suffer from that addiction.

As an obese person with a doctor, I can only conclude you have no personal experience in what you’re talking about and are making shit up.

Your opinion is wrong. Obesity, believe it or not, is a biological condition. It is not ‘exclusively’ a bad habit, and if you assume that it is then every conclusion you draw about it will be incorrect.

To make this very simple, when a person gets fat, it’s a change to their body structure - and it’s a change to how their body functions. And the neat thing about these changes is that when you lose weight, many of these things don’t change back. Your body has been configured to expect to be storing a lot of calories as fat, and what you call “normal” it calls “running on empty”.

Another thing that people who understand nothing about human weight is that the human brain is, in fact, attached to the human body. They ‘talk’ at the biological level, and the body’s messages are damn near irresistible. Hunger, thirst, suffocation, the need to pee - when the body talks, the brain listens, whether you want to or not. You can hold it back for a while, but the urges don’t go away - they get stronger.

Honestly, if a pharma company came up with a way to actually reprogram the body to stop wanting to eat so much, I don’t see that as being any worse than taking allergy medicine to stop dying of anaphylactic shock so much. The problem of course is that such magic medicine probably doesn’t exist, and if it did they’d extort us for it.

I don’t see how that contradicts what I posted.

I posted that we don’t need as many as we typically consume or in the form we typically think of when we see ‘carbs’, which you basically wrote again in a different form and which remains true.

It’s a subtle difference. It’s not the carbs that we need, but the essential vitamins and minerals that come with them.

Here’s a thought experiment. Let’s say someone invented a Star Trek style transporter. This device is set so that it automatically beams away any non-fiber carbs after you eat them. I think someone eating in such a way would not suffer any ill effects from having all their carbs removed. If the device was set to remove all protein or all fat, the person would soon become ill due to malnutrition. The one without the carbs wouldn’t become ill.

Of COURSE it is. Study after study shows that this is universally true for all animals. Put mice in a cage with unlimited food and they will eat themselves to death. Free feeding pets as opposed to meal feeding them almost always leads to obesity.

You are acting under the assumption that the human mind is entirely separate from the human body. It isn’t. The human mind is entirely formed from emergent interactions between electrical impulses in your brain and your biochemistry. Fuck up your biochemistry, and your mental state is affected as well.

You are assuming that the human body, and the way that it communicates with the brain, is rationally designed to achieve optimal outcomes in today’s society. But that’s not true. Your body is “designed” through evolution to survive on the African savanna just long enough to pop out a few babies and pass your genes forwards. This is what enormous selective pressure has pushed your body towards over millions of years. The fact that we’ve lived in cities for the last ten thousand hasn’t had time to influence your body nearly as much (and with the advent of advanced biotechnology, it is doubtful natural selection will ever act on us as a species again).

Human nature is designed around that savanna lifestyle. If you and your band find a dead zebra on the grassland, half eaten by lions, you will stuff yourselves full on its meat and crack open the bones (using stone tools) to suck out every last bit of marrow. This sort of high-fat, high-protien supplement to the human diet (which for the most part would still have been plant based) is a big part of how we were able to develop our large brains.

So when you eat fatty foods, your body is built to assume this is a once in a blue moon opportunity. It captures every last calorie it can and holds on to it for dear life, and it floods you with dopamine so that you continue building up your reserve.

There is simply NO MECHANISM in your body’s evolved system to comprehend and account for the fact that actually, this is the fourth time you’re having fatty food this week, or that this is a pizza that you ordered with a handful of taps to your smartphone, not a zebra that’s been picked over by lions.

Now, our rational mind CAN and SHOULD realize this and correct for the signals it receives from the body. But pretending that this is simple, easy, or natural is foolish. You are going against evolution there.

That doesn’t mean it isn’t possible. A horse is a prey animal, and it has an immensely powerful instinct to flee danger. But we have developed intensive training regiments, first to break a horse and make it allow a rider in the first place and then to overcome its aversion to noise and movement to the point where you can ride a horse in battle.

The instincts that govern our drive for food are no less powerful and no more rational than those that make a horse flee danger. At the end of the day, we are still apes. Our rational mind can certainly fight these urges, but we need to give people actual tools to do so, and not intentionally stack the deck against them by using our understanding of biochemistry and instinct to design intentionally addictive food.

This is your professional opinion based on how many years of experience in the medical field, exactly?

I largely agree with you. To be pedantic, I would point out that it is simple, it’s just not easy. It’s simple in the sense that you explain the issues in a brief post on this message board which took maybe a minute or two to compose. Putting it into practice, however, is extremely difficult. Maybe not for all of us, since there are many people who are not overweight or obese, but for a large proportion of the population, it is extremely difficult.

A key point is that the more obese you are, the more difficult it is for you, because the biochemical processes we discussed are self reinforcing.

So when big food conglomerates spend millions on advertising trying to convince you to make a bad decision, and every time you make that bad decision it physically shifts your biochemistry to make it more difficult to resist that decision in the future, that’s a problem.

Yes, it’s a very difficult problem to deal with. I wish I had suggestions on how to overcome the difficulty, but I don’t.

Because it is so profitable to create these addictive foods, I don’t see this changing in our society. The more food people eat, the more money they make. No company is going to make their food products less delicious, less enticing, or less addictive if it reduces profits.

One thing that might help is to have the messaging recognize that people have the urge to eat, but the choices of what to eat can increase or decrease those urges. Not only are some foods unhealthy, but they also increase the urges to continue eating those unhealthy foods. If instead they ate foods that did not trigger those urges and activate the brain’s reward centers, their weight would be better managed. This is one reason I think those low-carb diets give good results. People get off their carb addiction and are better able to keep their appetite in check. But just like all addictions, the urges to go back are strong and the person may fall back to their old eating habits.

We could make these companies serve society, rather than society serving them.

My anecdote. In July I was 215, taking High Blood Pressure medicine. Seeing heavy/heavier people drop like flies with Covid made me ask my doctor for a sensible alternate diet. I tried Atkins once and only rebounded. She told me just to cut carbs to 56g a day, and the only sweet stuff allowed were strawberries/blueberries/raspberries. Apparently being above 50g keeps you out of ketosis which she did not recommend trying. Long story short, I followed her advice and am now at 180. Still need HBP medicine but not as much and feel like a new person. For me it was a matter of survival. Maybe that’s what it takes.

Huh. I often find that my appetite often goes down when I haven’t eaten anything lately. The so-called “shrunken stomach” phenomenon, even tho your stomach hasn’t literally shrunk.

Maybe. Some searches on “shrunken stomach” appetite seem to show that this might actually happen.

I don’t believe we can really get by with so little carbs, but even if I grant you that we can, that doesn’t mean it is any way healthy or optimal in the long run. It’s obvious that added sugar is unhealthy. White rice and potatoes are not particularly healthy either, but something like sweet potato is.

Do you have a study that shows legumes and whole grains are not health promoting? Beans have a lot of fiber! The issue with eating grains is that most of the time they are refined or processed in some way. Compare whole grain oats, for example, which are so beneficial that they even improve type 2 diabetes.

Meat, in fact, is not a requirement for a healthy diet and would in fact be far from an optimal one if it is included. Fish could potentially be one of the very few health promoting animal protein sources if it wasn’t so widely contaminated with metals.

I fail to see how added oil in any diet is in any way health promoting considering it’s simply adding empty calories. Is it better to eat the actual coconut or to refine the oil from it and just consume that? Which study shows coconut oil is healthy? It’s not. Coconut oil is only better than maybe butter, but adding any oil, which includes olive oil, into a meal is not health promoting (unless you are literally starving and any calorie keeps you alive, even if those calories happen to be empty). The reason why olive oil is touted as being healthy is simply because it may be the least unhealthy added oil you can use when cooking, but that doesn’t, again, make it health promoting to use in and of itself. Eating actual whole olives would be better if the commercially available ones didn’t have so much salt.

Most people in western countries eat way too much protein anyway, so telling them to eat more is not a good idea, unless it is in the form of legumes and whole grains. A whole plant based ketogenic diet is better than most diets but even that diet is not optimal. Best to avoid keto diets for optimum health.

Not all carbs should be considered as equivalent in terms of overeating. In general, the simpler the carb is, the more of a reward activation it will create in your brain. Simple carbs like sugars and processed flours cause a quick and powerful biological reaction, which your brain urges you to continue seeking out. More complex carbs like in vegetables and whole grains take more work to process, so their effects are more subtle and less likely to trigger reward center activation. Most people are inadvertently making themselves carb addicts by eating highly processed foods where the carbs are mostly the reward activating simple carbs, along with other yummy stuff like fat, salt, and flavorings. Although removing all carbs from your diet is one option to help reduce carb cravings, likely you could get similar results by removing the simple carbs and just eating complex carbs.

Sure. It’s not like how it functions is really that simple. But a person who has been 400lbs for the past two years is biologically different from how they were when they were 200lbs before they got fat, and even if they got back down to 200lbs they wouldn’t be the same as they were the first time.

It’s sort of like how a person who has never drunk alcohol before is different from somebody who was a full-on alcoholic but who is now on the wagon.

One way to improve the diet related health of the population is to impose many or at least some of the same laws and regulations we have for tobacco. For instance we could ban all advertisements for unhealthy foods, like foods that contain added sugars and oil/fat and only allow advertisements for unrefined and minimally processed (mostly plant based) whole foods. Other restrictions could be done, like graphic packaging and a traffic light symbol scheme (green for health promoting, yellow for moderation, red for health detrimental), the latter already being a thing in some places (but no thanks to to big agriculture and their lobbyists that fight it tooth and nail). And stop subsidizing all unhealthy food manufacturing, retailers and restaurants, for one.

Diet related illnesses are due to exposure. We eat what is available, and the more junk and crap is available, the more we eat it. Remove or restrict crap and our diets would improve. Doing it in practice might be difficult due to public backlash, but we can still try to move towards it, however slowly. Most of the pushback is not from the people though, but from corporations, which by default don’t care very much about the health of consumers. It’s obscene that the US dietary guidelines are formed with influence from the agricultural sector. If they were based purely on health they would look quite different.

I still remember this opinion, expressed by a very important italian professor, lecturer, during a medical congress.
He said: “unfortunately in Italy obesity will never be treated as a disease, like it will be in the US”
These words sounded very negative to me, and I started asking myself the reason snd the background of it.

Thank you for your question, it is obviously quarrelsome.

Huh? No it’s not. I’ve had nearly a dozen pet cats. Every one of them has had free access to unlimited food. Not one of them has become overweight, let alone eaten itself to death.

For that matter, I, myself, have had access to unlimited food since becoming an adult. And I am overweight. But I’m not obese. And my blood glucose, and c reactive protein, and blood cholesterol and all that are all quite good. I have not eaten myself to death. Nor have I ever dieted. I considered it, after I gained a ton of weight with each pregnancy. But it seemed really unpleasant, so I decided to buy larger clothes, instead. This evening, I stopped eating my supper because I felt full, not because I was counting calories.

My secret? Probably I’m just lucky. But I do have two general dietary goals.

  1. I mostly eat foods with obvious sources. I like to be able to see what plant or animal died to feed me. I don’t religiously avoid highly processed food, but I do cook a lot from scratch, and I do try to include “whole” food in my diet. Supper tonight was oxtail soup made from ox tails, onions, butter, and added at the end, some barley and vegetables. And cranberry muffins, made from flour, eggs, milk, butter, sugar, and cranberries. (And salt and baking powder.) Not too much sugar, lots of freeze-dried cranberries. But health did, but my muffins are not cupcakes, either. (most commercial ones are.)

  2. I religiously avoid fake food. No artificial sweeteners. No indigestible fats. If it tastes like it has calories, it does.

I believe this helps my stomach know when I’ve eaten enough. I was talking to a diabetic friend about why there isn’t yet a good artificial pancreas. He says it’s partly because you need to take the insulin a little before digesting the food. How does your body know to do that? I bet it’s because your tongue tells your pancreas, “i taste sweet, sugar incoming”. In fact, I suspect that’s why our saliva starts breaking down starch into sugar. Not because we need that head start to extract the calories, but because we need that head start to signal the pancreas. Yeah, this is my hobby horse.

This is really interesting, and I think it supports my hypothesis about fake food. The people eating the highly processed diet didn’t just eat more processed food. They also drank fake lemonade, spiked with fake sugar. I suspect that’s why they were hungrier and ate more calories.