My reply above may have been rude, my apologies.
Not rude. Let me try to answer some points without further subquoting.
There’s a tremendous amount of controversy around the amounts of specific nutrients required and the amounts Americans actually get. The NIH itself, for example, says that magnesium intake from food may not be sufficient - your point - but notes that total magnesium intake among supplement users does exceed requirements. “No current data on magnesium status in the United States are available.” Individual studies are critical, but there is yet no consensus on this. Same goes for other nutrients and foods. Certainly some doctors and nutritionists make these recommendations but others cast doubt on them because even top-level longitudinal studies like the Nurses’ Health Study have come out with conclusions that have been superseded or reversed.
Bariatric surgery is not a societal solution. Only a small fraction of people even qualify, and the rate of failure is high. (Assuming that anyone even agrees on what success looks like. Full article here.) This in a procedure that requires long-term pre-surgery psychological counseling and continued after-surgery monitoring. Other health benefits, like lowered rates of diabetes, are encouraging. Still, everybody agrees that long-term benefits rely upon changes in lifestyle and attitude, along with the reduced calorie consumption. Which is true for every diet, making this just an extreme outlier, not a panacea.
My point about bariatric surgery is that it was originally thought it worked because of mechanical restriction. Now there is speculation that it works because it changes the endocrine system and the microbiome.
Bariatric surgery is not something everyone can do, but if drugs can be invented that safely create changes to the endocrine system, microbiome, enzymes that regulate fat synthesis, etc. that could cure obesity on a society wide level. If you create drugs that alter the microbiome and endocrine system to make a person’s body feel that a 10% body fat level is the natural set point, people will lose weight (possibly w/o effort, at least according to overfeeding studies where once people stopped being overfed they lost the weight they gained fairly easily) until they hit that level.
I don’t think anti-obesity efforts have worked. Anti-smoking efforts worked, the rates of adults who smoke are almost half what they were 50 years ago (I think they went from 40-50% down to about 20-30%). However I don’t think there is any evidence that asking people to change their lifestyles reduces obesity on a societal level by much. Obesity levels may taper, but that could be more due to genetics (people can’t get fatter with the current level of food and sedentary lifestyle available to them) rather than lifestyle changes.
As far as lifestyle changes, because we evolved not to starve asking someone to engage in a lifestyle that leads to sustained weight loss is something that goes against the fiber of what evolution designed us to do (sedentary animals with rich food survived lean years better). People aren’t going to undergo that en masse if they don’t have to.
I’d like to believe the level of lifestyle change needed to effect health is not so great that they are unsustainable. The biggest health benefits from exercise go from being sedentary to moderately active. Spending 2-3 hours a week exercising is all it takes, after that benefits seem to drop off. As far as diet, doing something as simple as supplementing your diet with a few servings a week each of nuts, whole grains, blueberries, fish, etc. could reduce the risk of CVD as much as pharmacological therapies for high blood pressure or high LDLs (roughly a 30% relative risk reduction).
Ultimately, bariatric surgery, when it works, still works on the principle of “Calories in minus Calories out”. All weight-loss programs work on that principle. The reason we have all the various weight-loss programs we do is not as alternatives to Calories-in-minus-Calories-out, but to make that easier for people to do.
I agree with some parts of this and disagree strongly with others. GQ isn’t the place to debate the causes and cures for obesity, though, so I’m going to drop out of this thread.
Yes, maybe many Americans could benefit slightly from more of certain vitamins, but you just do not (by and large) see the acute vitamin deficiencies that actually, you know, kill you. Maybe we should be getting more vitamin D (or maybe not - the research isn’t totally clear), but there aren’t very many rickets cases in the U.S. The benefits that we would get by eating more magnesium would be slight, but the benefits we would get by cutting down on our portion size would be rather larger (making wide generalizations, of course). Getting slightly less magnesium than the recommended daily value doesn’t kill you. Heart disease will.
Yes but the point is that (from what I know) when you undergo bariatric surgery you could undergo biological changes that lower your set point and make your body ‘want’ to be thinner.
Take you for example. I don’t know what you weigh, but I am certain there is someone out there who is 100 pounds fatter. If they lost 100 pounds and looked like you, their body would be fighting them constantly to get them to regain the weight. Their metabolism would slow, appetite would increase, they’d recover from being full faster, it would take more food to make them full, etc. For you you don’t have any of that to worry about. What is a bodyfat level for you to maintain effortlessly would require a herculean effort by someone else. So resetting people’s set points to a lower body fat is what will cure obesity. Right now we don’t know how to do that safely and affordably. Telling people to fight their biology is a losing proposition. Not only do most people gain the weight back, many end up heavier than when they started.
Right; such a person’s natural inclination is to be hungrier than I am, and more lethargic. So they’re prone to eating more Calories than they burn. They, like anyone else, could lose weight by burning more than they consume, but that’s going to be hard for them, because their inclination is to consume more, and to burn less. So anything that changes those inclinations is likely to help them lose weight, because it will make it easier for them to burn more than they consume.
Okay … let’s recap.
To the op: calories are not treated like they are the only things that matter. There clearly are people who emphasize calorie counting as the key method for losing weight and others who focus on a wide variety of other aspects (low carb, high protein, go vegan, eat Paleo, Mediterranean, DASH, and on and on). But with few exceptions even rigid calorie counters know that calories are not all that matters for health.
As to the rest … it does seem like there is a bit of talking past each other. Whether one believes in calorie counting or not, of course ultimately weight is lost over time if the amount of calories burned each day exceeds the the amount taken in. AND the machine is an adaptive beast modifying how much it burns as intake decreases and activating drives to eat more in response to weight loss. AND the machine adjusts those intake drives and the calories burned sides of the equation based on the composition of the diet and in response to activity, very likely in different ways for different people. Some people will respond well to calorie counting as a technique (with some attention to nutritional completeness) but many others need to choose an approach that also results in calories out being greater than calories in but does so with an approach that results in foods that are high satiety and not as hyperpalatable as much of what surrounds us and that possibly helps reduce both the body’s reduction of calories out in response to the hypocaloric state and the drives to eat more. AND someone who is obese does not need to become “normal” BMI to gain very significant health benefits.
Really I am not seeing many views expressed here that disagree much with any of that (Exapno had staked out that “nothing else” other than conscious control of calories works, but other than him/her I don’t see much).
So what drives the bickering we always see in these sorts of threads when posters really mostly agree?
My guess is that it is the implicit (but not necessarily intended) message that some receive from the “calories in vs out” side that obesity is simply a matter self-discipline. Current society is obesiogenic, full of low satiety hyperpalatable foods and without much activity built into our lives. Some are biologically prone to respond to those triggers more than others. The received (even if unintended) message of “it’s simple: just eat less” annoys those who understand that “out greater than in equals loss” is true and that it fails to capture the complexity of the human machine and why calorie counting works for so few.
As you know, I am very anti (calories in - calories out)/3500 but I do agree that calories are key. The problem is a lot of people don’t look at all of the factors that go into calorie consumption and instead say “Take the fork out of your mouth.” As an example take wheat. Wheat has more gluten now than it did 50 years ago. According to Wheat Belly, eating wheat tends to increase daily caloric intake by 400 cal simple because of hormonal reactions. Mrs Cad cannot have gluten because it interferes with thyroid receptors and she has Hashimoto’s. So yes it is a calorie count but wheat will incease calorie consumption and decrease metabolism without her being conciously aware of it. After going wheat free with no other changes, she lost 50 lbs.
Or how do diet drinks affect weight. There are some indicators that diet drinks do not have the impact on weight loss the calorie counters would have us think. The rabid Calorieists would have us believe that by drinking a diet coke we conciously eat more since I saved calories like “Oh I had a diet Dr. Pepper so now I can eat 3 Big Macs.” Now maybe the sweeteners cause an UNconcious desire for food (I have heard that theory viz. your body tastes something sweet and send out insulin anticipating sugar and finding none this creates hunger) but we don’t really know.
TL;DR - yes it is about calories but most don’t take into account all of the factors affecting calorie consumption & metabolism
I thought calories were the little buggers that hid in your closet and tightened your clothes at night while you sleep…
Well, diabetic nutritionist, same difference for the purposes of the thread
Nutritionally dense, concentrating on particular types of nutrients. Natural foods preferred to chemically created low fat or low sugar type stuff. Since I have other allergies and sensitivities that also make cooking from scratch preferable, this is not an issue. Besides, home made tends to taste better. I have always preferred normal fruits and veggies as snacks rather than the hostess twinkie type crap - my mom made a German chocolate cake with cooked fudge frosting that was to die for that had absolutely nothing premade in it [unless you count the chunks of baking chocolate she melted down:D] that beat the hell out of any storebought snack you could think of.
I figure at some point in time in the future, they will discover my truth - eat natural - there is nothing wrong with whole milk, butter, eggs and sugar in rational amounts unless you are genetically predisposed to have bad reactions to them. All the fad diets are worse for you than just eating normally, and that the only reason to go vegetarian or vegan is or religious/ethical reasons. [And PETA can kiss my ass … their fearless leader can just stop using modern medicine and die from lack of insulin as far as I am concerned, hypocritical bitch that she is.]