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Jack comments on Critiquing Gary Taubes, Part 2: Atkins Redux - Less Wrong
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Comments (186)
This is like saying that the success (or failure) of a product is simply (revenue - cost). Or that the key to winning a sporting contest is to score more points than the other team.
If you're going to argue that certain diets make it easier to eat less, why attack the "calories in, calories out" position like that (complain it's simplistic when it's true)? It's just going to confuse the hell out of your readers. Whether you're dieting, devising a product or competing at sports it helps to know what the goal is, because you can usually get to it in various different ways.
Edited for hopefully a bit more clarity.
Huh?
Which part confused you? "Huh" won't help me to help you, nor will it help me understand you.
The whole thing confused me, but the edit helps a bit. There is nothing particularly wrong with "Calories in, calories out" it just fails to illuminate anything at all which is why it's a bad response to make to any claim about the effects of diet. It also, as a practical matter leads to people thinking about their size as the result of a system where their best control levers are how much they eat and how much they exercise. If trying to eat less and exercise more is a bad way to try to lose weight then attacking the model as simplistic (despite it being a tautology) seems like a reasonable thing to do. That is-- aside from being uninformative it also seems like it might have counterproductive effects as far as people interpret it as dieting advice.
I sense there is a great deal of bias surrounding this topic.
The goal is to lose weight, right? And this guy being discussed is an advocate of the Atikins diet, right?
All I meant (and all I said) is that "Atkins works through the drastic reduction of the type of calories that make up 40-60% of American diets: carbs."
I conceeded that "There are lots of variables in regard to the psychology of dieting, physiological advantages to consuming certain foods and nutrients & genetic predispostion of metabolism"
And concluded that "dieting and body weight is fundamentally about simple caloric arithmetic".
...
From my wikipedia reserach, Atkins includes a two week "Induction" phase which involves what appears to me as nothing more than carb-eliminating & portion control.
Over the course of two weeks, I posit two things tend to happen to an Atkins dieter: (1) they lose weight through a rather dramatic reduction in calories & (2) they form some habits.
(1) leads to some increased positivity and will to continue & (2) helps them stick to the diet with less will power expenditure. (In many cases I've seen, and as a result of their increased will positivity and new habits, people incorporate some other helpful weight loss measures concurrently, such as consistent exercise, which furthers their efforts.)
You seem to be suggesting this is more complicated and magical than I think it need be, and then critiicizing my simpler solution.
OF COURSE dieting is hard because of lots of well established psychological and physiological reasons. I'm not trying to discount that. But pretending Atkins works primarily by some other mechanism other than calorie reduction is, in my current opinion, not true.
If I'm wrong, show me.
You mentioned insulin as a variable I'm ignoring... And then you said cases like those "don't make up a very significant fraction of people who are obese in the modern, western world".
...
By the way, I think I've made this clear, but I'll make it clearer because it is a big deal to me: I'm not in the over-simplified (ignorant) crowd who simply says "Fat people eat too much", as I believe this discounts the significant role that, for one case, individual differences in metabolism make in people's weight over the course of many years.
There is a "Skinny Elite" class who look down on those who are not skinny and make judgements in regard to their character, discipline, etc. This is the result of ignorance. Two people can have identical energy balances (cals in/out) over the course of a decade and end up 100+ lbs apart in body mass, and that is without figuring in the psychological & emotional toll it obviously takes on a person to "fail" in comparison to people who are much less disciplined in their diet and excerise regiment, and then be judged daily for it.
They also lose a lot of water weight.
Well I think the hypothesis is that by eliminating refined carbohydrates, you are adjusting your body's internal "food clock" so that you will naturally end up eating less. So it's analogous to the Shangri La diet, except that the Shangri La diet purports to adjust your internal "food clock" through a daily shot of flavor-free calories.
That's wrong. There meaningful disagreement about whether "Calories in, calories out" is true. Deciding whether it's true matters.
There are three positions:
1) It's the calories stupid. People should count calories and reduce their intake an then they will lose weight.
2) People can't just reduce calories easily. They need to take into account all sorts of psychological factors to successfully reduce calorie intake. This means making certain food choices that result in different levels of hunger.
3) Calories in doesn't matter much, you can eat 4000 kcal a day like Dave Asprey and still be fit and not gain additional weight.
There are plenty of paleo folks who argue 3) in some form but most not as strong as Dave Asprey. It's imporant to know when someone argues in favor of 2) and when in favor of 3).
There is meaningful disagreement between those positions, but none of them dispute conservation of energy.
Thanks for the clarification.
It illuminates the goal. There are smart and stupid ways to achieve that goal. I think simple calorie restriction without other concerns is a stupid way to achieve that goal, but I also think scolding anyone who states the goal is damaging to the goal of making people smarter about their diets. Through the power of connotation it's just going to make you look like a perpetual-motion-machine-quack to anyone not familiar with your arguments.
It could also make them come up with smarter ways to restrict calories the easiest way possible, which could be limiting carbohydrate intake.
... but it isn't. The question is how you do it, and I think you agree.
People interpret low carb diets all the time too as a permission to eat for pleasure as much as they want. Hedging against misunderstandings is advisable no matter what we're talking about.
Having thought about this some more, I think it's a good point. The problem with the soccer game analogy is that everyone is completely and acutely aware that you need to score more than the other side in order to win and that that's the only way to win. With dieting, weight loss, and obesity, a lot of people vaguely believe that calories don't matter; that there are a lot of thin people who eat lots and lots of food and stay thin; that there are a lot of fat people who eat very little food and stay fat; and so on.
Of course it's in Taubes' interest to have some vagueness on this point since he can sell a lot of books by being perceived as giving people permission to pig out.
Well is that a misinterpretation?I
I had this exchange with poster "Jack" a few posts back:
Me:
Jack:
It should be since he admitted that too much energy leads to weight gain. I suspect he meant that people naturally restrict their intake on certain diets, so you don't have to give them explicit warning about eating too much.
This leads me to believe some people are suffering from a typical appetite bias. Eating to satiety isn't the same thing as eating for pleasure. I could easily triple or quadruple my energy intake if I didn't have to worry about getting fat. This is why I try to make my food not too tasty and handle it more business-like.
I assumed he meant that in the absence of carbs, the body will either adjust its metabolism to burn any excess fat consumed or not absorb it in the first place.
That would be an extraordinary claim and I would like to see extraordinary evidence before I assume anything like that. I challenge anyone who believes that to eat 7500 kcal per day and few carbs for a week and see what happens, or say, 5000 kcal a day for two weeks.
Edited to be more reasonable.
Unless I'm wrong, there is a large chunk of the population who believe diets have some magical element that differentiates them from other diets. Atkins, from my limited understanding, involves a magical element, coming up with a sciency-sounding explanation for it.
Any insufficiently understood biological process will be indistinguishable from magic.
So people undergoing insulin treatment (for example) get fatter because they start overeating and stop exercising enough?
I think Chris is probably taking Taubes a bit literally (and I agree with the revenue-cost analogy), but I like http://wholehealthsource.blogspot.com/2011/08/carbohydrate-hypothesis-of-obesity.html , which he linked to in Part 1. There's quite a lot in it about insulin (too much for me to summarize here), but I've copied a couple of particularly relevant paragraphs below. Obviously if you can see any issues with them then I would be interested in hearing them.
"The idea of fat gain in insulin-treated diabetics (argument #3) is not as airtight as it might at first seem. On average, diabetics do gain fat when they initiate insulin therapy using short-acting insulins. This is partially because insulin keeps them from peeing out glucose (glycosuria) to the tune of a couple hundred calories a day. It's also because there isn't enough insulin around to restrain the release of fat from fat cells (lipolysis), which is one of insulin's jobs, as described above. When you correct this insulin deficiency (absolute or relative), obviously a diabetic person will typically gain weight. In addition, short-acting insulins are hard to control, and often create episodes where glucose drops too low (hypoglycemia), which is a potent trigger for food intake and fat gain.
"So what happens when you administer insulin to less severe diabetics that don't have much glycosuria, and you use a type of insulin that is more stable in the bloodstream and so causes fewer hypoglycemic episodes? This was recently addressed by the massive ORIGIN trial (17d). Investigators randomized 12,537 diabetic or pre-diabetic people to insulin therapy or treatment as usual, and followed them for 6 years. The insulin group received insulin glargine, a form of long-acting "basal" insulin that elevates baseline insulin throughout the day and night. In this study, insulin treatment brought fasting glucose from 125 to 93 mg/dL on average, so it was clearly a high enough dosage to have meaningful biological effects. After 6 years of divergent insulin levels, the difference in body weight was only 4.6 lbs (2.1 kg), which is at least partially explained by the fact that the insulin group had more hypoglycemic episodes, and took less metformin (a diabetes drug that causes fat loss). A previous study found that three different kinds of long-acting insulin actually caused a slight weight loss over three months (17e). This is rather difficult to reconcile with the idea that elevated fasting insulin is as fattening as claimed."
Edit: Fixed link.
So I don't take the weight gains from a high-carb diet to be directly analogous to a diabetic injecting insulin. Mainly, I'm talking about artificial insulin injection here just as a simply rebuttal to the notion that weight gain/loss is entirely about eating too much/ not exercising enough. People naturally tend to underestimate how much biochemistry influences decisions, mood and personality. It's a product of lingering Cartesian mythology.
That said, most of what I've seen on insulin and leptin resistance emphasizes peak insulin level in the minutes to hours after eating rather than a moderate difference in baseline insulin. What is going on is probably more complicated than a straight-shot from carbohydrates to insulin to fat. We probably need a more committed, more knowledgeable or less busy defender of Taubes here.
Then it's a good example, and I'm with you that your weight is determined by more than whether you have the willpower to say "today I'm going to exercise and not eat too much". (Though most researchers probably agree with Taubes on this: http://wholehealthsource.blogspot.com/2013/01/comment-in-nature.html .)
I think Stephan on Whole Health Source does a good job of refuting Taubes' claims on the particular importance of insulin resulting from carbohydrate consumption (I can't remember specific posts, but I think there are several others in addition to the one Chris linked to), but it might be that I would think otherwise if I were a bit more knowledgeable. He had some sort of falling out with Taubes at some point, and, like Taubes, he has a theory about what causes obesity (http://wholehealthsource.blogspot.com/2011/11/brief-response-to-taubess-food-rewad.html) and is presumably disproportionately likely to interpret evidence in ways that support his theory.
For example, it's not clear to me whether you are for or against this position in form of a question. Should it be?
I don't think weight gain from insulin treatment has anything to do with the diet and exercise decisions people make. Obviously, as a matter of fact they take in more calories than they burn.
I think you're correct, but I'm not sure how this translates to low carb dieting. You can make any healthy person eat too much if you give them insulin. Give them enough, and they will die if they don't.
Some diabetics obviously take too much insulin, and this will make them eat more. Taking too much insulin is a decision. Do you find this agreeable?
A common problem with diabetics is many of them eat unnecessarily large evening snacks out of fear of nocturnal hypoglycemia even if they take just the correct amount of insulin. This leads them to get hyperglycemia in the morning, which leads to upping the dose and the cycle continues.
Gary Taubes argues that someone who eats more carbs is going to produce more insulin.
Froom Good Calories, Bad Calories:
I think the hypothesis is plausible, and if it were true the amount of carbohydrates people tolerate before their insulin secretion went crazy probably would vary greatly. I'm not sure if it applies to fructose, since its cell uptake doesn't seem to be regulated by insulin. I'm pretty much ready to accept this idea as one of the major causes of obesity, but not necessarily the most important.
Does he say anything about insulin resistance in relation to this idea?
Far as as I understand he see a lot of insulin resistance as the result of elevated levels of blood insulin. I think he makes that argument in more detail and I'm probably not the right person to recount all the details.
I personally don't think that there's something like a ultimate cause of common obesity and that there are probably a lot of different factors at work.
From what I've read about diabetes, the need for insulin varies somewhat unpredictably. It's hard to be sure one has taken just the correct amount.
That's true especially in the beginning, but people become incredibly good at predicting how their needs vary through experience. Getting sick is an important exception, that's when things go wacky.
Do you think whether we use the word "just" or "roughly" was important to my main point?
I'm ignorant as to why that happens, and I'll assume it is true.
Why does it happen?
And what percentage of the general population do circumstances like this (or other such examples) apply to?
Well that's what insulin does. It's the hormone that mediates growth in adipose cells. If a person has broken insulin regulation (aka diabetes) and then you start injecting them with the stuff there is a good chance they'll get fat (the effect of insulin is a little more complicated than that, such that people react differently-- obesity has a significant genetic component).
There are a lot of known hormonal and metabolic disorders that can cause obesity. They don't make up a very significant fraction of people who are obese in the modern, western world-- but it in some societies it's probably the only way some people ever get /got fat.
Examples?
Basically all hunter-gatherer societies, as far as I know.
Ah, that's reasonable, but could be just because food is more difficult to get, and exercise isn't optional.
The issue's a bit more complicated than that. Skeletal evidence shows us that overall nutrition is usually worse after the agricultural transition, with average heights (a decent proxy for nutrition) usually dropping by several inches after a region switches to an agrarian lifestyle.
This doesn't necessarily mean that agrarians are making fewer calories per unit effort, though. They may be limited in protein or micronutrients but not in calories, with stunting thanks to deficiency issues; actually that's rather plausible. Alternately agrarian methods might by limited by expenditure of effort during some limited season (plowing, say, or harvest -- I don't know exactly how bronze-age agriculture worked), which could give you higher peak effort but lower average effort. Or the aristocratic classes that usually come with an agrarian transition might be confiscating all the good stuff for their own use.
(Agrarians are making more calories per unit land no matter how you slice it, but that's more historically than nutritionally significant.)
The question was whether there were any non-hormonally obese people, not what the average person looked like. I'm pretty sure agriculture made it much easier for high status people to overeat. In fact, obesity was probably a status symbol.
I would agree this is true. From my recall and simple research, something like ~17% of individual metabolism is dependent on factors that are suspected to be genetic, and this, as a result of simple arithmetic, can lead to obesity fairly easily. (e.g. we eat and exercise identically and end up at very, very different weights).
I still don't understand what the mechanism by which -- apart from simple caloric arithmetic -- Atkins works? Are you saying it is a result of its effect on insulin in the body?
Since, like you, I don't suspect (though we may be wrong) insulin-caused obesity is a significant % of the western world, it still is my view that the Atkins diet is primarily nothing more than an "eat less" diet disguised as pseudoscience.
The genetic component could also affect hunger and eating behavior.
It seems to me reasonable (and likely) that it does. Of course we have individual differences in appetite and metabolism.
The crux is what Atkins, or any diet, does besides improve caloric arithmetic. I'd say it does primarily nothing in the majority of people. I'd love to hear a suitable counterproposal.
If they get hypoglycemia because of too much insulin then yes, this would make them eat more. If you're hypoglycemic you won't like to exercise either. If insulin can store energy from thin air, I would like to understand the mechanism.
Again, huh? All of your replies in this thread sound like they're replying to a position I haven't taken.
Perhaps you should make it clearer what your position is then. The ifs were there because I wasn't sure I understood you, so I was replying to a hypothetical.
Being reminded of obvious things isn't always useless. (For example, Stein's law “If something cannot go on forever, it will stop” is a tautology if you think about it, but...)