= 27d567bc2d48d9f40e9ccc20ea370b15)
Locaha comments on Critiquing Gary Taubes, Part 2: Atkins Redux - Less Wrong
You are viewing a comment permalink. View the original post to see all comments and the full post content.
= 783df68a0f980790206b9ea87794c5b6)
Loading…= b715d02e85f7b3b4ae65ca3d3e450868)
Subscribe to RSS Feed
Powered by Reddit
= f037147d6e6c911a85753b9abdedda8d)
You are viewing a comment permalink. View the original post to see all comments and the full post content.
Comments (186)
Maybe I missed it somewhere in the discussion, but: in the model of "calories in, calories out", is it assumed that all excess calories go towards building more weight?
It assumed that they will be either stay 'in' and build weight or they will go 'out'.
Taken as that it's true.
However there are quite a lot of ways that energy can go 'out'. I can sometimes produce enough heat while laying down and meditating to relax to sweat.
I'm weighing at the moment 55kg. My weight through the last 5 years was all the time between 53 kg and 58 kg.
There are instances where I lost a kg of body weight over night for no apparent reason. On the other hand throwing 800 kcal of maltodextrose per day into my tea didn't gave me an effect of my weight that I could see in daily tracking data even through I took it for months and then stopped with it.
It's sort of true by definition, if you make 'calories out' inclusive enough. Which makes the statement tautological, which is why Taubes says it doesn't explain anything.
Almost all people spend more calories on base metabolism (what they would spend if they lay in bed without moving for 24 hours), than they do on physical activity. We can also spend significant energy on heating ourselves if we're cold, or just due to different metabolic states. There are probably other categories too.
There are also issues of varying efficiency in digestion and absorption; two people may eat the same food but end up gaining slightly different amounts of calories.
In some versions. At a minimum, it's assumed that all calorie deficits will be made up by taking fat out of storage.
This is strange. Why is the model so simple? It's written nowhere that the human body must convert all calories to fat and must take all calorie deficits from fat. In the hypothetical situation where you eat X calories at 40% efficiency, switch to eating 0.5X calories and your body switchs to 80% efficiency, you end up eating half as much calories without changing your weight.
If you push, people who say "calories in, calories out" will probably say "But you have to have some common sense-- of course, I meant some sort of muscle-sparing strategy".
However, I believe the fundamental motivation is bullying-- it's an excuse to tell fat people they shouldn't care about their quality of life. Trolls will tell fat people to just stop eating.
That's not a particularly charitable interpretation. "Calories in, calories out" feels like the same kind of simplifying reduction that a lot of other scientific models have. It's one of those statements that's parsed like a natural law.
It's perpetuated by an emotional need to have a model where you can control your own destiny. Skinny people want such a model because they enjoy having skinniness be a character trait. Fat people want such a model because they need to hope - to have the counterfactual of "if only I did this action, then I'd be skinny".
The truth lies somewhere in between. Losing fat and keeping it off is more complicated than "eat less", and less difficult than "absolutely nothing you can ever do will change how much fat you have on you." The obesity epidemic in America is evidence of this - it's not caused by character flaws so it's more complicated than eating less, and it's caused by something so you can do that same something to reverse the effect. The answer is likely some combination of iterating through strategies until you find the one that works for you, fixing emotional or life issues and your relationship with eating, and learning broad strategies that help your life in general.
It's a subject where I have a hard time being sane, and I'm not aiming for charitable. It's possible that I should cut people more slack for meaning well, or at least not knowing how much damage they're doing and not wanting to know how much damage they're doing, but it's beyond me at the moment.
People who have cancer are congratulated on losing weight. People in depths of dangerous eating disorders are told how good they look, and the compliments dry up when they get healthier. People who use weight-increasing anti-depressants to not be suicidal are told to give up the drugs.
I grant that it's easier to prove that the culture is insane on the subject than to prove that losing fat isn't a good health strategy.
You haven't addressed the question of how urgent it is for people to lose weight.
"Iterating through strategies" is only a good idea if the strategies are low cost-- and a fair number of them aren't.
The culture is insane on the subject, and losing fat is very good for you. That's what makes it tricky - if you start fighting the cultural insanity and meanness to fat people in a naive way, you wind up with the reversed stupidity that is Healthy At Every Size and This Is Thin Privilege. Personally, the answer for me was to get my life together - I moved across the country away from my parents, moved in with much more emotionally healthy sister, went on a keto diet and lost fifty pounds (5"10' male, ended high school at 160, went from roughly 220 to 170). Getting my shit together happened first - and then the weight loss was almost an afterthought.
You can lead a horse to water, but you can't make them drink. Fat loss is fine and all, but most people got fat for a reason. I know I did - an extraordinarily stressful college environment combined with social isolation. I could deal with leaving those emotional needs unmet - for a time - if I was meeting at least some of my needs with comfort foods.
More generally, people in an unhealthy environment and state of mind do unhealthy things. It's really difficult to fix the specific way it gets expressed without simply pushing people into their next best alternative.
I'm not sure the right way to express this idea, so I'll unpack it a bit more. There are a number of weight loss strategies, and they each work for some people and not for others. Use some research time to figure out what's likely to work best, try it, and collect data about how it is going. Evaluate it when you expect to have noticeable results. If it's working, keep going - otherwise, pick a new strategy that's far enough away in solution space that you don't expect it to fail for the same reasons.
I got pretty lucky by having keto work for me as the first method - although perhaps my success is more about fixing issues in my life and less about the specific diet.
What is your evidence that losing fat is very good for people?
I'm going to ask for a pretty high standard-- at least five years of fairly stable fat loss, outcome-based evidence of improvement, and a reason to think that the improvement isn't from exercise and/or a low glycemic diet. Some people don't lose a lot of fat doing those things, but they do get healthier.
Strategies aren't just about what works and what doesn't. Some strategies make things worse for some people, and it's hard to get information about that and harder (impossible?) to get statistics.
I may have inverted the whole cause-effect thing -- after all, I did just admit that doing better in your life makes it much easier to lose fat. So it's entirely plausible that doing better means that you simultaneously lose fat and do other things that make your life better/healthier.
Overall, body fat isn't the node you want to target anyways, but rather the vague overall level of healthiness and life satisfaction. I believe there's influence going both ways -- that is, losing fat helps many people live healthier and more fulfilled lives, and that having a healthy and emotionally fulfilling life makes it easier to lose fat. I don't know enough to make an analysis of the relative merits of telling people how to change eating habits X, Y, and Z, as compared to teaching them strategies to deal with their emotions and interpersonal relationships in a healthy way. I do know that they're both vaguely good ideas with obvious benefits and opportunity costs, and definitely better than meandering along the same kind of strategies that lead them to want to make changes in their life in the first place.
I doubt there is any direct evidence since it's pretty unusual for people to lose weight and keep it off for at least 5 years. And probably a lot of those people adopted lifestyle changes which would have been very good for them regardless of whether they lost the weight or not.
Still, I think it's reasonable to believe that losing fat and keeping it off (assuming that you were obese to begin with) is a healthy thing for a couple reasons. First, one can analogize obesity to cigarette smoking. Evidently, both things cause harm to your body. But it's well known that if you quit smoking, over time the excess health risks due to smoking go down and after 15 or 20 years your risks are pretty close to those of the never-smoked population. Common sense says that it should work in a similar manner for weight loss.
Second, I believe that there is research showing that objective measures of metabolic health such as cholesterol levels; blood sugar levels; and blood pressure tend to improve in obese people who lose weight. Again, this is suggestive that losing fat is good. This is also consistent with common sense. If excess fat increases your risk of health problems, then losing that fat ought to reduce those risks.
However, if very few people keep the fat off, then the effects of regaining it also need to be considered.
Gastric bypass patients are an example of a population where there is reason to think that the stable weight loss is due mostly to fewer total calories, and they do seem to experience positive effects.
Liposuction, on the other hand, does not seem to share this positive health profile. (Of course, the "fat loss" in liposuction is very location specific)
Reduced weight seems obviously helpful if you have bad knees or some other joint problems. As for general overall health, I haven't a clue.
"Seems" is the operative word. There are a fair number of people who say that losing weight helps their knee and/or hip joints.
However, I've also read accounts by people who found that losing weight didn't help, but getting medical attention for specific problems did.
Ragen Chastain, a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they'd get if a thin person had the same knee problems.
(Of course it depends on how much fat those people had before.)
Admittedly not terribly strong evidence, but see Figure 1 in this study.
It doesn't look at the effect on mortality (if I read it correctly, it's at least using actual deaths rather than an estimate) of losing fat or trying to lose fat.
That anecdote doesn't even separate cause and effect. Maybe you lose weight because you moved, and the diet had no effect. Or maybe your emotional state improved because you lost weight, and moving had no effect - big changes in weight are known to cause or at least correlate with emotional changes.
Everything happens for a reason, but most events have many complexly interacting causes, not a single unentangled one. So your claim needs a lot of evidence, and as far as I can see you're not explicitly presenting any.
It was the diet, full stop. The diet was months after moving, and I stayed at the old weight before starting the diet, and I stopped losing weight when I went off the diet.
I wouldn't have lost weight without the diet, which wouldn't have happened without moving. It's really the difference between A->C and A->B->C. The counterfactual where I successfully go on a keto diet without the social support of my sister isn't something that would have happened.
Let me be more specific in the counterfactuals I'm envisioning. You tell a person with a comfort eating problem to go on a specific diet, and they wind up saying they're on a diet but end up hiding their comfort eating. Any amount of diet advice is not going to work for them because dieting is solving the wrong problem. The right solution is teaching emotional awareness, alternative strategies for meeting your emotional needs, and general skills for improving your life.
I'll retract the "most" part of "most people got fat for a reason", because even if it's true I don't have the data to say that - all I really have is a story about how diets fail for people with certain issues.
If indeed it's an epidemic - that is, highly correlated in space and time - it's very unlikely that the cause can be found and fixed in purely personal terms like 'emotional and life issues', which are unlikely to have changed in tandem for the US population recently.
Agreed 100% - it's much more complicated than just emotional overeating, and perhaps my views on the subject are colored by my own experiences. Diet, exercise, education, lifestyle choices, etc all play their part as well.
I disagree. It's fairly straightforward to cause a lot of emotional and life issues for people. We did it during the Vietnam War with the draft. College debt is a more contemporary example. Or we can have macroeconomic factors that, on the margin, move people away from friends and family or take more stressful jobs with longer hours. Hell, even the transition from manufacturing to service and knowledge jobs can do it - if you close down a factory and re-employ the workers by having them deal with irate customers as part of their day, you can contribute to more emotional and life issues.
Many countries have been involved in terrible wars, then bounced back quickly to affluency that permits casual overeating (on a financial level, that is). Almost none of them developed an obesity epidemic. Even more countries have had economic troubles, and yet ditto. It doesn't seem to me that your model has real explanatory / retrodictive power.
How well does the US obesity epidemic correlate in time with the e.g. the Vietnam war? (And with the people who were drafted vs. those who weren't?) Perhaps more importantly, if you're willing to include less drastic things like college debt, I think very few generations haven't had a comparable trauma of some sort, and yet they did not develop an obesity epidemic.