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Lumifer comments on Open Thread for February 18-24 2014 - Less Wrong
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I agree that trying to avoid all pain can be a failure mode. But insisting that pain needs to be plowed through can also be a failure mode.
The advice "You should run a marathon by continuing to run even if it hurts" might perhaps be useful as part of a package of different interventions to a runner who's hit some kind of a motivational wall.
But in other situations it is completely inappropriate. For example, suppose a certain runner has a broken leg, but you don't know this and he can't communicate it to you. He just says "It really really hurts when I run!" And you just answer "Well, you need to run through the pain!"
This is an unreasonable request. If you were more clueful, you might make a suggestion like "You should go to a doctor, wait for your broken leg to heal, and then try running later."
And if enough people have broken legs, then promoting the advice "You should run a marathon by continuing to run even when it hurts" is bad advice. Even if we assume that people are still capable of running on broken legs and will not collapse, you are generalizing from your own example to assume that the pain they suffer will be minimal and tolerable, rather than excruciating and intolerable.
If some people have metabolic problems - and right now I'm not claiming they do, just creating a possibility proof, and if you agree it's possible but don't think it's real we can get into that later - then they're like the broken legged people.
Working off Taubes and a few other of the low-carb people, some people's fat cells do not release energy. If they suffer any caloric deficit at all, even 300 calories or whatever you consider a reasonable small amount, their bodies will immediately start starving and catabolizing muscles or, in the worst case, vital organs. There have been examples (though the implications and generalizability are still debated) of people starving to death while weighing three or four hundred pounds, because for some reason their bodies couldn't get to their fat and so were forced to catabolize the liver or heart or something.
(this is what "starving to death" tends to mean in real life; you are so starved that your body breaks down important tissues it can't afford to lose, or builds up too many tissue-breakdown waste products)
Imagine that you are literally starving to death - let's say you've been without food for three months and you're down to the bone like those heart-wrenching photos out of some African countries. You have no energy and can barely move out of your bed. In theory it is possible for you to use willpower to force yourself to continue going on with your daily activities, and not have complaints like "I can't starve and think at the same time". In practice, this seems like a pretty poor plan if you have any other options.
If Taubes et al are correct, fat people who can't mobilize their body's energy reserves are in exactly this situation. Any caloric deficit and they're literally starving, their bodies are trying to figure out whether they should cannibalize the heart or the liver first, and they're not in the mood for continuing to go about daily activities with a smile on their face any more than that African in the famine is.
If your body has fully functional fat metabolism, and you're operating at a caloric deficit by successfully burning off fat, and you tell them "Hey, I feel moderately hungry but really this isn't so hard", you're comparing apples to oranges, the same way as the healthy runner to the runner with the broken leg.
A better solution would be to come up with some way to fix the thing where the body can't mobilize its fat reserves and so either has to stay fat or starve to death. I think this is the project the paleo people are working on: figuring out how to make the body say "Okay, caloric deficit, better burn some fat cells" instead of "Oh no, caloric deficit, better assume I'm starving to death and jack appetite up to eleven while catabolizing all of my muscles".
So is our disagreement that you don't think even Taubes' picture provides a situation in which one should privilege bodyhacking-type solutions over willpower-based solutions, or just that you don't think Taubes' picture is correct?
In that case the interesting question is whether these people who will literally starve to death before losing fat are exceedingly rare metabolic freaks, nothing more than medical curiosities? If their prevalence is in single digits per million they are just a red herring in the discussion of obesity. I suspect that for pretty much any generally accepted and valid health advice there is some exotic medical condition which makes following this advice a horribly wrong thing for that particular individual.
In general, I think it's highly useful to state that being in energy deficit through (usually) eating less or (less usually) spending more is the only way to lose weight outside of surgery. That's not the final word on the topic, but it should be the first. Otherwise you get equivalents of alcoholics who believe they'll fix their dependency by avoiding one particular kind of alcohol and drinking some other kind.
Yes, there are different ways to maintain energy deficit. In some cases you can just bulldoze through on willpower (or sufficient motivation). In some cases your personal biochemistry will be cooperative and in other cases it will not. Sometimes adjusting your hormonal and metabolic balance will do wonders, sometimes it will do nothing.
People are different. It's complicated :-/
People have literally died of that mistake, so there might be some reason to want to avoid making it-- like tracking what' actually happening to people's bodies when they're trying to lose weight.
Also, disorders tend to exist in a range of intensity, so that's another reason to keep track of the effects of dieting-- even if people whose bodies don't release energy from fat enough to avoid death are very rare, people who who have a lot of difficulty with losing fat shouldn't be assumed to be lying, and may be losing more muscle mass than is good for them.
Of that mistake? Links, please, to cases where people actually bothered to control their electrolytes, vitamins, minerals, and other essentials -- they just denied themselves calories and died from starvation still weighting a few hundred pounds.
"Have a lot of difficulty with" and "biochemically cannot" are very different things. A lot of people have difficulty with losing fat -- this does not imply that they cannot do it, only that they are unwilling or incapable of paying the price to do it.
Alternatively they may be accumulating more fat than is good for them.
As a practical matter I am not a big fan of using weight as the target variable. I much prefer either the body fat % or getting naked in front of a full-length mirror.