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Diet Drugs Work: Why Won't Doctors Prescribe Them?
Hugh Pickens DOT Com writes "Suzanne Koven, a primary-care doctor at Massachusetts General Hospital in Boston, writes in the New Yorker that the FDA has currently approved four drugs that will help patients lose weight but few primary-care physicians will prescribe them. Qsymia and Belviq work by suppressing appetite and by increasing metabolism, and by other mechanisms that are not yet fully understood. 'But I've never prescribed diet drugs, and few doctors in my primary-care practice have, either,' writes Koven and the problem is that, while specialists who study obesity view it as a chronic but treatable disease, primary-care physicians are not fully convinced that they should be treating obesity at all. The inauspicious history of diet drugs no doubt contributes to doctors' reluctance to prescribe them. In the nineteen-forties, when doctors began prescribing amphetamines for weight loss, rates of addiction soared. But in addition, George Bray thinks that socioeconomic factors play into physicians' lack of enthusiasm for treating obesity because obesity is, disproportionately, a disease of poverty. Because of this association, many erroneously see obesity as more of a social condition than a medical one, a condition that simply requires people to try harder. Louis Aronne likens the current attitude toward obesity to the prevailing attitude toward mental illness years ago and remembers, during his medical training, seeing psychotic patients warehoused and sedated, treated as less than human. 'What the hell was I thinking when I didn't do anything to help them? How wrong could I have been?' Specialists are now developing programs to aid primary-care physicians in treating obesity more aggressively and effectively but first primary-care physicians will have to want to treat it. 'Whether you call it a disease or not is not so germane,' says Lee M. Kaplan. 'The root problem is that whatever you call it, nobody's taking it seriously enough.'"
shucks, ive no idea, either that or because someone is paying someone else more for something else
The problem with slashdot is that most of its users were bullied and stuffed into lockers as kids!
Your diet is a perpetual thing, not something you do for a little while to lose weight. Eat healthy, be healthy. Drugs and short term adjustments in what you eat aren't going to do shit.
I'm totally waiting for some breakthrough study that shows giving the plumbing a day off now & then is beneficial. But I guess that might hurt profits somewhere. Oh well, so much for scientific inquiry.
Get thee glass eyes, and, like a scurvy politician, seem to see things thou dost not.--King Lear
Nothing in medicine is no where near "fully understood."
Maybe doctors are not prescribing drugs for obesity because it's 100% curable without any kind of drug...?
I don't respond to AC's.
Ask yourself the following:
(1) Are you cooking most of what you eat yourself?
(2) Have you cut all sugar, pasta, bread, and other starchy foods, and most saturated fat and meat from your diet?
(3) Have you been tracking your calories and weight daily for the past month?
If the answer to any of these questions is "no", you haven't seriously tried losing weight, and nothing is likely to help you.
Diet, exercise, and self control. I rarely hear doctors prescribe that either.
I learned bad habits in my teens and twenties. It was hard to break the "all you can eat" mentality when I got to my forties.
It's hard work to maintain my weight. Lots of exercise, continuing to watch my diet, and endless self control to not eat everything in sight.
Simple equation (uh, so I ain't no mathematics teknishun).
Slashdot: Tired of exercise and eating right? Well fellow sir with no discipline, we have your easy solution right here. Just give some dollars to your fellow pharmaceutical giant, and we'll give you a miracle cure.
The previous post is a fine example of the problem: treating obesity as a moral failing. If you were a "good person" you'd have the willpower, eat right, etc.
Sure, modern lifestyles and diets are a contributor to the problem, but not the entire cause. There is ample peer-reviewed validated research out there that shows that some people are more efficient at metabolizing food, and that you can exercise as much as you like and eat as little, and still not lose weight as much (and suffer a variety of undesirable side effects in the process).
Bear in mind also that the underlying biochemistry of the "average adult" has changed as the result of food and activities during childhood. A travesty to be sure (juvenile onset diabetes, for instance), but now that you have that 20 year old with the screwed up biochemistry (in terms of comparison to 1900s man), you're not going to fix it by changing diet and activity.
And then, there's the practicality problem. If your job, which pays for the food you eat, requires you to sit in a cube with a headset on and a keyboard, no amount of Outside magazine inspired "get out and get fit" exhortation is going to provide an opportunity to "live a healthy lifestyle". Companies talk the talk, but when it comes to adversely affecting productivity, they do not walk the walk: that's why company wellness programs emphasize things like smoking cessation.. it's something you can do on your own time that saves the company money (yes, it's a good thing, but the real point is that the employee is doing the heavy lifting).
And so, after sitting in the cube all day, or inspecting people at a checkpoint, or whatever task there is, you ride the bus to your second job, so you can make the rent on your apartment in the food desert. Not a whole lot of time to prepare that nutritious meal from non-existent ingredients.
So, before exhorting "good healthy ways to eat", let's talk about paying people enough so they can afford to do so (in terms of time available, etc.)
Fat mice, when fed fecal matter from thin humans, lose weight. It seems much less expensive to me than pharmaceuticals, and there are no known side effects. http://www.nytimes.com/2013/09/06/health/gut-bacteria-from-thin-humans-can-slim-mice-down.html?_r=0
Gently reply
Many conditions that are treated with pills could as effectively be addressed with proper diet, nutrition and exercise. Curiously, doctors are rarely averse to prescribing medications for most of these; it is noteworthy that obesity is treated differently. On the other hand, maybe it's time the pills were left on the shelf and patients were required to take responsibility. Big pharma wouldn't like it, but a host of side effects would be avoided, billions of dollars would be saved, and "survival of the fittest" would actually mean something in the social context.
Hello,
I'm a weight loss and weight long term control success story, more or less. But having done it, I know exactly how hard it is.
I'd love it if the US population could dump their extra pounds by taking a pill. It'd just be a win for everyone, and the only people who'd "lose" are those who feel superior because they've managed to do it without the pill.
And even THOSE people will be paying lower health insurance premiums because the population is healthier in general.
If the pills really work, BRING 'EM ON! Who knows, if I can't exercise some day (I'm currently taking a few weeks off because I got rear-ended in my car!), then I'll need them myself!
--PeterM
"Specialists are now developing programs to aid primary-care physicians in treating obesity more aggressively and effectively"
Change "Specialists" to "Drug Company Sales Specialists" and it will probably be more accurate.
There has been so much moralizing about weight--obesity is seen as a moral failure and weight loss is seen as a triumph over the sins of sloth and gluttony--that pills are inevitably seen as the cheater's way out. Old moralizing habits are hard to break; doctors can't go from haranguing people about their dietary practices to quietly slipping them a prescription overnight.
Eat shit? No, I'm not going to Britain no matter how obese I am.
I'm guessing that the one big reason that they aren't prescribing- they are scared of legal action- remember the Fen-Phen debacle. Fen-Phen also worked, but apparently caused cardiac issues, resulting in lawsuits and legal damages of over $13B USD.
Most doctors education is lacking, Once the leave med school I don't see them going back for more education. My family doctor of 45 years graduated med school and became a GP in 1955, he even delivered me when I was born, and I saw him regularly until he died this past year. I know his education in medicine was way out of date but he was smart enough to refer me to a different doctor or specialist when It was needed. GP's need to do the same and refer patients to specialists that have more recent education that know about the treatments.
I know my doctor was the exception, he did house calls and worked until he died. I know he charged people what they could pay and refused to abide by the "minimum pricing racket" that the insurance companies and feds require. He became a doctor to help people, not to become wealthy. And he helped people all the way to the moment he died.
And yes the last 2 decades I drove all the way back to that small town to visit him as my doctor. Because I wanted a doctor that cared about people, not his Porsche. (He drove a Chevy btw...)
Do not look at laser with remaining good eye.
Weight loss in a pill is achievable.
GOOD HEALTH IN A PILL is not.
People are fat because they have poor diets and lifestyles and because most modern food is crap designed to make you crave more. Giving them a pill to remove the symptoms of their poor health will only reenforce their bad behavior and makes things worse. It'd be a loss for everyone. The population will get worse. WEIGHT IS THE EFFECT NOT THE CAUSE. Treating the effects doesn't fix their underlying causes.
Fat mice, when fed fecal matter from thin humans, lose weight. It seems much less expensive to me than pharmaceuticals, and there are no known side effects.
No side effects? Puking your guts up after every meal because you're eating other people's shit would be classified as a side effect. And anyway, where are you going to find enough thin peoples' shit to feed all the fat people?
How about prescribing a non-american diet, and more physical activity.
The way that humans gain weight hasn't changed over time.
Our diets and activities have.
"It is no measure of health to be well adjusted to a profoundly sick society." ~ Jiddu Krishnamurti
My wife is morbidly obese. She for years has tried to lose weight with various diets and drugs. These had temporary weight loss effects, but all ultimately failed.
Why? Was my wife of inferior moral fiber and simply unable to follow through? Is she simply someone who needs to eat from a smaller plate, sit further away from the table, exercise more, eat less sugar, eat less carbs, eat more carbs, follow some arcane points system?
Nope. None of that works.
I'm a software engineer. Failure is a daily occurrence, and when we fail and study the failure, we learn the underlying problems and then we have success; and I've constantly encouraged my wife to keep trying. And she has; for over 10 years.
Two years ago, she contacted a weight counsellor / psychologist in Florida. In that time, they have peeled back the layers of her life, looking for the real, underlying problems. And, they found them. Who knew, for example, that being sexually abused as a 4yo child for years would cause problems? Who would have thought that when the attacker (a family "friend" next door) said things like "you would look prettier if you lost a bit of weight", it causes problems like gaining weight to try and make the pain go away? Why on earth would a narcissistic mother cause problems - especially when a 4yo comes to her bleeding from the vagina and covered in semen, and the mother simply wipes it away and says it never happened?
My wife's weight is far from something to be ashamed of. Instead, it's the mark of a person who came through some of the most horrendous things you can imagine - and lived.
The reason all the diets and drugs failed? Denial of the past and the problems in it. Simply becoming an adult doesn't mean the past will not affect you.
The future? Looking good. Since breaking through and working through all of her past, the underlying need to eat compulsively has gone. Guess what? She's loosing weight without a restrictive diet, drugs, surgery - whatever.
Obesity isn't a "disease" or anything like that. It's the symptom of something else. Medical dollars are best spent for people who are ready to lose the weight AND deal with their pasts by supplying them with competent psychologists, not the latest diet pills.
When you can just eat less.
the food industry does not want people to suppress appetite. they're trying to have people eat more, not less
As a primary care physician, I gave in years ago. I now prescribe assorted appetite suppressants whenever some one asks me, it saves me lots of arguments, and a lot of time.
However, I get them back monthly for weigh ins. The drugs work great for a couple months, losing 4~8kg a month, then tapering off to nothing. Folk then realise that this is not a wonder cure.
The only stuff that works long term is eating less +/- exercising more, or surgery to shrink your stomach (actually the latter works pretty well, better than pills long term, in my experience. little change out of $10K, but probably worth it)
Pills are short term appetite suppressants. The following year, you are back to your previous weight, but your wallet is much lighter. Look to advice that you already know about for long term losses.
Yep, its not your fault and "medication" is the answer.
What about lawsuits from things like fen-phen (http://en.wikipedia.org/wiki/Fenfluramine/phentermine).
Try eating less?
Everyone wants the "quick solution" and if one isn't available something else to blame other then their own bad habits.
I've known a few overweight people and most of their family was also overweight. After going to their house for dinner a few times I saw a possible cause but instead you will hear about "genetics" or some such.
Actually, slashdot covered the mice gut bacteria transferred from small amounts of fecal material back in September. I wonder if it's too difficult to patent shit compared to drugs. http://science.slashdot.org/story/13/09/06/2130223/gut-bacteria-in-slim-people-extract-more-nutrients
Gently reply
They have patients coming in day in and day out who swear they eat like a bird and they exercise regularly and are still gaining weight. Perhaps 1 in 1000 of these patients have some medical condition; the rest will likely have been eating candy bars in the waiting room, or will constantly snack on "energy bars", or whatever. And they hold bizarre ideas of what sorts of foods "don't count" (like celery... with dip).
Giving them drugs is just a waste of time, effort, and drugs. And if they don't work or have side effects, lawsuit time.
You can eat tons of stuff that isn't so good for you, right? Cool. And, how old are you?
I was underweight for much of my life. Around age 25 or so, I FINALLY "bulked up" to 160 pounds. I stayed near that weight right up to about age 47.
Age has some nasty surprises for some of us. One day I looked down, and realized that I had a pot belly. Wow, man! That ain't me!
At the same time, my knees started giving out on me. I don't run any more, can't run. Oh - to be honest, I CAN run, but a quarter mile jog is going to leave me suffering for a week or more.
So, I got a pot belly, I'm far less active, and that pot belly now tips the scales at ~195, has actually reached 200 a couple of times.
At six foot tall, 200 pounds isn't "obese" - but it's unhealthy. For me, at least, YMMV depending on your body build.
When you're over 50, getting close to 60 years old, let us know how easy it is to lose those unwanted pounds. If taking a pill could reduce the number of fat cells for me, I would seriously consider getting some.
However, I do understand the equations very well. Those pills aren't going to do anything good that is permanent. About the only way to remove fat permanently, without serious exercise and diet, is surgery.
I'm NOT willing to go that route.
"Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
Ok, but can we at least bake the shit into some brownies first?
I felt bad for the man who had no signature, until I met a man who had no comment.
Actually treating the effect is often quite an effective way, especially when it makes it easier to treat the underlying causes (you can't exercise if you are fat, even if you can physically, you often can't due to social pressure, etc)
I suspect many doctors are reluctant to proscribe diet pills because then people will think "if I take these pills, I can keep eating all the junk I want/not exercising and yet still loose weight" which is not true.
If someone could tell me exactly what and how much to eat and how much and how hard to exercise. But dieting is all a lot of guesswork and maybes, and each and every person is an unique snowflake now'a'times that this can evidently not be solved by science.. Seriously; exercising is boring and so is food, and i would like to do them both as little as necessary.
Another thing, no one has ever straight out told me to go hungry to lose weight. The closest was the diplomatic answer (after i directly asked) that i should "redefine what hungry is"... ?!? What? Is dieting some kind of zen thing? Stupid. I would rather have the pills than deal with all this confusion and guesswork.
The Brits aren't skinny because they eat shit, they are skinny because given the option of eating British food and starving, they starve.
I am officially gone from
These drugs ARE NOT NEW!!
They are not sufficient absent increased healthy workout regiment.
Furthermore the literature reports only 3-5% weight lost. This is essentially an insignificant amount!!
I have not even mentioned the possible side effects.
Unfortunately there is no magic bullet!!
We are what we eat!!!
....even and especially when it's unspoken.
Most people think of obesity initially as a function of morality, principally a lack of will power. You're obese because you have no self control over food. You eat too much.
This is reinforced by the notion of energy balance, which in turn reinforces the morality aspect, because the notion of energy balance leads to an additional conclusion, you don't get enough exercise, which is of course another failure of character. Now you're obese due to your lack of willpower to both control your eating AND exercise enough.
Even when doctors (like my doctor) try to approach the issue of weight they do it initially from the perspective of energy balance more formally, but underneath it always boils down to a failure of will power, since you aren't able to control your eating or exercise. Yet they treat other conditions like strep throat without an implied question of whether I have good hygiene or wash my heads enough.
The implied morality and self-control issues coupled with the flawed energy balance model keep doctors from pursuing more effective solutions to obesity, especially because some of the solutions defy the implied moralism. Low carbohydrate diets don't have a calorie target at all, they openly suggest you eat until you're full, and the causes are associated with too many carbohydrates which is some ways more analytic (what you eat, not how much). Drug therapies are the same kind of thing, they seem to be a "free ride" allowing immoral indulgence versus self-restraint.
The reality is that having low income encourages poor food eating habits. Nutrient dense foods are expensive, while calorie dense junk foods are cheap. The primary reason for this is corn subsidies. Corn-derived foods and corn-fed livestock costs less, junk foods are processed for increased addictiveness, and the net result is that it costs less to have a satiating high-calorie, low nutrient diet than one that is appropriate for lifestyle.
What's so funny about this (and reinforced by the other replies to your post) is that people really object to the morality of other people "getting away with something" -- eating too much of the wrong food and not exercising enough.
I'm surprised they don't object to people with infections being treated with antibiotics, since if they had better hygiene they wouldn't get sick.
Why should you care if someone else is healthier by taking a pill?
Without all the illnesses caused by obesity the drug companies would be bankrupt. They will never sell any diet drug that solves more problem then they cause.
Stop starving your body by living on quick rushes of carb, and get off your ass.
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Yes, mod as "troll" - much easier than making a counterargument.
Do you have ESP?
This is typically due to eating too much starch and junk food. The problem isn't caused by being poor, but rather is correlated with the same bad financial habits
Being poor certainly has something to do with it. The cheapest foods by weight that you can typically find in a grocery are rice, pasta, oatmeal, dry beans, and potatoes. So if you're poor enough that you really have to watch your food budget, you will be eating basically starches with a bit of protein mixed in and maybe a couple of carrots a week. Sure, you're going to be eating less of it, but that may not be enough to offset the sheer carb load.
The case of people ending up penniless after winning the lottery is hardly uncommon, and often referred to as the Sudden Wealth Effect. Pro athletes are also frequently victims of it, and not infrequently lose everything they've earned by the time they're 40 years old. The biggest problem is this: As soon as you're rich, everybody who's ever known you, or kinda known somebody who's known you, or is working for a good cause comes knocking to ask for a handout. Imagine, for instance, that you are sitting on $20 million and your mother comes by and wants your help to buy a nice house: How easy would it be for you to say no? So you say yes to your mother. But now your brother wants the same thing. And your sister. And your cousin. And your best buddy Vinnie from high school. And so on. Former NFL quarterback Bernie Kosar mentioned that a lot of people who knew him had his payday circled on their calendars, because that was their payday.
And for the record, I've experienced both being dirt poor and wealthy enough that people regularly try to hit me up for cash.
I am officially gone from
I'm a doctor, and I consider obesity as a symptom with a cause rather than a disease. When I'm treating patients, treating their symptoms is less preferable than finding treating the underlying cause. For example, if one of my patients was anaemic, I'd be inclined to first discover the slowly bleeding tumor in their ascending colon rather than start them on iron supplements. The tablets would fix the anaemia all right, but the underlying cause would still be there.
It's the same with obesity. Obesity is never there for no reason and there are myriad causes for this presentation. It is not as of itself, a disease. The summary and article suggests that physicians are being somehow stingy or prejudiced when the don't prescribe these. I'd imagine the opposite is true, that they are rightly regarded as an end of the line treatment before drastic interventions such as surgery and not to be prescribed willy-nilly. This is even more true considering that they are so new and the only trials which have been done were performed by the drug company. In a life-saving drug, I'd be inclined to prescribe these medications but with these, I'd be more inclined to see if any side effects emerge in the general population in the way that they did with Vioxx (rofecoxib)
I am slender and everyone in my family is slender. Therefore I don't really care if strangers get fat.
The last popular diet drug worked too well. It also reduced your heart valves. So I can fully understand why doctors don't want to prescribe these things...
So does crystal meth, high doses of caffeine, any other stimulant. The only downside is they tend to make you crazy and/or kill you.
Having been alive before the US went into hambeast mode, I note that the poor weren't fat fucks back then.
Eating habits changed, ideas of personal responsibility changed DRASTICALLY, and self-destructive behaviors became accepted.
Dear fatasses:
You are not "big", a "BBW", "thick", etc. You are a tub of shit by choice and no respect is owed that choice because it is so very self-destructive. If you defend that choice, no respect is owed to you as a person because that level of stupidity is more disgusting than your rolls. Do what you will but don't expect validation.
Put down the fork, stop snacking, purge your home and life of junk food, and toughen the fuck up. People today HATE that message because they are willing to be conditioned to passivity.
I do a lot of my shopping at Walmart (due to location) and when I changed my eating habits it cost LESS than buying shit. There are many aisles in a super market you can and should completely ignore. Eating healthy doesn't suck and there is plenty of tasty good food made available by the same businesses who will sell you garbage if that's what you want.
"This post is an artistic work of fiction and falsehood. Only a fool would take anything posted here as fact."
But reducing the amount of fat in people who are overweight / obese will still increase a person's health.
1) Obesity is not a disease, it is a choice
2) It is not a choice of poverty, except for wildly ludicrous values of "poverty" in which the "impoverished" can still afford ample enough food to become obese
3) The medical profession has no interest in treating obesity because it is a cash cow for the industry. Obesity is job security for doctors
So, just because you were lazy and didn't "try harder" earlier, you assume everyone is just as lazy, and just needs to "try harder".
Well, guess what, not everybody is like you.
Your personal physiology is identical to everyone elses', and so what worked for you will also work for every single other person on earth? Great! Spread the news! With this astounding insight, the obesity epidemic will be cured in no time!
Wait? What's that? You mean the metabolic pathways for storing and releasing energy are complex and very different from person to person? You mean that the body actively fights to retain fat stores when less energy is available resulting in crippling pain, headaches, listlessness, inability to cocentrate and insomnia? You mean to say that obesity is caused by numerous interrelated factors that each require corrective action in concert to be effective? It even says so in TFA? Well shucks!
Who'd have thought an illness that 100 million people are unable to cope with might actually be difficult to cure?? No, no! That can't be it. Let's just say they're lazy gluttonous porkchops so we don't have to find solutions to a difficult problem. So much easier for us to sleep well at night.
Scientists point out problems, engineers fix them
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Im always amazed at the level of anger when the topic of obesity comes up. If there is a pill that helps fat people get skinny, so what? The logic must go like this "I put so much work into being fit, I am upset when someone else gets similar benefits without that same effort."
Manic
A tragic result of the aggressive way the US have enforced their ways to literally all over the world has put aside classes of drugs that are so much beneficial text they are presented as maladies, like amphetamines opioids etc. two things: I dont have anything against the middle US citizen, they don't know and they act because of manipulation. They do need to wake the f up. Second opinions regarding these things are and must be accepted only earn someone has actual experience, like I do. Amphetamine is by no means more addictive than coffee. I mean pills, no smoking, mainlining, even snorting qualifies but let's stick to pills. I use these for years, they are incredibly safe to overdoses, and billions would have been saved from the pharma lobbies researching $hit that make teens kill out entire classes with submachine guns. Likewise for opiates, and you average Joe who have your Ativan or Xanax will have a hard ass time to kick it than morphine or heroin. Again, I'm talking oral stuff made lie every other drug. Those who don't gave a clue but gears of the war on drugs go enroll yourselves. If we follow this path we should ban booze, smokes, guns, and a bunch of other things. Can your economy stand closing JAILS, COURTS, PHARMA INDUSTRIES, LAW ENFORCERS, and CUT DOWN MORE THAN HALF of their employees ? You know the answer.
There was a story on CBC.ca the other day about how it actually costs $2000 more per year for a family of four to eat healthy foods. Imagine that, roughly $200/month extra for healthy food. That's insane.
Economically, it's tough: starchy foods loaded with carbohydrates have been promoted for the past 30 years as being "good" for you so that they are the foods that are produced the most, and thus have the lowest cost. Making the switch to fatty foods, vegetables, fish, and meats would require a complete turn around in the food economy - a really difficult change to affect.
It's going to have to be driven by people consciously making the decision to eat better. I'm not holding out hope for that, though.
This is basically what Dr. Joel Fuhrman M.D. would say. He writes extensively about this on his website for free as well as publishing a number of books and helping patients in his practice. Losing weight is simple when you stop eating bad stuff and eat a proper diet, but you do need to follow the physicians advice as regards the bad stuff. It is not obvious what is bad to eat and what is good to eat unless you research the medical literature like Fuhrman has done, or you follow Fuhrman's advice.
Neal Barnard M.D. is another physician who also focuses on corrective diets in his practice. And there are others as well.
None of these M.D.s would prescribe the diet drugs because they are completely unnecessary.
i am sorry this is not biochemistry this is made up "science". When ketosis is entered (by depleting ready carbohydrate resources) the body can metabolise fat into ketones (via the liver). The reason this myth persists is because for decades medical researchers couldn't imagine the brain running without glucose, which is a necessary condition of ketosis.
A bit of medical history: Prior to the 1920's or so, ketogenic states were commonly encountered in two medical conditions: Epileptics, and Type I diabetics.
For epileptics, a ketogenic diet was one of the few methods of seizure control available, prior to the invention of anti-epileptics -- the whole goal was to run your brain mostly on ketone bodies. It's still used in some difficult cases, although it takes a great deal of discipline and attention, as the requirements are stricter than what a weight-control ketogenic diet requires.
For the Type I diabetics, a ketogenic diet (with intake set at near-starvation levels) was the only way to keep them alive, prior to the discovery of insulin -- but it could not keep them healthy, as they gradually wasted away and either died in a state of starvation, or in a state of diabetic keto-acidosis. Once mass-produced insulin became available, the skeletal figures of diabetics plumped up, and the ketogenic diet fell by the wayside.
Unfortunately, these two medical uses of the ketogenic diet also meant that the ketogenic state became associated with disease conditions, and thus something to be avoided.
I as a person that struggled w/ weight his whole life, I have to say that 99.9% of stuff in popular culture, and that which is marketed to people is wrong. [Including posts in Slashdot.] Well not wrong in totality, but wrong because it's not a life long way to good health and proper weight. After much reflection and self experiment, the only way that works for me, long term, is adopting the following:
- Staying moderately active on a continual basis
- Primarily eating a low fat, whole food, plant based diet
I'm now about 90% vegan for health reasons. There are tons of questions most people have, as I would have had myself just four years ago. Four years ago, I was pounding 12 egg whites at a time, eating like a body builder, because that was my background. Did it work eating 200gs of protein a day and limiting my carbs, yes! But then, my will would be clouded by all the other stressor of life and I'd be back to 20% body fat within a few months. This kind of diet, though containing little red meat, didn't help my heart either - my genetic gun is loaded, like many others, to have high blood pressure and high cholesterol. So at the age of 31 my doctor was already saying I was borderline and recommended drugs. So the saying is, "we could tell him to eat straw, but he won't, so here's some drugs." I didn't want to take drugs as a first resort so I began to study and found out about plant based diets. The next year I went back to the doctors 25lbs lighter [170 down from 195], with a cholesterol level that was a little over 200 down to well under 100. During this year I maintained, and maybe even gained, a few pounds of muscle. The best thing of all it's cheap, satisfying, and I never have to worry about over eating. I can eat 2 big bowls of potatoes and veggies each meal, 3 times a day, and loose 2 lbs a week. [I'd recommend more variety though.] Then when your out and about with friends and family for Thanksgiving eat some turkey, but keep it only for those more special occasions.
There's a reason all the top doctors recommend more plant based diets to people like Bill Clinton. Because they work best for the human body, scientifically for long term health. Protein, is a non-issue unless you want to get really jacked and go beyond you genetic limit. Gorillas eat a 90-100% diet of plants and look at them. People today think meat is more health then it is because they're addicted to all the fat in it, and who doesn't want to find out that their bad habit's are good for them. People don't realize that a 95% fat free cut of beet isn't 95% calories from protein and 5% calories from fat, it's by weight and the calories from fat is closer to 50%. Ever wonder why you don't see a % sign next to amount of protein on the nutrition label? Because the amount of protein required scientifically is way less than the dairy farmers and meat producers would like to have you believe.
Hope this helps someone.
It isn't a win because a pill isn't going to stop diabetes (for example). Losing weight can be hard, especially (ahem) when you get above 40 but it isn't impossible. Pills like this should be reserved for the morbidly obese and should only be used in conjunction with mandatory and perpetual doctor care. The goal isn't weight loss. The goal is good health. You can have a BMI of 10% and be in horrible health with diabetes and any number of other ailments.
Get your PostgreSQL here: http://www.commandprompt.com/
Eh, lets put cheep diet drugs in the checkout aisle, ready for impulse purchase, and make chocolate available only by prescription and so expensive you need insurance to afford it. Just to see what happens.
Hi mate, I'm a type 1 diabetic in my mid thirties and I empathise completely with your comments and hope you're looking after yourself and keeping your HbA1c levels as low as possible.
In my experience I am constantly surprised by the lack of actual knowledge and education about diabetes. Sure, there's lots of awareness, which is good, but nobody seems to actually know anything. And unfortunately, I have to include doctors in that category. I've had the good (or bad) fortune to have my condition assessed in four different western countries (US, Canada, Australia and the UK) and found that only half the doctors I have seen could actually give me helpful and constructive advice for the treatment of the condition.
Having said all that, I also notice a massive difference between the advice from doctors regarding exercise, dieting, and losing weight. The problem (as I see it) is that the primary goal of diabetes care is to stabilise blood sugars. Which makes sense, and is obviously a good thing. But going beyond that, and wanting to lose weight or be an athlete, is not well supported by the medical field at all.
So, if I could offer some advice for you, don't give up hope and don't accept that you can't lose weight due to the diabetes. The comments you made about planning ahead tell me that you really know your stuff and you are very self aware of the condition and what is at stake. Which is great! Just try and take that to another level and build more exercise into your plan. Yes, your insulin requirements will come down, but you monitor this as you currently do normally, keep an eye on things and adapt. Something to be aware of is that exercise makes me more sensitive to insulin for about 24-72 hours. On top of that, after exercise my blood sugars are high. DO NOT treat post exercise high blood sugar with insulin, you will hypo within an hour. Instead, just chill and drink plenty of water and your sugars will come down quite happily by themselves. Of course, this is what happens to me, and your body may be different. Sorry if any of this is stuff you already know, I don't mean to be patronising, just helpful. Finally, my specialist is a huge fan of Metformin. It has protective benefits against heart disease, makes you more sensitive to insulin, lowers blood sugar over a nice long period of time, and helps to reduce apetite. I was told that 2g per day is the effective dose that's right for me and that patients should take as much as they can "handle". I say it like that because the side effects are stomach upsets, gastric pain and diarrhoea, which as you can imagine isn't the best of fun. So I take my full dose of Metformin and a small (10U) amount of Lantus each day and that keeps my basal blood sugar pretty much perfect. Most importantly I can go to the gym without eating anything and not have a problem with hypos. I only take Humalog for large meals that I have no control over: so a dinner party, or special meal, but in general I eat low carb meals and don't take any Humalog at all. I also gave up drinking about six months ago, which changed my life for the better, though have a glass of red wine every month or so since I love the flavour, and there is a protective effect against heart disease in those low amounts.
To be more active I would encourage you to be firmer with your own personal plans. I set a fixed time for exercise each day and it carries as much value in my day as a meeting with the boss or lunch with the girlfriend. I do not allow it to be moved or messed with, and so I get to the gym (or swim, or jog, or cycle: diversity helps!) every day for my little workout.
Anyway, I just wanted to reach out and say G'Day and let you know that you can do it and you can get your weight down, even with diabetes. Maybe my own experience has been helpful for you, or others here, but regardless, good luck with everything!
I have been to my share of doctors, and while a very few commented on my weight saying I needed to lose 20-30 lbs, none of them every prescribed healthier eating habits and exercise. Doctors seem to be about treating illness and disease not maintaining health by building healthy habits in their patients.
It was not until I started taking responsibility for my own health, by eating more raw green vegetables, dramatically reducing the amount of refined sugars and white flour. When I lived in the US I gave up red meat, pork and poultry chocked full of steroids and antibiotics. One of the more interesting traits was my shopping patterns in grocery stores. I spent 90% of my time in the produce area and virtually none of my time going up and down the aisles where the "value added" products were on display.
Vigorous exercise at least 3 times a week has to part of the regimen.
I think doctors seem to ignore these common sense measures and as a whole the industry has not geared its practice to promote and encourage these lifestyle choices. Perhaps there is less profit in curing the affliction rather than treating the disease ?
Fen-Phen worked great for 70% of the people who used it. Unfortunately it caused heart damage in about 30%, up to and including death. Wyeth says it has set aside over $21 billion to settle damages from suits.
Help stamp out iliturcy.
His basic assertion that if people eat less calories than they expend they will lose weight is 100% correct. Saying "it's a complex disease and the body wants to store fat and there's different metabolic pathways" is irrelevant - if you eat less, you will lose weight.
Slashdot: providing anti-social weirdos a soapbox, since 1997.
Here are two more 100% correct assertions: you can live forever as long as you avoid death, and you can be wealthy by earning more money than you spend.
During World War 2, the "Minnesota Starvation Experiment" was conducted. 30 healthy men had their maintenance level of calorie intake measured for a month or two, and then had that calorie intake cut in half with no changes to their daily minimum half an hour of exercise. At the end of the study, the participants had an average drop in resting metabolism of 30%, and that's not 30% lower than when they were heavier, it was 30% lower than predicted for someone at their new skinnier sizes. Most of the men had developed an eating disorder, a mood disorder (bipolar, depression, etc...), an obsession with food, or all three.
The devil is in the details.
That's a very tyrannical way of putting it. Some people can only afford to eat calorie-rich food, and many of them don't really eat that much of it. If you want them to cut their portions to lose weight, you have to be willing to look them in the eye and say "You know all those other stressful priorities in your life, like trying to find a way out of your poverty? Forget those and just eat less, no matter how hard it throws your mind and body out of whack, because you're a fatass who can't afford compassion."
Yes - and it can also make you very sick at the same time. People have starved themselves to death whilst remaining obese.
To simply say "eat less, you'll lose weight!" makes as much sense as saying "just remove all the microorganisms from your blood stream, and you'll be cured!" Simple, right? Whilst technically correct, unfortunately it is not at all a useful suggestion. The sooner people stop deluding themselves with trivial knee-jerk responses that tacitly blame the patient, the sooner we can make progress to finding an actual solution for a real problem. Remember: if it was that easy, nobody would be fat.
Scientists point out problems, engineers fix them
altslashdot.org: The future of slashdot.
It is the cause. It IS a social one.
It is because of corporate food production, factory farming and industrial "recipes" that make cheap and plentiful Soylent Soy or Corpulent Corn - with added glutimate to overstimulate appetite generation.
These are the product of an agribusiness that has made this production a part of public policy, through the US Farm Bill and other legislative manipulation.
If you are deliberately misinformed, marketed to death, and underpaid, the last thing you need to solve for the attendant health effects is more pills. It's like plugging your nostrils, because you have a cold.
But I bet the pharmaceutical and health-insurance rackets love the idea...
"Flyin' in just a sweet place,
Never been known to fail..."
Your first statement is technically correct, much like the GP, but misses a key piece of information that everyone is trying to drill into his and your head, which is when you body detects it's getting less calories it works AGAINST YOU by trying to burn as few calories as possible. So by eating less calories and exercising, many people end up with all the lovely health issues listed above. So unless you're saying that crippling pain and insomnia are the costs for losing weight, "it's a complex disease and the body wants to store fat and there's different metabolic pathways" is completely relevant.
Your second statement, the typical oversimplification of the first made by people with prejudices against the overweight, is flat out wrong. If you eat less than you eat now, you will not necessarily lose weight. Millennia of evolution will scream at your body telling it that starvation may be coming and it will do everything it can to reduce metabolism in response.
So, the reason why these pills work and should be taken seriously is they appear to counteract or block the starvation response to reduced caloric input which causes all those lovely crippling side effects for the large number of people who are just not cool enough to be thin by will-power alone. Now, feel free to continue on acting like you're somehow a special snowflake on the internet by picking on the over weight.
All this even though the children of obese parents are more likely to obese even when they're raised by someone else.
Another factor that often gets overlooked in this debate is the role of sugar in our diet. (Here's a written summary of the video.)
Last spring, the convenience stores in my area started stocking fresh fruit, so I switched my habitual breakfast from coffee and a Snickers bar to coffee and a piece of fruit. Around the same time, I saw the video linked above, and started actively avoiding sugar whenever it's convenient. These are the ONLY changes I've made to my lifestyle, but since then I have lost about four inches off my waistline.
Sugar is toxic. Do yourself a favor and avoid it. (Did you know that a 12oz can of coke does as much liver damage as a 12oz can of beer?) And artificial sweeteners are even worse. They mess up your insulin response profile and impede the signals which tell your brain when you've had enough to eat. (If you have a diet coke with dinner, you'll likely eat more food.)
The BBC did a four-part series on the "weight loss industry" earlier this year. It does a pretty good job of exposing the hype and marketing BS behind our current situation. Worth a look.
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
if you eat less, you will lose weight.
Maybe so, but that doesn't mean your weight loss will be 100% FAT loss. On the contrary, consuming less calories can also cause your body to store up MORE fat, to compensate for the food shortage. Numerous studies have shown this effect... you just end up with a smaller "fat" rat than the control subject.
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
There's a whole raft of class consciousness and outright warfare here.
Eat healthy foods, get lots of exercise is great when you're a software weenie making $100k a year plus options and your "falling off the wagon" is when you have to spend a couple weeks of all nighters pushing the next release out. At least you'll be able to hop on your $3000 mountain bike and zip over to the farmer's market at the Ferry Terminal to check out the free range caviar as a taste enhancer for that special goat cheese made from organically raised goats with the finest genetics imported from the Hindukush (where people live to be 100 years). I know, that's a bit extreme, but you found out about it at your daily yoga class from the young lady next to you.
Now, let's think about Mom with 2 kids (oops daddy got shot because he was in the wrong place at the wrong time when the gang came by.. damn, can't those gangbangers understand gun control? TWO hands on the weapon, son). She has to get those kids off to school early (thank god they're in a Title 1 school, so they get fed at school, yeah, it's probably burritos with lots of fat that cost the district 0.35 each, but hey, it's calories) so she can get on the bus to her first job. It's not quite minimum wage because she's technically a "trainee" and there's an exception for the food service industry, but at least she gets 15 hours a week, if she's *nice* to the manager. And then she has her other job, also at minimum wage, but she gets only 30 hours a week there, and it's an hour bus ride between the two (it's only a couple miles, but because of tax cuts, the bus only runs once every 40 minutes). So she's spending about 50-60 hours a week AT WORK, and bringing in the princely sum of about $360/week. She has to spend about $600/month for rent for a crappy 1 bedroom apartment (no, she probably doesn't get to live in "beautiful studio apt, only $1651/month plus first& last" (searching Craigslist for south central LA. Or maybe she's lucky and got section 8 housing in Nickerson Gardens). And another couple hundred on utilities (she needs that cellphone so she can call in for her work schedule, which changes every other day).
Yeah, she's gonna spend some more hours on the bus going to Santa Monica's 3rd street farmer's market? Nope..
She's going to spend her money on the highest calorie/dollar food, and guess what.. high fat, high sugar, high processed is what you get. At least the kids don't complain too much about being hungry.
Gahhhh...
(tl:dr The drugs work. People think about obesity wrong.)
To those that say they don't work, I would suggest you look at the trials. One of the differences between these regulated prescription drugs and supplements or (most) diets is that there are actual double-blind placebo controlled studies behind them. They do work. There is very good research to show that they do.
Qsymia, which I am on, gives an average of ten percent body weight loss beyond placebo, and the weight stayed off out to two years, which was the end of the study. I went from 269 to 253 in my first six weeks (13 pounds or 4.8%.) I feel much better now, and I have taken up weight lifting again. My weight isn't dropping, but I am clearly losing fat and gaining muscle. My weight is pretty stable, but I can feel ribs that I haven't felt since the nineties. None of my leather belts fit anymore. I'm wearing a belt with a friction buckle until I stop shrinking.
I also just got my quarterly labs back and my A1c is down 1.2% and my lipids are great. I'm getting lightheaded when I stand up too fast (orthostatic hypertension;) I have an appointment next week to talk to my doctor about reducing my blood pressure medication. You don't just lose weight, but the comorbidities go away with about 5% weight loss.
The main problem with obesity drugs can be seen in the comments here. People for whom obesity is not a disease don't understand what it is like to fight the disease. I'm old enough to remember when depression was treated the same way as obesity is treated now. Polite people said "try to think happy thoughts." "Just snap out of it" was a more common response. Today most people understand that some people have broken brain chemistry, and telling a depressed person to work harder at being happy isn't going to work. The researchers understand that obesity is a disease, and telling people to work harder at being healthy isn't going to work either. But most people don't understand that yet.
To the person who said diet pills are short term only, you are right and wrong. When a person who is on medication for a chronic condition stops taking their medication, the condition returns. That is how you know the medication is working. Obesity is a chronic condition. Because obesity was once thought of as something that could be cured, like an infection, pills used to be given for a short period. People would lose weight on the meds, the doctor would pronounce them cured, they would stop the meds, and they would regain the weight (and the high blood pressure, and the diabetes, and the dislypidemia, and all the other fun stuff that goes along with central body fat.) The researchers and educated doctors now understand that obesity is a chronic condition that responds well to medications. (It also responds very well to *intensive* lifestyle modification and surgery. Most doctors miss the word "intensive" in that sentence, which is the subject of another rant.) The current expectation is that you stay on the drug the rest of your life, possibly with drug holidays.
For me, Qsymia has been life changing. I had lost about 100 pounds of fat over about six years, but I was stuck and I still had type 2 diabetes, high blood pressure, and horrible lipid numbers. I was working out, hard, at least eight and a half hours a week plus two 50 minute weight lifting sessions with a private trainer. I watched what I ate, but I was still obese and I still had the health problems. Eventually I got discouraged and stopped working out hard. I still did 300 minutes a week on a treadmill, but I wasn't killing myself in the gym or lifting. Interestingly, I lost muscle and gained a little fat, but it made very little difference to my overall health. With Qsymia my eating changed dramatically, I lost a bunch of fat, and my lab numbers got better.
Whether you prefer anecdote or data, the result is the same. Qsymia is a game changer.
(Some disclosure. I'm a computer guy with no medical training. My girlfriend is an MD wh
So where are these studies of these 100 million people who eat a balanced diet and get plenty of exercise (REAL exercise, not swiping their cards at the gym then sitting on a weight machine watching TV), but still can't lose weight or be in shape? I've yet to meet someone overweight who wasn't entirely responsible for their state. And yes, it is pure laziness to eat shit food and never set foot on a treadmill.
I have a couple of good friends that have lived in poverty nearly their entire lives. I know this does not apply to everyone but this is their situation.
1. They are fat.
2. They do not work.
3. They do not eat they drink beer and smoke all day.
4. Not two fucks given, they are perfectly happy with the way they live.
There is nothing that can be done to fix that, they are poor and will always be poor until they die. Until then everyone else gets to foot the bill.
If poor people are overweight, then they just need to spend more time with their personal trainers.
Clearly, it's a matter of laziness.
You are welcome on my lawn.
Hello,
I'm a weight loss and weight long term control success story, more or less. But having done it, I know exactly how hard it is.
I'd love it if the US population could dump their extra pounds by taking a pill. It'd just be a win for everyone, and the only people who'd "lose" are those who feel superior because they've managed to do it without the pill.
And even THOSE people will be paying lower health insurance premiums because the population is healthier in general.
If the pills really work, BRING 'EM ON! Who knows, if I can't exercise some day (I'm currently taking a few weeks off because I got rear-ended in my car!), then I'll need them myself!
--PeterM
Health is something that isn't nearly as simple as almost everyone seems to love to believe. The truth, based on current medical evidence, is that something like 60% of "obese" people are by all metrics besides BMI perfectly "healthy", while something like 60% of the people who are part of the epidemic of diabetes and afflicted with massive amounts of cardiovascular disease are people of normal body weight who everyone assumes are "healthy" solely due to their "normal" BMI. It just plain isn't that simple.
Obesity, diabetes and cardiovascular disease have been proven in recent decades to not be nearly as well linked as almost everyone still believes. Getting the obese to lose weight with pills therefore will not necessarily result in a strict increase in overall "health" of our society. In fact most of the pills that help promote weight loss have been shown to cause rather extreme negative side effects. Such as fatal heart attacks.
Everyone still believes that you must stay away from saturated fats and cholesterol, even though it's been shown over and over again that increasing or decreasing "dietary" fats and cholesterols has almost no link whatsoever to increasing or decreasing levels of fats and cholesterol in the body and blood, most of which is created by your own liver. In fact, if I'm quoting Dr. Lustig correctly, the link between the ingestion of the fructose molecule and bad blood glucose, fat, cholesterol and triglyceride levels is about 50 times better than the link between those things and the ingestion of any kind of dietary fats. Yes, fructose. According to Dr. Lustig's research, fructose, and its close relative ethanol, may be the root cause of metabolic syndrome, obesity, diabetes and the explosion of cardiovascular disease. Not starches or dietary fats.
Also quoting Dr. Lustig, evidence indicates that approximately 99% of human beings cannot maintain any form of weight loss for more than a few years, if they even succeed in losing any weight the first place, which most people don't. Thus, no matter how long everyone continues to insist that obesity is a personal willpower problem that should be solved by the individual... THIS. WILL. NEVER. SOLVE. THE. PROBLEM.
EVER.
If we really want to solve the societal pandemic of obesity we need to completely discard the idea that it's caused by some personal moral failing (of the lower classes, no less). We went from 10% to 60% obesity over the last 40 years. If we keep relying on the magic pixie dust of "personal responsibility", 90% of our grandchildren's generation will be obese and 90% will have diabetes starting from early childhood regardless of body weight. There is a systemic problem in the modern diet that is causing this explosion of obesity and diabetes, and we need to find PRACTICAL solutions that fix it on a society-wide basis.
Linky:
http://www.youtube.com/results?search_query=lustig+sugar&sm=3
A placebo will work if you get the right one.
Qsymia and Belviq work by suppressing appetite and by increasing metabolism, and by other mechanisms that are not yet fully understood.
I'd say this is why. Popping a pill to change something that is ultimately the result of a million years' of evolution isn't something that should be done lightly. We're still infants, what do we know?
...treat the cause: carbohydrate intake.
Carbohydrate intake drives blood sugar.
Blood sugar drives insulin.
Insulin drives fat accumulation.
Stop eating carbohydrates. It's simple.
Prescribing drugs for obesity is like prescribing a drug so that people can continue their heroin habit without suffering some of the typical "nodding" effects.
The medieval Christians had their list of the 7 Deadly Sins (Sins that may lead you to eternal damnation). Fat people are the living embodiment of 3 of them - Sloth, Greed and Gluttony. We look down on fat people because they offend our sensibilities at some deep, almost unconscious level, that we have as a bone deep part of our culture. (Not saying it's right, just saying why.)
None of them can see the clouds; The polished wings don't care.
Getting crappy processed foods and sugary drinks off the shelves is the way to go. Unfortunately that won't happen without changes in their marketing. These low-nutrition "foods" are addictive, if only because they cloud the brain into seeking another quick fix.
Unhappy with the cost of health insurance? One third of U.S. healthcare costs are attributable to weight issues.
The doctor talks about food intake and exercise because they are the options with the least side effects. If he assumes its because of lack of will power, he's an arrogant dick.
Energy balance always holds (1st law of thermo and all that), but if your doctor believes the energy balance consists entirely on food intake and exercise he is assuming two things:
1. No one ever takes a shit, urinates, sweats (100% of food energy is converted to body energy).
2. Core body temperature is only maintained thru constant exercise (no heat is generated while sitting on your butt)
Of course this is not the case. So the energy balance is really:
food energy in = (unconverted food energy) + (resting heat transfer) + (heat transfer thru exercise) + (energy storage)
In other words, you do eat too much *given the other conditions*. You can increase unconverted food energy by eating things that don't digest (Olestra, high fiber foods, high moisture foods). You can take amphetamines to boost your resting heat transfer. If you're not interested in anal leakage or addiction, you're pretty much left with eating less (in terms of calories) or exercising more.
Have you ever heard the term "healthy body, healthy mind"? Well it's true.
Your idea of easy must be very different than mine. I can jog five miles easily. I can prepare and eat healthy foods easily (and inexpensively). It's all a matter of how complacent you've allowed yourself to become in your living situation.
If you read the results when they publish stories about these drugs they're not effective for weight loss. Sure, losing 5% of your starting body mass in a year sounds great unless you can do simple math. If you weigh 300lb that means you'll lose 15lb in a year, just over a pound a month. Now read the pages of potential side effects and tell me that's a worthwhile medication.
Sadly the ONLY effective weight loss drug was amphetamine. They stopped using it almost 50 years ago. I think that it deserves another look as an effective weight loss drug. Yes it has side effects but all of them do.
For everyone doing the "eat less, exercise more" or "do this fad diet by cutting essential food groups" rhetoric - shaddap. I see weight loss drugs as a way to get a person down to near a healthy, maintainable weight and then they're done. During the assisted process is where counseling and monitoring come in. By the time they've lost the weight they have made lifestyle changes to keep it off.
I'm overweigth. Not a lot anymore, because I've lost a lot of fat. But, and I'm speaking from experience, it is NOT easy to keep the weight off.
Some people can eat a lot and stay thin as a rail, but I can eat a small amount and still gain weight. You would be right in saying that I should eat even less to keep the weight off and you would be right. But when I feel like I'm effectively starving to keep my weight under control it really isn't easy. I exercise above average, I eat way below average, and still I have a hard time to keep the weight off.
Seems like I am very efficient at taking energy out of the food I eat. I really wish that wasn't so.
To summarize: not every fatty eats a lot of unhealhty food. A lot are, believe me, but loosing the weight takes a lot more discipline than it would for normal (for lack of a better word) people. The body is a weird chemical factory, that much is sure.
They're "poor", not in poverty. Two different things.
Do you have ESP?
This is typically due to eating too much starch and junk food. The problem isn't caused by being poor, but rather is correlated with the same bad financial habits
The biggest problem is this: As soon as you're rich, everybody who's ever known you, or kinda known somebody who's known you, or is working for a good cause comes knocking to ask for a handout.
Read about the guy I was talking about. He bought a mansion, a million dollars worth of cars, a lear jet - all in the first year. He blew $12M in the first year. It had nothing to do with people hitting him up for cash - he blew it.
Do you have ESP?
Pithy advice about eating certain foods and exercising works if you can tolerate "healthy" foods and your body can tolerate exercise. That's what people tend to forget.
I've always said that food does not make you healthy, but that only healthy people can tolerate "healthy" food. Cause and effect are backwards.
Yes, eating less will make the fat go away, you are right on that part. But how much less would one have to eat? For some people the amount of food they can eat before they store it as fat is very, very little. It is a fact that some people can eat a lot and stay thin and some can eat a little and get fat. Yes, those fatties can eat even less and loose weight, you are right about that. But they (yes, I'm talking from experience) would feel like that are litterally starving on the little bit of food they can eat.
Example: I gain weight when I eat three slices of bread (with low calorie topping, or none at all) and 200 grams of vegetables a day. Nothing else, just that. And yes, I exercise at least an hour a day. I'm hungry 24/7/365. I feel like crap and close to dying, all the time.
Really, you couldn't know how it is unless you have the same experience.
Yes, you are technically correct. But practically, not every fatty is eating a bucket of wings for breakfast. Anecdote: I eat two slices of bread and 200 grams of vegetables a day. That's it, no more. And I'm overweight. Sure, you are right that I should eat even less, maybe one slice of bread and 50 grams of vegetables would make me get rid of the fat. Perhaps. Probably. But I feel like I'm starving (literally) 24/7/365 as is and eating less would make me, probably, rethink if life is worth it at all.
Bottom line: some people should lay off the triple cheese burgers, most should exercise more. And there are some that eat very little and still struggle. That you personally don't have that problem is your blessing. Not everyone is that lucky. I'm not, that's for sure.
Food is often social and portions are uncontrolled. This is especially true if you eat out a lot to get that social interaction.
There is a rather famous Cornell study that showed people will basically eat what's in front of them until it's gone:
http://foodpsychology.cornell.edu/content/bottomless-bowls-why-visual-cues-portion-size-may-influence-intake
A good trick if you eat out is to immediately ask for a "to go" container, and then put half your restaurant portion into the container, close it, and set it aside. Then enjoy the remainder and the social interaction that usually goes with eating out.
This is idiocy at best, I managed to lose more than 70 pounds in less than 15 months by doing exactly the following:
Cutting out going to the buffet 4x a week.
Journaling all my calories (I don't care about the protein/carbs/fat grams)
Walking 2-2.5 hours a day at 3 MPH (every day)
Doing 270 pushups (9 sets of 30) every other day
and doing dumbbell exercises with 20-30 pound weights every other day (same day as the pushups)
I went from 245 and a 44 inch waist to 168 and a 32/33 waist
I don't diet (if I want to eat something, I'll eat it), I don't do the gym (waste of money), and you need
to make a change in the way you eat in order to lose weight, plain and simple.
If this were true, then there would be no such thing as fat gay men.
Your wife is a likely victim of false memory syndrome. In other words, the psychologist planted those memories in her through suggestion. It's a really nice setup, your wife gets absolved of all personal responsibility for her obesity and the psychologist gains a patient who will be dependent on them for the rest of their life.
Drug addicts aren't constantly being bombarded with happy, uplifting advertising claiming how good it is to use drugs.
Yes they are. Often these adverts end with "Ask your doctor if $drug is right for you." And other times, they're Cheech and Chong movies.
You sound fat.
All this even though the children of obese parents are more likely to obese even when they're raised by someone else.
Ah yes, the old nature vs. nurture argument.
We've seen that people who learn skills can actually pass them on (and it's been proven out scientifically in mice) and so hell, maybe you can even pass on getting fat, let alone being fat. But it's still not a waste of time to do what you can to control your own fat. You might have a harder time, or you might never be able to have a certain kind of body, but that's not a reason to just give up completely — only a reminder to keep realistic expectations.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
Having read about a time before people in the US were unremitting assholes, I note that... oh never mind, there was no such time.
If you take a shit on people's emotional state, their eating disorder is only more likely to plague them.
You're right that they have to make the choice to not be fat, but frankly I don't think it's so simple as to say that people actually chose to be fat to begin with. Addiction is a real thing, and food really is addictive.
One of the biggest problems I see is that people don't know how to cook any more. I don't know what happened there, but it's pathetic.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
I started running 40 miles / week and lost 40lbs. No other changes.
How about just a poop transplant? The idea leaves a better taste in my mouth.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
It's because there is more money is pushing CHOLESTEROL, DIABETES, and HYPERTENSION drugs for the pharmaceutical companies.
TLDR, but as innocent as the original author is batting his eyes, he's forgetting to remember the debacle of the last big weightless drugs That is, Fen-Phen ( fenfluramine/phentermine) and Redux ( dexfenfluramine ) , both of which were well supported by trials, glowingly approved by the FDA and caused dramatic heart conditions often resulting in death in most people after even as little as 6 months use.
So maybe, just maybe that factors into why doctors are gun-shy about the new batch.
Mediator which is 2nd gen diet drug like those one, is killing adn has killed people.
Makers are currently being sued in France for manslaughter and negligence.
My Kingdom for a MOD point! This Khelden guy is just full of himself. The same BS gets said from Congress too, just try harder, pull yourself up by those bootstraps! No one ever notices that not everyone has boots.....
Yes, if you want to be fat and miserable, listen to a nutritionist. They'll tell you to cut out all tasty foods and subsist on grains and high-bulk low-calorie vegetables. This will leave you hungry (and on the pot) all the time but would cause you to lose weight if you kept grain portions under control. But most likely you'll add oils (e.g. salad dressings) and eat too much grain, and while you'll still feel like you're eating nothing but "healthy foods", you're actually overeating in total.
Stop eating bread.
Stop eating potatoes.
Stop eating sugar.
Lose weight.
I'd just like to point out the irony here of couchslug calling everyone else here Lazy Fatty McFatfucks.
Society wouldn't be so obsessed with telling other people what to do if obesity wasn't something that caused a visible change to a person's body. The bottom line? An awful lot of the feigned "concern" about weight loss is driven by people's own selfish desires for people around them to fit a personal preference of what they deem physically attractive.
IMO, so much of this comes down to individuals making personal decisions about lifestyle. Since I know myself better than anyone else, I'll use myself as an example. I think I eat "somewhat healthy". I grew up with a parent who worked in the medical profession and imposed a lot of rules on my eating, growing up. Never had a snack between meals under my parent's roof, for example, and got into the habit of never eating any of those sugary cereals for breakfast ... only the healthy ones like Special K, Product 19, Grape Nuts or Kellogg's "Nutri Grain" products. We always had well balanced meals, even if some of my mom's decisions and beliefs are currently considered wrong. (EG. I remember she avoided avocados, believing they were "too fatty" and therefore bad for you.) But here's the thing. I *also* decided long ago that computers and I.T. was what made me happy and was my career path. That's not very compatible with an "active lifestyle" since you're usually just sitting in front of a screen for 8+ hours a day. I could do what some people do, and go to the gym early in the morning or at night every day or two. But I don't, because it bores me to death and I have so many other things I'd rather do with those hours of my life.
So here I am in my 40's now and surely I could be in better health if that was my primary focus ... but I'm "good enough" to suit me, and IMO, that's ALL that should matter. I'm not the "ideal weight" but I'm not obese either. Last doctor's visit, everything checked out just fine, such as blood pressure. Could stand to have lower HDL levels, I was told, but they weren't horrible. I don't smoke and I don't even drink very often anymore, so I figure I have those things in my favor at least.
It disturbs me when I see other people in a very similar situation to myself, yet they're actually paying doctors to inform them they "need to lose 15 or 20lbs." and they're trying to make all these extra efforts towards that goal. If you didn't already decide for YOURSELF you want to do that, you shouldn't let someone else scare you into doing it now. Nobody ever "got out of life alive" anyway. Live a fulfilling life and live it the way YOU like. It belongs to nobody else but you, and only you can say if making a bunch of changes or compromises in an effort to add a few years onto it is worth it or not. (In my case, it's really not.)
The study conclusively proves that it's not a good idea to starve yourself on 1500 calories/day of low-grade carbohydrates. Considering their diet was also devoid of vitamins, fats, and proteins, you can't just say: "a ha! A diet composed entirely of pasta, potatoes, and rutabagas gave bad results - therefore, diets don't work!" It comes across as more of a rationalization than anything. There's also a lot of evidence than eating a diet of nothing but empty calories is bad for you, even if you get in plenty of food.
It's easy to imagine that the subjects would have had much better results if they were allowed to eat some fruits or vegetables with their experiment. Or eggs, or dairy, or meat. The experiment really bore very little relation to the expected diet of a person who wanted to lose weight.
Slashdot: providing anti-social weirdos a soapbox, since 1997.
All of the parent's comments are seeming to point toward one fact: refined sugars are simply bad for you. I did read, on Slashdot I believe, how rats had the desire to eat more after they ate high fructose corn syrup --it wasn't the case for corn syrup, only HFCS.
IIRC, the USA is the only country where our soda/pop have HFCS as the sweetener and not cane sugar. HFCS is in almost every processed food from bread to coffee creamer.
If you're in a poorer neighborhood, it's likely you don't have access to a standard grocery. I heard Whole Foods is tying to make a push into poorer neighborhoods in order to introduce healthier foods. They're starting in Detroit and I wish them success. If obese people don't get access to proper nutrition, then they're only going to make health care more expensive for those that do take care of themselves.
No sig for you! Come back one year!
...that will never be disproved, is the first law of thermodynamics.
"Our opponent is an alien starship packed with atomic bombs," I said. "we have a protractor"
Yes, I think this is a big part of the hate of the overweight. "They're getting to eat all the tasty food I'm denying myself, so I'll make them pay a social price."
I've always found it both disgusting and a bit amusing, the way people get so angry and upset when you dare to suggest that maybe they are not victims, maybe they actually could assert some control over the problem they're having. The earlier posts in this thread did not deserve a "-1, Troll" moderation. Stating what you actually believe in a sincere manner is not trolling. It's not a "-1, MakesMyDenialUncomfortable" mod for fuck's sake.
Everyone I know who successfully lost weight and kept it off for years did it by making permanent, sustainable, healthy changes in their lives. A few of them learned to like veggies and other healthy foods. Others did that and also formed the habit of regular exercise. The point is to consume fewer calories than you burn until you reach a new equilibrium. Like so many other things that upset people, this works every time it's properly tried.
It is a miracle that curiosity survives formal education. - Einstein
What's the point of mentioning this? You said these were 30 healthy men. "Healthy" implies they were not obese. They had already balanced their calorie intake against the rate of burning calories. Naturally, adjusting an already healthy balance is going to create problems.
This says nothing whatsoever about what happens when obese people reduce their calorie intake. Obese people got that way because they were consuming more calories than they burned. For them, reducing caloric intake sounds like a good idea (although an instant 50% cut sounds drastic - if that were me I'd make more gradual adjustments).
But your Starvation Experiment doesn't address this at all. Again what was the point of posting it?
It is a miracle that curiosity survives formal education. - Einstein
Junkie logic.
That's all this is. "Look, normal weight people can be unhealthy too!" (So it's okay that I'm obese...) "Personal responsibility never works!" (So I shouldn't even try...)
If we really want to solve the societal pandemic of obesity we need to completely discard the idea that it's caused by some personal moral failing
(It's not my fault that I can't control my diet or be bothered to exercise regularly. It's society!)
I've little doubt that this post will justify that package of Oreos you'll shovel down later. Damn society, keeping you fat.
Required reading for internet skeptics
Yes - and it can also make you very sick at the same time. People have starved themselves to death whilst remaining obese. To simply say "eat less, you'll lose weight!" makes as much sense as saying "just remove all the microorganisms from your blood stream, and you'll be cured!" Simple, right? Whilst technically correct, unfortunately it is not at all a useful suggestion. The sooner people stop deluding themselves with trivial knee-jerk responses that tacitly blame the patient, the sooner we can make progress to finding an actual solution for a real problem. Remember: if it was that easy, nobody would be fat.
"Eat less" isn't the same thing as saying "eat nothing or nearly nothing while failing to obtain the nutrients you need".
"Blame" is also a small-minded concern. When I personally needed to lose some weight, there was no concern with fault or blame. I (get this) *took responsibility* for my own condition and made some adjustments to it. Some sustainable, permanent adjustments that did not involve neglecting the nutrition I needed. It was never a problem after that. In fact it was one of the easiest things I've ever done. That's because I took responsibility and accepted that the power to change it was within myself, the exact opposite of victimhood. This is exactly what I never see from fat people. They're victims and they are hostile to the idea that they don't need to be. That's because they don't understand the difference between fault/blame and responsibility/power. That's the part that is "not that easy" for so many because we have such a shallow, small-minded culture that doesn't like to think too deeply about much of anything no matter how much better life can be.
All you are saying is that doing something the stupid and careless way won't yield a good result. This was already known.
It is a miracle that curiosity survives formal education. - Einstein
if you eat less, you will lose weight.
Maybe so, but that doesn't mean your weight loss will be 100% FAT loss. On the contrary, consuming less calories can also cause your body to store up MORE fat, to compensate for the food shortage. Numerous studies have shown this effect... you just end up with a smaller "fat" rat than the control subject.
If you gradually switch from "eating more calories than I would have ever needed" to "eating about the right amount, give or take" I strongly doubt you'll have this problem. At least that wasn't my experience. The studies I have seen were all concerning unsustainable fad diets that you could not continue using for the rest of your life.
It is a miracle that curiosity survives formal education. - Einstein
(Did you know that a 12oz can of coke does as much liver damage as a 12oz can of beer?)
So almost none at all? Heh.
Thing is, sodas are typically sweetened with high-fructose corn syrup. Only the liver can metabolize fructose. Personally, I drink water and only occasionally have a carbonated drink. There are lots of good reasons to avoid sodas; sugar is only one of them. Once you get used to drinking water, you'll wonder how you were ever satisfied drinking what is basically syrup.
It is a miracle that curiosity survives formal education. - Einstein
Weakness is "addictive". There is an ancient, proven approach to fighting weakness.That is identifying it and developing the will to fight it by struggle.
The same struggle athletes fight to be fit is the struggle everyone else must make if they want to be fit. Of course it hurts, but the horrible consequences of obesity hurt far more.
Life is struggle. Choose what your "pain" will buy you.
"This post is an artistic work of fiction and falsehood. Only a fool would take anything posted here as fact."
What bothers me is when people pretend that all bodies are created equal. I have two brothers that can eat anything they want (in whatever quantity) and never seem to put on any weight. Meanwhile I run 20+ miles a week (and have done so for 5 years) and strictly control my calorie intake just to maintain a somewhat overweight body (not morbid, but certainly not skinny).
They give me shit every time we eat together as a family for watching what I eat, reminding me that they can be skinny without ever having to put any effort into it.
In this thread you have a bunch of "skinny brothers" telling the rest of us we just have to quit cramming our faces full of junk food. They think they know the facts, when the truth is they don't know jack.
Your entire "argument" consists of a series of bare assertions. Please find below what you originally wrote. I have highlighted the problematic parts.
In the US, the lower classes (who are "poor") have a big problem with obesity (bare assertion). This is typically (weasel word, i.e. weakening adverb) due to eating too much starch and junk food. The problem isn't caused by being poor (bare assertion), but rather is correlated with the same bad financial habits (bare assertion) - specifically the inability to delay gratification - that's makes them poor in the first place. This doesn't describe *everybody* who is poor in America, but it seems (weasel word) to be a majority. Listen to Dave Ramsey for an hour (anecdote) and you'll hear people who are poor and yet make $100,000/year. Actually, just read a story yesterday about a guy who won $27,000,000 in powerball and died penniless a few years later.
That last sentence is also an anecdote.
If you would like to make a real argument, I can carefully explain to you why you are wrong.
Explain. Genuinely curious.
So you have evidence that obese people who lose weight don't have a similar reduction in metabolism? Please post it.
I don't think any of us fat folk are advocating that we all give up and live on twinkies, Pepsi, and booze. What I'm saying is that depending upon genetic factors, it's possible no amount of willpower will permit a given person to be thin - and anyone who asserts otherwise is a dick, and it's impossible to know just from casual interaction which people are fat from sheer laziness and which have a difficult or impossible fight to be otherwise.
I'm more like you than I am like your brothers, and it's still true.
Eat better, exercise more. It's not rocket science. And I bet it would work for 95% or more of obese people. It works for everyone on Biggest Loser, for example, and those are the fattest of the fatties anywhere.
I've never going to model swimwear, but I lost 40 lbs over 2 years and have mostly kept it off, with minor ups and downs. If I could cut out the muffins and ice cream I bet I'd drop 20 more.
However, a weight-loss pill would at least address all those issues caused by simply being overweight alone, such as joint issues, high blood pressure, and some fraction of diabetes incidence.
What's more, the less you weigh, the easier it is to exercise. Just imagine a 300 pounder trying to huff away on a hike or something. Losing the weight might be the springboard to a healthier lifestyle overall--something that perhaps would be unachievable with the extra 150lbs that are now gone.
And as you point out, obesity is partly due to consumption of low quality food. Low quality food is cheap--it costs maybe $2k more a year for a family to eat healther, I see in the news today. $2k isn't exactly peanuts to someone on minimum wage, and it could be "$2k and a lot of time" for someone who lives in a food desert.
Safe & effective "diet pills" might mitigate the damage and cost of a low-cost, low quality cheap diet--which is a win for everyone who pays into the medical system.
I agree that pills like "Pen Fen" or whatever it was called, that cause heart issues, need to be treated with caution. However, the premise of the article was that pills that are safer and still effective have come out, but they're not being used.
While it would be better for everyone to eat quality food and get appropriate amounts of exercise, a pill that mitigates the damage of NOT doing those things is just a big win for everyone.
The perfect should not be the enemy of the good, and we shouldn't leave an 80% solution on the table just because it isn't a 99% solution.
--PM
Part of my point is that you should not only care whether someone takes a "short cut" to good health, you should be HAPPY about it--because your health insurance premiums are going to go DOWN because other people are healthier.
It's flat-out in your best interest to make obtaining good health as cheap and easy as possible FOR EVERYONE.
--PM
A few years ago, my doctor prescribed something for this purpose to me with no argument whatsoever.
For some idiotic reason, it hadn't occured to me that state insurance wouldn't cover it. It doesn't matter how fat you are, and how much it isn't an issue of vanity, they won't. My understanding is that even most private insurers won't touch it. If diet and exercise haven't been working for you, or if you've deteriorated to the point that exercise is difficult, the only option insurance will ever consider is stomach stapling. They won't even touch the cheaper, reversible, and less harmful other surgeries that operate on similar principles. Only stomach stapling. That's it.
This crap usually costs around $200 or so a bottle, if I remember correctly, so basically they're only available to rich people obsessing over the last five pounds that won't fuck off of their perfect waistlines.
'murica
Said the fucking twig faggot who probably eats like dog shit and weighs 150 and wonders why anyone else could be fat. Fucking retard.
For the love of karma, mod parent up.
The calories in minus calories out crowd all need to die in a highly exothermic reaction. Body weight is controlled by complex biochemical feedback loops dominated by insulin, leptin, and ghrelin. Fructose kicks the insulin loop right in its nuts. Excess body fat and stomach stretching throws the leptin-ghrelin balance off.
If you want to solve obesity, step one is to require that food labels disclose their monosaccharide content, particularly for fructose. Step two is to ban HFCS as a food ingredient. Even replacing it with higher quantities of ordinary, all-glucose corn syrup would be an improvement.
People will reflexively scoff at this, but it's Puritanism. If you're a good God-fearing person, you'll have willpower and be able to lose weight. If you're fat, it's because you're a bad person. Doctors have prescription power because they're a different kind of better person. Why should a good person give a bad person something that will encourage them to still be a bad person?
Americans (at least) refuse to accept how pervasive the basic concepts of Puritanism are in our society. The "head & up, good, below the head, bad" attitude is everywhere and irrational. Read some Thaddeus Russell before you disagree.
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
when you make so much more money when it is fat?
"something like 60% of "obese" people are by all metrics besides BMI perfectly "healthy""
This is just false, don't you have any actual studies to link to instead of a doctor on youtube?
Thin is beautiful. Fat is disgusting. You are disgusting and you will never get an attractive woman. You are doomed to the ugly fat pigs that nobody wants.
Good old war-time extenuating circumstances: Lots of science gets done!
Doctors are reluctant to prescribe them because it's socially awkward for someone to look another person in the eyes and say "You're too damned fat and can't seem to control the Doritos going in your mouth so here's some prescription drugs."
We're in a time where people are rebelling against being thin. It's hard to stand up and say "You're too damned fat "
And you sound stupid. Way to go, hero.
"The level of hate and vitriol I hear coming out of the mouths of people in the fit and healthy crowd is borderline psychotic. People that attack the overweight, and regurgitate empty platitudes about diet and exercise, need to be loaded up into a pit, have gasoline poured on them, and set on fire. All us overweight people that struggle to just maintain ourselves on a day to day basis can stand over top and tell them to "walk it off" while they scream in agony."
Um, it's pretty obvious to any reader where the hate is actually coming from here. This in response to statements of simple scientific fact.
Life is difficult, for all of us, in different ways. We all need to learn to overcome our own struggles and nobody can truly tell me exactly how I personally need to approach mine any more than they can tell you what will work best for you, BUT, some facts exist whether we want to believe them or not, and "shooting the messenger" helps no one. It is much much much more complicated than just eat less move more, but the fact remains that if, by whatever means, one can manage to expend more calories than they absorb, they will, without question, lose weight. Sometimes there are other underlying physical or emotional problems that make it nearly impossible to do so consistently, but that doesn't make the statement invalid nor "hateful" in any way, it just means it's oversimplified and likely stated by someone who doesn't realize the full extent of that complexity.
Just about everyone COULD eat better than they do, and even if it doesn't cause some sort of miracle weight loss, it will still improve health. Just about everyone COULD exercise more than they do, even if it means taking the stairs before sitting down in the cubicle for 4 more hours. Once again, it still does help even if it doesn't cause some huge miracle. But if one resigns themself to "I can't" or " it's too difficult" or "there's no time" then very little progress can be made. I'm fine with using pills as a way to kickstart the process and show that yes, it's possible, but they're useless long term, and I would never even consider something like Topiramate that is really an Epilepsy drug but happens to have anorexia as a fairly common side effect.
And whoever modded that clearly very hateful and angry post as "insightful" should really do some more introspection.
So what's your definition of "works?" Because the people on The Biggest Loser do not keep it off and are doing things in a very unhealthy manner, including going against doctor's orders. There have been a number of exposes about how horrible things are "behind the scenes" there with everything from people being screamed at to exercise until they literally collapse to people peeing blood to purposefully dehydrating themselves for the weigh-ins but not being allowed to drink when the doctors say they have to for health reasons. Using The Biggest Loser as your example of how things just makes you look like a bigot who doesn't care what the means are as long as the end has a result (except, oh wait, there is no good result since no one could live like they do on the show so they immediately gain everything back).
So where are these studies of people who have lost weight and kept it off for over five years? The studies out there show that 95% of people who diet and exercise do not keep the weight off.
Dude, I eat lots of bread and potatoes. I also eat lots of rice and noodles and pasta. And Im not nearly fat. But I don't eat meat, nor do I slather everything with Gravy and butter. Probably more importantly, I eat reasonable portion sizes.
As much weight loss as a 12 oz can of beer?! Wow! So you mean none?!
The important takeaway is youre both right along with 'its complicated' crowd. Everyone is different and reacts differently to foods differently. Took me 30 years to stabilize on vegetables plus chicken / fish. No sugar drinks and as few carbs as i can.
Tweak your diet and exercise until it works for you. Dont worry what works for someone else.
It's a pity those search terms don't include Dr Lustig's most recent video which I transcribed for the hearing impaired:
http://www.youtube.com/watch?v=ceFyF9px20Y.
The actual problem is really Slashdot, as in sitting here reading it instead of going out and hoeing the weeds, pushing an unpowered lawn mower back and forth, riding your bicycle 20 miles to and 20 miles back from work, etc.
I have memorizerd the calorie content of everything I normally eat, and stick it in a spreadsheet every day along with the calories burned by the exercises I do. I'm fairly sedentary, doing a lot of reading of Slashdot, Facebook, a local forum, the Drudgereport, and playing some occasional games. I'm 6' and 225 lbs, and my metabolism is 1800 calories a day as calculated over time in the spreadsheet.
Now, to lose weight, I have attempted exercise alone. That is, eat normal, exercise buns off. I could, at one point, exercise 1000 calories on an elliptical crosstrainer in an hour, and 1600 calories in about an hour and 40 minutes. I can't do it every day or my joints will get sore. I lost about 10 lbs over a year like that, because I kept getting interrupted by vacations (exercise is difficult after driving 14 hours on the road), getting sick, getting hurt (mainly back muscle pulls) and so just 10 lbs happened. I then tried cutting back calorie intake and exercising, which was working, when I was interrupted by: 1) getting sick and then 2) getting injured and then 3) a 3 week vacation and 4) Getting hurt again and 5) getting sick again. Then, I worked on a project to rallymaster 2 SCCA National Rallies, and I'm a terrible multitasker, so only had time for the rallies, and was too tired / distracted to exercise.
The rallies are completed, the events ran, were a great success, but I've lost all my aerobic fitness and now 600 calories on the crosstrainer is about my limit for the time being. I'll get it back, but its a few weeks away, I think. Meanwhile, my doctor discovered a vitamin D deficiency which might maybe have something to do with all the sicknesses, dunno. That's easily handled with the OTC vitamins available, so as soon as I get the aerobic capacity back, I'll get on Nutrisystem, which I know works and worked before when I lost about 25 lbs which I gained all back and then some, and will attempt to lose about 35 this time in about 3 - 4 months. I think it'll work.
But just saying "just do it" isn't quite so simple. Stuff happens, stuff gets in the way, and DAMN it is difficult. I guess the key is to never give up...
Yeah, I should have said "stress" instead of damage. In moderation, the liver can handle the load without trouble. But drinking a 64oz Big Gulp every day could lead to problems.
I also switched to drinking water many years ago. I still drink fruit juice, but only in very small amounts. (I can make a 12oz bottle last a week.) I might say I have a semi-low-carb diet, if it weren't for all that beer. ;-)
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
DOCTORS Don't make $$$ when people are WELL... Simple Enough????
I hadn't heard about the Whole Foods initiative, but it is welcome news. I hope it goes well.
There's another effort by the actor Wendell Pierce along the same lines, called Sterling Farms which is up and running in New Orleans now, with plans to expand in other cities. I hope this goes well too. Every little bit helps.
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
Sorry, I should have specified those with a "predisposition" to obesity, whether by genetics or prenatal environment or some other cause. They have various "breeds" of lab rats with such disorders, and they respond to low-calorie diets the way I described.
There was a study of Dutch people born during of WWII, and those who were in a certain stage of gestation (2nd trimester IIRC) during a particularly harsh period of widespread starvation grew up with a much greater propensity toward obesity. Such people would also respond like those rats to a low-calorie diet, preserving the "fat ratio" at the cost of growth or something else. (Sorry, no citation handy. I saw it referenced in another YouTube talk.)
The point is, the standard "received wisdom" about calories-in-calories-out is not necessarily applicable to everyone equally. As the GGP was saying, it's a lot more complicated and "individual" than that.
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
> Starve
> 1500 Calories/day
1500 Cal/day is equivalent to eating five cheeseburgers per day. Guess how I know you're fat.
or one really good cheeseburger.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
Primary care physicians are not complete idiots.
New drugs pushed through the FDA's pharmaceutical company corrupted processes are viewed, and rightly so, with caution and skepticism by competent physicians.
Treating symptoms with drugs is big business.
Nobody knows exactly HOW these new "diet drugs" work. Nobody knows the long or even relatively short-term consequences of putting a million people on these drugs.
Drug companies spin and do PR CONSTANTLY, and aggressively.
Implying that primary care physicians don't drug people enough ( a ridiculous and OUTRAGEOUS assertion, as we are the most drugged-up nation on earth), like this article does, and ignoring the inconvenient facts about these new drugs, the HUGE unknowns, THAT is pure PR fluff.
Taking a pill does nothing to address sedentary lifestyles and dietary alterations that are absolutely essential to maintain optimal health.
You have some influence on how you view yourself, what you are. Not everybody should just automatically accept that they need to be a patient for the rest of their lives.
It's great for drug companies, but disastrous for everybody else.
Any physician that fails to take "First, do no harm" seriously is not a physician at all. Run. Run VERY far away from doctors like that.
Of course.... guilty rich people ALWAYS blame 'corporations' or Bush administration, or some other vague entity for social ills. If you want to 'educate' the poor on leading a better life, then you also need to convince them not to buy $200 sports jerseys, $100 bottles of Tequila, and designer clothes. Why stop at the products of agribusiness or drug companies? Oh, the rappers, sports heroes, and NY ad agencies will LOVE you. No party invited will be forthcoming. NYT will not publish your story, as it steps on the feet of too many advertisers. There are probably a LOT of reasons why given drugs are not prescribed. That is a topic of reams of research in many different fields.... and there is never a simple answer. Maybe there is a plot, but more than likely not. But, the real reasons are not of any interest to the authors in the mainstream press if there is a corporate 'conspiracy' involved. Won't get the article in Mother Jones. “For every complex problem there is an answer that is clear, simple and wrong.” – H. L. Mencken
Even a small girl needs more than 1500 calories to maintain their weight. It doesn't matter if the calories come from eating 5 small cheeseburgers or from 3 balanced meals. Get back on 4chan.
I see you keeping track of the things you know you need to, but I wonder if you've considered that there are just some foods that you shouldn't ever eat at all...
I don't see how taking a new diet drug, which is what this article is about, is going to change your underlying condition. I'm not even certain that any of the new diet drugs are not contraindicated for people with type-1 diabetes. Personally, I wouldn't trust my physician if I had your condition and he attempted to prescribe me a new diet drug.
There are specific foods that you can't have. Ever. I suspect you know what they are already, but just can't seem to replace them with the foods that aren't a problem. Without exception this is the real issue with people living with type-1 diabetes.
I'm almost certain stating this fact probably makes you want to throw me in that pit with the healthy people who are aggressive and passionately motivated about their own health to make the necessary sacrifices to maintain it. It doesn't change the facts. People manage to accomplish what you claim you can not do all the time. You aren't ready to do it, fine. That's YOU, in YOUR OWN HEAD. There will always be some drug company ready to exploit you because of this, and there will always be some doctor that reluctantly lets you have the latest pill that he knows isn't going to help you long term one damn bit.
Find out what specific foods you can't have anymore. You'll know, because after you eat them your levels will be a fucking mess. Yeah, it means testing your levels A LOT. Yeah, it's hard to do. It isn't impossible, it's what you NEED to do.
You ARE whining, and you have a right to, it sucks. You also have a right to put people down who actually have managed to succeed. Does that make you feel good about not trying, about accepting you're helplessness ?
First of all, how is it that one doctor's opinion is considered proof that "diet drugs work"? I think the author needs to re-evaluate their understanding of scientific method and the criteria by which they assert facts. Even if FDA has been given enough data to pass it's standards with four new drugs, this doesn't translate into an unfortunate situation where diet drugs "work" but aren't being prescribed. Endemic to the problem of a diet drug is the issue where the patient seeks to find a magical way to eat bad things in a world where people can easily eat bad things all the time and are encouraged to do so. Alternatively the patient seeks to remove the urge. So a drug either alters the metabolism or suppresses the appetite. I've no doubt these new drugs make advances over their harsher or more deadly predecessors, but taking them fails to address the root of the problem. Physicians understand this. When you go in to your doctor looking for a magical prescription for something like this, they ask you a few questions as they are required to do, urge you to consider that merely changing your lifestyle is actual solution to the problem, then resignedly give you the magic pill. The drug is supposed to be the last resort, but everyone from the manufacturer to the patient conspire to use it as a blanket solution. And then you may get the effect you desire, and you also get the expense and side effects of the drug, and you've ultimately done yourself a disservice that will descrease your quality of life or possibly even kill you eventually. Every doctor will tell every patient that they need to eat a better variety of foods, less unhealthy foods, and smaller portions. But then society and in most cases, the individual, proceed to ignore the true solution and encourage the opposite.
Cancer is a disease is SOMETIMES caused (and often exacerbated) by diet but CANNOT be cured by diet. Type II diabetes, hypertension, heart disease and stroke are diseases dramatically influenced by lifestyle with regards to etiology and treatment. As physicians we do a HORRIBLE job preventing these illnesses and do a very poor job treating them because we have minimal control over personal behavior. Yet the diseases above account for the majority of morbidity and mortality in this country. They account for the majority of healthcare costs . . . or as we like to put it (revenue/profit). I'm a physician scientist. I specialize in health behaviors and molecular pharmacology of the brain. There will NEVER be a drug that will get you to NOT eat food that you find appetizing. Why? Because such a drug has to distort the most primal circuits in the brain (reward pathways). So yes such a drug will not only 'end' obesity but it will end drug addiction, curiosity, love, learning and just about everything else that makes the human existence worthwhile. Several people have posted anecdotes about weight loss on Qsymia and Belviq. But that's like saying "if I videotape myself having unprotected sex and then release in on the Web I'm going to get rich . . . what could possibly go wrong?" You are going to get the typical outcome . . . public shame. In research trials sponsored by drug companies the published results are "efficacy". Efficacy is the ability of a treatment to produce an effect under controlled conditions. Effectiveness is how well it works under typical conditions. Qsymia and Belviq are NOT very effective. A small fraction of people will optimize their diet, increase their physical activity and subsequently realize significant weight loss. But for MOST people they will lose an insignificant amount of weight or lose (then regain the weight). The only thing guaranteed are side effects because there is no such thing as a medicine without side effects. Belviq has a better side effect profile but the combination in Qsymia is probably the more efficacious weight loss approach. But here's the kicker. This debate is absolutely ridiculous. If we could get the American South (white, black and Hispanic) to live a lifestyle comparable to Colorado or Utah, rates of virtually every major disease would plummet in a matter of years. Healthcare as a percentage of GDP would fall EVERY year. We would be healthier, happier and more productive as individuals and as a nation.
Ed Pickles anyone? I was a counsellor for a diet group. Most of the clients were middle to upper class, the poorer people couldn't afford the diet if they had a family to feed in addition. Obesity is linked with many psychological and behavioural traits and people may also be genetically disposed to them. Giving someone a drug, may not resolve the problem, merely suppress the symptom or create some other sort of substance dependence. Obesity should be treated through a qualified nutritionist with a background in psychological tools for best effect.
Junkie logic.
That's all this is. "Look, normal weight people can be unhealthy too!" (So it's okay that I'm obese...) "Personal responsibility never works!" (So I shouldn't even try...)
If we really want to solve the societal pandemic of obesity we need to completely discard the idea that it's caused by some personal moral failing
(It's not my fault that I can't control my diet or be bothered to exercise regularly. It's society!)
I've little doubt that this post will justify that package of Oreos you'll shovel down later. Damn society, keeping you fat.
No, it's called science, jackass. I never said anything about blaming "society" for any individual's obesity. That would be silly.
Feel free to go lecture the ever-increasing numbers of morbidly obese six-month-old infants about how they're using "junkie logic" and failing to take "personal responsibility" for their lives. You can start out early telling them how they're useless losers who are just a drag on society while they giggle and drool and chew on their little fat fingers. You'll still be wrong, and you'll still be an ignorant asshole.
By all means tell us how it's all their parents' fault and how it's been perfectly normal throughout human history to put INFANTS on restricted calorie diets and forced exercise programs to keep them from becoming MORBIDLY OBESE starting IN THE WOMB.
The war on fat will continue to be precisely as effective as the war on drugs as long as yours is the prevailing attitude.
In other words, it will continue to be a dismal and ever-more-costly failure that is damaging our society rather than helping it.
I used to tell my doctor that my body wants to be a particular weight, it just happens to be going up a couple of pounds every year. That was actually pretty accurate. The body has some pretty amazing mechanisms for maintaining weight homeostasis so that in general, healthy people don't experience dramatic weight fluctuations. Eat more, burn more, poop more, absorb less. Unfortunately for those of us on western diets, processed carbs, sugars, preservatives, artificial ingredients, grain oils, etc. undermine those very mechanisms of metabolic homeostasis. By the time I'd developed full-blown type 2 diabetes, I'd had 30+ years of elevated serum insulin levels to create insulin and leptin resistance. I was carrying 100 extra pounds of fat, which we now know is metabolically active and contributes towards chronic inflammation and a host of health problems.
I discovered a book entitled "Eat to Live" by Dr. Joel Fuhrman, basically went vegan, lost 50 lbs and became 'un-diabetic'. I would say that I still probably have the same underlying metabolic problems, so when I eat processed carbs and sugar the weight can come back on really quickly. When I eat the Fuhrman way, I lose weight, when I don't, it comes back. I still have another 50 lbs to lose and frankly I'm not sure I can do it. There's a special place in hell for people who look at other people's problems and declare them easily solved, a matter of laziness, ignorance, etc. I don't have trouble with gambling, smoking, drinking, drugs, holding down a job. I even know exactly what I need to do to reach my goals. But that doesn't make it easy.
Well I definitely wouldn't suggest doing it that fast, but yes, lots of exercise and healthy eating gets rid of the weight.
And yep, once you're fat, it seems it will always be a fight to keep it off. Sucks, but true.
Undoing moderation.
For hire.
Not eating like a pig. You never saw any fat prisoners at Auschwitz, right?
> Stop eating bread. ...and replace it with what?
> Stop eating potatoes. ...and replace them with what?
> Stop eating sugar.
Granted.
> Lose weight. ...or die because you can't actually afford to eat now.
Cheeseburgers are also highly fattening and unhealthy. You can't look at calories alone when you are deciding what to eat.
You might want to get checked for diabetes. You're eating an awful lot of high starch food.
That is because those people are treating a diet like something they only have to do once in a while.
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Comment removed based on user account deletion
High Fructose Corn Syrup was introduced into the mainstream markets in the early 70's.
The obesity epidemic started in...imagine that...the middle to late 70's.
HFCS (or some other similar product) is in pretty much everything we eat from cereal to
bread to processed fruit, condiments, etc., and the "food" companies are allowed to keep
feeding this stuff to us all.
Odd how any other corporations (except big tobacco and big Pharma) would have the feds
crawling down their throats if they were killing their customers. But I guess that's what you
get when you have the best legislators and judges that money can buy.
I'm amazed at the hostility here towards anyone who suggests self control and healthy eating and the amount of comments suggesting if you can't get time to excercise, popping a pill to offset your overeating is good. Seriously? You guys are all in denial. really. In the UK there's a TV show called 'Secret Eaters'. Each week they get some fat people who are mystified as to why they can't lose weight. They get them to record what they eat for a week and film them for a week. They then compare what they said/thought they ate compared to what they really ate. In almost every case they were scarfing more than twice the calories they claimed. One guy was going on about his healthy eating, breakfast cereals, healthy option for lunch sandwich, home cooked evening meal full of vegetables. He reckoned he got through 1800 calories a day so why wasn't he losing weight? The film of him showed he was actually getting through 4-5000 a day and on Sunday, 9000. One thing that really surprised him was a cheese sauce that he put on his vegetables (yeah, I know) that ended up as being 1500 cals on its own.
I want a list of atrocities done in your name - Recoil
because medicine is not a long-term solution (as much as some people like to believe that). As soon as you stop taking it you pretty surely will get a bounce back effect. Its much more sustainable to educate the people to eat healthy (and less).
Given that there are plenty of people who have lost weight going from being obese to a healthy weight without a reduction in metabolism I think that's a given.
GP is right, you're extrapolating. You're taking one experiment in a specific set of circumstances and trying to extrapolate it to all cases.
The clue is in the experiment name itself - "starvation", obese people losing weight isn't starvation, giving them a balanced diet albeit with less calories is a completely different set of circumstances to starving people with a lack of balance in their diet including necessary vitamins.
B-complex vitamins help your metabolism when it comes to breaking down carbohydrates and so forth. The study you cited effectively found that vitamin-B deprivation can result in reduced metabolism - no shit, but as the GP said, what the fuck has this got to do with reducing the calorific intake of obese people given that we can maintain their vitamin B levels whilst doing so?
Reducing calorie intake isn't necessarily the same as causing vitamin imbalance, no one has suggested the latter, but your study did the latter as well as the former.
you know what else works like a charm? Putting the fork down, not eating garbage food all the time and a tini tiny bit of weekly exercise. The best part is that you don't even need a doctor to prescribe it, why don't we all do it? How crazy would that be?
What's so funny about this (and reinforced by the other replies to your post) is that people really object to the morality of other people "getting away with something" -- eating too much of the wrong food and not exercising enough.
Easy to explain, though:
It lessens their sense of superiority, so they feel threatened by it and lash out against it.
It's a classic, very typical, and sadly far too common, behavior. Well-understood in psychology. Of course, the twits being guilty of it have no idea about that and the fact that they are, indeed, typical, and literal, twits. It's all quite entertaining. Or, rather, it would be, if it wasn't also for the fact that the exact same mechanisms underlie most of the bullying and other hostile inter-person behaviors that plague our societies. I really loathe that kind of people. They are the source of so many problems.
Hi folks, I am a primary care doctor. I have tons (literally) of obese patients with all the attendant consequences like diabetes, arthritis, sleep apnea, high blood pressure, poor circulation, and more. I do not prescribe weight loss drugs, never have, doubt I ever will. Reasons are simple and obvious. 1) they don't work. They produce an insignificant amount of weight loss and do it only over the shortterm. 2) they have bad side effects. Along with the lack of benefit, they sure do harm people. Xenical causes such massive diarrhea as to cause fecal incontinence. Pooping your pants uncontrollably... do I need to explain any further why no one takes this med? 3) they have a LONG history of causing severe and unanticipated health damage. Heart valves with fenfluramine, addiction with amphetamines, etc. 4) they do nothing to change people's underlying weak efforts at diet, exercise, and fitness, which produce real health. When patients stop the drugs, they lose the (minimal) benefit, and they go back to being what they were before. --JSt
The response to the rest of the article is that probably why doctors are not prescribing diet pills for obesity is because they are educated and not idiots. Other than in very special circumstances, pills are not the answer. Eating habits and lifestyle changes are. The weigh secret is this: Eat a bit less and better (and you know how idiot), and be a bit more active. That's it.
And yes you are right. Anyway that has done a smidge of research (and I have done very little) will tell you it is VERY obvious that the BIGGEST issue with food, isn't fat, salt, or whatever, it is sugar. Specifically refined sugar. People didn't have access to in the past what we do now, and what we do now is ubiquitous in everything. It is like trying not to eat salt in processed foods. It isn't possible. With only a few food choices a typical person will be well over their health allotment of sugar in a day. Hell I have had two coffee's this morning and I probably am already. Anyway it is everywhere and in everything, and actually trying to avoid it can be difficult. Part of the reason is the addiction thing people keep mentioning. I am not sure I would go so far as to say it is intentional on the part of the food industry, but I would say that it has been institutionalized over time for successful profits. Anyway the more refined the worse it is. The reason is the less refined, the longer it takes for your body to absorb it, while the more refined it goes a straight shot through your system. I bet if you looks at rates of diabetes from years ago to now it is through the roof and getting worse, partly due to obesity which is in part caused by sugar anyway, and partly directly to do is increase consumption.
Anyway it is the one thing that I look a bit closely at and try to regulate a bit in my diet. However even things that seem "healthy" like certain fruit juices, and some grains are just loaded with natural sugars, it isn't just the artificially refined stuff.
Unless you don't eat enough, at which point the body stores it all as fat. That's my wife's problem. She doesn't eat enough, so she doesn't lose weight. When she was able to actually eat the 2000+ calories a day she should be eating, she began losing weight.
The problem is, she has a small stomach (nvm jokes about the size of the belly over it) and it was sometimes physically painful for her to eat that much food. She can't just "graze" all day with the job she works, so she can't get the calories regularly and effectively.
We're trying to figure out other ways and options, but it's not always "eat less and you'll lose weight".
Lego brick diet seems the new way to go... :)
"After eating lego bricks, I am just not hungry anymore!"
(May cause gastrointestinal problems and instant death, this diet isn't for everyone)
Remove the doctors from the equation. Permit licensed pharmacies to sell the medications directly to the consumer without a prescription. Problem solved.
"Type-1 diabetics, can eat any and all foods, but they have to be cognizant of the effect and impact. There is a difference between cannot, and should be cognizant of the side effects."
This is only partially true. Elimination of all foods that cause radical impact IS a viable solution. Foods that do not cause the spike are foods that do not cause the weight to be packed on. Complete elimination of them is really the ONLY solution. And they tend to be foods that many athletes eliminate, so it can, and is done successfully .
We all have to deal with remarks from unkind people who simply don't understand, and lack experience. The line we have to personally draw is when we deceive ourselves. You don't need empty platitudes, I agree, nobody does. What people need is to seek out the people who have actually been where you are and come back from it. What they discovered is that the entire medical approach of "you can eat anything anyone else does, just be cognoscente of it's impact" is seriously flawed, it isn't helpful or true, not if you want to have optimal health.
Those foods are poison to people with a particular metabolic reaction to them. They must be eliminated entirely and replaced with foods that are neutral or have a positive impact.
There are people all over the internet that have accomplished it, they aren't difficult to find, but their conclusions are difficult to accept when the medical establishment is determined to keep people perpetual patients, and patients are unwilling to make the necessary changes.
You, and people with similar conditions, need support and positive approaches, and I'm here to tell you, it IS out there if you just look for it and ignore the others that don't really care.
What's the point of mentioning this?
Probably to show that losing weight is more complicated that just "eat less". There are lots of factors into how the body works well beyond total number of calories eaten. Even the number of meals meals eaten in the day affects things. Chances are that if obese people just ate less calories and changed nothing else, their bodies would assume that they are are having issues finding food and otherwise risking starving and lower their metabolism and shift to storing more fat. Weight loss is going to be a factor of many variables including, but not limited to: calories eaten, form they are eaten in, number of meals per day, metabolism, physical activity, and how the changes are introduced. Just saying "eat less" doesn't understand the problem and will probably not work for anybody that believes that's all their is too it and possibly complicate the issue even more. The solution for obesity is more like a life style change on many levels which in some cases may require surgery or drugs to be successful.
The main problem is that for hundreds of thousands of years, the main problem was getting enough to eat. The human body developed many different tactics such as making things like fats and sugars taste good, storing as much food as fat as possible, to probably even how hungry people feel. This has really only changed in the last 50 years so now that their is ample cheap food those hundreds of thousands of years of evolution are coming into play to make us fatter.
The Brits aren't skinny because they eat shit, they are skinny because given the option of eating British food and starving, they starve.
I thought the British liked curries.
I knew we had to put up with tech shills around here, but are we really going to allow stories from homeopaths now?
Share your nutritional qualifications and your education in the science fo addiction or shut the fuck up. Evidence based reasoning or take your prejudice elsewhere.
[FUCK BETA]
Goodness, you're unlucky on the calorie front. I'm 5'6", 165, though I do walk 2.5 miles every day (but I'm also female, which should ding me on the metabolism front). All those calculators try to put me at 1600 a day, sustaining -- but I was losing significant weight at 1800. My own figures have me thinking that 1900 - 2000 will actually be my break-even point (I'm aiming for 155; I was thinner that that once and people thought I was ill; lots of muscle on me).
I'm a she-slashdotter... but I make up for it by living with my folks.
I shouldn't leave out that that just goes to show we're all different. Targeting a number doesn't mean much if the number isn't taylored specifically to you.
I'm a she-slashdotter... but I make up for it by living with my folks.
Obese people lose fat and reach normal weight all of the time, but statistically speaking, keeping it off more than five years is rare.
Further, keeping the fat off for more than five years is rare even though the media, their medical professionals, and their peers are all willing to remind them obesity is unhealthy.
Further, keeping the fat off for more than five years is rare even though modern beauty standards trend to slimness in everything except women's breasts (and there's no known way to concentrate body fat in one particular part of the body).
List all of the successful diet studies that followed participants for five years or longer. I dare you.
So maybe one third or more of the first world population around the globe are lazy gluttons and we all pig out despite knowing full well that it's unhealthy and unattractive, and every single one of us lacks the strength of character to fix the problem on our own. And certainly some significant percentage of us are just lazy gluttons. But all obese people, all over the world? Even most?
Those are really small cheeseburgers. And in this particular case, it was 30 adult men who were instructed to do at least a brisk 45 minute walk for half an hour a day. Their calorie intake to maintain their size before the study started was 3200 per day.