The obesity model is flawed
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This energy-in-energy-out conception of weight regulation, we argue, is fatally, tragically flawed: Obesity is not an energy balance disorder, but a hormonal or constitutional disorder, a dysregulation of fat storage and metabolism, a disorder of fuel-partitioning. Because these hormonal responses are dominated by the insulin signaling system, which in turn responds primarily (although not entirely) to the carbohydrate content of the diet, this thinking is now known as the carbohydrate-insulin model.
Its implications are simple and profound: People don’t get fat because they eat too much, consuming more calories than they expend, but because the carbohydrates in their diets — both the quantity of carbohydrates and their quality — establish a hormonal milieu that fosters the accumulation of excess fat.
That the environment plays a critical role is a given. The undeniable evidence is the enormous increase in the prevalence of obesity worldwide. In the U.S., 12% of Americans lived with obesity 60 years ago; more than 40% do today. Something has changed in the environment — in diets or lifestyles — to trigger such a dramatic rise in the prevalence of obesity. But is it nature or nurture that the environment triggers, behavior or physiology, minds or bodies?
n the case of obesity, the hormonal/constitutional hypothesis also encountered dogmatic resistance in response to its single most direct practical implication: Diets that can successfully resolve obesity are not those that induce us to eat less, per energy-balance thinking, but those that reduce circulating levels of insulin, accomplished most effectively by replacing dietary carbohydrates — sugars, starchy vegetables and grains, and the like — with fat.
Physicians and diet book authors have been promoting carbohydrate-restricted, high-fat diets — ketogenic diets, now commonly known as keto — for going on 200 years, most famously Robert Atkins, a New York cardiologist. By arguing, as Atkins and others did, that fat could be lost without limiting calories by fixing the hormonal dysregulation of fat storage — restricting what one eats, not how much — these books were treated as de facto quackery. By advocating that we eat fat-rich foods, they were considered dangerous.
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BS.
Show me the studies which prove that low-carb high-fat diets work better than other diets with the same total calorie consumption.
I have looked into the studies quite a bit while I lost 70lbs. The only reliable conclusion one can draw from them is what ultimately matters is in fact "energy-in-energy-out". It doesn't matter much whether the calories come in the form of carbs, fat, or protein (although the latter has the advantage of being more satiating).
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@klaus said in The obesity model is flawed:
The only reliable conclusion one can draw from them is what ultimately matters is in fact "energy-in-energy-out". It doesn't matter much whether the calories come in the form of carbs, fat, or protein (although the latter has the advantage of being more satiating).
Agreed on energy-in-energy-out. Though not to claim there is no difference between consumption of carbs vs fat vs protein, other than satiation. Speaking only for my own system, the relative quantities of each macro make a big difference. I have only recently determined -- and now confirmed -- that higher (in my case much higher) protein consumption is having an almost magical effect on weight loss, hallelujah.) There are also effects of one versus the others on liver health and how rapidly digestion occurs.
And don't sneeze at the effects of satiation. The longer a macro stays with you, the easier it is to not eat prematurely -- extremely important in weight loss.
Congratulations on your 70lb loss. That is excellent.
Success is measured by your discipline and inner peace. – Mike Ditka
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@catseye3 said in The obesity model is flawed:
@klaus said in The obesity model is flawed:
The only reliable conclusion one can draw from them is what ultimately matters is in fact "energy-in-energy-out". It doesn't matter much whether the calories come in the form of carbs, fat, or protein (although the latter has the advantage of being more satiating).
Agreed on energy-in-energy-out. Though not to claim there is no difference between consumption of carbs vs fat vs protein, other than satiation. Speaking only for my own system, the relative quantities of each macro make a big difference. I have only recently determined -- and now confirmed -- that higher (in my case much higher) protein consumption is having an almost magical effect on weight loss, hallelujah.) There are also effects of one versus the others on liver health and how rapidly digestion occurs.
And don't sneeze at the effects of satiation. The longer a macro stays with you, the easier it is to not eat prematurely -- extremely important in weight loss.
Congratulations on your 70lb loss. That is excellent.
Be careful with high protein diets. Too much protein can be a bit hard on the kidneys.
Always remember, Operation Valkyrie was an act of sedition.
Warning: I post things that interest me. Read and comment at your own discretion. -
@copper said in The obesity model is flawed:
Eat less
Weigh less
It works
Very true.
And if you can understand that the difference between a good habit and a bad habit is that a bad habit makes you feel good in the moment but is bad for you downstream and a good habit is the opposite you are on your way.
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@loki said in The obesity model is flawed:
And if you can understand that the difference between a good habit and a bad habit is that a bad habit makes you feel good in the moment but is bad for you downstream and a good habit is the opposite you are on your way.
Say on, bro. Immediate gratification is a stone bitch.
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@catseye3 said in The obesity model is flawed:
@loki said in The obesity model is flawed:
And if you can understand that the difference between a good habit and a bad habit is that a bad habit makes you feel good in the moment but is bad for you downstream and a good habit is the opposite you are on your way.
Say on, bro. Immediate gratification is a stone bitch.
Marketing on steroids. Get the seratonin drip going in your brain, make you salivate and open your wallet. You are essentially powered by your robotic overlords.
Not you Cats but people in general.
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Calories in/Calories out model is a bit flawed in that as a couple of folks have noted, calories are not all processed the same. And different sugars are processed in different ways.
And yes there are a lot of studies to back that up - Jason Fung documents those in his books.
Very simplistically, even a person who is lactose intolerant will not process calories in the same way as someone who does not suffer lactose intolerance. Our nation's obesity rate has increased as the use of fructose has increased - as it is processed differently than glucose. Glucose is can be used by every cell in the body whereas fructose cannot be used by cells.Fructose puts stress on the liver - resulting in it being stored as fat.
And there are those studies of diet sodas (zero calories!) which result in an increase in weight. How is that? Once again, non-sugar sweeteners stimulate insulin production. so zero calories in - and a weight increase. The calories in/calories out model is shaking a bit there - nicht wahr?
When I was younger and running 50-70 miles a week and lifting weights 5x a week, by restricting food intake, I lost 35 lbs. So that can work - but over a couple of decades I regained the weight ever so slightly every year.
This past year, I followed Jason Fung's suggestions of knocking out the snack meals - confined my eating to a 6 hour period per day - along with limiting carbs/sugars - and lost 35 lbs again w/o the 2 hour a day workout routine.
I think insulin as a driver of obesity model has some compelling evidence. The issue with limiting calories is that people rebound in weight over time. There are millions of people who lose weight doing calorie restriction - only to regain it.
Do some reading of Jason Fung's books for a great deal more research on the subject.
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Paraphrasing Gary Taubes: calories in / calories out indicates that a person 100 pounds overweight at 40, who was lean at 20, would have averaged 50 calories more than their metabolic rate per day over those 20 years. Anybody believe that that person's obesity is attributable to 50 excess calories per day, on average?
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I fasted for 16 hours a day all last week, and cycled 40 miles over the weekend.. Weighed myself this morning and I'd put on 3 pounds.
There are words for how I feel, but I won't sully the purity of the board with them.
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@doctor-phibes said in The obesity model is flawed:
I fasted for 16 hours a day all last week, and cycled 40 miles over the weekend.. Weighed myself this morning and I'd put on 3 pounds.
There are words for how I feel, but I won't sully the purity of the board with them.
You have to poop more.
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@doctor-phibes said in The obesity model is flawed:
I fasted for 16 hours a day all last week, and cycled 40 miles over the weekend.. Weighed myself this morning and I'd put on 3 pounds.
There are words for how I feel, but I won't sully the purity of the board with them.
Water weight plus any fat converting to heavier muscle.
Weigh yourself daily at the same time. You will see patterns based on behaviors. But there is always a 3 pound fluctuation based on how much excess or lack of water you are carrying.
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@loki said in The obesity model is flawed:
@doctor-phibes said in The obesity model is flawed:
I fasted for 16 hours a day all last week, and cycled 40 miles over the weekend.. Weighed myself this morning and I'd put on 3 pounds.
There are words for how I feel, but I won't sully the purity of the board with them.
Water weight plus any fat converting to heavier muscle.
Weigh yourself daily at the same time. You will see patterns based on behaviors. But there is always a 3 pound fluctuation based on how much excess or lack of water you are carrying.
That's what I normally do - every morning first thing. I'm fairly sure in this case it's water, however it's still aggravating, particularly after the fasting.
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I thought this was a Fat Shirley thread…
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@klaus said in The obesity model is flawed:
Show me the studies which prove that low-carb high-fat diets work better than other diets with the same total calorie consumption.
https://www.bmj.com/content/363/bmj.k4583
Participants 164 adults aged 18-65 years with a body mass index of 25 or more.
Interventions After 12% (within 2%) weight loss on a run-in diet, participants were randomly assigned to one of three test diets according to carbohydrate content (high, 60%, n=54; moderate, 40%, n=53; or low, 20%, n=57) for 20 weeks. Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg. To test for effect modification predicted by the carbohydrate-insulin model, the sample was divided into thirds of pre-weight loss insulin secretion (insulin concentration 30 minutes after oral glucose).
Main outcome measures The primary outcome was total energy expenditure, measured with doubly labeled water, by intention-to-treat analysis. Per protocol analysis included participants who maintained target weight loss, potentially providing a more precise effect estimate. Secondary outcomes were resting energy expenditure, measures of physical activity, and levels of the metabolic hormones leptin and ghrelin.
Results Total energy expenditure differed by diet in the intention-to-treat analysis (n=162, P=0.002), with a linear trend of 52 kcal/d (95% confidence interval 23 to 82) for every 10% decrease in the contribution of carbohydrate to total energy intake (1 kcal=4.18 kJ=0.00418 MJ). Change in total energy expenditure was 91 kcal/d (95% confidence interval −29 to 210) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d (91 to 326) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet. In the per protocol analysis (n=120, P<0.001), the respective differences were 131 kcal/d (−6 to 267) and 278 kcal/d (144 to 411). Among participants in the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis (P<0.004). Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet (both analyses). Leptin was also significantly lower in participants assigned to the low carbohydrate diet (per protocol).
Conclusions Consistent with the carbohydrate-insulin model, lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
