[HN Gopher] Once an Addict, Always an Addict?
       ___________________________________________________________________
        
       Once an Addict, Always an Addict?
        
       Author : vitabenes
       Score  : 166 points
       Date   : 2021-08-08 08:31 UTC (14 hours ago)
        
 (HTM) web link (www.deprocrastination.co)
 (TXT) w3m dump (www.deprocrastination.co)
        
       | ddtaylor wrote:
       | Thats an ad.
        
       | DoreenMichele wrote:
       | I hate this idea that _addiction_ is someone just getting high so
       | they don 't have to feel bad feelings, which seems to be the
       | underlying assumption of most discussions.
       | 
       | My dad drank heavily for a lot of years. I grew up hearing tales
       | of his legendary drinking. Mom would buy him a case of beer on
       | Sunday and if he ran out mid-week, he would drunkenly accuse her
       | of drinking his beer -- which makes no sense because mom is a tea
       | totaller. He would go on a bar crawl on nickel night and hit
       | dozens of bars with his buddies. Etc.
       | 
       | He was in the army and he fought in the front lines of two wars,
       | WWII and Vietnam. He retired when I was three and apparently
       | began tapering off.
       | 
       | I don't recall him having the DTs. I don't recall him drinking
       | heavy in my lifetime. I recall him having a beer as part of
       | dinner when I was four or five.
       | 
       | When I was seven, he was diagnosed with a heart condition. He
       | blamed it on the alcohol and never touched the stuff again
       | (except for a few sips when my brother hit drinking age while
       | talking to him about what made for a good beer, I think).
       | 
       | By then, he had been out of the army for four years or so. He had
       | time to taper off for a few years before making his dramatic
       | announcement that he wasn't drinking again.
       | 
       | I think he drank to suppress his nightmares from serving in two
       | wars. I think he didn't need to actively suppress his nightmares
       | anymore after he dropped his retirement papers and no longer had
       | to live in fear of being sent back.
       | 
       | I think people drink and drug for a reason. We just mostly don't
       | bother to try to figure out what the reason is for this specific
       | person and we just act like "You are a badly behaved child who
       | needs a spanking and you need to just try harder." And then blame
       | them when that stupid idea consistently fails to be an effective
       | solution to their problem.
       | 
       | Edited. Cuz typos and auto-corrupt.
        
         | dkersten wrote:
         | Reminds me of this TED talk:
         | https://www.youtube.com/watch?v=PY9DcIMGxMs _" Everything you
         | think you know about addiction is wrong"_, where he asserts
         | that addiction isn't caused by the things we typically
         | correlate with it. I was going to try to summarize, but I don't
         | think I can do it justice. Its not long.
         | 
         | > I think people drink and drug for a reason. We just mostly
         | don't bother to try to figure out what the reason is for this
         | specific person
         | 
         | Absolutely. This is totally in line with what that guy says in
         | the video too.
         | 
         | One thing he says: _" The opposite of addiction is
         | connection."_
         | 
         | I know that personally, when I have problems that I struggle
         | with and don't feel like anyone in my life can help me with or
         | talk to about them (sadly has happened once or twice in my
         | life), I have a tendency to binge, with anything that provides
         | a brief escape, be it alcohol, drugs, video games, TV series',
         | chocolate. Of course, its never been too bad, severe or long
         | lasting for me, so it hasn't been too much of a problem and I
         | wouldn't claim it comes close to what an alcoholic or heroin
         | addict goes through, but I can at least see how someone might
         | slip into such things, as a distraction from reality. And its
         | usually coupled with a feeling of isolation and loneliness,
         | feeling like you're alone with problems you don't know how to
         | solve. So you hide from them instead. That's the impression I
         | got after thinking about my past situations at least.
        
           | webmobdev wrote:
           | > One thing he says: "The opposite of addiction is
           | connection."
           | 
           | Makes a lot of sense - I once read that a defining parameter
           | to determine addiction is how it affects relationships.
           | Addicted people often fight and eschew relationship in favour
           | of their addiction. I am reminded of this often when I see
           | kids fight with their parents about how much time the spend
           | on their phones / tablets / computers instead of doing other
           | activities.
        
             | tacocataco wrote:
             | "I am reminded of this often when I see kids fight with
             | their parents about how much time the spend on their phones
             | / tablets / computers instead of doing other activities."
             | 
             | To be fair, some parents arent worth connecting with. I'm
             | really happy for you if this isn't your personal
             | experience.
        
               | webmobdev wrote:
               | Parental upbringing does obviously affect one's
               | personality, and it is fair to say many addicts do come
               | from dysfunctional families - https://www.healthyplace.co
               | m/blogs/debunkingaddiction/2020/7... ...
        
             | dkersten wrote:
             | That's interesting and now that you mention it, yeah, that
             | totally makes sense.
        
           | unparagoned wrote:
           | I used to like that video but it hasn't aged well. The whole
           | opioid epidemic showed how you can make addicts out of lots
           | of people through getting them physically addicted.
        
         | phkahler wrote:
         | I'm confused. You wrote both of these:
         | 
         | >> I hate this idea that addiction is someone just getting high
         | so they don't have to feel bad feelings...
         | 
         | >> I think he drank to suppress his nightmares from serving in
         | two wars.
         | 
         | I mean... I thought the dad story was going to contradict that
         | first thing.
         | 
         | I agree with you (I think) that many people use addictions to
         | sooth or avoid unpleasant feelings. I know some people who even
         | admit that's why they do it.
        
           | DoreenMichele wrote:
           | I think my father needed his sleep. I think that was his main
           | goal: Getting enough sleep so he could function.
           | 
           | There likely were other benefits. As another comment here
           | notes, alcohol is also a blood thinner. My father was on
           | blood thinners for many years after being diagnosed with a
           | heart condition and did have a large clot at one point that
           | he could have lost his leg over.
           | 
           | But I think the fact that he apparently began winding down
           | his drinking when he left the military means his primary
           | reason for drinking was likely to manage his fear of being
           | sent back to the front lines. That's not the same thing as
           | avoiding bad feelings per se. It's more like moving stage
           | fright out of your way because your paycheck depends on your
           | performance and you need to perform in the here and now
           | regardless of how you feel.
        
           | [deleted]
        
         | Spooky23 wrote:
         | I'm glad you shared this.
         | 
         | A colleague early in my career was badly wounded in Vietnam and
         | was a heavy drinker into the late 90s. It was an escape from
         | physical and mental scars afaik. The experience out a heavy
         | toll on his kids, his 4 wives, and coworkers who had to deal
         | with some of the side effects.
         | 
         | When I met him in the early 2000s, he had turned that aspect of
         | his life around and moonlighted as an addiction counselor. His
         | thought was that he could tell you within 2-3 days who would
         | make it out of a group program -- they had to have a reason.
         | 
         | For my friend, his granddaughter's birth was a wake up call
         | that lit up his motivation. It sounds like for your dad,
         | leaving the army was the trigger.
         | 
         | Several members of my extended family struggled with alcohol -
         | at the time growing up I saw it as a weakness or failure, which
         | I regret. Growing older and gaining more understanding led me
         | to a conclusion similar to yours in the subject.
        
         | blakesley wrote:
         | You say:
         | 
         | > I hate this idea that addiction is someone just getting high
         | so they don't have to feel bad feelings, which seems to be the
         | underlying assumption of most discussions.
         | 
         | But then the rest of your comment is a story about your father
         | seemingly doing exactly that. What have I misunderstood here?
         | Not trying to be flippant, I'm genuinely confused.
        
           | edgyquant wrote:
           | I struggled with addiction to alcohol and cocaine for a long
           | time. I would not say, at least do feel it's the case, I was
           | trying to escape. It was fun, and as time when on it was just
           | a thing I did. Eventually my body started feeling it and it
           | took me two years to get clean (I still drink about once a
           | month.) But nowhere along that decade long road did I ever
           | feel like I was escaping my life. I was amplifying it, I can
           | write twice the code on cocaine (I'm already pretty fast) and
           | alcohol is a social thing, I got hooked because it was cool
           | to drink so I drank more than everyone else. I would be the
           | last guy up at a party.
           | 
           | I think the other poster, whether what he said was correct or
           | not, is right that it is a disservice to chalk an addict up
           | to someone escaping life. This removes the majority of drug
           | addicts who got hooked from pain after surgery and now can't
           | stop, or the ones who could stop but enjoy the feeling it
           | creates. Not all drug addicts are homeless people sleeping on
           | the streets. I have an ex who's sister runs a chain of stores
           | and she's a legit meth head, you could never tell though
           | because she does it in moderation and doesn't look like she
           | takes anything at all.
        
             | sitkack wrote:
             | > write twice the code on cocaine
             | 
             | HN dog whistle? Tell us more.
        
           | jatins wrote:
           | Yeah, I also found it slightly conflicting. I think the
           | author is probably saying that those bad feels are probably
           | not an answer in themselves but have an underlying cause that
           | often gets overlooked.
        
             | afarrell wrote:
             | I believe the word people generally use is "trauma".
             | 
             | - nightmares and insomnia
             | 
             | - intense negative emotion
             | 
             | both can be caused by trauma.
        
           | DoreenMichele wrote:
           | I have already clarified this detail:
           | 
           |  _I will also add that suppressing nightmares is about being
           | able to sleep through the night so you can do your job the
           | next day, not necessarily about avoiding negative feelings
           | per se. Plenty of people take sleeping pills and are not
           | characterized as addicts for trying to address their sleep
           | issues so they can function._
           | 
           | https://news.ycombinator.com/item?id=28106688
           | 
           | My father worked long, hard hours for a lot of years. He
           | needed his sleep to do so.
        
             | deadalus wrote:
             | suppressing nightmares = avoiding bad memories or past
             | experiences
             | 
             | being able to sleep through the night = experiencing peace
             | artificially
             | 
             | not necessarily about avoiding negative feelings per se =
             | its about avoiding past experiences and not being able to
             | face the 'issues' because you think they will break you or
             | annoy you
        
               | DoreenMichele wrote:
               | I have a serious medical condition that can seriously
               | interfere with my sleep at times. I see absolutely no
               | contradiction in saying "Addiction is not just about
               | avoiding bad feelings" and saying "I think he drank to
               | suppress his nightmares."
               | 
               | Multiple people have told me that's a contradiction and
               | I'm wrong to take that position. It's probably not worth
               | arguing any further and needs to be filed under "We can
               | just agree to disagree on this detail."
        
               | al_coidineahol wrote:
               | I really appreciate your comments on this site, this
               | comment and all the other ones that I've seen over the
               | years, because you give a much needed reality check and
               | are articulate and honest.
               | 
               | I do think though, that it is a contradiction to say
               | that. Avoiding nightmares is exactly about avoiding bad
               | feelings. Other people might end up doing it earlier in
               | the day if they don't have anything around them.
               | 
               | > I hate this idea that addiction is someone just getting
               | high so they don't have to feel bad feelings
               | 
               | That's exactly what addiction is. Getting high is just
               | fun.
               | 
               | > I think he didn't need to actively suppress his
               | nightmares anymore after he dropped his retirement papers
               | and no longer had to live in fear
               | 
               | EDIT: There is a sibling comment.
        
               | deadalus wrote:
               | I empathize with you and I respect your opinion. You
               | presented a new perspective on this topic.
        
         | runawaybottle wrote:
         | I think he drank from the pressure of having children and a
         | family. Think about the reasons why he quit, his family, and he
         | never showed much of it to his children. The reasons for
         | quitting are often the reasons for starting.
         | 
         | Sorry for getting all Freudian.
        
           | DoreenMichele wrote:
           | I think the opinion of a random stranger who never met my
           | late father likely has less merit than my own.
        
             | Vrondi wrote:
             | We have nothing to go on except for the words you posted,
             | and those words seem to contradict themselves. So,
             | discussing them or asking for further clarification seems
             | reasonable.
        
               | DoreenMichele wrote:
               | Certainly. And I have been perfectly happy to engage with
               | such comments.
               | 
               | That's not what the dead comment was doing.
        
             | runawaybottle wrote:
             | I agree, just a discussion.
        
               | DoreenMichele wrote:
               | Stick to discussing the _idea_ I 'm suggesting and don't
               | tell me and the world what I should think of my own
               | father.
               | 
               | While I am making this follow up comment, I will add that
               | no one ever once characterized him as an alcoholic, he
               | never attended AA or any kind of treatment, and my mother
               | did not care that he drank heavily because "he was never
               | a mean drunk and there was always enough money."
               | 
               | All the stories I heard growing up about his legendary
               | drinking were told as humorous stories that my parents
               | laughed about from the good old days. I'm the youngest of
               | three children. My father never hid his drinking from
               | anyone. I just didn't happen to personally witness it
               | because he largely stopped after he left the military
               | even before he officially announced that he was quitting.
        
               | runawaybottle wrote:
               | Again, I'm not here to fight you. I still struggle with
               | addiction, so I'm seeing if I have any insight to offer.
               | The reasons are often so damn simple, but the solutions
               | are the slipperiest of slopes. That's how we slide into
               | it, for literally the simplest reasons.
               | 
               | Yeah, it could be the nightmares, or it could be
               | something even simpler.
        
               | DoreenMichele wrote:
               | Alcohol is known to suppress dreams. It's a physical
               | mechanism impacting brain function in that regard.
               | 
               | I'm not suggesting "suppressing nightmares about the war"
               | is the reason other people drink. Just that was the
               | reason I believe my own father drank. It's a conclusion
               | that took me a long time to make and it's based on an
               | analysis of the facts of his life.
               | 
               | If you are still struggling with addiction, maybe you
               | don't yet have the answers you need. Maybe the pat
               | answers you are parroting are part of the problem.
               | 
               | They are answers that actively promote a sense of
               | helplessness and actively discourage pinpointing a
               | specific cause. I'm suggesting that's exactly the problem
               | with our current mental models.
               | 
               | Edit: I will also add that suppressing nightmares is
               | about being able to sleep through the night so you can do
               | your job the next day, not necessarily about avoiding
               | negative feelings per se. Plenty of people take sleeping
               | pills and are not characterized as _addicts_ for trying
               | to address their sleep issues so they can function.
        
               | touisteur wrote:
               | With kids to feed, one does what he or she has to do to
               | go through backbreaking or stressful work.
               | 
               | Drinking suppresses nightmares but gives a less
               | refreshing sleep. Must have been tough to make that
               | choice... I wonder if he smiled less or had trouble
               | enjoying things when he stopped... More stress or less
               | patience. But you already shared so much about your
               | father, you don't need to answer!
               | 
               | As for the sleeping pills, after I've seen how they made
               | my grandpa dependent, and now that I'm trying to taper
               | off antidepressants, I'd like to moderate. They probably
               | are addicts, just not with the negative connotations of
               | _addict_ , if you see what I mean. I wished we'd help
               | more people tapering off stuff.
               | 
               | Kudos, though, to people doing what they can to give
               | their children and spouse a life without money worries.
        
               | kelnos wrote:
               | > _no one ever once characterized him as an alcoholic, he
               | never attended AA or any kind of treatment, and my mother
               | did not care that he drank heavily because "he was never
               | a mean drunk and there was always enough money."_
               | 
               | I feel like whenever I read a description of alcoholism,
               | an essential component of it is that you can't stop
               | drinking _despite_ it negatively affecting your health,
               | work, relationships, etc. If he was able to drink at that
               | level without causing those negative consequences, then I
               | think it makes sense that no one would have thought of
               | him as an alcoholic.
        
               | DoreenMichele wrote:
               | It was also a different world back then. Drinking and
               | smoking weren't stigmatized like they are now and there
               | were fewer OTC drugs to medicate aches and pains. People
               | with physically demanding jobs routinely had a beer at
               | the pub on the way home to ease their aches and help them
               | sleep and it wasn't anything you needed to explain or
               | justify.
        
         | treeman79 wrote:
         | I have a clotting disorder. Factor 5. My blood clots much to
         | easily. Alcohol is a blood thinner. Think long term covid
         | symptoms.
         | 
         | My personal opinion is that many relatives in the family drink
         | themselves to death in effort to feel normal.
         | 
         | On Normal prescription blood thinners my symptoms go away
         | quickly and come back whenever I stop them.
        
         | gnicholas wrote:
         | Not sure if it was an autocorrect, but teetotaling is unrelated
         | to tea.
        
           | DoreenMichele wrote:
           | Nope, not autocorrect. My personal deficiency. Thanks for
           | bringing that up. I love learning new things from the many
           | pedants who hang here.
           | 
           | https://en.m.wikipedia.org/wiki/Teetotalism
        
             | gnicholas wrote:
             | Yeah almost closed with a /pedantic tag for a lighter feel.
             | I have enjoyed learning from you also!
        
         | junon wrote:
         | "Auto-corrupt" wow I'm somewhat upset I didn't think of that
         | first.
         | 
         | Unsurprisingly autocorrect tried to autocorrect it to
         | "autocorrect".
        
         | GordonS wrote:
         | My grandfather was similar - he started drinking after he
         | returned home from WW2. He kept the outward appearance of an
         | old-school hard guy, but he was plagued by nightmares and was
         | obviously very disturbed by some of the things he'd seen and
         | done. As kids, we used to love listening to his war stories,
         | but every now and then he had to stop and wouldn't finish a
         | story. As kids, we didn't understand how this seemingly
         | invincible man, who we basically idolised, could have such
         | demons.
         | 
         | He drank heavily for decades - vodka and super-strength lager.
         | As a kid, I don't think I ever once saw him without a can of
         | beer at his side.
         | 
         | One day when I was 16 or so, he ended up in hospital because of
         | his drinking. He decided he would stop drinking - and he just
         | did, having only a single hiccup in the 10 years or so before
         | he died. It was really quite incredible - that must have taken
         | incredible strength and will power after decades of abuse.
         | 
         | I've had my own brushes with drink a long time back, and I
         | fully agree with your reasoning - I think most people that use
         | drink and drugs are able to do so safely and responsibly, and
         | most of those that don't sink into habitual drink or drugs for
         | a _reason_ ; trying to ease pain (physical or psychological),
         | make life more bearable, or to escape it altogether.
        
           | DoreenMichele wrote:
           | Someone once told me that just up and quitting alcohol or
           | other things without treatment, drama, etc. was kind of the
           | norm for the generation that fought in WWII. I have also read
           | that Vietnam vets did a lot of drugs while in Vietnam but
           | most of them quit when they returned to the US and did so
           | without any kind of treatment.
           | 
           | Vietnam was really ugly. Women and children were acting as
           | suicide bombers and it was an unpopular war, so we did one-
           | year tours and most people going were about 19 years old
           | (compared to mid twenties for average soldier age in WWII)
           | and you are most likely to die in your first battle. If you
           | survive your first battle, your odds of surviving the war go
           | up.
           | 
           | So there were a lot of people seeing their first battle at a
           | young age and it was a meat grinder. It was ugly even for a
           | war.
        
             | scns wrote:
             | As these experiments have shown over 40 years ago, animals
             | cease doing opiates when their needs are met.
             | 
             | https://en.m.wikipedia.org/wiki/Rat_Park
        
               | bko wrote:
               | The narrative is popular, but if you read the criticism
               | and failure at replication, you'll see the study is far
               | from conclusive.
        
               | tartoran wrote:
               | Not only that but animals can't fall off the wagon
               | because they don't control the intake and even if they
               | had the temptations you wouldn't know
        
             | notdang wrote:
             | > Women and children were acting as suicide bombers and it
             | was an unpopular war.
             | 
             | From my experience with the URSS Afgan war veterans, the
             | problem is not when children and women are trying to hurt
             | you. The post-war nightmares come from you deliberately
             | hurting them in most unimaginable ways. Unimaginable even
             | to the perpetrators after the war finishes.
        
               | DoreenMichele wrote:
               | It was only intended to say in a nutshell "When you have
               | a situation where people think it's appropriate to strap
               | bombs to children, things are extremely ugly."
               | 
               | I didn't really want to go into a whole lot of details.
               | The ugliness of war is not really directly on topic and I
               | try harder than I used to to make my point in a way that
               | shouldn't require trigger warnings.
        
             | RobertoG wrote:
             | >>"I have also read that Vietnam vets did a lot of drugs
             | while in Vietnam but most of them quit when they returned
             | to the US and did so without any kind of treatment."
             | 
             | I have read elsewhere that something that makes a big
             | difference when quitting drugs is change your environment
             | totally. That means, the group of people you spend time
             | with, but maybe, also, work and even home. Moving away to
             | another city or country probably helps.
             | 
             | Frequently, we don't realize to what point we are our
             | environment.
        
               | DoreenMichele wrote:
               | "Change your people, your places and your things" is
               | something I have heard as a recommended best practice for
               | overcoming addiction. I suspect there is some element of
               | psychology involved but probably also physical effects.
               | 
               | It's more or a less a recipe I followed as part of my
               | efforts to address a completely different health issue
               | having nothing to do with addiction. I think we are in
               | the infancy of our understanding of how germs, chemicals,
               | etc. proliferate in our lives and shape them.
               | 
               | And, yes, hopping a flight back to the US and making a
               | clean break with Vietnam -- both the place and the war --
               | likely helped them make a clean break from their
               | addiction in this case.
        
               | jeremyjh wrote:
               | Yes but they are really talking about habits/triggers
               | there. They have another saying: "Wherever you go, there
               | you are." The core assumption of twelve-step programs is
               | that the problem is defects of character in the
               | individual.
        
               | DoreenMichele wrote:
               | It's a known best practice. Best practices work well
               | whether or not our ideas about why they work are
               | accurate.
               | 
               | I'm speculating that we don't fully understand _why_ it
               | works and it may be effective for reasons beyond _habits
               | /triggers._
        
             | pnutjam wrote:
             | Yup, and imagine seeing all the new people show up and get
             | killed immediately. How that must have effected the way
             | they interacted with people, and how it must have felt to
             | be treated that way when you first show up.
             | 
             | The new people would get you killed if they didn't learn
             | how to avoid dying.
        
               | [deleted]
        
             | SerLava wrote:
             | I think a bigger factor was that we were the good side in
             | WWII and the bad side in Vietnam.
        
         | papito wrote:
         | There is truth to that. We abuse substances without
         | understanding why. Getting to the root cause of that
         | existential angst is not easy. And I say "abuse" to distinguish
         | between that and physiological dependency. I think the word
         | "addiction" is overused, as most addictive behavior is
         | overindulging and a chronic, negative habit loop.
        
         | sys_64738 wrote:
         | Alcoholism in one person isn't contained to just one person. It
         | affects everybody around them as they need to live with the
         | fallout. An alcoholic will do anything to get their next drink
         | and restricting cash access leads to horrendous consequences
         | sometimes.
         | 
         | When you live with that in childhood then you make sure you
         | don't get exposed to it in adulthood. I drink socially but made
         | sure to marry somebody who hates alcohol. Living with an
         | alcoholic as an adult isn't good for your mental health.
        
       | harlanji wrote:
       | Being an addict seems more social than anything. It's possible to
       | go through a party phase and then years later go through an
       | unrelated tough patch, having not touched drugs for years, and
       | then hear whispers of addiction to explain the unrelated issue.
       | Nobody dares broach the subject, and so a person clean for years
       | and never really an addict can have their life ruined by others
       | calling them one. Maybe they have real pictures from the phase or
       | similar to circulate. It is slander even if the photos are real,
       | and there's no recourse. That can happen to a non-addict who
       | experimented; can only imagine how likely a true addict would be
       | to relapse in such a hopeless situation. Addiction is a
       | destructive habit or system that needs to be replaced.
        
       | jl2718 wrote:
       | "There are people who went through AA, recovered from their
       | alcohol addiction, and are able to drink moderately."
       | 
       | There are also people who have survived skydives without a
       | parachute. This article seems like some kind of self-
       | justification for returning to destructive behavior. I imagine
       | their codependent somewhere rolling their eyes again at this
       | mental gymnastics routine. Here we go again....
        
       | kelnos wrote:
       | I really want to believe this, because "once an addict, always an
       | addict" has always sounded like an unsupported, junk-science,
       | catchy thing to say, and not something based in reality. And I
       | don't really want to believe (yes, I know this is an emotional
       | take), that some people's brains are just fundamentally "broken"
       | in a way that means they can't enjoy some nice things without
       | destroying their health and relationships.
       | 
       | I think also the idea of addiction (or an "addictive
       | personality") as this inherent, unchangeable thing just doesn't
       | pass the smell test for me. Our understanding of the human brain
       | is still pretty limited, and making a blanket statement like that
       | just doesn't make sense.
       | 
       | I can certainly understand this attitude for practical reasons:
       | if you can get an alcoholic to stop drinking, and stay sober for
       | the rest of their life, yes, you've certainly solved that
       | problem. But I also suspect you haven't solved some of the
       | underlying issues (e.g. around anxiety, dealing with emotion,
       | etc.) that probably led them to drink excessively and
       | uncontrollably in the first place.
       | 
       | But I know very few people who have (to my knowledge) gone
       | through this sort of thing, so while I can intellectually spout
       | off what I believe to be true, it's not coming from a position of
       | experience.
       | 
       | The only real data point I have that perhaps aligns with this
       | article is my father, and this is only from what I was told (by
       | him, decades later). In his teens and early 20s, he drank heavily
       | (to the point of doing some pretty unsafe things), nearly every
       | night of the week; he was friends with the bartenders at many of
       | the local bars, and would stay after closing to continue
       | drinking. But during my childhood, I'd only known him to have a
       | beer or two at a family get-together or neighborhood block party,
       | so I asked him what changed. He said that he wanted to marry my
       | mom, and that required him to put all that behind him. She was ok
       | with the occasional social drink, but binge drinking or any kind
       | of drunkenness was not kosher. He told me all this when I was in
       | my late 20s, while we were having dinner at a brewery... drinking
       | beer, of course.
        
       | imvetri wrote:
       | "you are an addict, be addicted to something else" - movie quote
        
       | SargeZT wrote:
       | For anyone who wants a more evidence-based approach to addiction
       | than 12-step programs, SMART recovery might do the trick for you.
       | It helped me greatly with my alcohol addiction, and it doesn't
       | treat addiction as a forever thing. I've been sober for 6 years
       | or so now, and I haven't needed to attend a meeting since I beat
       | the addiction.
       | 
       | Meetings are free, there are online sessions all the time, and
       | it's just a great community overall.
        
         | vitabenes wrote:
         | Interesting, I'll take a look at that. Congrats!
        
         | toyg wrote:
         | What is your experience about the following paragraph?
         | 
         |  _> you can go from being addicted to alcohol, to having a
         | social drink once a week._
         | 
         | That goes against pretty much everything I've ever been told by
         | addicts to alcohol and drugs. Once you've been "in the tunnel",
         | there just isn't "a social drink" - even a drop will get you
         | off the wagon for good.
        
           | SargeZT wrote:
           | For alcohol that may be true, but the ultimate goal of SMART
           | is sobriety. There is another (smaller) branch of REBT drug-
           | based therapy called 'Rational Recovery' that uses naltrexone
           | (an opiate blocker) before drinking to reduce the pleasurable
           | feeling associated with drinking.
           | 
           | I tried it, but it didn't work for me. It certainly makes
           | drinking less pleasurable, but I was using it as a coping
           | mechanism for my anxiety.
           | 
           | I think for some people, that approach might work. Also, if a
           | person solves their underlying psychological problem which
           | led to the need of alcohol for a coping mechanism, I think it
           | might work as well.
           | 
           | I'm probably saddled with anxiety for life, but I've learned
           | healthy coping mechanisms. Besides the taste of a cold beer
           | after mowing the lawn, I don't miss it in the slightest.
        
           | retrac wrote:
           | It's not my experience. I do believe it's riskier than simply
           | abstaining long-term. You are, in fact, reminding yourself of
           | something you found so compelling once that it derailed your
           | life. But personally, I have been addicted to amphetamine and
           | alcohol/benzodiazepines badly enough in the past, that I
           | could not discontinue them suddenly due to the severity of
           | the withdrawal. Yet in recent years I have felt able to get
           | drunk at a party for example, without serious cravings in the
           | weeks that follow. And I'm back on amphetamines for ADHD
           | which I take to schedule. I won't lie though; the thought of
           | taking two pills instead of one does occur to me not
           | infrequently. The temptation is probably always there once
           | you know what it's like. But my experience is that no, it
           | doesn't automatically derail necessarily.
        
           | [deleted]
        
           | runawaybottle wrote:
           | That's not 100% true. _Exhaustion_ is real. Can you watch the
           | same Marvel super hero movie for the n-th time, even though
           | you loved the first few? You can't, you just get tired. Burn
           | out is real even amongst addicts.
           | 
           | You literally get _tired_ of this shit. Before I became an
           | addict, another legitimate addict told me why he stopped - he
           | just got tired. I'm talking years of daily drinking, and all
           | the consequences that come with it (every bridge burnt, every
           | path destroyed, credentialed as a true fuck-up). Exhausted.
           | 
           | That's the thing about abuse. If you took one hit of cocaine,
           | and you die, that's the end of your abuse. Addicts can take
           | hit after hit after hit, and still live. That's scarier than
           | death, and extremely tiring.
           | 
           | I am tired of it, pure exhaustion is a way out. The
           | implication of that is that you yourself are such a piece of
           | shit that you didn't quit until you yourself got tired.
           | 
           | It's shameful.
        
             | sethjgore wrote:
             | Check out the Sinclair method.
        
               | BayAreaEscapee wrote:
               | I'm going to second the Sinclair method, which involves
               | taking naltrexone or nalmefene. I started with the
               | Sinclair method at the same time I started participating
               | in SMART recovery online meetings. I only drink alcohol
               | about once a week now and only in moderate quantities.
               | 
               | Here are some links for anyone interested:
               | 
               | https://www.amazon.com/Cure-Alcoholism-Medically-
               | Eliminate-A...
               | 
               | https://www.youtube.com/watch?v=6EghiY_s2ts
        
       | awaaythroow wrote:
       | The author states that thinking that you have an addictive
       | personality is unhelpful. Articulated that way, it could be true,
       | but understanding that there is a predisposition towards
       | addiction[1] is helpful to overcome it, and does not contradict
       | the fact that one can recover from addiction.
       | 
       | From Overcoming Sex Addiction by Thaddeus Birchard [2]:
       | 
       | " _A predisposition towards addiction, be it genetic or a legacy
       | from the historic family dynamic, is important to understand. It
       | reduces shame to know that you are vulnerable to sexual addiction
       | not because you are morally deficient but because you are
       | predisposed towards addiction either through genetic inheritance
       | or though interfamilial patterns. The more that shame is reduced,
       | the more that the drive to act out sexually is lessened._ "
       | 
       | " _Once you understand that this dysfunctional regulation was set
       | up in childhood, there is a reduction in shame because you are
       | not responsible for having the problem. However, you are
       | responsible for what you do about it._ "
       | 
       | [1] For example, because of childhood trauma. See
       | https://youtube.com/watch?v=_-APGWvYupU and
       | https://newyorkpathways.com/sexually-acting-out-as-response-...
       | 
       | [2] I'm halfway through this book and found it very helpful. I
       | recommend it for anyone dealing with addiction.
        
       | YarickR2 wrote:
       | Well, quit smoking cold turkey after doing so for 10 years. No
       | addiction. Quit eating lots of sugar, after doing so for 30
       | years, replaces with fruits and nuts. No addiction. Can't stop
       | reading books, doing so for 40+ years; addictive as hell. I know
       | iv drug users , they quit and do not look back, so , oaaa does
       | not hold true in general
        
       | rhyn00 wrote:
       | Marc Lewis, a neuroscientist has a nice book on the topic, which
       | to me makes complete sense (and is grounded in sound science).
       | His view on the topic is that addiction is nothing special, just
       | a learned behavior. Hebbian learning states that neurons that
       | fire together wire together (corollary: neurons that don't, the
       | connection weakens). The neurons in the limbic system control
       | emotions, attention, desire, and fear. The prefrontal cortex
       | (PFC) controls planning, expectation, and long term planning. We
       | are motivated to do things that we desire, or avoid things we
       | fear, which is controlled by the limbic system (also involving
       | dopamine release).
       | 
       | Let's take drugs for an example but this can apply to other
       | behaviors like internet usage, eating, falling in love, becoming
       | obsessed with a hobby, or cronic anxiety toward something
       | (avoiding fear). When we take a drug (or do xyz behavior ) it
       | gives us a positive feeling (pleasure, or comfort in avoiding
       | fear) and probably a favorable outcome occurred, so we are likely
       | to engage in the behavior again. Each time we engage in the
       | behavior the connection between the limbic system and the
       | stimulus that triggers it, strengthen. When the trigger happens
       | the limbic system lights up and triggers the PFC to create a plan
       | and imagine how good it will be (then a positive feedback will
       | occur - this is craving). Over time more and more stimuli will
       | become triggers. Also, if you don't use it you lose it, and the
       | neurons responsible for long term planning will weaken their
       | connection to the limbic system (also, shown in brain scans),
       | making it harder for you to assert self control.
       | 
       | However, your brain is plastic, and you can also unlearn the
       | behavior over time (studies also support this). Meditation can
       | help because you can stimulate these neural pathways in a
       | controlled environment. For example you can imagine how a trigger
       | leads to drugs, then you can imagine how drugs leads to bad
       | things while meditating - over time you can strengthen the
       | connection from the trigger to the emotion and imagery of bad
       | things happening. Ofcourse meditation is not the only thing that
       | can help, but the main idea is that you want to make your brain
       | associate the bad behavior with bad outcome, and strengthen the
       | association of good outcomes with fear/desire circuit.
       | 
       | Book: The Biology of Desire: Why Addiction Is Not a Disease -
       | https://www.amazon.com/Biology-Desire-Why-Addiction-Disease/...
       | 
       | Youtube: The Neuroscience of addiction -
       | https://www.youtube.com/watch?v=aOSD9rTVuWc
       | 
       | Edit: typos
        
       | chiefalchemist wrote:
       | A or B? Why does it have to be binary? It seems that a spectrum
       | is in order.
       | 
       | Our brains are all not exactly the same. So there's a case for A.
       | 
       | Our lives are all not exactly the same.So there's a case for B.
       | 
       | The best answer might be C, a spectrum. A spectrum that considers
       | both and some combination of A and B.
        
       | [deleted]
        
       | cratermoon wrote:
       | Addiction is a brain disease, and it matters:
       | https://pubmed.ncbi.nlm.nih.gov/9311924/
        
       | runawaybottle wrote:
       | It's very hard to understand addiction. I know I had two distinct
       | addictions for wildly different reasons. With certain games or
       | porn, it's just, I loved it too much. Later, with alcohol and
       | prescription meds, it just made me feel less shitty. The former I
       | just enjoyed it too much, and the latter, I never found a better
       | substitute for anxiety and self hatred.
       | 
       | One was truly an insatiable desire, the other was truly self
       | medication. If you suffered from this, it's very hard not to
       | think you were born this way.
        
       | lookalike74 wrote:
       | > "Opinion A can make people feel powerless. I'm an addict and
       | I'll be that way forever- it creates feelings of shame and being
       | a victim. It also creates a stigma in society that addicts are
       | somewhat broken and can't be fixed.
       | 
       | Opinion A seems a little bit outdated. Abstinence isn't
       | necessarily the goal."
       | 
       | This isn't a very informed argument at all. One, abstinence isn't
       | the goal of AA or 12-step ; recovery is the goal, and it starts
       | with abstinence. Two, addiction is best defined as having lost
       | the power of choice. So not only does this opinion ignore that,
       | it propagates the very stigma it intends to diminish.
        
         | sneak wrote:
         | Reminder: AA and 12 step are faith-based, and aren't very
         | effective when actually measured (roughly equal to the
         | effectiveness of not using AA/12-step).
        
           | lookalike74 wrote:
           | Sorry, there are untold (but not unknown) millions more
           | people around the world who've recovered from addiction with
           | 12-step than anything medical. AA was founded in part by a
           | doctor (himself an alcoholic) who recognized that medical
           | science had no solution to alcoholism. Fast-forward to now
           | and the 'medical solution' to addiction is usually another
           | addictive substance. Can those help? Sure, and they do. But I
           | don't think there's been any significant studies confirming
           | medical science has a better solution than 12-step. If you
           | have evidence that relapse rates are lower outside of 12-step
           | than within, please share because I've never heard of it.
        
             | sneak wrote:
             | > _But I don 't think there's been any significant studies
             | confirming medical science has a better solution than
             | 12-step._
             | 
             | This is false. 12-step is a faith-based system, and is
             | approximately equal to other unscientific systems in terms
             | of success rate.
             | 
             | The AA book itself perpetuates the lie of its
             | effectiveness:
             | 
             | > _Rarely have we seen a person fail who has thoroughly
             | followed our path. Those who do not recover are people who
             | cannot or will not completely give themselves to this
             | simple program, usually men and women who are
             | constitutionally incapable of being honest with themselves.
             | There are such unfortunates. They are not at fault; they
             | seem to have been born that way._
        
               | EdwardDiego wrote:
               | I went to AA when I was concerned about my drinking. A
               | fair few people there seemed to have swapped alcohol
               | dependence for AA meeting dependence.
               | 
               | Definitely better to be reliant on a supportive group of
               | peers than something that'll eventually kill you, but
               | felt like swapping smoking for vaping - definitely better
               | for you, but not solving the underlying cause.
               | 
               | And their view that you're always going to be an
               | alcoholic, for the rest of your life feels like a belief
               | rather than scientific fact, and sometimes, a self-
               | fulfilling prophecy when members relapse.
               | 
               | But ultimately, it works for some people, so more power
               | to them.
        
               | janto wrote:
               | Your dismissal of 12-steps system purely due to it being
               | faith-based, is unscientific. Psilocybin (a religious
               | experience inducing substance) appears to be a very
               | promising treatment.
        
               | danaris wrote:
               | "This drug induces hallucinations. Some people interpret
               | those hallucinations to be religious in nature.
               | Therefore, this drug is faith-based."
               | 
               | That's not a very strong chain of logic. The 12-step
               | system is, at least based on my very limited
               | understanding, founded with assumptions that the people
               | using it will be either Christian or theistic and raised
               | in a culturally Christian society, and thus have a
               | similar notion of "faith in a higher power". That's what
               | "faith-based" means.
        
               | janto wrote:
               | Psilocybin has a distinct spiritual phenomenology that
               | not all hallucinogens have.
               | 
               | While there is a difference between a faith and a
               | spiritual experience, they both work within a religious
               | framing of life, which might be helping the individual
               | with addictive behavior here.
        
             | [deleted]
        
             | lotophage wrote:
             | Here's an article from The Atlantic that you might want to
             | read.
             | 
             | > Its faith-based 12-step program dominates treatment in
             | the United States. But researchers have debunked central
             | tenets of AA doctrine and found dozens of other treatments
             | more effective.
             | 
             | https://www.theatlantic.com/magazine/archive/2015/04/the-
             | irr...
        
           | lookalike74 wrote:
           | "The 2020 Cochrane meta-study of Alcoholics Anonymous says
           | that, based on randomized controlled trials, AA-oriented
           | therapies have a 42% abstinent rate one year after treatment,
           | compared to the 35% abstinence rate with other therapies." ht
           | tps://en.m.wikipedia.org/wiki/Effectiveness_of_Alcoholics_...
        
         | darkerside wrote:
         | The ironic thing, as a former smoker, is that we never lose the
         | power of choice. We simply choose not to exercise it, and
         | perhaps forget that we can. But it's always there. And the one
         | weakness of many of these programs is that they never force the
         | person to confront that uncomfortable reality within
         | themselves. IMO.
        
       | ChemSpider wrote:
       | Just the other week I read in a medical textbook:
       | 
       | If you are overweight (obese) at age 18, there is only a 15%(!)
       | chance that you will manage to have a more healthy weight during
       | your adult life. I found that number utterly depressing and
       | shockingly low.
        
         | watwut wrote:
         | Through, while long term weight loss have unintuitively low
         | success chances, it is possible to improve health results
         | themselves.
         | 
         | Things like moving regularly improve people's health even if
         | they don't result in long term weight loss. The same with diet
         | change - you can eat better and have better health even if you
         | remain fat. You can lower your sugar consumption, stop to drink
         | sweetened drinks and your chance of getting diabetes 2 will go
         | down regardless if whether it moves your weight.
        
         | heavenlyblue wrote:
         | And if you're not obese at age 18, what is the chance you are
         | obese when you're an adult? I have a feeling it's actually
         | larger than 15%
        
         | Barrin92 wrote:
         | Relevant to the topic of personality and choice in the article.
         | Robert Plomin in his book _Blueprint_ cites the pretty
         | astonishing finding that the weight of adopted children is
         | pretty much not at all correlated to the weight of the adopted
         | parents, whereas the weight of the birth parents is a strong
         | indicator for weight in adulthood, even if separated at birth.
         | 
         | https://imgur.com/XIyvzFz
        
           | darkerside wrote:
           | Is that surprising? Weight is strongly correlated with
           | height, which is absolutely genetic. I'm sure that BMI would
           | be less correlated than pure weight, although I don't know by
           | how much.
        
         | Buttons840 wrote:
         | It's worth remembering that only a portion of those people
         | actually make losing weight a goal. It might be a high portion,
         | but still a portion. Simply making the goal increases your
         | chances.
        
         | maccard wrote:
         | That lines up with intuition; if you are obede at 18, chances
         | are your parents have not prioritized a healthy relationship
         | with food, meaning it has never been a priority for you or your
         | family, and you are unlikely to change those entrenched habits.
        
           | [deleted]
        
           | dathinab wrote:
           | That might depend a lot on the country you are in/from.
           | 
           | The huge majority of (similar aged) people I had meet between
           | 16-20 which had been obese where so because of "health
           | issues" not directly related to them eating unhealthy being
           | lazy.
           | 
           | As such it's not surprising if you have problems changing it
           | because "just" eating healthy and doing sports is far from
           | enough to fix it. And trying to fix it with that is often a
           | task needing far more discipline and self control then the
           | large majority of humans (independent of weight) have.
           | 
           | I mean let's be honest the difficulty many of this people
           | face is way higher then the difficulty for a young(1) health
           | male to get a black belt in Judo, Karate or similar.
           | 
           | (1): Start training with ~14 or earlier, through not
           | necessary with high commitment, then at some point later
           | (e.g. 16,18,20) added commitment trying to get a black belt.
        
             | maccard wrote:
             | Are health issues unrelated to obesity the primary cause of
             | obesity in under 18s?
             | 
             | Also, I specifically never called anyone out as lazy. The
             | majority of obesity is overeating (a single Starbucks
             | muffin is a 10k run). Yes there are people with
             | imbalances/medication that are outliers but most people
             | aren't outliers.
             | 
             | I specifically called out a relationship with food being
             | something that's carried into adulthood as the cause of the
             | relationship between those figures.
             | 
             | An obese 14 year old may have some underlying health
             | condition but is more likely to be a victim of
             | socioeconomic problems; lack of access to healthier and
             | more balanced foods, or to have obese parents (which
             | appears to be a good indicator for childhood obesity).
             | Neither of these are easy solves, and the blame doesn't lie
             | with an individual, but it does explain that someone who is
             | obese as a child is more likely to be obese as an adult.
        
               | amanaplanacanal wrote:
               | There was a recent article discussed here that made the
               | case that our obesity epidemic was primarily caused by
               | something environmental, not by individual eating
               | choices. It seemed pretty convincing.
        
               | dathinab wrote:
               | > Are health issues unrelated to obesity the primary
               | cause of obesity in under 18s?
               | 
               | Idk, I can only speak about people in my environment.
               | 
               | Where I can only remember one case which might have been
               | because of overeating and I say might because I simple
               | don't know.
               | 
               | Multiple of the obese people I did know had a more
               | controlled and some times far more healthy diet then most
               | people I know.
               | 
               | Many cases I know did slowly but continuously got bigger,
               | i.e. something which can totally happen without
               | overeating.
               | 
               | I also had meet people the other way around, like needing
               | to consume ~6000+ kcal a day when they don't do sports or
               | they are at risk of becoming severely underweight...
               | 
               | > called anyone out as lazy.
               | 
               | The main reason I mentioned sport is because I know of a
               | case where the person had a controlled diet and did more
               | sport then most other people in class and still looked
               | quite square, from what I learned this person slowly over
               | multiple years got more and more weight without being
               | able to lose any of it.
               | 
               | > . The majority of obesity is overeating (a single
               | Starbucks muffin is a 10k run).
               | 
               | I'm not sure if it's the majority. It's definitely a
               | thing, and very often a thing for extreme cases. It also
               | might very well play a big role in countries with unusual
               | many and many unusual extreme cases of obesity. But many
               | of the cases I know did slowly accumulate weight over
               | years without being able to lose weight starting from a
               | very very young age on.
        
         | zz865 wrote:
         | I'm impressed 15% of people can lose weight. I'd expect 99% of
         | people to weigh the same or more at 40 than 18.
        
           | MattGaiser wrote:
           | I want to know the attached caveats to that. Is it 15% lost
           | weight at some point or the much more impressive, 15% lost
           | weight and kept it off?
        
         | float4 wrote:
         | Someone on HN once made the comparison between obesity and the
         | old attitude people had towards depression. When you were
         | depressed, you "just" had to go out and do things. You "just"
         | had to drive out the negative thoughts with positive ones. etc.
         | 
         | When you're overweight, you "just" have to get into a caloric
         | deficit. "Just" undereat 7700kcal and you've lost 1kg of
         | bodyweight. It's that simple.
         | 
         | Except it's actually hard.
        
           | choeger wrote:
           | That doesn't mean it's not true, though. Obese people _do_
           | lose a lot of weight when they undereat and depressive people
           | _do_ profit from outside activity, sports, etc.
           | 
           | It's just that life often looks like you cannot do it for
           | various reasons. The complicated thing is of course to find a
           | tiny crack in that bubble of constraints where you can force
           | a change.
           | 
           | Just an example: For many people it would be beneficial to
           | ride a bike to get to work. This alone won't change your body
           | completely, but it is a great start, losing you a couple of
           | hundreds of kcal per day _and_ encouraging more bike tours.
           | But that 's obviously not possible for everyone and it is
           | difficult to tell from the outside whether someone just
           | rejects this approach because they are lazy or for valid
           | reasons.
        
             | elliekelly wrote:
             | I would encourage you to track your steps for a week and
             | then get two 50lb bags of sand from Home Depot and carry
             | them around with you everywhere you go for a week. Compare
             | the steps you took in week #1 to the steps you took in week
             | #2 to see how "lazy" you've become from carrying around all
             | the extra weight. It's hard work being fat. Literally.
             | 
             | "Just ride your bike" is an easy solution for someone who
             | is already normal weight but it's not nearly as easy for
             | someone who's overweight.
        
             | ben_w wrote:
             | The problem is the word "just", not the rest of the advice.
             | "'Just' eat less" has been straightforward for me when my
             | scales tell me I needed to do that, but it clearly isn't
             | for _most_ people else obesity wouldn't be one of the
             | single biggest issues in western healthcare.
        
               | andi999 wrote:
               | Same with climbing everest without oxygen bottles, 'just'
               | use less air.
        
               | ekster wrote:
               | Is choosing to eat less really analogous to choosing to
               | be able to breathe without oxygen?
        
               | ben_w wrote:
               | Climbing Everest without _supplemental_ oxygen is
               | possible and has been done[0], and isn't the same thing
               | as "breathing without oxygen".
               | 
               | [0] e.g. https://en.wikipedia.org/wiki/Reinhold_Messner
        
               | ekster wrote:
               | Ok interesting, but I still wonder if that's really
               | analogous to choosing to eat less food?
               | 
               | That the person who did it has their own Wikipedia page
               | makes me think it is probably harder.
        
               | andi999 wrote:
               | It seems 200 people did it so far, around 4% of all
               | climbers (at some point of time)
               | :https://www.mensjournal.com/adventure/climbing-everest-
               | adria... probably more of the 5k could have done it if
               | they wanted to do it (and prepare longer for it).
        
               | ekster wrote:
               | Also interesting! I am still unsure though how losing
               | weight is like climbing mount everest without
               | supplemental oxygen. Can you clarify that part?
        
               | andi999 wrote:
               | It is about the usage of 'just'. So while in the first
               | case people think the just is justified, the before
               | mentioned data indicates that only a few people manage to
               | 'just' do it. The order of percentage of ppl beeing able
               | to do it is the same as something which seems very hard
               | to do (the everest thing). So while objectively they are
               | comparable it shines light on that the usage of 'just' is
               | bad in both cases while the subjective perception is very
               | different. Not sure if I can make it clearer.
               | 
               | Edit:maybe I was thinking to complicated in this reply.
               | The analogy is: you have two different things which can
               | be achieved through doing a specific thing, but doing
               | this thing is hard in both cases so using the word 'just'
               | is not appropriate which is easier to see in the example.
        
               | tfigueroa wrote:
               | Yes. The odds of someone climbing without supplemental
               | oxygen vs achieving and maintaining weight loss are
               | comparably low, presumably because they are very
               | difficult, and cannot "just" be chosen so simply.
        
               | [deleted]
        
               | roenxi wrote:
               | Changing habits is hard, making choices is hard, doing
               | things that feel uncomfortable is really hard. I have a
               | lot of sympathy, for the idea and we all struggle with
               | stuff like that.
               | 
               | But unfortunately this isn't a complicated subject.
               | Weight is controlled by diet and standard healthy diets
               | are very well known. Nearly everyone can keep their
               | weight down. Even if people don't, it is objectively not
               | that hard to do. A lot of people don't accept the rewards
               | are worth the discomfort.
        
               | balfirevic wrote:
               | > doing things that feel uncomfortable is really hard
               | 
               | > [keeping their weight down] is objectively not that
               | hard to do
               | 
               | Would you mind picking one?
        
             | watwut wrote:
             | It is bad advice, because if you just randomly restrict
             | calories, you will run into other issues.
             | 
             | One problem is that calorie restriction itself is modifying
             | how your body works. So, the weight lost in diet is
             | typically gained back super quickly. And if you repeat the
             | cycle, your body also adjusts by spending less calories.
             | 
             | The other problem is that it just lowering calories easily
             | leads to nutritional deficiency of some sort. Which leads
             | to feeling bad all the time, being tired and passive,
             | unable to perform as previously. So the diet will
             | eventually fail for that reason - because you will be more
             | dysfunctional and breaking it will paradoxically make you
             | more functional.
        
               | xvilka wrote:
               | Unless you follow the diet to the maximum - eat only
               | compatible food and skip incompatible (according to the
               | chosen diet), calculate calories every single day. In my
               | case keto diet worked the miracle. Maybe other people
               | could be successful with other, different diets. But it
               | does work if done properly. Same with exercise. Random
               | exercise can be just as bad as restricting calories.
               | Exercise should be systematic and balanced, as well as a
               | diet.
        
               | SamoyedFurFluff wrote:
               | Keeping track of macronutrients and carb counting sounds
               | significantly harder than "just eat less" and I think
               | bolsters the argument that it may in fact be hard to lose
               | weight.
        
             | loves_mangoes wrote:
             | I don't like how people, still, treat lazyness as a root
             | cause, not as an effect.
             | 
             | Lazyness is a bug, it's a failure state, it's a medical
             | condition. Much like depression, psychology cannot treat it
             | in all cases, but taking the approach that people are just
             | born lazy and iredeemable seems like the most unscientific,
             | least promising, and most likely to annoy your devoted
             | commenter.
        
               | gmadsen wrote:
               | in my personal experience, laziness is absolutely a
               | thing. As an example, many friends in college would go
               | party or hang out far more often than I did. Its not that
               | I didn't like hanging out, its that I valued the long
               | term payout of good grades more than my current
               | suffering.
               | 
               | I've also ran through the mountains until I literally
               | couldn't stand from a pile of stress fractures. Even
               | though very stupid, its an example of mind over matter.
               | 
               | To me laziness is an inability to mentally force action
               | over the brains signals to not incur distress or effort.
               | 
               | I feel pretty confident that there is a large overlap of
               | "lazy people" with people that would have a hard time
               | taking cold showers in the morning for a month, if hot
               | water was available.
        
               | zamfi wrote:
               | > in my personal experience, laziness is absolutely a
               | thing. As an example, many friends in college would go
               | party or hang out far more often than I did. Its not that
               | I didn't like hanging out, its that I valued the long
               | term payout of good grades more than my current
               | suffering.
               | 
               | This sounds more like you're trying to explain the
               | behavior of your friends and are choosing the word
               | "laziness", but that's a pretty reductive explanation for
               | why some people like to party and others don't.
               | 
               | Perhaps if you were willing to do the hard work of
               | questioning your own assumptions and seeing life through
               | your friends eyes a little more you could have more
               | sympathy.
               | 
               | But perhaps you aren't because that's hard work and
               | causes distress you'd rather not incur, and it's much
               | easier to describe human behavior as "laziness" than to
               | understand it's causes.
        
               | dri_ft wrote:
               | broke: calling people lazy.
               | 
               | woke: accusing people of being unwilling to do the hard
               | work.
        
               | gmadsen wrote:
               | I do that plenty, I used that example because it seemed
               | most appropriate for this forum. It was probably because
               | they had a support system, so they felt there lives would
               | be ok even if they did average in school, where I felt I
               | would literally be homeless if I lost my scholarships.
               | 
               | you know who wasn't lazy in school? All the immigrant
               | friends I had.
               | 
               | I could have instead, easily described the 100s of people
               | I grew up around, that would skip work and get drunk
               | instead, spend all their paycheck the day they get it.
               | The obesity, the abuse, the drug addiction.
               | 
               | I have zero sympathy for able bodied people that can't
               | cope enough to feed their children. I don't care the
               | causes, nor are they relevant.
               | 
               | I have worked for $10 an hour doing construction in 100
               | degree weather, and I have also work as a SWE at a FAANG.
               | I have seen the complete lack of self awareness most
               | professionals and/or those from upper class backgrounds
               | have.
        
               | loves_mangoes wrote:
               | >I used that example because it seemed most appropriate
               | for this forum
               | 
               | Any example you pick is going to be complicated. Because
               | they're people. They're doing their best.
               | 
               | Assume good faith. It's not a law, but it helps.
        
               | [deleted]
        
               | webdog wrote:
               | > I have zero sympathy for able bodied people that can't
               | cope enough to feed their children.
               | 
               | Growing up in generational poverty and finding myself out
               | of it, I carried a similarly angry perspective about
               | people for a while as an adult.
               | 
               | I would suggest listening to the stories of people who
               | you say can't cope and maybe be open to the idea of
               | empathy.
               | 
               | Zero sympathy costs more energy than you maybe might
               | realize. Is it really worth it? It wasn't for me.
        
               | NateEag wrote:
               | In my experience, people who focus on laziness are NOT
               | saying the lazy person is irredeemable - they're usually
               | saying precisely "You're choosing to be lazy and you
               | don't have to. Choose to be different!"
               | 
               | Granted, they often don't think through how to do that,
               | or why the person might be struggling to perform, but
               | it's not usually a belief that the person is incapable of
               | doing better.
        
               | pmoriarty wrote:
               | _" You're choosing to be lazy and you don't have to.
               | Choose to be different!"_
               | 
               | This gets to the very important question of how much
               | choice do we really have.
               | 
               | People are the way they are because of how they were
               | raised, their genetics, where and among whom they were
               | raised and their life experiences. There's arguably some
               | choice mixed in there too, somewhere, but how much real
               | choice people have is debatable.
               | 
               | If people don't have much choice in the way they are, it
               | explains why they have a really hard time changing, and
               | there's no sense in blaming them for something they can't
               | change.
               | 
               | Of course some people _do_ change, but maybe that 's
               | because they were the kind of person who could, and other
               | people are the kinds of people who can't.
        
               | loves_mangoes wrote:
               | Thank you for trying to explain their thought process --
               | I appreciate that, that's very kind!
               | 
               | I appreciate that you're very empathetic, and I feel like
               | not everyone else is. There's a whole lot of people who
               | probably can't imagine what it's like to be somebody
               | else. That's hard, isn't it?
               | 
               | But when you tell lazy people not to be lazy, and they
               | don't do it, then it almost sounds like you must either
               | be calling them dumb, or defective.
               | 
               | So that's why I feel like thinking of it as treatable is
               | a nice and friendly middle ground. Which a lot of people
               | don't seem to.
               | 
               | That doesn't seem to be their impulse. Oh, they're lazy.
               | Let's not fix that.
        
               | RobertoG wrote:
               | In my experience, people who focus on the laziness of
               | others are trying to bring the focus at how they
               | themselves are not lazy. There is something similar going
               | on with overweight. What's so difficult? just eat less!
               | look at me! It's a status game, instead of trying to
               | help.
               | 
               | Anyway, to say to somebody "don't procrastinate" is like
               | given a guitar to somebody and tell them "just play!".
               | Sure man, how?
        
               | loves_mangoes wrote:
               | That's hard to want to believe. The problem is if you
               | assume they're not trying to help, then either they need
               | help (too), or there's not much we can do about it.
               | 
               | I feel like a whole lot of people are trying to help,
               | they're just really bad at it and they need help
               | themselves.
               | 
               | .
               | 
               | Thankfully, psychiatry!
               | 
               | Read a book, boys & girls & enby friends.
        
             | atoav wrote:
             | The issue e.g. with obese people isn't that they didn't
             | have the bright idea that they could "just" eat less or
             | "just" move more -- the issue is that there are very often
             | underlying paychological reasons for the way people take
             | decisions. This is _not_ laziness, this is having a
             | personality structure that makes it harder for you to stay
             | healthy.
             | 
             | We all want to be happy, if for some reason happiness for
             | you is tied a lot more to eating than to being healthy and
             | fit, you can try all you want _it just wont make you happy_
             | if you do. That means tackling obesity means also asking
             | yourself hard questions about what food does for you, how
             | it got that way (e.g. having grandparents which nearly
             | starved can have an severe effect on the food habits for a
             | few generations down the line, sometimes parents can only
             | express their affection through food which means now you
             | equate food with existential parental love). Changing
             | habits is hard, understanding your own psychological
             | drivers and doing something about it against the resistance
             | of your brain is way harder. Never underestimate the
             | struggles other people have to take in order to do the
             | thing that is easy for you.
        
               | ekster wrote:
               | Some people preferring being obese because they are happy
               | about eating lots of food isn't really a counterargument
               | to the fact that losing weight is as simple as eating
               | less.
        
               | danieldisu wrote:
               | And getting rich is as simple as earning more and
               | spending less, why are you not rich already?
        
               | ekster wrote:
               | Honestly I am doing quite well by following those simple
               | practices. But creating wealth out of nothing is surely
               | more difficult than eating less of what you already have
               | access to.
               | 
               | Anyway, the point was that being ok with being obese
               | because you are happiest eating a lot doesn't make eating
               | less any more complicated. It's just choosing to do
               | something different, which everyone is free to do.
        
               | atoav wrote:
               | Sliding infinitly far on your socks is totally easy in a
               | world where you ignore friction and the human need to
               | eat/sleep/etc.
               | 
               | Similarily it is totally easy to imagine getting fit/slim
               | by ignoring the forces acting on someone who is obese. Of
               | course one can do that if it fits with ones world image,
               | but I tend to like my models closer to reality.
               | 
               | Don't underestimate what it does to a kid if e.g. one
               | parent has troubles expressing love through any other
               | means than cooking. Suddenly love comes in the form of
               | food. Similar with situation where ancestors nearly
               | starved -- this can fuck up multiple generations. Both
               | examples will take conscious effort to tackle one's
               | psychological drivers, maybe therapy, but quite certainly
               | a lot of time and effort.
               | 
               | Think about a bad habbit you tried to loose and multiply
               | it by a magnitude then you get a glimpse of what this
               | would feel like for an actual obese person (note: I am
               | not obese, neither have I ever been obese). This is why
               | "just eat less and move more" as a statement is
               | ridiculous: a bit like "have you just tried not to be
               | poor" or "have you tried not being depressed all the
               | time". While factually correct it displays ignorance of
               | the forces at play.
        
               | cinntaile wrote:
               | If you ignore the psychological factors then it's just
               | eating less, but the point is that it's not and you seem
               | to not understand that.
        
               | ekster wrote:
               | If you are happy as you are and don't want to lose
               | weight, why would you be eating less in the first place
               | much less running into psychological problems preventing
               | you from doing so?
               | 
               | If the part I don't understand is that there is no such
               | thing as being overweight and happy, and people who feel
               | that way have psychological defects, then it's not that I
               | don't understand your point but I do disagree.
        
               | gmadsen wrote:
               | the psychology was just described to you above. Not sure
               | what foundation you have to "disagree" with. Human
               | actions and thought patterns are not some libertarian
               | utopia of perfect rational behavior based on an economics
               | equation
        
               | atoav wrote:
               | Maybe you should have a serious dialogue with any obese
               | person to figure out why it is hard for them if you care
               | about forming a model of the world that represents actual
               | reality.
               | 
               | Most obese people are _not_ happy with their body or the
               | ways their eating habits impact their live in many ways.
               | Most obese people are also happy when they eat or worse:
               | they are unhappy when they don 't eat.
               | 
               | If eating gives you a short term improvement even if it
               | makes you unhappy in the long term then you might just do
               | it, like in any other addiction (btw. a well researched
               | topic).
               | 
               | The way out of this is _not_ to  "just eat less", the way
               | out of this is to tackle the reason why you only can be
               | happy when eating _and then_ eat less.
        
               | panta wrote:
               | > We all want to be happy, if for some reason happiness
               | for you is tied a lot more to eating than to being
               | healthy and fit, you can try all you want it just wont
               | make you happy if you do.
               | 
               | The point is that overeating won't make us happy either.
               | Maybe it will give some 15 seconds of gratification but
               | then most of us will feel guilt, and the long term effect
               | has terrible consequences. Maybe the problem lies also in
               | the fact that our simple brains can't really understand
               | the future. I've read somewhere that many asiatic
               | languages don't have a future tense, hence people there
               | when facing the choice of eating something think along
               | the lines "if I eat this I AM fatter/less healthy" and
               | this could be a factor in the way lower obesity
               | prevalence.
        
               | atoav wrote:
               | > The point is that overeating won't make us happy
               | either. Maybe it will give some 15 seconds of
               | gratification but then most of us will feel guilt, and
               | the long term effect has terrible consequences.
               | 
               | I don't deny that. Some get unhappy enough to derive
               | enough energy from this unhappiness to tackle this as a
               | real problem. Of course the first box you need to tick to
               | get better is to accept your behaviour is problematic and
               | realize that it makes you unhappy in the long term.
               | 
               | Some might never reach that step to begin with. Many
               | however realize the problems and want to get better but
               | they can't because they constantly fight the symptoms and
               | not the cause, or because their lives give them enough
               | excuses not to do it (whether they are valid excuses or
               | not doesn't matter too much).
               | 
               | I chose to believe that people are a product of both
               | their environments and their own choices. So we are
               | neither completely determined by the circumstances we
               | grew up in nor are we completely free to decide to "just"
               | do things 180deg different than we were lead to believe
               | our whole lives. We can shape our environments and
               | ourselves within certain boundaries and over given
               | timescales, but for this we need to know the forces which
               | act upon us. And everybody has forces acting upon them,
               | the believes, rationalizations and stories we tell
               | ourselves about our place in the world are partly a
               | product of this: we try to be happy with ourselves in the
               | place that we have within the universe. We try to
               | establish meaning in the chaos.
               | 
               | This is why explainations like "some people are just
               | lazy" is less of a true statement about the world, but
               | more of a true statement about the stories a certain type
               | of person has to tell themselves in order to feel good.
               | Because if the weren't "just lazy" suddenly one had to
               | reflect upon the environment, the incentive structures
               | that shaped them into the way they are. Suddenly one
               | would feel the ethical need to change said environment
               | and feel powerless confronted with the scale of the
               | problem. Nah. Moar better to say they are "just lazy",
               | then one can stop thinking.
        
               | SamoyedFurFluff wrote:
               | That still validates the statement that people who
               | overeat also need to really consider the reasons they
               | overeat and why. It's a real deep psychological study as
               | to why this short term joy is apparently worth the guilt
               | later and figuring out strategies to counteract it.
        
             | amanaplanacanal wrote:
             | Have you ever been obese and lost a lot of weight and kept
             | it off for a long period? I'm wondering if you are speaking
             | from personal experience, or just repeating things you have
             | heard from other people.
        
           | qq4 wrote:
           | What is the new attitude towards depression? I think that
           | going out and doing things along with driving out the
           | negative thoughts with positive ones tends to work. Yes it is
           | hard, but that is besides the point. It's not insurmountable.
        
           | dkdbejwi383 wrote:
           | It's like how you can write perfect software by "just" not
           | writing any bugs into it
        
           | anothernewdude wrote:
           | I don't buy calories in. Life forms are full of parts that
           | encourage stability. Your body maintains blood pressure,
           | temperature, oxygen etc. Why not weight as well?
           | 
           | That the relationship of calories in to calories absorbed is
           | linear needs some heavy proof before I'll believe it.
        
             | amanaplanacanal wrote:
             | Agreed. Even simple things like your hunger level are under
             | hormonal control.
             | 
             | Calories out is equally suspect. Your body has mechanisms
             | to adjust his many calories you burn, and those are not
             | under conscious control.
        
             | sethammons wrote:
             | You are currently downvoted but I think there is something
             | to homeostasis.
             | 
             | My favorite counter point to calories in/out crowd is that
             | the body is a dynamic system. The calories out portion
             | doesn't stay constant. I have lost weight while eating more
             | because my base metabolism increased. In "That Sugar Film,"
             | the guy eats the same amount of calories and same activity
             | level but starts to include "daily recommended sugar" and
             | increased his weight. The body is a dynamic system and will
             | change how it stores and processes energy. Yes, you can't
             | violate thermodynamics and eating a calorie deficit will
             | cause weight loss (and possibly other issues), but the
             | system tries to adapt.
        
             | wirrbel wrote:
             | before you downvote this comment, consider
             | 
             | (a) CICO (calories-in/calories out) is not the same as the
             | energy conservation principle, you can claim that CICO
             | model does not work while firmly believing in the energy
             | conservation principle
             | 
             | (b) CICO isn't untrue, its just too simple to model the
             | bodies approach to managing the fat stores. Fat storage is
             | very much controlled by insulin and cortisol. If one or
             | both are high, your body is primed to increase your fat
             | storage
             | 
             | CICO crowd equates 7000kcal with 1kg of fat body mass and
             | then you can do calculations that losing 10k of body mass
             | in a year can be achieved by reducing caloric intake by
             | 200kcal/day, or increasing expenditure by the same amount,
             | or a mix of both.
             | 
             | Experienced dieters know that this doesn't work as easily.
             | 
             | I was trying to loose weight with CICO and hang out in the
             | CICO-crowd forums for 2-3 years until I realised I couldn't
             | lose more than 10kg that way until I plateaued. And in
             | these forums, it seemed to be similar for many.
             | 
             | Then, with fasting and/or keto forums I hang out in there
             | are so many more credible reports of extreme weight loss.
             | And that is because water fasting and/or keto reduce the
             | amount of insulin your body emits, and thus allows your
             | body to really tap into the fat reserves it has in store.
        
               | Gauge_Irrahphe wrote:
               | The inability to burn calories because of nutrient
               | deficiencies is the biggest flaw of CICO. You just won't
               | burn more than your metabolism is capable of burning no
               | matter how hard you try. You can't will yourself to use
               | energy that isn't available. Keto has nothing to do with
               | insulin, it's just a backup mechanism that fails last.
        
               | ItsMonkk wrote:
               | Right.
               | 
               | When you weigh a certain weight, you have a certain
               | resting energy expenditure.
               | 
               | Let's say the average 200lb(Sorry for the American units)
               | man burns 2000 calories a day. If he then goes a week
               | only eating 1500 calories, he will have burned a pound,
               | and now only weighs 199lb, and his new resting energy
               | expenditure will be slightly less. The next week when he
               | is still eating 1500 calories, he will lose only 0.99
               | pounds.
               | 
               | So of course you will run into a time eventually when you
               | plateau. At some point 1500 calories a day will be your
               | new equilibrium weight and you will no longer lose weight
               | without additional changes.
               | 
               | This is typically an argument the other way, as when you
               | do the math this way it's very clear that the energy when
               | stored as fat is incredibly energy efficient. An extra
               | 100 calories might mean that you gain a pound in slightly
               | more than a month, but you won't settle on your new
               | equilibrium until you gain more than 10 pounds. According
               | to wolfram alpha, the basal metabolic rate of a 200lb
               | male is 1997 calories. The basal metabolic rate of a
               | 300lb male is 2465 calories. The daily energy expenditure
               | of a 200 pound male, who runs daily for 3 miles over 30
               | minutes, is equivalent to a 300 pound male. 100 pounds of
               | fat is actually a shockingly small amount of daily
               | calories difference.
               | 
               | Anecdotal evidence: I've lost 70 pounds, then regained
               | the 60 pounds, then lost the 60 pounds, and am currently
               | up 30 pounds. Simple does not mean easy.
        
           | vitabenes wrote:
           | In principle, it's simple. In reality, it gets complex and
           | hard.
        
           | Gauge_Irrahphe wrote:
           | Lead deficiency makes animals both sedentary and depressed.
           | Somebody fucked up big time.
        
           | blfr wrote:
           | Simple and easy are not the same. It is simple if not always
           | easy.
        
             | RobertKerans wrote:
             | This is the critical point, most sibling comments are
             | conflating the two [when in fact they are completely
             | different]
        
               | float4 wrote:
               | Yeah, I purposefully used the word "simple" when I meant
               | straightforward and "hard" when I meant difficult, but I
               | should've explained why I used those words. Either that,
               | or I myself have gotten the meanings of the words mixed
               | up.
        
               | RobertKerans wrote:
               | Meaning seems correct afaics? In particular any
               | commenters who build software or engineer products should
               | recognise this, making simple things is often very hard.
        
               | jmull wrote:
               | Hm. There _is_ a distinction between simple /complex and
               | easy/hard, but it's a basic semantic one. Simple/complex
               | refers to a system or problem, while easy/hard refers to
               | the difficulty of controlling the system or solving the
               | problem.
               | 
               | The problem in this thread with making a distinction
               | between simple/complex and easy/hard is that people are
               | referring to different things. People are even talking
               | past themselves so it's no wonder others don't understand
               | what they mean.
               | 
               | E.g., the energy model of weight gain/loss -- CICO, or
               | calories in, calories out -- is simple. But CI depends on
               | interactions between evolution, hormonal systems (a
               | complex balancing feedback system all its own),
               | psychology, age, money, society, culture, family, food
               | supply, etc., which is complex. For a particular person
               | at a particular point in their life, that bundle of
               | factors may happen to be balanced "downward" so that CI
               | is easy to control and weight loss is simple -- and
               | easy). In other cases, a person may need to dig in to
               | those factors and find a way to rebalance them, which is
               | complex -- and hard.
               | 
               | When you're actually referring to the same thing, simple
               | and easy or complex and hard go together. It is easy to
               | control simple system. It is hard to control complex
               | ones.
        
               | RobertKerans wrote:
               | Yes you are right, and it is this:
               | 
               | > Simple/complex refers to a system or problem, while
               | easy/hard refers to the difficulty of controlling the
               | system or solving the problem.
               | 
               | I do think the distinction is important. I did realise as
               | soon as I'd typed the last comment that it was just
               | people talking past each other -- apologies to others in
               | the thread, I should have edited. But what I mean: with
               | specific exceptions (genetic, psychological, physical)
               | _normally_ both the process and the solution is simple,
               | because of the energy model. Eat less, eat sensibly,
               | exercise very regularly, and the _majority_ of people
               | will see positive results. That 's simple, not quite
               | trivially so, but almost. Actually doing that is not,
               | however, easy for the majority of people.
               | 
               | A better example I think is: I smoke. This is clearly not
               | good for a number of reasons. The solution, and the
               | process to get to that solution is _comically_ simple: I
               | just stop. But yet it is hard.
        
         | Aerroon wrote:
         | Maybe the underlying reason why you're overweight later in life
         | is the same reason you're overweight by age 18?
         | 
         | I think a lot of people upon seeing that statistic will assume
         | that being overweight by 18 will lead to being overweight later
         | in life, but that's not necessarily the case. Perhaps the
         | body's self-regulation on food is 'inherently broken' and
         | that's why they end up overweight in both cases?
        
         | andreasha wrote:
         | What's the name of the medical textbook?
        
           | yonixw wrote:
           | This research suggest even lower chanches:
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539812/
        
           | ChemSpider wrote:
           | See for example here:
           | 
           | https://resident360.nejm.org/from-pages-to-practice/will-
           | ove...
           | 
           | "Obese 2-year-olds had a 75% chance of still being obese at
           | age 35 and obese 19-year-olds had an 88% risk."
        
         | alpaca128 wrote:
         | It's similarly bad with alcohol. The lower the age of the first
         | super drunken state the higher the chance of alcoholism later
         | in life. It really messes with the young brain.
        
         | DoreenMichele wrote:
         | I think all that suggests is that we do poor a job of helping
         | specific individuals pinpoint the root cause of obesity _for
         | them_.
         | 
         | I have lost multiple dress sizes without trying to do so. I
         | finally got the right diagnosis in my thirties, "a better name
         | for my problem than _crazy_ ", and changed my diet in
         | accordance with medical recommendations.
         | 
         | I was 245 pounds for at least three years. I haven't weighed
         | myself in upwards of a decade but I've likely finally dropped
         | back below 180 pounds this year. I say that based on no longer
         | feeling like "a beached whale" who has trouble getting up out
         | of a chair and past experience with where that point occurs for
         | me in terms of weight.
         | 
         | I imagine the minority who do solve it likely don't really talk
         | much about what actually worked for them and why they think it
         | worked. I have gotten insane amounts of ugly pushback for
         | trying to talk about what works for me and my opinions about my
         | own life and body and medical condition.
         | 
         | If you have any sense, you find what works for you and keep
         | your trap shut so the "crabs" don't rip your arms off.
         | Unfortunately that means the other 85 percent don't get to hear
         | "calorie counting might just be a broken mental model and seems
         | largely unrelated to what worked for me" and that leaves a
         | whole lot of people stranded behind our current broken mental
         | models because it's not socially acceptable to say "Well, that
         | doesn't fit my experience. Here's what I think about my own
         | life and maybe we can work out better mental models."
        
         | strken wrote:
         | I was obese[0] 3 months ago, and had been that way for about
         | two years. Now I'm a healthy weight. It was easy to do with
         | minimal lifestyle changes - calorie tracking, minor dietary
         | changes, and couch to 5k running a couple of times a week.
         | 
         | The way most studies of weight loss work is by recruiting a
         | pool of obese applicants. This is intrinsically biased: someone
         | who has had a lifelong struggle with obesity can be recruited
         | across 100% of their lifespan, whereas someone who spent two
         | years obese and then lost the weight and kept it off can only
         | be recruited for that 2 year window, or 2.5%. There are
         | probably other factors that come into play that bias the sample
         | even further.
         | 
         | The question these studies answer is "given a random obese
         | person, how likely is this person to lose weight?" This is a
         | relevant clinical question, and the answer is usually a pretty
         | low percentage. For an individual who hasn't struggled with
         | obesity their entire life, a more pertinent question is "given
         | that I have just become obese, how likely am I to lose the
         | weight again and keep it off?" The chances of that are much
         | higher.
         | 
         | [0] By BMI, which has a pretty big margin for error, but I was
         | visibly overweight.
        
           | rantwasp wrote:
           | it depends how long you've been obese, how obese you were and
           | if there were external factors that led there.
           | 
           | glad getting back to a normal weight worked for you. This is
           | awesome.
        
           | graeme wrote:
           | Did you grow up obese though? I think the statistic suggests
           | there is something to having the body _grow_ under those
           | conditions.
           | 
           | I was athletic growing up and I'll always have that
           | experience and know how it feels. Someone obese at 18 has no
           | reference point and neither do any of their body systems.
        
             | strken wrote:
             | No, but I'm trying to explain the sampling bias, not
             | talking about growing up obese. If you randomly sample
             | obese people at any age, 18 or 81, your sample will still
             | be biased by years-spent-obese.
             | 
             | There probably is some effect from growing up obese, but
             | the sampling bias is hugely relevant to interpreting the
             | statistics, and it's not talked about much.
        
               | graeme wrote:
               | Fair point
        
       | fitba72 wrote:
       | The disease model of addiction is still hotly debated in the USA.
       | It has been widely discredited and thrown out in other western
       | nations. What's the difference in these nations? These other
       | nations have some form of socialized medicine so you don't have
       | to have a medical illness to have your treatment costs covered.
       | On the contrary, the only way to get treatment costs paid for
       | addictive behaviours in the USA, by a medical insurance company,
       | is if you have a disease. Try asking your medical insurance to
       | pay to stop you making bad choices or changing your habits. The
       | work of Stanton Peele is seminal in this field for anyone
       | interested. Also check out The Freedom Model. Completely
       | heretical to AA types but to rational thinkers struggling with an
       | addictive behaviour, it could be life changing.
        
         | MattGaiser wrote:
         | > Try asking your medical insurance to pay to stop you making
         | bad choices or changing your habits.
         | 
         | If they found a way to scale monitoring to prove you changed,
         | they absolutely would. The challenge is proving it.
        
         | refurb wrote:
         | This clearly isn't true since plenty of people get access to
         | psychotherapy who have public and private insurance without
         | being diagnosed with a specific illness.
        
           | chillwaves wrote:
           | Every time I look at a therapist while seeking treatment,
           | they always put a disclaimer on their insurance page that a
           | diagnosis is required to be paid for claims. Maybe it's just
           | my state.
        
           | amanaplanacanal wrote:
           | Will insurance really cover a psychiatrist without a
           | diagnosis? I always assumed the doctor was reporting a
           | diagnosis to the insurance company even if they weren't
           | telling the patient.
        
         | wintermutestwin wrote:
         | >On the contrary, the only way to get treatment costs paid for
         | addictive behaviours in the USA, by a medical insurance
         | company, is if you have a disease. Try asking your medical
         | insurance to pay to stop you making bad choices or changing
         | your habits.
         | 
         | Bingo. In the late 80's there was an explosion of teenagers
         | going into drug rehab centers which were usually setup in
         | hospitals with unused bed spaces. It had no correlation with
         | teen drug use increasing and everything to do with insurance
         | paying for it.
        
       | Dumblydorr wrote:
       | There's physiological addiction, withdrawal alleviation, and
       | psychological addiction too, to games or habits or anything.
       | Then, I find where you live, who you know, and how you use drugs
       | in patterns while also living in those patterns, this makes it
       | harder to quit. Finally, there's the coping, the escapism, the
       | alternate forms of consciousness, which help us get through the
       | suffering of daily life.
       | 
       | For me, only using legal "softcore" stuff, I have to think in
       | terms of delay and moderation. I am fortunate, as Lincoln once
       | said, to not have the urge and scourge of strong addiction to
       | alcohol. I can't claim some magical fortitude or moral
       | superiority, I was lucky enough to have a safe life and a "meh"
       | feeling about alcohol and nicotine.
        
       | rvn1045 wrote:
       | Here is what helped me kick two major addictions in my life:
       | 
       | I smoked 3 packs of cigarettes a day for 6 years straight. It
       | started to take a huge hit on my health and I quit.
       | 
       | I smoked marijuana every night for 4 years then quit and have
       | just smoked it occasionally.
       | 
       | I started doing vipassana several years ago, everyday a little
       | bit of a good chemical balance accumulates in my brain and body
       | to the point where a lot of cravings start to disappear and you
       | feel good in your head and body even without drugs like caffeine.
       | 
       | I wouldn't say I've beat all my cravings but they're 90% better
       | ..
        
       | float4 wrote:
       | > Your brain can start functioning normally again in a span of a
       | few months. It doesn't have to be the same, but it should work
       | just fine.
       | 
       | The two articles linked to at the bottom talk about multiple
       | years, the third link points to a news article that refers to
       | some research that uses one year as a minimum.
       | 
       | This feels more believable than "a few months". My flat mate has
       | ADD and has phases during which he's clearly addicted to alcohol.
       | At one point he stopped drinking completely for over 6 months,
       | but drank a small amount _once_ and things spiralled out of
       | control again.
       | 
       | He _does_ view addiction as a personality trait (in part because
       | he knows that people with ADD develop addictions more often), and
       | that attitue actually seems to help him. These days he abstains
       | from addictive things because he  "knows" that he'll get addicted
       | to them once he starts.
       | 
       | I believe in the thesis of this blogpost (that addiction is in
       | fact an emotion regulation problem, and that it can therefore be
       | cured), but the approach my flat mate takes these days works
       | pretty well, at least for the first year.
        
         | donatzsky wrote:
         | Notice that they said _can_ , not _will_ start functioning
         | normally in a few months. Basically it 's a lower bound, and
         | elsewhere they do say it can take years.
        
         | sethjgore wrote:
         | I suggest you mention the Sinclair Method to him. It has worked
         | wonders for thousands who were addicted to alcohol. It is a
         | cheap prescription that you take before drinking and over time
         | people actually drink normally again since the brain is
         | rearranged (the medicine takes away pleasure from the
         | drinking). It might save his life or reduce his cravings.
        
         | loa_in_ wrote:
         | Alcohol is a depressant - it gradually wanes your higher
         | cognitive skills over the course of hours. Very convenient when
         | one's thoughts are racing. I believe there's no causation in
         | "drinking once" -> "drinking more". I believe there's causation
         | in "trying to self medicate" -> "drinking".
        
           | [deleted]
        
           | bserge wrote:
           | _being forced to self medicate by the healthcare industry_
        
       | [deleted]
        
       | dalu wrote:
       | I quit nicotine. Because I had to. My lungs hurt. I tried to quit
       | before but something always brought me back. Nicotine is the most
       | addictive substance I ever took. I did take a lot of drugs.
       | Different drugs.
       | 
       | This article for me is just another on the trash heap. You have
       | to differentiate. There is mental and body addiction. There are
       | so many reasons.
       | 
       | I know people who quit heroin. It's not all the same.
       | 
       | Overcoming something is "easy" just stop taking it anymore and
       | find other things to do instead.
        
       | cupcake-unicorn wrote:
       | Honestly I don't think putting it into sharp categories like A or
       | B are useful.
       | 
       | I don't have addiction but I suffer from chronic mental illness.
       | Strangely despite being diagnosed at a young age and having dealt
       | with it all through college and into my mid 20s people were still
       | treating me like it was just something I could "get over". So I
       | guess this is more in the B camp. For me this wasn't helpful and
       | I felt just as helpless because the problems didn't go away.
       | 
       | Now I embrace the fact that I have a chronic mental illness that
       | is NOT going to go away. This is more in the A camp. But once you
       | embrace that at least for me I felt less helpless. I knew it
       | wasn't going away and I worked to put up supports because it
       | wasn't just a passing thing. It never will be for me.
       | 
       | You can change your response to things and that's maybe the
       | "neuroplasticity" he's talking about? But your brain actually
       | isn't that plastic after childhood. If addiction is anything like
       | my mental illness you'll always have the same response in a
       | situation. You can have years of learned behaviors and coping
       | mechanisms but that doesn't mean that it doesn't destroy you
       | initially when you run into a rough situation. It's accepting
       | that and how to deal with it and the aftermath that you can
       | change.
        
       | scandox wrote:
       | > This has some merit, for example, when it comes to alcohol -
       | you can go from being addicted to alcohol, to having a social
       | drink once a week.
       | 
       | To anyone who has experience of alcoholism from any angle...this
       | is absurd.
        
         | vitabenes wrote:
         | First, can is the important word here. The point is that if the
         | rest of your life is okay, there's no need to run away by
         | drinking yourself under the table. You seem to be implying that
         | there are no people on Earth who went from addiction to
         | moderation. There's nuance to it.
         | 
         | To be fair, however, we're not encouraging people who've
         | struggled with alcoholism (esp. severe) to have a drink.
        
           | toyg wrote:
           | _> if the rest of your life is okay, there 's no need to run
           | away by drinking yourself under the table._
           | 
           | That's... not how it works. One might have become an
           | alcoholic because the rest of their life was shit; but
           | _remaining_ an alcoholic is another matter. Highly-
           | functioning addicts are still addicts. A lot of neurochemical
           | processes don 't care for the social or psychological
           | situation.
           | 
           | It's a bit like saying that "people can sail the Atlantic in
           | a kayak"; a few might make it, but the overwhelming majority
           | will die under the waves, and telling them they can do it is
           | just Bad.
        
             | vitabenes wrote:
             | Fair enough, given that the rest of the series is more
             | about behavioral addictions that substance addictions, it
             | might make sense to change that passage. Thank you for the
             | feedback.
        
           | [deleted]
        
         | bunnyfoofoo wrote:
         | Agreed, if you're in recovery, do not attempt moderation. That
         | normalizes the behavior and is a slippery slope. Seriously
         | thinking this may work for you is a probable sign you should
         | talk to your sponsor or attend an AA meeting.
        
           | throwawaycuriou wrote:
           | The AA perspective on this can come across binary and
           | tautological: if one is an alcoholic, moderation is
           | impossible. But the reality is alcohol dependencies occur
           | across a varied spectrum. Implying there is only one solution
           | is theism.
        
             | bunnyfoofoo wrote:
             | Whatever works for you to keep you sober. If you're feeling
             | tempted and want someone to talk to though, go to an AA
             | meeting. You don't have to agree with any of the religious
             | stuff they say to be around people that know what you're
             | going through and can help.
        
               | throwawaycuriou wrote:
               | Depends on where we place the goalposts. Abstinence or
               | agency? For some cases, full abstinence is the most
               | effective means to a fruitful life of agency. For others,
               | an appeal to our inherent agency (rather than submitting
               | to the impossibility of control / higher power) is the
               | path, possibly one that returns to moderate use.
        
       | locusofself wrote:
       | I have some strong, perhaps knee jerk feelings about the idea
       | that addicts can come around to become healthy social drinkers,
       | smokers, etc. I feel like some probably can, but most probably
       | can't. As someone who had major addiction issues for about a
       | decade and has been clean for 12 years, I have no desire to test
       | those waters, and feel a bit offended at the notion that my life
       | would be better if I figured out how to be a functional user. I
       | have everything to lose and very little to gain.
        
         | jkhdigital wrote:
         | I know, right? My wife basically never drinks, and she's doing
         | just fine. I'm really not missing anything by abstaining from
         | alcohol for the rest of my life.
        
       | fxtentacle wrote:
       | This article seems weird to me, because I view non-substance
       | addictions as a way of procrastination, which in turn is a way to
       | fix a bad emotional state.
       | 
       | When your environment is hostile and depressing, and it certainly
       | is for many people now thanks to covid and the faceless megacorps
       | we have to deal with to get through daily life, then it kind of
       | makes sense to disassociate from reality and get lost in a good
       | video game.
        
       | the-dude wrote:
       | I have always believed there must exist a reason I had
       | addictions. Somehow after about 2 decades, a midlife crisis and
       | starting all over again, and then some years : I seem to have
       | come to terms with these reasons. I seem to understand them, and
       | accept them and therefore accept myself.
       | 
       | And then the urges just disappeared. I tapered off the substances
       | and am clean for over a year now. Fingers crossed. YMMV.
        
         | White_Wolf wrote:
         | I don't know about drugs as such but 15 years after quitting
         | smoking I still dream I'm smoking and wake up in the morning
         | with the urge to light one. If I get a whiff of one when
         | walking down the street... It hurts.
         | 
         | For me: I think I'm still addicted to it or at least I have the
         | neural pathways of one.
        
           | the-dude wrote:
           | Actually this was one of the first 'signs' for me. When I
           | started to really relax, say a 1-2 hour walk in one of our
           | parks, embracing the void as I like to call it : I noticed I
           | didn't smoke. After a while I stopped carrying the
           | cigarettes.
        
           | darkerside wrote:
           | Pain is mandatory, suffering is optional.
           | 
           | Have you read easy way to quit smoking?
        
             | White_Wolf wrote:
             | Fo me it was not exactly easy. I self imposed a limit, in
             | the beginning, of 1/h (used to smoke around 2x20 packs/day-
             | chaining 2-3 at a time). When I was confortable with 1/h I
             | went cold turkey with shivers and the full monty. I
             | wouldn't do that a second time tbh.
             | 
             | On the other hand: My wife had 0 issues and quit overnight.
             | She said she only wanted a smoke a few times/year (maybe
             | 3-5 times or so)
        
               | projektfu wrote:
               | I have a friend who has a similar experience to you. He
               | quit years ago, around when I quit. I had been talking
               | about the book, "The Easy Way to Stop Smoking", so I
               | assumed when he quit he had read it. He had not. He
               | continues to suffer when he thinks about cigarettes and
               | when he smells it across the street or in a park.
               | 
               | I recommended that he read it anyway, and that it is a
               | really useful book for getting over that part of the
               | addiction. He still has not read it. He reads 100 books a
               | year and has not read this inexpensive little 240-page
               | book. Well, some people choose to suffer.
        
               | darkerside wrote:
               | https://www.allencarr.com/easyway-stop-smoking/how-to-
               | quit/
               | 
               | Really, just buy the book. But don't worry about the
               | ceremonies of having that final cigarette. What's
               | important is the base idea. Your mind has been tricked
               | and tricked you in return, and all you need to do is
               | decide to stop playing its games.
        
               | White_Wolf wrote:
               | Sorry. My bad. I didn't start again. So far I managed to
               | hold my ground and not touch ciggies.
               | 
               | I meant - I wouldn't start smoking again to go through
               | stopping.
        
               | the-dude wrote:
               | I think he is saying although you already stopped, the
               | book might still be valuable.
        
               | darkerside wrote:
               | Yes, this :)
               | 
               | I say this as a happy former smoker. Something I never
               | thought I would say.
        
           | dlkf wrote:
           | That tracks. A few months after I quit, I asked my Dad (who
           | quit in the late eighties) when the cravings go away for
           | good. He laughed and said "they don't."
        
             | elb2020 wrote:
             | My dad says the same. But it's been five years since I quit
             | tobacco, and I do not get the cravings anymore. I might get
             | faintly reminded of it, still, connected to certain
             | situations, but nowhere near what I'd call a craving.
        
             | jethro_tell wrote:
             | It's that post dinner smoke for me. Everything else is
             | easy, but I have to have that battle every day.
        
         | dcolkitt wrote:
         | This is just an ancedata, but my 90 year old grandmother smoked
         | like a chimney her whole life. Randomly woke up one morning and
         | had zero desire for a cigarette. She's been tobacco free for
         | nearly a decade.
        
         | toyg wrote:
         | Clarity of purpose makes all the difference for me. The periods
         | where I know what I want and what to do, I have no need for any
         | addiction. When that feeling of purpose and control goes away,
         | I become a slave to them. In some perverse way, they make life
         | endurable when my brain says it shouldn't be.
        
           | rakejake wrote:
           | This x1000. I wouldn't qualify as an "addict" by clinical
           | definitions, but I have a set of bad habits. Over the last
           | year or so I have been making journal entries . The journal
           | entries made me realize exactly what you said - the odds of
           | falling into bad habits multiply several fold during periods
           | where I don't know what I should do.
           | 
           | I realize now that maintaining a journal is a very important
           | and fruitful habit. It is a valuable exercise to record your
           | feelings and state of mind at regular intervals. It will help
           | you figure out your failure modes and patterns (if any) to
           | your successes and failures.
        
         | vitabenes wrote:
         | Congrats!
         | 
         | Hm, why do you think the urges disappeared? Does it coincide
         | with getting your life in order or not?
        
           | the-dude wrote:
           | Not so much _life in order_ , still working on that. The
           | internal discrepancies, finally understanding why and what.
           | Finding peace.
        
             | vitabenes wrote:
             | Yes, life in order is more of a work in progress in
             | general. In any case, good work dude!
        
       | throwawayapatra wrote:
       | I smoked meth almost everyday for a few years, abruptly quit, and
       | never relapsed. I've been trying to quit diet soda for more than
       | a decade and I can't go longer than a week ..
        
       | ChrisMarshallNY wrote:
       | I have opinions and...more importantly... _skin in the game_ ,
       | here. It's been my experience that most of this stuff is written
       | by folks, to whom addiction is an intellectual exercise. Maybe
       | they know someone that may or may not be an addict, and the
       | chances are good, that what happens to that person won't really
       | be life-changing to the person writing about their pet theory.
       | 
       | Things are quite different, when it's _your_ ass, or someone that
       | you _really care about_ , experiencing it.
       | 
       | There's also a great deal of money to be made. Desperate people
       | are easy marks.
       | 
       | That's all I'll say.
        
         | mikevin wrote:
         | > That's all I'll say.
         | 
         | I respect that but I'd wish you'd say more. I have no way to
         | verify who's more knowledgeable about this, you or the person
         | writing the article but as someone who knows a friend of a
         | friend who might be dealing with this kind of problem I'm
         | having trouble finding any real conversation about it. it seems
         | like it's all advertising or armchair psychology when it comes
         | to online resources about this.
        
           | ChrisMarshallNY wrote:
           | Feel free to contact me offline. Most of the folks that have
           | something to say, don't really do so in public.
        
         | teach wrote:
         | Agreed. This article, while interesting enough, is clearly
         | written by someone who is not an addict and does not have
         | close/intimate relationships with any addicts.
         | 
         | "In theory there is no difference between theory and practice,
         | while in practice there is." - Benjamin Brewster
        
           | SV_BubbleTime wrote:
           | > clearly written by someone who is not an addict and does
           | not have close/intimate relationships with any addicts
           | 
           | I have a disproportionately large number of addicts in my
           | family as a percentage. I grew up around this. This article
           | is written by someone working completely in theory.
           | 
           | There is nuance in everything, and many people may actually
           | beat addiction - but from what I've seen, to some degree it's
           | always there somewhere, forever dormant or just napping, just
           | takes the right conditions to come back.
        
         | jkhdigital wrote:
         | Nailed it. It's easy to pick apart the "official" writings of
         | AA since they were mostly written in the 1930s, but the books
         | don't do justice to the actual experience of someone recovering
         | from alcoholism.
        
         | [deleted]
        
         | moonshinefe wrote:
         | "to whom addiction is an intellectual exercise. Maybe they know
         | someone that may or may not be an addict, and the chances are
         | good, that what happens to that person won't really be life-
         | changing to the person writing about their pet theory."
         | 
         | Spot on. I also got a massive armchair amateurish feel reading
         | it. They feel very comfortable emphasizing that certain lucky
         | addicts can seem to recover and moderate, but don't really seem
         | to put nearly as much emphasis on addicts that might die or
         | ruin their lives if they read that advice and think they can
         | moderate before relapsing again. No mention in the article
         | about %s of addicts these facts apply to, no mention of the
         | author's name or credentials. Just a crappy article that
         | doesn't help the situation at all really.
        
         | nicetryguy wrote:
         | This article is at best naive and at worst dangerous and
         | deadly. Addiction is visceral and affects the ancient parts of
         | the brain, the best you can do with consciousness and reason is
         | outsmart it at every turn. Can you rationalize being hungry or
         | in love? It's more like a natural reflex that is described:
         | That's what it addiction feels like. Unfortunately you never
         | get to "eat" or "fall in love". It's at best annoying and at
         | worst crippling, and such is the rest of your life to some
         | degree. I wish you luck brother.
        
       | reducesuffering wrote:
       | I've perused Hacker News almost every single day for 5 years. How
       | do I break that addiction?
        
       | [deleted]
        
       | polote wrote:
       | To me, a lot of time addiction is a choice. I'm not saying all
       | the time, but very often still. I've tried helping different
       | people overcome an addiction, and even though at first they want
       | to stop it, when they start to think more about it they don't
       | really want it to stop.
       | 
       | If you are not entirely convinced that the addiction is doing
       | more harm than good, it is much more difficult to overcome it.
       | 
       | Trying to think rationally is not going to be very helpful, most
       | of people are not able to think that way, emotions and
       | perceptions are much more important. I often say, life is much
       | much easier when you are a rationalist
        
         | post_break wrote:
         | I think this is the dumbest take on addiction. I've seen normal
         | upstanding people resort to stealing copper to get a fix
         | because the drug has wired their brain to get that hit. Or food
         | addiction causing people to binge eat because they can't
         | function without it. This isn't "hey that feels good I need
         | more" this is "my brain is telling me I need this at all
         | costs". Are you the same type of person who thinks people just
         | need to "get over it" when it comes to depression?
        
           | polote wrote:
           | Of course you can't control an addiction, because your brain,
           | or body is asking for it. But when you are aware that you are
           | addict, there are ways to overcome it.
           | 
           | The fact that you don't have the energy, or motivation or
           | anything else to fix it is that you either don't feel like it
           | is going to be better without your addiction or you are not
           | able to maintain the long term work needed. And both of those
           | case are a choice. These are not easy choice, like choosing
           | the color of your socks on the morning, they are difficult
           | choices, but they are still choices you are making.
           | 
           | And when I talk about addictions I dont only talk about big
           | trauma, most of addictions are along the lines of people not
           | being able to prevent themselves to eat chocolate everyday.
           | 
           | People who think you just need to get over depression, have
           | never been depressed.
        
             | post_break wrote:
             | I understand, I hope you know that my initial comment was
             | curt, but I'm glad we're seemingly coming to the same
             | conclusion. I guess the "choice" is just a little different
             | in frame of mind.
        
         | balfirevic wrote:
         | > To me, a lot of time addiction is a choice.
         | 
         | What does "to me" mean here? Do you mean that's how you
         | perceived it in your own addiction?
        
         | EdwardDiego wrote:
         | Genuine question, have you ever recovered from addiction
         | yourself?
         | 
         | Because that phrasing is a bit odd, IMO.
         | 
         | No-one chooses to become dependent, and there's a lot of
         | optimism bias/hubris when people start dabbling in addictive
         | substances - I won't get addicted like _those_ people, I'm
         | different...
         | 
         | But the hard bit, as you've noted, is making the choice to end
         | your dependence. The choice to face whatever in life your vice
         | of choice was numbing you to, to face it naked and vulnerable.
         | 
         | ...that takes a lot of guts. And a lot of repeated attempts.
         | 
         | And you're right about the need for intrinsic instead of
         | external motivation.
        
         | SamoyedFurFluff wrote:
         | I think that's much harder to study whether or not it's a
         | "choice" because the scales of choice are extremely biased. For
         | example if someone is dealing with deep trauma, addiction may
         | be a way of preventing extremely distressing or suicidal
         | behavior by numbing or overwhelming the agony. If the choice is
         | "I'm going to kill myself tonight" and "I'm going to drink
         | until I don't feel anything anymore and will probably live to
         | see tomorrow" then the choice is really stacked towards
         | alcohol.
        
           | polote wrote:
           | That's what I meant by choice. I never said they made the
           | choice to be unhappy. They just made the choice to be
           | addicted. An addiction is not always something negative
        
         | omnicognate wrote:
         | I agree that it is, or can be, a matter of "choice", but that's
         | a subtle thing. What does it mean to "choose" or "want"
         | something when you have conflicting motives, when you both
         | enjoy and hate the same thing, even at the same time? I think a
         | large part of reaching emotional maturity (for some people at
         | least, me included) is about resolving those conflicts and
         | achieving a sort of unity of self. This often involves letting
         | some parts of yourself go, deciding not to be a particular
         | person any more, which the "addiction" may only be one aspect
         | of.
         | 
         | In my case I finally succeeded in quitting smoking, after 9
         | years of 20-30 a day and innumerable failed attempts to stop,
         | just after I got married, 18 years ago. It was easy.
        
       | Osmose wrote:
       | The premise of this article (that "Once an addict always an
       | addict" is false when evaluated from a rational, scientific
       | standpoint) is flawed from the start because the phrase isn't
       | _meant_ to be a rational, scientific claim.
       | 
       | The phrase is a contextual, emotional expression. Sometimes it's
       | used to express frustration that even after years of work and/or
       | progress, an addict might still _feel_ urges and have to deploy
       | coping mechanisms against them. Other times it's a way of
       | empathizing with someone who is a victim of a relapsed addict's
       | maladaptive behavior. Still other times it's a mantra for
       | recovered addicts to stay vigilant.
       | 
       | The repeated references to "victimization" are a red flag to me
       | that anything this author has to say about addiction isn't
       | inclusive of everyone's (e.g. my own) lived experience of
       | addiction. Admitting the difficulty and struggle of being an
       | addict does not weaken me and prevent me from working towards
       | recovery.
        
       | peter-m80 wrote:
       | I quit smoking 10 years ago. I still notice the addiction and I
       | think it will never go away.
        
       | satellite2 wrote:
       | What can really help getting addictions under control is
       | understanding how it is expressed in the brain.
       | 
       | Delta FOSB seems to be associated with addiction
       | https://en.m.wikipedia.org/wiki/FOSB#Delta_FosB. And having a
       | simple model of how it works helps in dealing with it.
       | 
       | Contrary to popular depictions addiction is not bolean, it's a
       | unbounded scale. And roughly each consumption of an addictive
       | substance increase addiction and for each substance some time is
       | required to go back to baseline. And if another take occurs
       | before this period, then the addiction will grow.
       | 
       | As a very simple model it's ovmbviously wrong but it's a very
       | helpful proxy.
       | 
       | Another euristic that is helpful in dealing with addiction is to
       | avoid repeated use before 6-7 times the halflife of the
       | substance. Such that > 99% of it has been eliminated.
       | 
       | Finally looking for "harm reduction techniques" when dealing with
       | a substance provides many helpful tips.
       | 
       | I believe those advice can probably be translated in the case of
       | an addictive behaviour instead of a substance but will obviously
       | yield less precise recommendations.
        
       | aaron695 wrote:
       | This article is not a good summary on addiction and current
       | understanding. It jumps around a lot between ideas that should
       | not be linked and is factually wrong often.
       | 
       | RE title - "Once an Addict, Always an Addict"
       | 
       | This doesn't rule out moderation, and it is well known you don't
       | use this wording or idea on some people.
       | 
       | Addiction treatments fail around 90%+ of the time. That's why
       | there are so many around, different ideas work on different
       | people, and probably so people don't get bored or despondent as
       | the churn through them multiple times.
       | 
       | "Once an Addict, Always an Addict" might be someones win, someone
       | else might just randomly stop.
        
       | ransom1538 wrote:
       | If you are out there struggling with addiction I would checkout:
       | Naltrexone. Naltrexone binds to the endorphin receptors in the
       | body, and blocks the effects and feelings of alcohol. IMHO: The
       | addict brain needs to be reprogrammed with chemicals - not just
       | 'understanding why' or making macaroni necklaces in rehab.
       | Naltrexone can be used with both opioid and alcohol dependence
       | and is extremely cheap. Once on Naltrexone you can still
       | drink/opioid and you wont get the high. Drinking a beer would be
       | like drinking a Coke on Naltrexone. Pounding down two liters of
       | Coke is gross - and your brain will start to associate that
       | drinking is terrible.
        
         | cupcake-unicorn wrote:
         | Low Dose Naltrexone is also a super interesting modality that's
         | gaining more traction. The idea is that at low doses you are
         | training your body to reset and produce its own endogenous
         | opioids.
        
       | tomhoward wrote:
       | At least twice, I had doctors describe me as having an "addictive
       | personality", and saying things like "that's just how you're
       | wired". I never went back to those doctors, as I refused to
       | accept that's what I was stuck with being.
       | 
       | I'd been an excessive drinker from my late teens through to my
       | early 30s. "Alcoholic", I'm not sure about; I've seen others who
       | were formally diagnosed alcoholic, including one friend who
       | ultimately died of it, and I wasn't that bad, but I was at least
       | very socially dependent. I also smoked tobacco heavily and
       | dabbled in some substances - not the most addictive ones, but it
       | could have gone down that path if I hadn't seen the warning
       | signs.
       | 
       | At 33 I stopped drinking and smoking completely (I'd quit smoking
       | a few years earlier but had started again that year). For two
       | whole years I didn't have a drop or puff, and focused on eating a
       | very healthy diet, cleaning up my body and getting my career and
       | relationships in better shape.
       | 
       | Along the way I found some deep emotional healing techniques. I
       | started doing them regularly, and have continued doing them
       | consistently for nearly 10 years since.
       | 
       | These days I can drink regularly for pleasure, and I never have a
       | problem with it. I barely ever get drunk unless it's a major
       | celebration, but if I do, I bounce back fine and have no
       | temptation to do it again any time soon. And I'm never remotely
       | tempted to smoke or use other substances when drinking, even when
       | around others who are.
       | 
       | One of those doctors expressed shock that I'd gone to all the
       | trouble of quitting my old ways, only to start drinking again. He
       | couldn't believe that it would be possible to go from the way I
       | was to having a healthy relationship with alcohol.
       | 
       | The most significant factor that's made the difference has been
       | the emotional healing work I've been doing. It's a practice that
       | methodically finds and enables releasing all traumas, complexes
       | and sabotaging beliefs/patterns from the earliest times in life.
       | 
       | So maybe it's valid to say one can have an "addictive
       | personality" and that I was one of those people. But we assume
       | that "addictive personality" equals "hard wired", without
       | realising that personality is very alterable if you work at it
       | consistently over a long enough period of time, with a focus on
       | the deep subconscious/unconscious aspects of personality.
       | 
       | I think organisations like AA do great harm when they tell their
       | patients that you're an "addict for life". It's such a
       | disempowering belief to have about one's self, and it's little
       | surprise that people relapse when they're given no hope of ever
       | being completely free of their addiction and able to live like
       | other healthy people.
       | 
       | These days, I have a young child, a great relationship with my
       | partner, family members and friends, my career is going fine, and
       | my physiological health continues to improve. The doctor I see
       | these days, on the infrequent occasions I need to see him, says
       | "whatever you're doing, keep doing it".
        
         | jkhdigital wrote:
         | There are no "patients" in AA; just self-identifying
         | alcoholics. And I understand where you're coming from, but for
         | every story of someone who was "disempowered" by a belief that
         | they are an addict for life I can give you a story of someone
         | who started drinking again after decades of sobriety and
         | completely destroyed the good life they had found.
         | 
         | Alcoholism is what you might call a hard problem, in that every
         | case is unique and there is no good way to know which "kind" of
         | alcoholic you are dealing with, or which approach is going to
         | have the most success, just by ticking off symptoms. AA clearly
         | works, and works astonishingly well, for a non-negligible
         | portion of the people who try it.
        
         | webmobdev wrote:
         | > I think organisations like AA do great harm when they tell
         | their patients that you're an "addict for life".
         | 
         | I really don't think you are the kind of "addict" that AA is
         | designed. They are often for people who have hit rock-bottom
         | due to their alcoholism.
        
           | tomhoward wrote:
           | I think I could have ended up at that kind of rock bottom had
           | I not found the path I ended up on. And more importantly,
           | there's no reason why the techniques I've found wouldn't work
           | for people in AA; they're just not widely known about. I
           | guess mainstream psychiatry and Christianity are the sources
           | for AA's methods, and they're just not aware of what else is
           | out there that could be more effective.
        
             | jkhdigital wrote:
             | My experience was that the AA "methods" are just a vehicle
             | for the true healing, which comes from the people. The
             | magic is not in the 12 steps, it is in the genuine
             | companionship and selfless service of the other alcoholics
             | who walk with you all along the way.
             | 
             | > there's no reason why the techniques I've found wouldn't
             | work for people in AA
             | 
             | Respectfully, I don't think you have any idea what you're
             | talking about. Spend some time in a few AA meetings, maybe
             | a meeting in a prison, and reconsider your hypothesis.
        
         | jorgesborges wrote:
         | I can relate to this. Drank heavily through my twenties. But I
         | went sober for two years during which time I identified
         | privately as an alcoholic and addict. I did the emotional
         | healing. I started to meditate daily and exercise and talk
         | about my problems. I had to slowly learn who I was as I had
         | drunkenly buried away and neglected so many aspects of myself.
         | After those two years of cultivating a healthier life and mind
         | I started to drink again. I can do so in moderation and with an
         | awareness of why I'm doing it. The takeaway for me was that I
         | wasn't an addict or alcoholic, although they served as helpful
         | labels while I grew and healed. I just hadn't taken the time
         | with myself to figure out why I was unhappy and I was
         | subsequently stuck in a feedback pattern of bad, unhealthy
         | behaviour.
         | 
         | Edit: Just wanted to add that I understand this isn't
         | everyone's experience and sometimes moderation isn't a
         | possibility. Just sharing my experience.
        
         | jethro_tell wrote:
         | Had the same addictive personality. Latter diagnosed with ADHD
         | which is a brain imbalance that has difficulty regulating
         | dopamine.
         | 
         | Unmedicated, I have a constant drive to find something that
         | gives a little reward. Cigarette, beer, doom scrolling Twitter,
         | unhealthy foods, other forms of unhealthy and impulsive
         | behavior.
         | 
         | Medicated, I don't have that feeling where I just need
         | SOMETHING. And my 'addictive personality' is just none
         | existent.
         | 
         | I've also done some work on myself as far as identifying
         | triggers and feeling and being able to identify where that
         | drive is coming from.
         | 
         | I think the addictive personality trope is really harmful and
         | it's more likely untreated trama or feelings or untreated
         | mental health.
         | 
         | Mental health is so overlook at least in the US health System.
         | It's a real bummer but I don't think any of us are beyond hope
         | and I hope that we can start to recognize and address that.
        
           | stevewodil wrote:
           | What medication did you end up with? I started recently
           | trying a few that haven't worked well for me.
           | 
           | I started on Wellbutrin which had a bad side effect for me
           | and had to stop, and now Vyvanse which doesn't seem to be
           | helping my focus at all.
        
             | rnjesus wrote:
             | for me, ritalin helped most with my focus, adderall xr
             | helped most with my motivation, adderall ir helps me
             | currently with my energy + motivation. i'd say adderall xr
             | is the best of the three, though i prefer vvyanse -- but
             | vvyanse is prohibitively expensive, and adderall xr is 4x
             | the price of the instant release. also, i had to take
             | adderall xr twice a day; the "extended release" formulation
             | only seems to add a few hours of duration over the instant
             | release. i've yet to try dexedrine, but i've read good
             | things about it.
             | 
             | overall though, i'd not rely on anecdotes about add meds.
             | people's experiences are vastly different in-practice, and
             | the only things you'll really find in common with other's
             | treatments are the more pronounced side effects. not to say
             | that there's anything wrong with asking for advice, just be
             | sure to temper your expectations a bit based on what you
             | read and try not to get too discouraged.
             | 
             | my advice is: if your doctor is willing, have them write
             | you seven-day prescriptions for the different medications
             | you'd like to try and see which one works best. keeping a
             | short journal about sleep, eating/drinking, mood, energy,
             | motivation, and productivity during this time also helps
             | gather some perspective. when you find one that works, try
             | it for a month, and then make a decision from there.
        
           | ipython wrote:
           | I'm curious about what works for you as well. I have to date
           | been able to regulate this through other behaviors - overwork
           | for one - that I can no longer do due to other constraints on
           | my time. It's becoming unsustainable.
        
         | missingrib wrote:
         | Can you expand a bit on the "deep emotional healing
         | techniques", or point me in the right direction to read more on
         | the topic?
        
         | simonccarter wrote:
         | Any links you can share on the emotional healing work you do?
        
           | jzig wrote:
           | Also I interested in learning more
        
           | tomhoward wrote:
           | It's hard to answer without triggering backlash in places
           | like this, as the whole world of this kind of healing is a
           | minefield of quackery and woo. It's taken me a long time to
           | work through it all and be able to winnow out the
           | practitioners and practices that are solid. And it's tricky
           | to recommend stuff online, as some of it is linked to
           | chiropractic (which I'm still not generally a fan of), and
           | there are big-selling authors who have written multiple books
           | about these topics, some of which is great, but some of which
           | would be a dealbreaker for many.
           | 
           | Having said all that, if you're keen to research this stuff
           | yourself, look up "Neuro Emotional Technique" and Psych-K,
           | and look for books by Dr Bruce Lipton and Bradley Nelson.
           | 
           | But I'm happy to share more about my own experiences and
           | practices if you contact directly. Email address is in my
           | profile.
        
       | golemiprague wrote:
       | I think the main way people get into some addictive behaviour is
       | the social norm around them, if everybody around you are doing
       | drugs or smoking or eating sugars or gambling there are good
       | chances you will also do it, it has nothing to do with personal
       | traumas. Maybe sometimes a certain personality traits can enhance
       | the addiction but you don't always need those amplifiers to get
       | addicted. It's true also for other bad behaviours which are not
       | necessarily addictive, like getting knocked up in an early age
       | for example.
       | 
       | The interesting thing is that many people do overcome those
       | addictions but many other struggle, so maybe we shouldn't try to
       | figure out what caused it since it is not that relevant to
       | rehabilitation but focus more on why some people succeed and try
       | to replicate it. I know it is not a simple task as the diet
       | industry shows very clearly, but some people do become thin, so
       | what makes them do the switch and can it be replicated? this is
       | the interesting question.
        
       | max_ wrote:
       | What exactly is an addiction? Am I a Hacker News addict?
        
       | zafka wrote:
       | Pretty much yes from my experience. Both personal and by
       | observation of others. That being said I know many
       | addicts/alcoholics who live happy productive lives- they avoid
       | the chemicals that suck them in.
        
       | throwawaycvid wrote:
       | Really funny thing happened to me last year. I got COVID, luckily
       | fairly mild but with some long lasting symptoms. The odd thing is
       | that I no longer have appetite for drink or opiates/cocaine (on
       | top of my maintenance medication) Surprising as I've been on that
       | path for 15+ years. It's not much but at least something good has
       | come out of (having) COVID...
        
         | evv555 wrote:
         | Dr. Drew had the opposite reaction where he started drinking
         | wine and smoking cannabis. He compares the symptoms to
         | suffering from head trauma.
        
       | post_break wrote:
       | I look at someone like Steve-o and say nah, people can change. If
       | someone as addicted as him can pull out of the spiral, then no
       | you can break the cycle. But not everyone can do that.
        
       | 123pie123 wrote:
       | I would probably class myself as someone with an addictive
       | personality. not with drugs (except alcohol), but with anything -
       | if I like something, I find it very hard to not have more, wether
       | it's good or bad. eg going to the gym 6x week or getting
       | takeaways every day
       | 
       | I've analsysed this for sometime and the best (for me) way of
       | dealing with it is to keep track of every thing I do or I like.
       | 
       | "The power of habit" book helped a lot with my ability to control
       | my addictions
        
         | ndury wrote:
         | It reads as if you don't consider alcohol a drug. Due to its
         | social acceptance people tend to look at alcohol this way but
         | when u give it a better look alcohol should be at least classed
         | as a class 1 drug substance, especially if we're going to keep
         | placing marijuana in the same class as heroine.
         | 
         | edit: typo
        
           | throwawaycuriou wrote:
           | I read that the opposite. 'Not with drugs (except alcohol)'
           | would include alcohol in the category of drugs.
        
             | 123pie123 wrote:
             | I would definately class alcohol as a drug,
             | 
             | but I feel like almost anything food/ drink could be a drug
             | (to me), since if I like it, it makes me want to crave it -
             | for many days/ weeks after.
        
               | EMM_386 wrote:
               | > I would definately class alcohol as a drug
               | 
               | I agree. It's incredible the lengths that people will go
               | to separate drugs and alcohol.
               | 
               | I always like to phrase it like this ...
               | 
               | If you took alcohol in a pill form, are you drinking or
               | taking drugs?
        
               | mnahkies wrote:
               | I'm somewhat surprised this hasn't been attempted as a
               | product actually. Guess it would probably be dreadful for
               | your stomach lining but would be a novel alternative to
               | shots
        
               | 123pie123 wrote:
               | you may want to check out alcohol powder
               | 
               | https://en.wikipedia.org/wiki/Alcohol_powder
        
               | wave_function wrote:
               | I would suspect the volume is simply too large.
               | 
               | The "haircut" where you pour a mixer into your mouth,
               | someone pours liquor into your mouth, and then you
               | swallow in a way such that the liquor doesn't touch your
               | mouth or throat is the closest thing to an "alcohol pill"
               | I can think of. Come to think of it, shots plus chasers
               | are somewhat "pill like" too
        
         | axiosgunnar wrote:
         | Note that you could probably ,,weaponize" this addictive
         | personality to achieve what normal people cannot (eg dedicate
         | an extreme amount of time to a difficult task and achieve it)
        
           | burade wrote:
           | That's not where health is though...
           | 
           | Health is balance.
        
           | curiousllama wrote:
           | I'm not who you're responding to, but I very much identify
           | with what they wrote. I once accidentally trained for a
           | marathon.
           | 
           | Weaponizing this is unhealthy. It doesn't end well. The
           | reason normal people can't do X and an addict can is because
           | an addict is making egregious trade-offs.
           | 
           | "I know I'm going to mess up my shoulder for the rest of my
           | life, but I'm going to bench heavy anyway"
           | 
           | "I know I haven't seen my kids in a month, but I'm going to
           | shut myself away and work on my side business anyway"
           | 
           | It's collapsing your entire life into a single, simplistic
           | max/min function. It's a quick path to misery.
        
             | ThrowawayR2 wrote:
             | I'm reminded of a quote from J. M. Barrie, the author of
             | _Peter Pan_ : " _You can have anything in life if you will
             | sacrifice everything else for it._ " I once thought it was,
             | and have often seen it used as, an inspirational quote
             | until I later read another opinion that it was a warning of
             | the dangers of being too single focused.
        
           | LanternLight83 wrote:
           | Note that dedicating an extreme amount of time to a task can
           | be unhealthy in it's own right, if it's to the detriment of
           | other aspects of life. Depending on exactly what you're
           | picturing, it may also be worth noting that hyper-fixation
           | can lead to working past the point of productivity (sometime
           | you just need to sleep on it, take a walk, etc.). It's not a
           | clear-cut advantage.
        
         | armchairhacker wrote:
         | Same. I literally got addicted to exercise. Not trying to brag,
         | I've also dealt with addictions to food, sleep, video games.
         | 
         | I also have mild OCD. And I'm not depressed, but i get bored
         | very easily and very fast.
         | 
         | The key for me is also habits, diversion, and moderation. I
         | have an easy time forming habits because of OCD so I just have
         | to prune bad ones, easier said than done. I also keep track of
         | how i feel, and just naturally feel bad if i eat too much or
         | sleep late, which seems to subconsciously make me not want to
         | do those things, so i don't have to use as much willpower.
        
           | 123pie123 wrote:
           | >just naturally feel bad if i eat too much or sleep late,
           | which seems to subconsciously make me not want to do those
           | things, so i don't have to use as much willpower.
           | 
           | feeling bad works a little in reducing various cravings,
           | 
           | but my brain seems to have a way of fading my bad memories
           | somewhat
        
           | matwood wrote:
           | I have touches of OCD. It's not all bad (it got me through
           | school and has made me decent at work), though when I was
           | younger I used alcohol a bit to disconnect. Met a great girl,
           | mostly quit alcohol, but that disconnect mechanism
           | transferred to MMOs. Faster forward a year or so and I'm
           | playing MMOs 8+ hours/day and girl leaves. I'm devastated and
           | lost. Walk into work a few days later and give all my MMO
           | accounts (yes, I had multiple accounts for the same game to
           | bot, buff, etc...) to a co-worker, and never played again.
           | Started back down the alcohol path, but this time caught
           | myself and decided to try the gym one day.
           | 
           | 20+ years later I still workout almost every single day. I
           | think about how easy it could have been to take a far worse
           | path, but exercise has been my savior. To paraphrase Henry
           | Rollins, 225# is always 225# no matter what else is happening
           | in your life. It is the great constant.
        
       | trabant00 wrote:
       | All the feel good theories in the world can't contradict the
       | numerous examples of addicts who relapse after trying to moderate
       | what they previosly used in excess.
       | 
       | The article is basically a hook for buying the course. They can't
       | accept the once always theory because it would make their product
       | not attractive.
        
         | dillondoyle wrote:
         | I also thought their 2 ways only characterization was
         | contrived. And I don't buy stock into the way they are founding
         | their arguments on their definition of the word 'disease.'
         | 
         | But I guess it's a good point that harm reduction is good and
         | abstinence is not the goal for everyone.
        
         | balfirevic wrote:
         | > All the feel good theories in the world can't contradict the
         | numerous examples of addicts who relapse after trying to
         | moderate what they previosly used in excess
         | 
         | How does it compare to the number of addicts who relapse after
         | striving to be 100% clean?
        
         | vitabenes wrote:
         | As the saying goes: all models are false, but some are useful.
         | Every theory has its limits, but that doesn't mean it can't be
         | helpful. The opinion that once-always theory can be damaging is
         | rejected by many people in the field, not just us. We're simply
         | presenting it in a digestible format (without the need to dive
         | into the sources for hours and hours). See the rest of the
         | series for a better understanding of the subject matter.
         | 
         | And yes, our blog is a part of our marketing, but that doesn't
         | mean that we "just" want to make money from it. The aim of the
         | whole project is to help people, in a sustainable way, with
         | some free and some paid resources.
        
       | moonshinefe wrote:
       | "If enough time passes, you can start engaging in the behavior in
       | a healthy way once again."
       | 
       | Spoken like the author has never had someone close with
       | addiction, imo. You'll notice that actual medical professionals
       | never are like "oh just quit your massively health-ruining
       | addiction for several years then you're good to go potentially!
       | Happens all the time, look at these studies." It's because such
       | advice or facts--while technically true in a % of cases--downplay
       | how devastating the next relapse might be for the addict (often
       | it means death, or at the very least, their life ruined). Framing
       | these things to addicts and individuals properly given their
       | situations is very important, but has been totally bypassed by
       | this author "helpfully." They present the article without
       | mentioning their intentions or target audience too, which hardly
       | helps.
       | 
       | "So I dove deep into the topic and looked at what science says
       | about it."
       | 
       | So what credentials if any do they have at evaluating scientific
       | consensus on addiction? Oddly enough the article includes some
       | sources but makes no mention of who the author is from what I can
       | see. Is this some high schooler's opinion after Googling around
       | for an evening? We can't be sure.
       | 
       | "This has some merit, for example, when it comes to alcohol - you
       | can go from being addicted to alcohol, to having a social drink
       | once a week." "However, that doesn't mean you need to avoid the
       | behavior forever."
       | 
       | This author needs to like stop repeatedly emphasizing this stuff
       | and muddying the waters--it HIGHLY depends. Again, this is spoken
       | like someone who has never seen someone kill themselves young
       | after that "one last relapse" because they thought they could
       | control it finally. So this article comes off very poorly and I'm
       | disappointed it got upvoted to be honest. Like, the lucky few
       | addicts who recover and can moderate (& their loved ones)
       | probably won't need this article. To the rest of the addicts and
       | people who may be giving them advice, it seems to be a pretty
       | irresponsible article to me.
        
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