[HN Gopher] South Asian people undergo type 2 diabetes remission...
       ___________________________________________________________________
        
       South Asian people undergo type 2 diabetes remission with low
       calorie diets
        
       Author : PaulHoule
       Score  : 128 points
       Date   : 2022-11-27 17:08 UTC (5 hours ago)
        
 (HTM) web link (medicalxpress.com)
 (TXT) w3m dump (medicalxpress.com)
        
       | chrisgd wrote:
       | I read a transcript of an endocrinologist suggesting intermittent
       | fasting (don't eat after 6 and wait as long as you can before
       | your first meal - start with 10am and keep pushing back as long
       | as you can). Then eat only veggies for your first meal, then
       | veggies and a deck of cards serving of meat for dinner.
       | 
       | Honestly, it sounds very difficult, but the doctor seemed very
       | confident that this works. I have started trying this (not T2,
       | but need to lose weight)
       | 
       | Anecdotally, a lot of people have suggested keto and low-carb
       | diets having been successful for them.
       | 
       | The source was Tegus (https://www.tegus.com/) which my company
       | had a free trial.
        
         | bitwize wrote:
         | C-f fasting
         | 
         | You never disappoint, Hackernews.
        
         | adrian_b wrote:
         | When losing weight, it is important to continue to eat a normal
         | amount of proteins, essential fatty acids, vitamins and
         | minerals.
         | 
         | Only either the carbohydrates or the (non-essential) fats or
         | both must be reduced. It does not matter which of them is
         | reduced, as long as the total calorie amount is restricted
         | enough. It may matter only due to personal preferences, which
         | may make one variant or the other easier to support.
         | 
         | One must use some digital scales for measuring the weight every
         | day at precisely the same moment, because the weight varies
         | during a day by much more than the difference between 2
         | successive days. An appropriate rate of losing weight is
         | between 100 grams and 200 grams per day, e.g. about 1 kg per
         | week. If the measurements show another rate, then the amount of
         | daily food must be increased or decreased until the rate is in
         | range.
         | 
         | Regardless with which diet you start, if you adjust the amount
         | of carbohydrates and fat according to the daily weight
         | measurements, in a week or so you will converge to the right
         | amount of daily food. However, this requires to measure by mass
         | or by volume all the food eaten. Those who do not succeed to
         | lose weight fail because they either do not measure what they
         | eat or they cannot abstain from eating more than what they have
         | planned to eat.
         | 
         | Losing the weight is the easier part. More important is to plan
         | a diet for after reaching the target weight, a diet that will
         | keep the weight constant, i.e. which must still be calorie-
         | restricted, but at a normal level, and which must be appealing
         | enough, so that one would never be tempted to eat again in the
         | way that caused the overweight in the beginning.
        
           | fock wrote:
           | > One must use some digital scales for measuring the weight
           | every day at precisely the same moment, because the weight
           | varies during a day by much more than the difference between
           | 2 successive days.
           | 
           | or just do a moving average over some days. Works better.
        
         | ramraj07 wrote:
         | The consensus from the most sensible people is, do the diet you
         | can stick to, in the end just eat less. That's most important.
        
           | theduder99 wrote:
           | yep, same deal with exercise. Doesn't matter how, I just
           | wanted some type of movement that I could get into the habit
           | of. Tried a bunch of different activities but was not able to
           | form a habit until I got a rowing machine and even then I
           | still have days where I don't want to use it :)
        
             | balls187 wrote:
             | For those days, find something less, like light stretching,
             | outdoor walk, skipping rope etc.
        
           | imwillofficial wrote:
           | My Candy diet isn't having the results I desire. It is,
           | however, delicious.
        
           | chrisgd wrote:
           | Not sure I agree
        
         | yazaddaruvala wrote:
         | > Then eat only veggies for your first meal, then veggies and a
         | deck of cards serving of meat for dinner.
         | 
         | > lot of people have suggested keto and low-carb diets
         | 
         | Just always remember: while rice, pasta and bread are
         | vegetarian they are not vegetables.
        
       | panabee wrote:
       | 1. the conclusions were based on 25 adults. is this a valid
       | sample size?
       | 
       | 2. why is liver fat a driver for diabetes? the article and the
       | paper don't address this.
        
       | wrycoder wrote:
       | Isn't this obvious?
        
         | yjftsjthsd-h wrote:
         | Why would it be obvious? For that matter, since I'm out of the
         | loop, what's the mechanism for losing fat to improve insulin
         | control?
        
           | chasebank wrote:
           | I thought this was common knowledge. Type 2 diabetes is 100%
           | reversible through diet.
        
             | Retric wrote:
             | Early Type 2 is generally reversible through diet, but
             | untreated you can suffer irreversible harm.
        
           | oaktrout wrote:
           | Simply put fat worsens insulin resistance. The mechanism is
           | complex, basically fat causes inflammation that causes cells
           | to not respond appropriately to insulin. This leads to
           | elevated blood glucose and all the effects of diabetes.
           | Remove the fat, decrease inflammation, improve insulin
           | resistance.
        
         | JPLeRouzic wrote:
         | > _Isn't this obvious?_
         | 
         | Please consider wondering why no doctors/scientist know how to
         | heal people with diabetes. Do they miss something obvious?
        
           | Vt71fcAqt7 wrote:
           | While not exactly obvious, this has been known for a while
           | now. It even became the position statement of the American
           | College of Lifestyle Medicine to restrict calories as a way
           | to induce remission:
           | 
           | > _Studies with therapeutic dosing typically used very low
           | energy diets (600-1100 kcal /day) with a weighted mean
           | remission rate of 49.4%, while studies with subtherapeutic
           | dosing typically used more moderate caloric restrictions
           | (reducing energy intake by 500-600 kcal/day) and the weighted
           | mean remission rate was 6.9%. Conclusions. Remission should
           | be the clinical goal in T2D treatment, using properly dosed
           | intensive lifestyle interventions as a primary component of
           | medical care for T2D patients._[0]
           | 
           | So while not exactly _obvious,_ it isn 't true that "no
           | doctors/scientist know how to heal people with diabetes." The
           | real issue is that people with DMT2 _generaly_ will not
           | accept low calorie diets. But those that do have a high rate
           | of remission and almost all have improved symptoms and
           | decreased progressions.
           | 
           | Edit: I should note that obviously the American College of
           | _Lifestyle_ Medicine would advocate for this. My point is
           | that there is sufficient liturature to back this up.
           | 
           | [0]Type 2 Diabetes Remission and Lifestyle Medicine: A
           | Position Statement From the American College of Lifestyle
           | Medicine (2020) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC
           | 7692017/?report...
        
             | PuppyTailWags wrote:
             | Wait, how long are people expected to be on 600-1100
             | kcal/day? Just for a little worse than a coin flip? That
             | sounds really miserable. Isn't that basically a crash diet
             | and no one stfus about not doing those because they can
             | mess you up long term?
             | 
             | I'm really confused how T2D are special such that crash
             | dieting doesn't mess them up further and put them further
             | in a hole. They're already messed up because of the T2D,
             | aren't they?
        
               | Vt71fcAqt7 wrote:
               | VLCDs are very safe, much safer than say all the co-
               | morbidities of obesity. The important thing is to chose
               | the right things to eat for those few calories. It also
               | assumes a sedantary office lifestyle with only minimal
               | exercise. If you work out or run you will need more. With
               | these caveats it is safe and effective and works for
               | obesity, type-2 diabetes and some metabolism problems.
               | 
               | It really is that simple. The first law of thermodynamics
               | doesn't go away so simply. Combine that with the
               | evolutionary preassure that favors those who can save and
               | expend energy and this all makes perfect sense. For
               | example, increased insulin sensitivity on a low calorie
               | diet makes sense evolutionarily. The only drawback is
               | that muscle will be consumed as well. The amount varries
               | by person, diet and exercise but it is minimal with a
               | high protien diet. So say eating 500 kcal of chicken
               | brest everyday and the rest of the calories spilt between
               | carbs and lipids would be a good way to do this diet.
               | 
               | "Crash diets" _do_ work as long as you do it for a few
               | months. People generaly do a few days and then start
               | binging  >200 TDEE. Obviously that won't work:
               | 
               | > _The active stage is characterized by a very low-
               | calorie diet (600-800 kcal /day), low in carbohydrates (<
               | 50 g daily from vegetables) and lipids (only 10 g of
               | olive oil per day). The amount of high-biological-value
               | proteins ranged between 0.8 and 1.2 g per each Kg of
               | ideal body weight in order to preserve lean mass and to
               | meet the minimal daily body requirements. This stage is
               | further divided in 3 ketogenic phases: in phase 1, the
               | patients eat high-biological-value protein preparations
               | five times a day, along with vegetables with low glycemic
               | index. In phase 2, one of the protein servings is
               | replaced by natural proteins such as meat/egg/fish either
               | at lunch or at dinner. In the phase 3, a second serve of
               | the natural protein low in fat replaced the second serve
               | of biological protein preparation. Being a very low
               | caloric nutritional pattern, it is recommended to
               | supplement patients with micronutrients (vitamins, such
               | as complex B vitamins, vitamin C and E, minerals,
               | including potassium, sodium, magnesium, calcium; and
               | omega-3 fatty acids) according to international
               | recommendations. This active stage is kept until the
               | patient loses most of weight loss target, about 80%.
               | Therefore, the ketogenic phases are variable in time
               | depending on the individual and the weight loss target.
               | The active stage generally lasts between 8 and 12 weeks
               | in total._[0]
               | 
               | [0] _The management of very low-calorie ketogenic diet in
               | obesity outpatient clinic: a practical guide_ (2019)
               | 
               | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820992/
        
               | PuppyTailWags wrote:
               | They sound miserable, though, is what I'm saying. How are
               | VLCD people expected to do any sort of fitness or do any
               | sort of mentally taxing labor if they're hungry and
               | running on little nutrition basically all of the time for
               | months? That seems totally unreasonable unless we send
               | obese people to some kind of clinic like we do for
               | addicts, and then how do they adapt back into the real
               | world? Are there any actual studies of people doing this
               | long-term and how this affects their bodies?
               | 
               | I was always told crash diets fuck you up for years. How
               | can this be true and also people are apparently starving
               | for months and that's totally fine?
               | 
               | EDIT: Wait, is my understanding is that you have to
               | starve for up to 4 months for a worse-than-coinflip
               | chance at diabetes? Do we know if it stays off for 5
               | years? 10 years? Do you have to coinflip again? What
               | happens if it doesn't work?
        
           | ddorian43 wrote:
           | Pretty easy to do it with low carb diets. See virtahealth
           | that is FDA approved
        
           | CyberDildonics wrote:
           | Robert Lustig has been giving the same presentation for over
           | a decade showing statistics that people who stop eating sugar
           | can reverse their type 2 diabetes.
           | 
           | https://www.youtube.com/watch?v=dBnniua6-oM
        
           | oaktrout wrote:
           | Most doctors know how to heal people with type 2 diabetes, at
           | least if you catch it early enough. It is well known that if
           | you lose weight and eat a healthy diet the insulin resistance
           | is reversible (some others in this thread have provided
           | citations showing this).
        
       | abadger9 wrote:
       | This happened to my grandmother! I frankly never believed it
       | because we're taught one cannot go into remission, but one day in
       | her 60s she no longer had to manager her diabetes.
        
       | lizardactivist wrote:
       | It always amazes me that all types of nutrition are folded into
       | the single "calorie" in these discussions.
        
       | nixcraft wrote:
       | In South India, they have a carbohydrate-rich diet. So when you
       | get hit badly with T2D, you switch to fish, limited brown/red
       | rice, and veggies. In most cases, all of your medication stop if
       | you maintain your weight and diet with exercise. Unfortunately,
       | only some maintain a diet and healthy weight. Even 10 kg weight
       | loss gives far better control for T2D.
        
       | myshpa wrote:
       | Low calorie diet is not the only way how to reverse diabetes. One
       | can eat to satiety and lose weight & reverse diabetes at the same
       | time.
       | 
       | https://www.youtube.com/watch?v=tAiXvrIMIIE Neal Barnard, MD | A
       | Nutritional Approach for Reversing Diabetes
       | 
       | https://www.youtube.com/watch?v=lSwL73evUdA Diabetes Reversal and
       | Weight-loss with Neal Barnard, M.D.
       | 
       | https://www.youtube.com/watch?v=EpRrD58Ah3Q Evidence-Based Weight
       | Loss: Dr. Michael Greger
       | 
       | https://www.youtube.com/watch?v=7rNY7xKyGCQ How Not To Die : Dr.
       | Michael Greger
        
         | MuffinFlavored wrote:
         | Eat to satiety while focusing on certain types of foods/drinks
         | instead of others?
        
       | knaik94 wrote:
       | The amount of calories per day caught my attention, 850kcal/day
       | with diet replacement products. I understand that with medical
       | supervision, there is less risk of malnourishment or nutrients
       | deficiencies.
       | 
       | The general advice, even from my primary care physician, has been
       | that anything less than 1200kcal/day is dangerous and is crash
       | dieting. Looking around, I found this other study studying total
       | diet replacement providing 810kcal/day as the sole food for 12
       | weeks, showed significantly greater weight loss compared to
       | standard counseling and modest energy restrictions. The
       | difference in weight loss was measured at 12 months. (BMJ
       | 2018;362:k3760 [1])
       | 
       | 25 BMI, which the diabetes study used in addition to T2D, is not
       | considered clinically obese in the US. 25 BMI is the line between
       | clinically normal and overweight. I wonder if crash dieting is
       | advised against on the assumption that most people will go back
       | to unhealthy eating habits instead of changing their diet, and
       | also become more likely to fall into binge-restrict cycles. It's
       | easy to imagine that if someone is able to make meaningful
       | changes, crash dieting is more effective than most other methods.
       | 
       | [1] https://www.bmj.com/content/362/bmj.k3760
        
         | xboxnolifes wrote:
         | > The general advice, even from my primary care physician, has
         | been that anything less than 1200kcal/day is dangerous and is
         | crash dieting.
         | 
         | Wouldn't this advise need to keep in mind absolute height? BMI
         | tracks the ratio between the height and weight, but it does
         | nothing to tell the difference between a short thin person and
         | a taller heavier (but same BMI) person. The latter which would
         | need more calories than the former. I know people who eat ~400
         | kcal less than me per day, because they are shorter and
         | similarly thinner. Following that why wouldn't their crash diet
         | threshold be sufficiently lower?
        
           | maximus-decimus wrote:
           | The argument I've heard is that the other nutriments needs
           | (vitamins, minerals, etc) don't scale as much with height. So
           | even a very short person would have a vitamins/mineral
           | deficit on less than 1200KCal per day.
           | 
           | How true is it? I don't know. But even then I don't see why
           | they couldn't take multivitamins.
        
             | throwaway09223 wrote:
             | Many American diets are calorie/energy rich and nutrient
             | poor. If you're eating 400 calories of healthy food you're
             | probably getting several times the vitamins and minerals of
             | the average American eating 2500 of fried, sugary food.
             | 
             | It's probably a mistake to connect the two.
        
               | dragontamer wrote:
               | Beef is very nutrient rich.
               | 
               | Yes, we Americans overeat beef / Hamburgers, but I don't
               | think anyone eating burgers is at huge risk of
               | malnutrition... as much as a risk of heart problems,
               | diabetes, cholesterol, etc. etc.
               | 
               | It turns out that a standard burger with beef, ketchup,
               | lettuce, onion, and bread covers most of your macro, and
               | even micro-nutrients. It also is way overboard on salt
               | and fats, but... that's not the particular problem here.
               | 
               | One of the bigger problems vegetarians have is finding a
               | proper replacement of meat and all of the easy nutrients
               | meat contains. All amino acids, various vitamins, iron,
               | etc. etc. There's a fair amount of nutrients here.
               | 
               | And even the worst McDonalds burger contains a variety of
               | lettuce / onions / ketchup that covers few nutrients that
               | beef is missing (ex: Ketchup has Vitamin A, Potatoes /
               | Fries has Vitamin C).
        
               | carlmr wrote:
               | >And even the worst McDonalds burger contains a variety
               | of lettuce / onions / ketchup that covers few nutrients
               | that beef is missing (ex: Ketchup has Vitamin A, Potatoes
               | / Fries has Vitamin C).
               | 
               | The amount of lettuce, tomatoes and onions is so minimal
               | I doubt it contributes to your vitamin intake in any
               | useful manner. If you eat a salad you get 50x that amount
               | of those vitamins.
        
             | AmericanChopper wrote:
             | You can supplement all your micronutrients with barely any
             | impact on calories consumed, so this is going to depend
             | specifically on what you're eating/supplementing.
        
           | knaik94 wrote:
           | My understanding is that 1200 kcal is independent of height
           | or weight. I was told that the rough calculation was based on
           | the lower estimate of basal metabolic rate and then
           | subtracting a couple hundred kcal.
           | 
           | We both come from a South Asian background and discussed how
           | the number would change for a home cooked vegetarian diet
           | which is more nutrient dense but low in protein, and I was
           | told that would lower it below 1200, but he didn't feel
           | comfortable recommending that diet unsupervised. He
           | emphasized that I should decrease calories by removing carbs,
           | then fats, then proteins. And that I should prioritize eating
           | proteins above fats and carbs, especially if I planned on
           | increasing the amount of exercise I did.
           | 
           | I asked him if the 1200kcal was net or gross. For example if
           | I did 2 hours of moderate exercise, should I eat back
           | 400kcal+ to maintain a net 1200kcal. He didn't have an answer
           | for me, other than saying, if I start to feel weak or
           | lightheaded I should immediately stop exercising. I don't
           | have pre-existing conditions related to blood glucose, but I
           | imagine that would would change many of these guidelines. I
           | was told to stay mindful of hydration.
           | 
           | The stories I hear of fasted work outs is the reason I asked
           | him about low calorie diets. My non professional intuition
           | makes me believe that even intense cardio should be okay, but
           | moderate or heavy resistance training should be avoided on a
           | low calorie diet.
        
         | sacnoradhq wrote:
         | Evidence needed: define "dangerous" in terms of micromorts
         | based on what BMR and demographics (i.e., age, BMI, FFMI,
         | height, gender)?
         | 
         | There are risks to ponder about how critical (e.g., time vs.
         | dangers) it is to get to a healthy weight. If someone
         | dangerously obese maintains hydration, electrolytes, vitamins,
         | and enough lipids to empty the gallbladder, getting to a low
         | adipose tissue state, resetting insulin, ghrelin, and leptin
         | sensitivities, and reducing the likelier risks of cancer(s)
         | seems like a good tradeoff than either lap-band surgery or
         | slow/plateau weight reductions.
         | 
         | Intense hunger goes away after about 72-80 hours of
         | "starvation", however brain fog and low energy dominate.
         | Careful "starvation" dieting down to slightly underweight isn't
         | something one can do without several months of spare time,
         | ready access to healthcare, and immense self-control.
         | Afterwards, self-control is absolutely required to avoid binge
         | cycles.
         | 
         | GLP-1 agonists are expensive but interesting crutches to get
         | there slowly.
         | 
         | It is likely that over millions of years of natural selection,
         | the human body is far more tolerant of borderline starvation
         | conditions than being stuffed with HFCS. Many types of cancers
         | associated with Western diets are likely due to the human body
         | becoming more hospitable, whereas chemotherapy and starvation
         | add cellular stress that kills off malfunctioning cells. It's
         | likely no accident whereas CHD, gout, diabetes, high
         | cholesterol, and cancers are the consequent of unnatural diets
         | and lifestyles.
        
         | wincy wrote:
         | Interesting, when I lost 80 pounds doing a ketogenic diet my
         | appetite leveled off at exactly 1200 calories per day. I wasn't
         | counting calories out of anything other than curiosity as I was
         | losing weight anyway. Getting even lower would have been pretty
         | difficult.
        
           | mmmpop wrote:
           | I did a lot of ketogenic diets when I was younger in an
           | attempt to shed all of the weight that comes with being
           | raised in Appalachia. It was my experience that it was a
           | great kickstart to a weight-loss plan for someone who was at
           | rock-bottom health and needed fast results while not feeling
           | like you're starving.
           | 
           | But I feel like it taught me to be bored with eating, and to
           | establish a more healthy relationship with food. High-fat,
           | mid-protein, low-carb sounds terrific for the first day or
           | two but once you're two weeks in, you're so sick of it all
           | that you'd just as soon drink some water and get back to
           | whatever you're doing.
        
             | wincy wrote:
             | Well I mean it worked for me because if I eat sugar I end
             | up consuming something on the order of 4000+ calories per
             | day. Something about carbohydrates makes me absolutely
             | ravenous for sugars.
             | 
             | Also if I don't eat right as I feel hungry I'll feel as if
             | someone has gut punched me. I get absurdly hungry.
        
               | JamesianP wrote:
               | Even artificial sweetener leads to craving carbs in my
               | case.
               | 
               | As for the "gut punch" though, sounds like gastritis or
               | something. Unless you're being metaphorical. For me,
               | water helps when I'm fasting and stomach pains start.
        
               | matthewdgreen wrote:
               | This feeling is so intense for me that I've come to
               | believe it's something to do with the carbs and my gut
               | microbiome changing. There's a 1-2 week delay between
               | changing diets and having these hunger pains start/stop
               | that makes this feel more credible to me than insulin
               | response changes or diet boredom. But: one should not
               | treat N=1 subjective experiences as having any real
               | value.
        
         | MuffinFlavored wrote:
         | dumb question: how easy is it for the average person to go from
         | an "American" diet high in addictive things like bad fats, corn
         | syrups, processed foods, etc. etc. to a "clean" 1200kcal diet?
         | 
         | I was under the impression it was like trying to fight drug
         | addiction and the chances of you sustaining it and not
         | relapsing/making up the missed calories later as near
         | impossible for most once you've become addicted enough to
         | things like Diet Coke, Chik-Fil-A, etc.
        
         | browningstreet wrote:
         | David Goggins lost 100 lbs in 3 months on an 800ish calorie
         | diet. I'm not recommending that... but what you can accomplish
         | when you own it versus doing it for other reasons is probably
         | significant too. Especially for when the "diet" (or whatever
         | word is preferred, a la "intervention") ends.
         | 
         | I lost 60 lbs over a couple of years and set a state lifting
         | record for my age group. I love what I do and kept the excess
         | weight off. I got good at what I do and the intrinsic reward
         | still burns, even though I'm not lifting for records anymore. I
         | wake up every day ready to go hard for at least 50 minutes. It
         | doesn't take me more time than that to stay in shape, but I do
         | eat consistent with my goals.. which is the harder part.
         | 
         | I personally think someone needs to really own their desired
         | outcome and then there are many valid and healthy ways -- and
         | even more "effective" ones -- to get there. Hard to measure
         | "own" though. Measuring every different kind of modality is
         | generally missing the point. We actually know how people get in
         | shape and stay in shape. The problem is generally in the mind.
        
       | lhl wrote:
       | There's a long history of studies showing Low-Calorie Diets as
       | being effective for reversing T2D. The late Sarah Hallberg wrote
       | a narrative review that I liked a lot a couple years back (see
       | section 3.2 for the part on LCDs):
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/
       | 
       | Hallberg SJ, Gershuni VM, Hazbun TL, Athinarayanan SJ. Reversing
       | Type 2 Diabetes: A Narrative Review of the Evidence. Nutrients.
       | 2019 Apr 1;11(4):766. doi: 10.3390/nu11040766. PMID: 30939855;
       | PMCID: PMC6520897.
        
         | seltzered_ wrote:
         | https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pub...
         | "Reversing Type 2 Diabetes and ongoing remission" was in my
         | bookmarks on this, there's a book written about it too.
        
         | 0xcde4c3db wrote:
         | > Furthermore, long-term achievement of diabetes remission,
         | adherence to the diet, and weight loss maintenance after the
         | diet remain a challenge. Studies have also suggested that
         | physiological and metabolic adaptation of the body in response
         | to caloric restriction may shift energy balance and hormonal
         | regulation of weight toward weight regain after weight loss
         | [67,68]. Thus, it is crucial that future studies are directed
         | towards assessing the long-term sustainability of diabetes
         | remission led by LCD and feasibility of this diet on the
         | physiological adaptation and body composition changes.
         | 
         | The basic problem, which has been unchanged for decades, is
         | that hardly anyone actually follows the "proper" diet on a
         | long-term basis without some kind of surgical or drug
         | treatment. Despite weight loss being a massive industry and a
         | very common goal, researchers routinely struggle to find study
         | subjects who have maintained significant long-term weight loss
         | without medical interventions, to the point that there's a
         | special registry to keep track of such people for scientific
         | purposes [1].
         | 
         | [1] http://www.nwcr.ws/
        
           | Vt71fcAqt7 wrote:
           | Most people don't announce to scientists that they've lost
           | weight. Lot's of people _do_ lose weight and stay that way,
           | it 's just that there are even more who don't.
           | 
           | Consider that the rate of obesity continues to increase in
           | the US. This shows that people are simply eating more and
           | doing less exercise. And of course those that are already
           | obese are the least likley to consume healthy ammounts of
           | food and exercise as needed.
           | 
           | In other words, yes, the issue with overeating is in fact
           | overeating. The only way to solve this problem for the whole
           | population (as in, not for a single individual) is to change
           | society and how it views unhealthy food. Off the top of my
           | head, fast food advertisments should be made illegal. The
           | entire point of those ads to get people to eat fast food.
           | This single step could reduce obesity in the US by a
           | noticable amount and requires no loss of freedom to any
           | individual. A sugar tax or the like is a more extreme
           | solution. But this idea is not unfounded:
           | 
           | > _Sugar, rum, and tobacco are commodities which are nowhere
           | necessaries of life, which are become objects of almost
           | universal consumption, and which are therefore extremely
           | proper subjects of taxation._
           | 
           | -Adam Smith
           | 
           | Book V: On the Revenue of the Sovereign or Commonwealth
           | Chapter III: On Public Debts
           | 
           | https://www.adamsmithworks.org/documents/chapter-iii-of-
           | publ...
        
             | kortilla wrote:
             | > Off the top of my head, fast food advertisments should be
             | made illegal
             | 
             | This is ridiculous. Nearly everyone I know who is
             | overweight eats hardly any fast food.
             | 
             | What I do see is lots of snacking throughout the day on
             | high carb things (chips, breads, etc) and just way too many
             | calories due to large serving sizes in both regular "slow
             | food" restaurants and meals made at home.
             | 
             | Fast food meals if you skip the sugared soda tend to be
             | closer to proper per meal calorie targets than sit down
             | restaurants because of how cheap they are.
             | 
             | At sit down restaurants the price is higher to support a
             | wait staff and lower throughput so they compensate with
             | ridiculously huge portions.
        
               | hombre_fatal wrote:
               | Apparently one major issue with fast food is the
               | hyperpalatability.
               | 
               | For example, when I visited my family in the states, I
               | ate two double cheeseburgers at a fast food joint at
               | 1000+ calories per burger, and I figured I could probably
               | eat two more in that sitting without issue.
               | 
               | In other words I ate 2000+ calories in a few minutes and
               | could have kept going. Even one burger has more calories
               | than I eat in a single meal.
               | 
               | Meanwhile, I couldn't eat 15 medium sweet potatoes (1000
               | calories) in one sitting.
        
               | JamesianP wrote:
               | But why would you do that? I think it's just calorie
               | density and behavior. You might just as well have eaten a
               | bucket of ice cream as fast as you could. I.e. before
               | your rising blood sugar has a chance to stop you.
               | 
               | Though I do think the public would be better off if they
               | replaced the bread with lettuce or something. It seems
               | like they're willing to do that anywhere I've gone.
        
               | syliconadder wrote:
               | It doesn't help that these calorie dense food are
               | hyperengineered to trigger our hunger more. A personal
               | prohibition seems to be the only way to tackle this.
        
           | adrian_b wrote:
           | Seeing that there are more than 10 thousand US people in that
           | database, which is unlikely to be complete, I do not think
           | that "hardly anyone" is the right term.
           | 
           | Nevertheless, I agree that such people might be a very small
           | part of those who lose weight.
           | 
           | About 15 years ago, I have lost about one third of my initial
           | body weight during almost a year, and then I have kept my
           | desired weight until today, without any kind of medical
           | treatment, either surgical or drug-based.
           | 
           | Nevertheless it was not easy and it required a lot of thought
           | and experiments with the diet, until I have learned how to
           | control my weight, after many years during which I had
           | believed that this is impossible. It also required completely
           | dropping many bad habits, for example drinking commercial
           | juices or eating commercial mixes of yogurt with fruits or
           | eating various kinds of "breakfast cereals" or any other such
           | commercial products containing an excessive amount of sugar.
           | I have never eaten or drunk again any of the products that I
           | have blacklisted, even if they were among those that I had
           | eaten or drunk daily, for many years.
           | 
           | I believe that most people are not introspective enough to
           | succeed in changing so much their habits by themselves so
           | they need some kind of external help. The main obstacles for
           | weight control are psychological, not physiological, i.e.
           | those who need to control their weight must learn somehow to
           | love to eat food that is different from what they had been
           | eating, because if they will ever revert to their old eating
           | style, then they will certainly also revert to their previous
           | weight.
        
       | ravenstine wrote:
       | Link to the actual published article:
       | https://www.thelancet.com/action/showPdf?pii=S2772-3682%2822...
       | 
       | What doesn't make sense to me is what this diet was actually
       | composed of.
       | 
       | > The programme induces weight loss with a period of formula low
       | energy TDR, providing all essential nutrients in around 850 kcal/
       | day, creating a sizable energy deficit and therefore substantial
       | weight loss.
       | 
       | Given that Counterweight Plus can be many things (judging by the
       | website), I don't know what this study actually demonstrates.
       | Maybe the weight loss and remission is associated with the lower
       | energy intake, or it may be associated with whatever diet may
       | have been eaten. What were the subject's diets before? We don't
       | know. Correct me if I'm wrong, but I'm not sure we can tell.
        
       | _JoRo wrote:
       | ;TLDR: Anecdotally, I've found it easier to lose weight / harder
       | to sustain weight after a few months of consistent exercise.
       | 
       | Mostly unrelated to this article and perhaps naive, but I found
       | it very difficult to gain weight (and even sustain my weight)
       | about 2 months after starting a 5/6 day cardio routine.
       | 
       | I started the routine walking at ~20 minute mile pace (3 mph) and
       | just incrementing the speed by 0.1 mph each session. At the 2
       | month mark I was ~8 minute mile (so about 7-8 miles a day).
       | 
       | At this point I was probably burning an additional 750-1k
       | calories a day from the running alone.
       | 
       | Combined with a slightly less calorie dense diet and I was
       | basically force feeding myself to try and maintain my weight.
       | 
       | Background: Late 20s 5'11" Male ~180 lbs (obviously a more ideal
       | situation)
        
       | dpbriggs wrote:
       | My parents, very much not South Asian, achieved the same thing as
       | per their doctor's recommendation.
        
         | oaktrout wrote:
         | Yes, this has been shown in other populations already. I think
         | the highlight of this study is that it worked in South Asians
         | also, as some might question if genetics/ culture play a
         | particular role. This adds to the evidence that weight loss
         | works for diabetes in all ethnicities.
        
           | PaulHoule wrote:
           | It's worth checking that "obvious" advice works in different
           | populations because it doesn't always.
           | 
           | For instance African Americans have high blood pressure at an
           | elevated rate and many of the medications that work well for
           | other Americans don't work well for them. It's important that
           | this population gets studies about treatments that work for
           | them.
        
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