[HN Gopher] The biggest losers: Metabolic damage or constrained ...
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The biggest losers: Metabolic damage or constrained energy?
Author : paulpauper
Score : 48 points
Date : 2024-01-10 18:58 UTC (4 hours ago)
(HTM) web link (physiqonomics.com)
(TXT) w3m dump (physiqonomics.com)
| paulpauper wrote:
| But most contestants regained a lot of weight and metabolisms
| slowed relative to bodyweight and stayed slow long after
| regaining weight. The adaptation explains why they regained
| weight so fast. It's incontrovertible that the show was a failure
| for the majority of the contestants. this also agrees with the
| high failure rates of diets overall and why formerly fat people
| regain so fast . Biology screws you over and has the final say.
| This is why it took so long to develop GLP-1 weight loss drugs
| and why they are such a big deal, by at last giving people a leg-
| up in this often losing battle against the body.
| SV_BubbleTime wrote:
| I don't understand how this needs anything beyond surface level
| complexity... you have fat people who for show reasons were
| tightly controlled on exercise and food intake - which works
| for well understood reasons - then they took that away and left
| the people to their lifelong established habits.
|
| Of course they regain the weight.
|
| These people didn't magically create mass from nothing. They
| ate too much for their activity. Done. Stop doing that if you
| don't want to gain weight. Obviously easier said than done. But
| I'm sick of the idea that these poor souls are visited at night
| by globs of mass that force their way inside.
|
| All these magic drugs are going to do is incentive bad food and
| bad habits. This isn't good news.
| belltaco wrote:
| > These people didn't magically create mass from nothing.
| They ate too much for their activity. Done. Stop doing that
| if you don't want to gain weight
|
| Not true.
|
| https://www.scientificamerican.com/article/science-
| reveals-w...
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082693/
|
| > discovered that certain Russian populations had large
| intestines that were about 57 centimeters longer on average
| than those of certain Polish populations. Because the final
| stages of nutrient absorption occur in the large intestine, a
| Russian eating the same amount of food as a Pole is likely to
| get more calories from it. People also vary in the particular
| enzymes they produce. By some measures, most adults do not
| produce the enzyme lactase, which is necessary to break down
| lactose sugars in milk. As a result, one man's high-calorie
| latte is another's low-calorie case of the runs.
|
| > Call out: Germ-free mice can eat more and gain less weight
| than conventional mice
| netr0ute wrote:
| The problem is, it still boils down to CICO due to
| thermodynamics. That means they're still eating too much
| given a certain amount of physical activity.
| chiefalchemist wrote:
| > "certain Russian populations"
|
| Yes, of course. There are always outliers. But 50+% of the
| American population doesn't fall into this bucket, do they?
| Nor did they suddenly become that after they were born
| (i.e., obesity is a relatively new problem and not so much
| driven by DNA else why didn't it exist so much even just 50
| yrs ago?).
|
| We keep looking for all kinds of "answers" to obesity but
| we already have the one that works for most people most of
| the time:
|
| Take in more calories than you burn, and those extra
| calories will become added weight.
|
| That's it. It is *that* simple.
|
| But people refuse to change their diet and/or lifestyle. In
| fact they're being told it's not their fault, as if someone
| else is responsible for what goes in their mouth and their
| sedentary lifestyles.
| SirMaster wrote:
| But what if consuming as low amount of calories as needed
| to be equal to or less than energy expended leaves you
| constantly feeling tired and with headaches and such from
| eating so little?
|
| Is this not something that actually happens?
|
| It seems like a spiral of doom. Eat less, so now I have
| even less energy for activity and thus now I am burning
| less energy, so I need to eat even less...
| awfulneutral wrote:
| It might be that simple from a high level conceptual
| standpoint, but when the amount of calories you burn
| passively adjusts up or down as your body fights to
| maintain its weight, it is much more complex.
| goostavos wrote:
| Sigh. Exhibit A of lazy internet arguing.
|
| The things you linked are completely irrelevant. First
| link: The calorie counts of _food_ are wrong? Sure.
| Absolutely. No shock there. Treat them as rough estimates.
|
| Second link: different people are different? Whoa. Wow. Oh
| man, mind blown.
|
| What you naively describe as "not true", the universe
| itself would describe as bedrock reality.
|
| Despite the bad scientism (i.e. coping) everyone hides
| behind, nothing changes the fact that if you burn more
| calories than you consume, you'll loose weight.
|
| If you aren't loosing weight AND counting all of your
| calories, guess what: you've counted wrong. Dial them back
| more. Keep dialing back until results are achieved. The gym
| bros have truly found This One Weird Trick that works 100%
| of the time.
| thefz wrote:
| You just proved the point you want to disprove. Those that
| absorb more calories gain more weight, thus CICO.
| paulpauper wrote:
| For those contestants, weight loss was a full time job, and
| they had trainers and dieticians. How is that supposed to
| work for average people who have jobs and families or do not
| have a lot of willpower? Weight loss drugs can make it
| easier, which I am all for. Availing oneself of medical
| technology is not cheating; it's why the technology exists in
| the first place.
| jay_kyburz wrote:
| I agree that people should accept help if they need it, and
| should not feel ashamed for doing it, but having a strong
| willpower is a superpower that will help people in all
| aspects of their lives. I wonder if there are ways you can
| improve your willpower.
| paulpauper wrote:
| _I wonder if there are ways you can improve your
| willpower._
|
| stimulants
| louwrentius wrote:
| Sure, blame the people. Fat shame all you want. Problem
| solved. Done.
|
| It's so easy, just stop eating so much. As if fat people
| haven't heard that one a bilion times over. As if fat people
| havent tried time and time again.
|
| Personal responsibility! you put that stuff in your mouth,
| rah! rah!
|
| Personally I'm actually sick of people having no eye for the
| bigger picture, for many systemic reasons and larger society,
| and just blame stuff like this on individuals.
| goostavos wrote:
| But... Not eating works, though?
|
| How are statements about reality fat shaming?
| wexomania wrote:
| Well, it is easy to hold people accountable for what they
| themselves put in their mouths no?
|
| That being said, there is some issues with the prevelance
| of hyperprocessed unhealthy foods.
|
| The fact that the most unhealthy options also tend to be
| the cheapest and easies, really do not help.
| Dagger2 wrote:
| Easy, yes, but not exactly correct and certainly not
| helpful in the slightest.
| thaanpaa wrote:
| It requires that complexity because a metric shit ton of
| scientific research shows that it is more complicated than
| that.
|
| Permanent weight loss of more than ten pounds is nearly
| impossible from a scientific standpoint. The success rate
| after 5 years of weight loss is somewhere around 0.1%. You'd
| think that if it was as easy as everyone claims, more people
| would succeed. Heck, many people who have had gastric bypass
| surgery regain a significant amount of weight, even if their
| stomachs have been reduced to the size of a ping pong ball.
| paulpauper wrote:
| yup, the stomach gradually expands and the weight returns.
| Really hard to beat the body.
| bodiekane wrote:
| My weight floats in a range that's 40-50 pounds lighter
| today than I was a decade ago. It's because I eat less and
| move more.
|
| Physically, weight-loss is utterly trivial. Literally
| everything that people say works, does. Eat less calories,
| eat less sugar, cut out snacking, cut out liquid calories,
| cut out processed food, reduce carbs, literally any and all
| of those work, choose whichever is most appealing to the
| individual.
|
| The challenge to weight and diet in America is mental and
| cultural. Obese people remain obese because they have
| unhealthy relationships with food and eat addictively or
| emotionally, using food to soothe anxiety, depression,
| loneliness, disappointment, etc and because cultural norms
| and advertising have normalized obesity-causing diets.
|
| Eat food. Not too much. Mostly plants.
| vkazanov wrote:
| Fully agree.
|
| The science of body metabolism is hard. But the rules for
| weight loss are simple: move more, eat less. For some
| people it's just "Move more, eat the same".
|
| "Eat less" means "less calories", volume can be the same
| - really helps.
|
| PS chips are a crime against humanity
| thefz wrote:
| Not even that, if you change what you eat, you can have a
| dramatic effect as well. Try cutting out carbs and sugar
| as much as possible, results in two weeks.
|
| Changing when you eat is a factor too.
| thefz wrote:
| > Physically, weight-loss is utterly trivial. Literally
| everything that people say works, does.
|
| You can't say this on HN, where weight loss is a myth and
| the only way out is to take a crazy life-altering
| medicine. Exercise? PFFT. I walked a flight of stairs
| once, and did not lose a single gram.
| vkazanov wrote:
| I understand that you don't mean 10 pounds in a strict
| sense but even 20 pounds is an easily achievable and
| sustainable goal for fellow overweight 40-something HN
| readers.
|
| It doesn't take more than restricted calorie intake and
| moderate excercise (walking, gym, etc). After a few cycles
| of gain/loss it becomes easier food consumption habits
| change
| mmmmmbop wrote:
| Do you have a citation on that 0.1%? I'd love to learn
| more.
| bluescrn wrote:
| The bad food habits are only going to get worse as meat+dairy
| is forcibly taken away from us by the powers that be.
|
| Fewer options for an appealing 'proper meal', more temptation
| to eat sugar-laden junk.
| frankus wrote:
| Do you have first-hand experience with being overweight
| and/or losing a significant amount of weight?
|
| I think you're vastly overestimating how much of this
| (particularly "calories out") is under voluntary control.
| We're discussing an article that showed that extra active
| calories burned tend to lead to a compensatory reduction in
| resting metabolism.
|
| And there are some very strong psychological/physiological
| drives that influence "calories in" (read up on the Minnesota
| Starvation Experiment for examples).
| paulpauper wrote:
| yup. many of these people who are on weight loss drugs
| already tried dieting and it did not work.
| jklinger410 wrote:
| > They ate too much for their activity. Done. Stop doing that
| if you don't want to gain weight.
|
| So much science out here to disprove this kind of statement,
| yet you still make it.
| thefz wrote:
| Welcome to weight loss discussion on HN, where any rational
| point like "eat less" or "calories in, calories out" gets
| downvoted and discussed to death.
|
| Apparently for this crowd taking medicines is better than
| stopping stuffing yourself, because you know, if you take a
| medicine you can keep stuffing yourself.
|
| Oh, and also "it's more complicated than that" is always a
| nice escape from the harsh reality of thermodynamics.
| Dagger2 wrote:
| It gets downvoted because it's stupid and unhelpful.
|
| If your body has the wrong idea of how much fat it should
| store, it'll do its best to force you to eat more to get
| that fat, even if it makes you unhealthily overweight.
| Medication can fix the body's idea of how much fat it
| should have.
|
| Taking that medication doesn't mean you can keep stuffing
| yourself, it means you can finally _stop_ stuffing
| yourself, without your body incorrectly reporting that it's
| starving. The point of the medication is to make it
| possible to do the right thing.
| arjie wrote:
| FYI the show was not an incontrovertible failure for most
| contestants
|
| > _Six years after the competition, median weight loss in 14 of
| "The Biggest Loser" participants was 13%_...
|
| That means at least 7 of them lost 13%. That's pretty
| significant. On Ozempic, average weight loss is 11% after six
| months.
|
| The show worked for the majority, and the difference between
| the people who it worked for and the people for whom it did not
| work is Physical Activity not Energy Intake. This is covered in
| the OP link and also in
| https://pubmed.ncbi.nlm.nih.gov/29086499/
| paulddraper wrote:
| Tbf they were massively obsese so they "should" have lost
| like 30% of their body weight.
|
| But yes, 13% is significant.
| waterheater wrote:
| Based on a Mayo Clinic article [1], it's possible that
| Ozempic affects ghrelin uptake [2].
|
| [1] https://diet.mayoclinic.org/us/blog/2024/how-does-
| ozempic-af...
|
| [2] https://en.wikipedia.org/wiki/Ghrelin
| CooCooCaCha wrote:
| Metabolic damage is mostly a myth.
|
| Fat, muscle, and activity burn calories.
|
| If you lose weight you're probably burning fewer calories unless
| you replace it with muscle.
|
| Activity levels also vary over our lives. We tend to be more
| active when we're younger.
| paulpauper wrote:
| an extra 10 pounds of muscle, which is average for someone who
| has never trained, maybe burns only 100 extra calories. The
| problem also is that muscle hypertrophy also entails gaining
| some fat too.
| CooCooCaCha wrote:
| Depends on how you bulk. You'll gain some fat sure, but you
| can limit this by eating healthier and not too much over your
| caloric needs.
|
| But my point is, if someone loses a bunch of fat their bmr is
| going to take a hit. Could be pretty significant on the order
| of hundreds of calories a day.
| belltaco wrote:
| > In 2016, Pontzer and colleagues published a study putting
| forward the constrained energy model: Energy expenditure does
| increase with more activity, but only to a point. Once physical
| activity gets really high, the body will adjust other components
| of the metabolism to keep your daily energy expenditure within a
| narrow range
|
| How do people who constantly repeat the mantra of thermodynamics
| in such threads explain this? How is the body burning the same
| calories with increased physical activity? Not to mention that
| people can extract more or less calories from the exact same food
| and quantity consumed.
| n4te wrote:
| The only thing that makes sense to me is that the body gets
| more efficient.
| jay_kyburz wrote:
| That what I imagined as I was reading, the act of breathing
| and pushing blood around the body just becomes easier when
| you are fit. (requires less energy)
| Workaccount2 wrote:
| Your nervous system also becomes more efficient at zapping
| the right muscles at the right time. The effect of this can
| be pretty dramatic too. Even a slightly out of sync
| orchestra just sounds wrong.
| pi-e-sigma wrote:
| The only plausible explanation is that it's at a cost of other
| functions that are vital long-term but can be turned down
| temporarily? Such as reduced creation of new blood cells etc.
| awfulneutral wrote:
| Couldn't your body burn more or fewer calories passively and
| release the energy as heat? Or you could make more or fewer
| micro movements throughout the day, in a way that adds up to
| whatever your body thinks energy expenditure should be?
| pi-e-sigma wrote:
| Lowering body temperature would be precisely one of these
| things you can do short term to maintain the same calories
| expenditure but would be unhealthy if prolonged.
| dtmaurath wrote:
| This is it! Well based on what I have learned across books
| and podcasts, namely Dr. Andy Galpin's discussion with Andrew
| Huberman, Ultra Processed People and Racing Weight. The
| shutdown of these systems is believed to give them a break
| and is one of the reasons that regular exercisers have better
| health (just think why is exercise even healthy? It wouldn't
| seem so. Spike cortisol, burn a ton of energy, stress joints,
| jostle around the organs. Seems bad to me but of course its
| not).
|
| Or you can find out for yourself. Touch your stomach during a
| run on a hot day. Its cold. Digestion is slowed and blood
| pulled away from the gut.
|
| N of 1. But I do not eat much more on the days I run 15 miles
| on the trail vs days off. I do not need to due to these
| adaptations.
| renewiltord wrote:
| The straightforward hypothesis would be "by reducing other body
| functions". For the duration of a Barry's Bootcamp class, my
| watch (probably over-)estimates my calorific expenditure at
| 1000 kcal. I know that right after that, I could probably not
| do too much Mathematics. Frequently, I encounter visual snow.
| But most of the time, I can do Mathematics.
|
| And then there's healing, and saliva generation, and digestion,
| etc. I'm sure there's a lot of room for energy savings.
| heyoni wrote:
| I'm like that too sometimes after a particularly difficult
| workout. I can't make conversation or make sense of things I
| would normally have no trouble with (programming related).
| ASalazarMX wrote:
| That could be explained if you start with an inefficient body.
| If you suddenly start running 5K races, you'll likely won't
| finish the first one, and it will hurt a lot the following
| days. As your body becomes used to the new activity, you'll
| start finishing your races and getting less drained afterwards.
|
| You're improving your fuel economy.
| paulpauper wrote:
| The body burns fewer calories later, like on immune system and
| digestion and other things
| gumby wrote:
| A couple of non-exclusive theories from a non-physiologist:
|
| Your body needs to burn less to maintain / manage the fat you
| are or rather were carrying around.
|
| Your body may be engaged in various processes that it turns
| down. It's possible, for example, that it may be engaged in
| various anti-cancer activities that aren't necessary as your
| body fat decreases (higher body fat is correlated with some
| cancers, though I don't believe a a direct causal link has been
| established...but this comment is all speculation anyway). Or
| the excess calories could signal your body to do other
| "discretionary" processes that it dispenses with in time of
| calorie deprivation. It's even possible that such discretionary
| processes could be statistically _bad_ for you in our current
| environment, which might be a reason why calorie deprivation
| may extend lifespan, at least in modern humans.
|
| Your gut could expend less effort to extract certain nutrients
| or vitamins from your food in a low calorie regime ("bah,
| opportunistically grabbing that extra Vitamin E is not worth
| the effort right now").
|
| Just some off the top ideation, not meant to imply that these
| ideas are _necessarily_ what happens but are ideas why simple
| thermodynamics is inadequate on its own to explain the
| phenomenon. The body is more than a simple calorimeter.
| Angostura wrote:
| In summary - the body adjusts. The increased hunger stimulated
| by the vigorous exercise will usually outweigh any calories
| burned off
| tech_ken wrote:
| Seems in line with other phenomena such as resting heart rate
| decreasing after sustained cardio training regimens. Your body
| just starts expending less energy during resting periods. This
| doesn't entail loss of function because the body is capable of
| operating in a wide variety of energy expenditure regimes
| bluGill wrote:
| Most people who quote thermodynamics don't understand it. They
| are just saying calories in = calories turned to fat + calories
| burned. Which is true, but not helpful. The body has many
| choices, including burning it and then using sweat to get rid
| of the extra heat. Since we have minimal control over if the
| body will do this there isn't anything more thermodynamics can
| input into weight.
| Gibbon1 wrote:
| > constantly repeat the mantra of thermodynamics in such
| threads explain this?
|
| As someone that took three semesters of thermo. I don't
| understand thermo in a deep way and they have a Randall Munroe
| School of Science understanding.
| waterheater wrote:
| The answer is: leptin. I just wrote a post about it, which you
| may find intriguing:
| https://news.ycombinator.com/item?id=38942521
| Swizec wrote:
| > How is the body burning the same calories with increased
| physical activity?
|
| As someone who runs marathons, the answer to "how does the body
| burn the same calories with increased activity" is: It doesn't.
| You _will_ feel a marathon metabolically no matter what. And if
| you don't eat like an absolute monster that day, you're
| literally going to feel insatiable hunger for multiple days
| until you get those calories back.
|
| Feeling hungry when your stomach is so full that you can't take
| another bite is quite an experience I'll tell you that.
|
| And yes, your grocery bill does get higher when training for a
| marathon. It's very noticeable.
| TylerE wrote:
| OT, but is anyone else's HN homepage like, super stale? Most of
| the posts are from 12+ hours ago, some from more than a day.
|
| Edit: 5/30 _less than_ 12 hours old, 16 /30 _more than_ 20 hours
| old.
| zilti wrote:
| I suppose they still have some issues, HN was down for a few
| hours today.
| TylerE wrote:
| Ironically, I didn't notice that because MY internet was
| down, due to heavy winds/rain from the big storm yesterday.
| SketchySeaBeast wrote:
| Mine as well. They had some outages today, I wonder if there's
| trouble afoot.
| dang wrote:
| Yes, it's related. Sorry.
|
| If you guys suggest (or submit!) some good submissions and
| let me know what they are, I can put them in the second-
| chance pool, which will accelerate the refreshing of the
| front page.
| hristov wrote:
| It looks to me like HN has been in a massive censorship mode in
| order to remove ongoing stories about the Bitcoin ETF, the SEC
| and the Twitter/X hack of the SEC's account.
|
| That story was on the top by far yesterday and then it
| suspiciously disappeared, after the comments took a very
| decidedly (and very deservingly, in my opinion) anti-Muskian
| bent.
|
| Since then there has been no story about the bitcoin ETF on the
| front page of HN even though it is a very important time for
| bitcoin (the deadline for bitcoin etf inclusion is today) and
| HN loves talking about bitcoin.
|
| So there is your answer.
| dang wrote:
| That has zero to do with this.
|
| (Btw HN has plenty of "anti-Muskian bent". A glut in fact! So
| I'm a bit mystified how that, of all things, would trigger
| suspicion)
| chiefalchemist wrote:
| In the last few months I read two books on this topic, and both
| (if I recalled correctly) mentioned The Biggest Loser (or
| similar).
|
| Exercised - Daniel E Lieberman
|
| https://www.npr.org/2021/01/05/953249677/exercised-explains-...
|
| Burn - Herman Pontzer (who I believe was a student of
| Lieberman's)
|
| https://www.scientificamerican.com/article/new-human-metabol...
|
| Both a fairly dry and academic, but do get into the weeds if
| that's your thing.
|
| A third book that's related but is an easier more entertaining
| read is "The Comfort Crisis" but Michael Easter.
|
| https://eastermichael.com/book/
|
| Easter actually interviews / quotes Lieberman.
|
| The gist of all three...from an evolutionary perspective, the
| human body is designed for lean caloric times. When there is more
| calories than there is activity to burn it, those calories will
| be stored as fat (in preparation for leaner times). There's no
| ceiling on that so you'll keep adding weight.
|
| In modern times, our evolutionary advantages become
| disadvantages. The best way to lose weight, is to not gain it in
| the first place.
| csours wrote:
| Hungry Brain by Guyenet is huge recommend from me, and I second
| the recommendation for Burn
| chiefalchemist wrote:
| I'll check that out. Thanks.
|
| Speaking of the brain, I've often wondered if less focus and
| thinking is also contributing to weight gain. The brain is
| responsible for ~20% of resting metabolic rate. If the brain
| consumes just a bit less calories per day, that's also going
| to add up.
| Angostura wrote:
| The calorific difference between an active and resting
| brain in negligible
| voisin wrote:
| Interesting! Source?
| DiscourseFan wrote:
| I've managed to keep a good amount of weight off for years, but
| only with vigilance, because even a couple weeks of
| unrestrained eating can be disastrous. I'm not at my _lowest_
| ever weight, that was during COVID, when I got hit with a nice
| D-variant, and lost my appetite for a month before force-
| feeding myself back to normal. _That_ was the my first
| experience with truly unhealthy weight loss, and made me
| realize that while being nice and slim is good in the short
| term, in truth we aren 't so far from the terrifying infectious
| diseases and famines that plagued humanity even last century,
| and if you aren't running around all the time desperate for
| something to eat, you probably don't _need_ to be doing much
| moving anyway. Thinner people are healthier out of evolutionary
| necessity, the environment is working against them! It 's
| desperation, all the other benefits of exercise still come to
| the heavy.
| slothtrop wrote:
| The more frequent the dieting and steeper the caloric deficit,
| the worse metabolic adaptation gets, and the longer it takes to
| return to normal. As I understand it that's the result discerned
| from more than just one paper. Layne Norton explores this at
| length in his book Fat Loss Forever and yt channel.
|
| The interesting thing in this link was the impact of change in
| exercise regimen. We know that exercise in itself can mitigate
| metabolic adaptation and leads to better outcomes, so maybe that
| should not be surprising (when they quit). The outsized impact is
| interesting. I wonder if those who sustained higher levels of
| exercise were actually in a steeper caloric deficit.
|
| It's possible to lose weight sustainably even without exercise,
| so perhaps it's fair to say that if you're going to exercise, you
| best sustain it.
|
| "damaged metabolism" was always kind of a semantic misnomer.
| cbsmith wrote:
| Wait. What this analysis seems to suggest is that the exercise
| (as long as it is a significant increase) actually encourages
| metabolic adaption.
| slothtrop wrote:
| Yeah I saw. But you'll see that the Biggest Loser contestants
| chased weight-loss on a very aggressive timeline. They have a
| steep deficit, _and_ relatively high intensity exercise
| regimen. Which could just further exacerbate the effects of a
| steep deficit. At any rate, all of them had lastingly bad
| metabolic adaptation, even if those who exercised more had it
| worse.
|
| In other studies (alluded to here as those where participants
| don't undergo anything so extreme), exercise is both a strong
| predictor of long-term weight-loss success, and can dampen
| metabolic adaptation (since more muscle and good
| cardiovascular shape boosts metabolism, usually).
|
| I'm not sure what the lesson is yet, but I would hazard that,
| in the long-term, it's more important to sustain tracking
| energy balance (sustainability of your diet is #1). Moderate
| exercise can probably help, but perhaps it should also be
| sustainable, and in that capacity there are rapidly
| diminishing returns to intensity of exercise (and perhaps
| going hard and then quitting is a risk factor for weight
| regain).
| cbsmith wrote:
| > At any rate, all of them had lastingly bad metabolic
| adaptation, even if those who exercised more had it worse.
|
| Yes, but as I read it, they all lastingly changed the level
| of exercise they were getting, and the extent of the "bad"
| metabolic adaptation seemed to correlate strongly with how
| big of a lasting change they made in exercise.
|
| > In other studies (alluded to here as those where
| participants don't undergo anything so extreme), exercise
| is both a strong predictor of long-term weight-loss
| success, and can dampen metabolic adaptation (since more
| muscle and good cardiovascular shape boosts metabolism,
| usually).
|
| Yes, trading fat for muscle increases your baseline caloric
| consumption, but that's not the same as long-term weight-
| loss.
|
| I'm curious about what studies you've seen, because I've
| seen several other studies that suggest the opposite: that
| diet is a stronger predictor than exercise of long-term
| weight-loss success, and this analysis suggests that the
| more exercise the more likely it is that it will feed in to
| metabolic adaptation.
|
| > I'm not sure what the lesson is yet, but I would hazard
| that, in the long-term, it's more important to sustain
| tracking energy balance (sustainability of your diet is
| #1). Moderate exercise can probably help, but perhaps it
| should also be sustainable, and in that capacity there are
| rapidly diminishing returns to intensity of exercise (and
| perhaps going hard and then quitting is a risk factor for
| weight regain).
|
| My speculation is that the lesson is that in general there
| are diminishing returns from having a caloric deficit,
| regardless of the means to achieve it. Which fits with the
| idea that it is easier succeed with small, lasting changes
| than to create a more significant deficit for a shorter
| period of time. It would explain the insane failure rate of
| the weight loss industry, which for obvious reasons needs
| to show significant short-term results.
| arcticbull wrote:
| > It's possible to lose weight sustainably even without
| exercise, so perhaps it's fair to say that if you're going to
| exercise, you best sustain it.
|
| Exercise is for muscle gain and general health, not for weight
| loss. You have to exercise a truly absurd about to burn enough
| calories to lose any meaningful amount of weight. You'd have to
| run from SF to LA to lose 10lbs, and that's assuming you eat
| nothing else to compensate which humans are notorious for
| doing. Your body has a very strong homeostatic drive, and will
| absolutely push you to eat more and to be more sedentary
| outside of work-out time to compensate for any additional
| exercise you do.
|
| There's no studies or evidence whatsoever that shows it has a
| meaningful impact on weight loss. Weight loss comes from what
| you put in (or rather don't).
|
| This write-up from 2016 references 60 studies and meta-analysis
| which all show the same. [1]
|
| tl;dr: you should exercise for health and for muscle gain, not
| for weight loss.
|
| [edit] Note that metabolic adaptation results from caloric
| restriction dieting too, which is why 95% of diets fail.
| Basically only GLP-1s and gastric bypass have been clinically
| shown to result in meaningful, sustained, long-term weight
| loss. Obesity is a dysfunction of the gabaergic central nervous
| system. That's why everyone's so excited about GLP-1s.
|
| [1] https://www.vox.com/2016/4/28/11518804/weight-loss-
| exercise-...
| slothtrop wrote:
| You're confusing things. The real gains qua WL from exercise
| are what is lost from resting metabolic rate, not calories
| burned "during" exercise. Also: satiety, and other health
| benefits that have an impact.
|
| > There's no studies or evidence whatsoever that shows it has
| a meaningful impact on weight loss.
|
| Absolutely not true.
|
| > Weight loss comes from what you put in (or rather don't).
|
| It's energy balance. But just as increasing satiety helps
| (through food choices), exercise is a strong predictor of
| long-term WL success.
|
| > This write-up from 2016 references 60 studies and meta-
| analysis which all show the same.
|
| You're quoting a vox article, and it's making the
| aforementioned erroneous conflation about calories burned
| during exercise.
| arcticbull wrote:
| > Absolutely not true.
|
| Please cite a study that shows that exercise results in
| long-term sustained, clinically meaningful (>5%) weight
| loss. I have looked extensively and found none. And that's
| not for a lack of extant studies.
|
| > It's energy balance. But just as increasing satiety helps
| (through food choices), exercise is a strong predictor of
| long-term WL success.
|
| As far as I can see, there aren't any successful long-term
| (>2y) weight loss studies that don't involve GLP-1s or
| bariatric surgery, so maybe that's where the issue lies.
|
| > You're quoting a vox article, and it's making the
| aforementioned erroneous conflation about calories burned
| during exercise.
|
| I don't think it is, I looked over the studies they link
| to, but I'm open to being wrong. I don't really have a
| horse in this race.
| waterheater wrote:
| I don't mean to be overly repetitive, but the answer is leptin.
| I just wrote a post about it and quoted some of your comments:
| https://news.ycombinator.com/item?id=38942521
| waterheater wrote:
| A shift in understanding the metabolism has been gradually
| occurring since the 1990s with the isolation of leptin.
|
| What is leptin? Discovered in 1994, leptin is a hormone that
| signals the availability of energy reserves in the body. "High
| leptin levels are interpreted by the brain that energy reserves
| are high, whereas low leptin levels indicate that energy reserves
| are low", the latter causing the body to enter a resource-
| minimizing starvation mode [1]. More recently, leptin has also
| been shown to regulate "neuroendocrine and immune function and
| [play] a role in development" [2].
|
| Why is leptin so important to obesity? "Most obesity occurs in
| the presence of increased leptin levels", which suggests a form
| of "leptin resistance" in obese individuals [2].
|
| Leptin changes our understanding of body fat, also called adipose
| tissue. We generally think of body fat as simply stored energy
| reserves, so fat can be burned by decreasing our caloric intake
| (diet) and increasing our energy usage (exercise), forcing our
| body to dip into its reserves. This approach is generally
| referred to the calorie-in/calorie-out (CICO) model. While true
| to an extent, this perspective is too simplistic, given one key
| fact: leptin is primarily produced in adipose tissue [1]. This
| fact means body fat is actually an endocrine system organ.
|
| Consider this: an obese individual has elevated leptin levels. A
| decrease in adipose tissue causes a decrease in their leptin
| production. Due to leptin resistance, low leptin levels causes
| the body to enter starvation mode, and hardcore dieting causes
| leptin levels to drop further, which makes weight loss even more
| difficult. What they mean by "metabolic adaptation" may be
| understood as "leptin adaptation", though I'm just speculating
| there.
|
| It's strange that so many articles talk about weight loss and
| "metabolism adaptation" without mentioning the hormone signalling
| energy availability. With leptin, we clearly see the body has an
| energy availability feedback loop, and fighting the intrinsic
| dynamics of a feedback loop rarely leads to good outcomes.
|
| On this vein, I want to highlight slothtrap's comments:
|
| >The more frequent the dieting and steeper the caloric deficit,
| the worse metabolic adaptation gets, and the longer it takes to
| return to normal.
|
| >I wonder if those who sustained higher levels of exercise were
| actually in a steeper caloric deficit.
|
| >perhaps it's fair to say that if you're going to exercise, you
| best sustain it.
|
| These comments align with present understanding of leptin
| dynamics. A steep caloric deficit pushes the obese body into
| starvation mode, so net energy expenditure from high levels of
| exercise will be decreased. Weight loss will be maintained once
| the body adjusts its leptin production and usage, which, as of
| now, can only be accomplished with habit.
|
| It's also worth mentioning here the hormone ghrelin, which was
| identified in 1999 and is nicknamed the "hunger hormone" [3].
|
| [1] https://en.wikipedia.org/wiki/Leptin
|
| [2] DOI: 10.1146/annurev.physiol.62.1.413
|
| [3] https://en.wikipedia.org/wiki/Ghrelin
| voisin wrote:
| > However, low leptin levels causes the body to enter
| starvation mode, and hardcore dieting causes leptin levels to
| drop further.
|
| What about fasting? Dr Jason Fung wrote a book about fasting
| that IIRC says that it does not cause starvation mode.
| thefz wrote:
| Agree, straying from thermodynamics is wrong. Human fat holds
| around 8000Kcal per Kg. Stop eating altogether. Every the
| 8000th Kcal more or less you would have lost 1Kg of fat.
| waterheater wrote:
| My reply to him addresses this. Intermittent fasting works
| better than starvation.
| Toutouxc wrote:
| There's the issue of not being able to decide what gets
| burnt. I've read that under certain circumstances, the body
| can actually burn the muscles faster than it burns the fat.
| Which obviously makes exercise harder.
| aantix wrote:
| It's not always going to be fat.
|
| The dramatic weight loss induced by GLP-1's demonstrates
| that.
|
| We're seeing a disproportionate amount of lean muscle mass
| loss.
| waterheater wrote:
| Just looked up his book "The Obesity Code"; not sure if
| that's the one you're thinking of.
|
| Dr. Fung says obesity is a basically a hormonal issue, not a
| caloric issue. He discusses a "causality test": "If we inject
| this hormone into people, they must gain weight". According
| to Dr. Fung, leptin and ghrelin don't pass this test, but
| insulin and cortisol do. Still, leptin and insulin appear to
| have a close relationship. "Insulin promotes fat storage.
| Leptin reduces fat storage. High levels of insulin should
| naturally act as an antagonist to leptin. However, the
| precise mechanisms by which insulin inhibits leptin are yet
| unknown." He also says that "too much insulin causes obesity"
| and that "obesity is a state of leptin resistance." (Sorry
| for that mini book review; I needed to understand what he was
| saying.)
|
| On the fasting point, he's explicitly supportive not of
| regular fasting but intermittent fasting: "Diets must be
| intermittent, not steady...we cannot fast all the time. It
| won't work."
|
| Based on my fast read of his work and my own understanding,
| intermittent fasting keeps leptin levels high enough that the
| body doesn't kick into calorie restricting mode. One approach
| which seems to accomplish this is eating close-to-zero carbs
| five days/week (say, during the week) and then eating lots of
| carbs two days/week (say, on the weekend). The burst of carbs
| will cause leptin levels to spike since the body now has tons
| of available energy. Over the week, the leptin levels will
| remain elevated, but since you're minimizing carbs, the body
| will draw energy from adipose tissue.
| throwup238 wrote:
| _> This approach is generally referred to the calorie-in
| /calorie-out (CICO) model. While true to an extent, this
| perspective is too simplistic, given one key fact: leptin is
| primarily produced in adipose tissue [1]. This fact means body
| fat is actually an endocrine system organ._
|
| This part I think needs more explanation. The reason calories-
| in/calories-out model is too simplistic (I would call it almost
| useless if not completely wrong) is because of mitochondrial
| uncoupling proteins [1] that control how much energy in the
| protein gradient gets converted to ATP and how much is lost to
| waste heat. These uncoupling proteins are upregulated by leptin
| so when your leptin levels fall, your body literally changes
| how efficient its metabolism is to do more work with fewer
| calories. Body fat isn't just an endocrine organ, it might be
| the primary metabolic controller with a nasty catch 22 feedback
| loop - which would help explain why a certain minimum
| percentage of body fat is required or else a person enter organ
| failure.
|
| That's why there are some people who don't seem to gain much
| weight despite eating a lot of food: their bodies are naturally
| less efficient and lose a lot more energy to thermogenesis.
| Without taking that metabolic adaptation into account, CICO is
| nothing but harmful dogma that needs to die. Otherwise people
| are fighting what might be one of the most important biological
| adaptations humans have.
|
| [1] https://en.wikipedia.org/wiki/Uncoupling_protein
| ninkendo wrote:
| CICO doesn't work across individuals for reason you outline
| (just because I lose weight with a certain level of calories,
| doesn't mean you will, etc.)
|
| But for a single individual, working to establish your base
| metabolic rate by counting every calorie and weighing
| yourself regularly, you can _always_ find a way to be
| successful with the CICO model. If you establish a baseline
| that your metabolic rate is (say) 2000 calories a day, then
| eating 1600 calories a day will cause you to lose roughly a
| half-pound to a pound per week. It does _not_ mean that every
| individual's baseline metabolic rate is the same.
|
| As you also outline, your base metabolic rate also changes as
| your weight does, so re-baselining by continually measuring
| caloric intake and your weight to recalibrate is always going
| to be necessary.
|
| Given the above CICO almost seems tautological: Measure the
| weight loss you actually observe at a given calorie level,
| and that tells you... how much weight you will lose at that
| given calorie level. So it is almost useless as you describe.
|
| BUT, the main reason I'm still a proponent of CICO is that it
| simplifies dieting away from thinking about _what_ you eat,
| and instead focuses on _how much_ you eat. If I establish
| that I need to eat 1800 calories a day, I can still have a
| Big Mac meal and drink some beers. But I may not be able to
| eat much else that day. That alone makes it useful for me.
| What _isn't_ useful to me, are diets that essentially limit
| the _type_ of food you eat and tell you to just go nuts and
| eat however much you want: I will often find myself hating
| the foods I'm restricted to, and the quantity I eat may end
| up being such that I gain weight anyway.
|
| To me, CICO is simply a technique that says "actually measure
| how much you're eating", no more and no less. That is what
| makes it a useful tool.
| waterheater wrote:
| Knowledge of leptin changes this because what you eat does
| actually matter. The goal should be intermittent fasting,
| where you eat little-to-no carbs about five consecutive
| days/week and then plenty of carbs two consecutive
| days/week. This approach ensures leptin levels in the obese
| body remain high enough to prevent onset of starvation mode
| while minimizing glucose levels to promote catabolic action
| on body fat [1].
|
| The bottom line is: you're welcome to eat your Big Mac and
| beers, just only two days out of the week.
|
| Also, stress has an important role to play on weight loss.
| Stress causes your adrenal glands to release cortisol.
| Cortisol increases glucose levels through gluconeogenesis
| by making glucose from non-carbohydrate sources, such as
| proteins from muscles.
|
| [1] https://en.wikipedia.org/wiki/Catabolism
| ninkendo wrote:
| It sounds like any other of these diets that tell you
| when and how to eat but not how much. I'm pretty sure I
| could gain weight when doing everything you describe, if
| I eat _really_ terribly during the days I eat "plenty of
| carbs".
|
| The key to CICO is that you're _actually measuring_ not
| just the calories you eat, but the weight you gain /lose,
| and are continually calibrating. If my diet jacks up my
| leptin levels such that I don't lose weight, that will
| show up on the scale, and I have to adjust my calories
| down to compensate. With this system I am _guaranteed_ to
| lose weight so long as I don't cheat. This is trivially
| true: the calibration could technically push you all the
| way to zero calories per day (which will never happen in
| practice, obviously.)
|
| Case in point, I lost 50 lbs with this approach, eating
| McDonald's nearly every single day. I kept it off for
| roughly 8 years. (I since became a dad and have let
| myself go tremendously, gaining ~30lbs back, but I will
| cross that bridge soon.)
| waterheater wrote:
| >If my diet jacks up my leptin levels such that I don't
| lose weight, that will show up on the scale, and I have
| to adjust my calories down to compensate.
|
| >With this system I am guaranteed to lose weight so long
| as I don't cheat.
|
| Unfortunately, that's just not true. Here's some great
| quotes from the book "The Obesity Code" (which I've just
| recently found and find an excellent book):
|
| >The abrupt increase in obesity began exactly with the
| officially sanctioned move toward a low-fat, high-
| carbohydrate diet.
|
| >A 30 percent reduction in caloric intake results in a 30
| percent decrease in caloric expenditure.
|
| >Total energy expenditure is the sum of basal metabolic
| rate, thermogenic effect of food, nonexercise activity
| thermogenesis, excess post-exercise oxygen consumption
| and exercise.
|
| >Since hormones control both Calories In and Calories
| Out, obesity is a hormonal, not a caloric, disorder.
|
| >If hormones regulate fat growth, then obesity is a
| hormonal, not a caloric disorder.
|
| >Sugar will increase the blood glucose level and provoke
| an insulin response from the pancreas. Olive oil will
| not...[cause] significant increase in blood glucose or
| insulin. The two different foods evoke vastly different
| metabolic and hormonal responses."
|
| All of this is to say that it's not enough to simply
| adjust calories. Yes, calories matter to a point, and
| starvation (e.g., 0 calories for an extended period of
| time) is effective in the long-term but will also harm
| your body. The best available scientific evidence shows
| that continuing to decrease caloric intake can make
| weight loss more difficult for an obese person.
| voisin wrote:
| You focus on carbs specifically, but IF is about all
| calories being eliminated for periods, and it doesn't
| necessarily mean you eat plenty on the break days (if you
| take break days at all - some people exist on 16:8 or
| 20:4 or whatever perpetually). I think you have something
| important here but the wording is ambiguous and I am
| wondering if you can clarify your thinking?
|
| Are you saying only carbs matter with respect to leptin?
| throwup238 wrote:
| This is the dogma that I'm talking about.
|
| _> If you establish a baseline that your metabolic rate is
| (say) 2000 calories a day, then eating 1600 calories a day
| will cause you to lose roughly a half-pound to a pound per
| week._
|
| At this point it's pretty safe to say that's likely untrue
| at the population level. This is a cutting edge area of
| research but the UCP1 adaptations seems to happen really
| fast, for some people on the order of weeks. On the order
| of months for the vast majority of the population. It
| doesn't take long for the basal rate to fall to whatever
| your intake is because the system evolved to naturally have
| a _lot_ of room to spare. The human body _always_ adapts
| and if I were a gambling man, I 'd say this is largely why
| most people fail at dieting: after a month or two the
| results stop and they have to further decrease their intake
| which interferes with other pathways and tanks motivation.
|
| If it works for you, that's great! You're one of the lucky
| ones, maybe because you've hit your floor for uncoupling
| proteins. But given just how hard dieting is for most
| people and how bad the obesity epidemic has gotten, it's
| probably not useful for the majority of people. A far more
| holistic approach that tackles macro- and micronutrient
| deficiency, motivation, lifestyle, and not just net
| calories is required.
| ninkendo wrote:
| > It doesn't take long for the basal rate to fall to
| whatever your intake is because the system evolved to
| naturally have a lot of room to spare
|
| All this is accounted for in this sentence of my post:
|
| > your base metabolic rate also changes as your weight
| does, so re-baselining by continually measuring caloric
| intake and your weight to recalibrate is always going to
| be necessary
|
| If you're actually measuring yourself at the scale to get
| the ground truth of your actual metabolic rate, and
| you're doing this _every single day_ , then there isn't a
| single thing that can change this: UCP1 adaptations, fat
| viruses, leptin changes, hormones, stress... _all of
| this_ is covered by the actual weight on the scale. If I
| ate X calories and gained Y lbs, I need to adjust my
| calories by Z, _no matter the reason I gained those
| pounds._
|
| You can argue that such a diet is too hard, and that for
| some people the adjustment to your calories is going to
| leave you essentially starving, but it doesn't change the
| truth of the matter that it _will_ work if you do it
| right. Now, whether it's worth it for people, and whether
| the process is going to leave you _utterly miserable_ or
| even _extremely unhealthy_ as a result, I'm making no
| claim on.
| aantix wrote:
| Thoughts on Adenoviruses as being a root cause of obesity?
|
| https://www.geneticlifehacks.com/weight-loss-genetics-obesit...
|
| "Interestingly, animal studies show that the gain in fat mass is
| not due to eating more or moving less... Animals ate the same
| amount of chow, but those infected with adenovirus 36 increased
| fat tissue by 60-80%."
|
| https://pubmed.ncbi.nlm.nih.gov/17135605/
|
| "A 2004 twin study showed that the Ad-36 antibody-positive twins
| were "significantly heavier and fatter as compared with their
| antibody-negative counterparts". This was a groundbreaking study
| indicating that the Ad-36 virus was likely causing obesity."
| waterheater wrote:
| It may be a contributing factor in some cases. The study
| published in Obesity you link says the adenovirus affects
| insulin, leptin, and corticosterone. An important note about
| the third item: "In many species, including amphibians,
| reptiles, rodents and birds, corticosterone is a main
| glucocorticoid, involved in regulation of energy, immune
| reactions, and stress responses. However, in humans, cortisol
| is the primary glucocorticoid..." [1]. Note that the adenovirus
| itself wasn't definitively causing obesity, but obesity is
| caused by the adenovirus' effects on certain hormones.
|
| I highlight this because obesity is increasingly being
| reestablished as a hormonal problem. See my post and replies
| for more information about this change:
| https://news.ycombinator.com/item?id=38942521
|
| [1] https://en.wikipedia.org/wiki/Corticosterone
| anothernewdude wrote:
| I like how it's being positioned as "damage". It's the body
| working more efficiently with less fuel. That's not damage, it's
| adaptation and homeostasis.
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