waitwhat? said:

---

I get the feeling you're a personal trainer or dietician or something. One of those professions that rely on convincing people that losing weight is more difficult than "eat less, move more."

---

Nope, just someone fighting this battle and frustrated with "eat less, move more" not working. I've put in some time learning more and have come to realize that it's not something that can be boiled down into a simple equation that everyone can be squeezed into (no pun intended).

amercer said:

---

Veering way off topic here, but this is a fascinating show about the science of fat and weight loss.

https://www.kpbs.org/news/2020/apr/07/nova-truth-about-fat/

One of the more interesting findings is that exercise doesn't really make much difference. Your body is incredibly good and conserving energy and fighting attempts to move away from its set weight point.

Consuming less calories does work, but the rate of reduction from the average Americans diet is really hard for most people to comprehend.

---

Yep, exercise is more of a mental support thing and makes you look better once the fat sheds off. It's mostly about the diet.

And no offense but if y'all don't learn the difference between "less" and "fewer" I'll blow my calories out.

KidDoc said:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

Sadly there is no quick or easy fix which is what people want. Also there seems to be some metabolic switch that goes off when you start puberty so if you are chubby at that age your body has a pathologic set point that we don't know how to fix making long term weight loss very difficult.

---

As my grade school kids get older I've noticed how there are just a lot more chunkier kids around than I remember. Even with all the sports and activities so many are into. (Maybe because we are a fast food nation of families always on the go?)

The second scares me. But how much is it metabolic and how much is mentally ingrained poor decision making patterns? We're still a culture of finish your plate and food == love.

tysker said:

---

Quote:

---

And no offense but if y'all don't learn the difference between "less" and "fewer" I'll blow my calories out.

---

well, I could care fewer

---

You hit me with the double frustration. I'm sure you could care fewer.

I'll refer you to this page from the dictionary which points out that the distinction between fewer and less is ahistorical bull*****

https://www.merriam-webster.com/words-at-play/fewer-vs-less

ramblin_ag02 said:

---

Quote:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

---

Yeah, the "don't mention obesity" thing should only apply to acute sick visits. Sick people don't want to hear about diet and exercise. Nobody with the flu wants to hear that they are fat. It's not appropriate to the situation. It is appropriate in almost any other type of visit though

---

Part of me wants to say you're doing a disservice by not being honest with patients about why they're having the reaction they have. The other part knows that people will stop going to the doctor if they're told "lose weight and be more healthy" so the net positive is to just keep it to the illness at hand.

Quite the unnecessary catch 22 yall are in.

amercer said:

---

I'll refer you to this page from the dictionary which points out that the distinction between fewer and less is ahistorical bull*****

https://www.merriam-webster.com/words-at-play/fewer-vs-less

---

They also changed the definition of gender to make some people happy. They're only reasonably on definitions that aren't currently topical.

There are some instances where it's arbitrary, but there are also rules about how to use them.

ramblin_ag02 said:

---

Quote:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

---

Yeah, the "don't mention obesity" thing should only apply to acute sick visits. Sick people don't want to hear about diet and exercise. Nobody with the flu wants to hear that they are fat. It's not appropriate to the situation. It is appropriate in almost any other type of visit though

---

And with online reviews I am sure you cannot be as direct as you want sometimes. Most people don't want to hear flat out they are overfat

tysker said:

---

KidDoc said:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

Sadly there is no quick or easy fix which is what people want. Also there seems to be some metabolic switch that goes off when you start puberty so if you are chubby at that age your body has a pathologic set point that we don't know how to fix making long term weight loss very difficult.

---

As my grade school kids get older I've noticed how there are just a lot more chunkier kids around than I remember. Even with all the sports and activities so many are into. (Maybe because we are a fast food nation of families always on the go?)

The second scares me. But how much is it metabolic and how much is mentally ingrained poor decision making patterns? We're still a culture of finish your plate and food == love.

---

No there is good evidence that formerly obese people have to eat roughly 10% fewer calories daily even if they return to normal BMI compared to their peers that were not obese in the past. It is pretty depressing and frustrating. The long term "cure" rate for adult obesity is around 3-5%.

No data or research has proven that this chronic tendency for your body to return to obesity ever stops or goes away either.

I'm a fairly chubby doc @ 34.3 BMI this morning. That is better than the 39 I was in my late 20s and worse than the 29 I was before I gave up running due to back pain 6 years ago or so. I was a chubby elementary kid and got in great shape with football & lacrosse through college then in medical school it all came right back! Still fighting that daily battle of the bulge!

HBO had a good series called "Weight of the Nation" that dug into some of this data.

waitwhat? said:

---

ramblin_ag02 said:

---

Quote:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

---

Yeah, the "don't mention obesity" thing should only apply to acute sick visits. Sick people don't want to hear about diet and exercise. Nobody with the flu wants to hear that they are fat. It's not appropriate to the situation. It is appropriate in almost any other type of visit though

---

Part of me wants to say you're doing a disservice by not being honest with patients about why they're having the reaction they have. The other part knows that people will stop going to the doctor if they're told "lose weight and be more healthy" so the net positive is to just keep it to the illness at hand.

Quite the unnecessary catch 22 yall are in.

---

I'm also not going to talk about mammograms, prostate checks, or colonoscopies when someone comes in the flu. That's not why they came in that day, and they are not in any mood to discuss non-acute problems

ramblin_ag02 said:

---

waitwhat? said:

---

ramblin_ag02 said:

---

Quote:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

---

Yeah, the "don't mention obesity" thing should only apply to acute sick visits. Sick people don't want to hear about diet and exercise. Nobody with the flu wants to hear that they are fat. It's not appropriate to the situation. It is appropriate in almost any other type of visit though

---

Part of me wants to say you're doing a disservice by not being honest with patients about why they're having the reaction they have. The other part knows that people will stop going to the doctor if they're told "lose weight and be more healthy" so the net positive is to just keep it to the illness at hand.

Quite the unnecessary catch 22 yall are in.

---

I'm also not going to talk about mammograms, prostate checks, or colonoscopies when someone comes in the flu. That's not why they came in that day, and they are not in any mood to discuss non-acute problems

---

Well said. Fair enough.

KidDoc said:

---

tysker said:

---

KidDoc said:

---

I can tell you for a fact that my medical students talk about childhood obesity every single day in clinic. It is a major medical issue for our country.

Sadly there is no quick or easy fix which is what people want. Also there seems to be some metabolic switch that goes off when you start puberty so if you are chubby at that age your body has a pathologic set point that we don't know how to fix making long term weight loss very difficult.

---

As my grade school kids get older I've noticed how there are just a lot more chunkier kids around than I remember. Even with all the sports and activities so many are into. (Maybe because we are a fast food nation of families always on the go?)

The second scares me. But how much is it metabolic and how much is mentally ingrained poor decision making patterns? We're still a culture of finish your plate and food == love.

---

No there is good evidence that formerly obese people have to eat roughly 10% fewer calories daily even if they return to normal BMI compared to their peers that were not obese in the past. It is pretty depressing and frustrating. The long term "cure" rate for adult obesity is around 3-5%.

---

What evidence are you taking about? It flies in the face of basic physics.

I'll cut off my left nut on video if there is any legitimate study that shows that person A that lost 100lb and is now 150lb must consume 10% fewer calories than person B that is the same weight and height as person A but never became overweight in order to maintain weight.

This is the type of misinformation that keeps America fat.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/

This is a brief overview of the issue. There are decreases in metabolism and increases in appetite that occur with weight loss as the body resists weight loss. I read somewhere that it takes 3 years steady at lower weight before the body stops trying to fight to gain it back, but I can't find that right now

3 years sounds about right

My doc has got me on a great plan to lose weight

ramblin_ag02 said:

---

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/

This is a brief overview of the issue. There are decreases in metabolism and increases in appetite that occur with weight loss as the body resists weight loss. I read somewhere that it takes 3 years steady at lower weight before the body stops trying to fight to gain it back, but I can't find that right now

---

WAIT! Are you and your article suggesting that as a body becomes smaller it takes less energy to sustain that body??

Stop the presses!

Aggie_Boomin 21 said:

---

Once you involve metabolisms, anabolisms, and hormones it gets less simple than an equation

---

No, it doesn't. Only people that make money off this or that are trying to make excuses for not being able to lose weight say so.

It is literally physics. There is a certain amount of energy that is required for you to live. That's your BMR. It doesn't change based on feeling. It is based on your actual body and the energy required to sustain it.

If you right now raise and lower your right arm, it will require the same amount of energy regardless if you've eaten 3000 calories or 1000 calories. If you lose weight and your arm becomes lighter then it will require less energy to make that movement.

People make this more difficult than it really is because there is money to be made. Nobody wants to admit that they stay fat because they don't have the will power to lose it, so they pay others to convince them that it's not really their fault.

You doctors supporting this narrative should be ashamed.

I'm 5'11" 195lbs and sub 15% body fat, and could easily decrease that if I wanted to as I choose to ingest 3000+ calories a day and actively burn 5000+ weekly through workouts.

Does any of that make me unique, special, or physically impressive? No. I recognize I'm likely slightly above average. The point of that is to show you're reaching waaaaaaaaay too far with these assumptions. I'm not a fatty that creates excuses to not lose weight.

I'm also not a moron and I recognize that people are genetically predisposed to certain body types. Of course this doesn't mean you can't fight these genetics, or even change them through long term behavior. What 2 peoples' bodies do when they ingest 1000 calories made up of the 3 macros will not be the same anabolically.

Hormone levels are absolutely massive in weight management. Look at the effects low and high testosterone levels have, and then do the same for estrogen. If it only came down to calories ingested and calories burned, do anabolic androgenic steroids not work?

Hormones, post-chubby, etc. probably are all fair points.

That being said, if we all got dropped on a desert island for with no booze and a ration of 2,000 calories per day, I am pretty certain none of us would be clinically obese returning to society.

Or you can just stop eating like this guy, went from 450+ pounds to 196 without eating for 382 days. I would have liked to see his blood work before and after

amercer said:

---

Healthy, sustainable weight loss happens at the rate of pounds per month. No one at a BMI of 40 was going to get healthy in time to save themselves from Covid.

---

True but there are many things you can do to boost your immune system naturally, including increased vitamin D, fish oil, and reducing sugar intake and other inflammatory foods.

Think of all the people that are going to continue wearing masking due to habit or the thought they actually are saving them? If we spent a year pushing vegetables, low sugar, diet, exercise, and sunlight how like we did for masks and distancing, we would be a far healthier nation for future pandemics.

perhaps this is just cynicism on my part, but my experience is that many people need/want their negative circumstances to be someone else's fault. And that extends all the way to personal health.

Tell people that the severity of their illness, their risk of complications from minor insults, etc... are heightened by their excess weight and most people just block it out and continue on unchanged.

They are completely deaf to those suggestions because it implies they have personal control, and they don't want that. They need to be able to blame their problems on some other group, some corporation, some perceived intrinsic unfairness in the world.

Obesity negatively affecting essentially everything health and disease related is the world's worst kept secret. It's common knowledge. I don't think it's that we're not talking about it, I think it's that the only person that matters, each individual, isn't listening.

I think it is more of people take the easy route, not the simple one.

You said nothing of substance besides you're apparently jacked. Congratulations.

Everyone talking about "calories" and how they're burned still don't understand what they're talking about. Calories are a unit of energy. Calories are not little beads or something inside your food. Yes, your body processes different foods differently, and some foods take more energy to break down than others. But it doesn't change that your body requires a certain amount of energy to sustain itself and can't lower that without shutting down organs, nor will it artificially increase its energy requirement just because there's more energy to be used.

There are some very rare instances of disorders affecting energy use and expenditure, but they're rare. The vast majority of us process foods very similarly. Genetics plays a role is where fat gets stored, but not how much energy your body requires to perform some general function.

Stop misunderstanding what a calorie is and the whole process of weight gain and loss becomes much easier to understand, besides the anomalies. I say this, again, as someone who has lost a lot of weight simply by eating less and moving more.

It's a matter of will power. Anything else (99% of the time) is an excuse.