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Author Topic:   More on Diet and Carbohydrates
Percy
Member
Posts: 17965
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.1


Message 166 of 237 (762992)
07-19-2015 8:38 AM


Just How Ineffective are Dieting and Exercise
An article in today's Business Standard describes research revealing that most obese people are likely to stay fat:

quote:
The chance of an obese person attaining normal body weight is one in 210 for men and one in 124 for women, increasing to one in 1,290 for men and one in 677 for women with severe obesity, the findings showed.
...
"This evidence suggests the current system is not working for the vast majority of obese patients," Fildes said.

The paper, Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records, actually describes the problem much better than the non-technical article:

quote:
Overweight and obesity are growing global health concerns. Strategies to control obesity emphasize obesity management and weight reduction as well as obesity prevention. In the United Kingdom, a national strategy report recommends that the management of obesity be an integral part of clinical practice. This envisages that patients may transition from obesity to a more healthy body weight. A target of 5% body weight loss is often recommended for obese individuals who intend to lose weight. However, access to weight management interventions may be limited, and weight management interventions have only small and poorly maintained effects on body weight. To understand the frequency with which reductions in body mass index (BMI, defined as weight in kilograms divided by the square of height in meters) may occur in a large population, we estimated the probability of an obese individual attaining normal body weight or a reduction of 5% in body weight.

Did you catch the key sentence in the middle of that paragraph. "Weight management interventions have only small and poorly maintained effects on body weight." Ain't it the truth.

If dieting and exercise are such huge failures (see first quote, 1 in 210 for men, 1 in 124 for women, of achieving a normal weight), why do we persist? One possibility is that if we didn't we'd be even fatter, but while this must be true to a degree, we also know that the body seems to pick its own weight range, and that eating more or eating less has a greatly diminished effect outside that range. Certainly you can't blame people for the failure of these strategies - when something works for almost no one, it isn't people's fault.

Until doctors can point to effective weight loss strategies, say at least 50% successful, they should abandon the annual shaming that the annual physical has become.

--Percy

Edited by Percy, : Change author.


Testing my signature.

Replies to this message:
 Message 167 by Jon, posted 07-19-2015 9:49 AM Percy has responded

    
Jon
Inactive Member


Message 167 of 237 (762995)
07-19-2015 9:49 AM
Reply to: Message 166 by Percy
07-19-2015 8:38 AM


Re: Just How Ineffective are Dieting and Exercise
If dieting and exercise are such huge failures (see first quote, 1 in 210 for men, 1 in 124 for women, of achieving a normal weight), why do we persist?

Because we know the ill effects obesity has on overall health. Because being obese is not normal for almost anyone.

... we also know that the body seems to pick its own weight range, and that eating more or eating less has a greatly diminished effect outside that range.

That part of that range might include 'obese' seems unsupported by the evidence showing people just like us in other societies who are astonishingly less obese than we are.

There iswith very rare exceptionno physiological barriers preventing any person from maintaining a normal and healthy weight if they so choose.

Until doctors can point to effective weight loss strategies, say at least 50% successful, they should abandon the annual shaming that the annual physical has become.

Well, just 'cause the doctor doesn't have a treatment up her sleeve doesn't mean she shouldn't tell you there's something wrong.

The 'shame' is cultural and internal. It's the doctor's job to give medical advice. And the medical evidence is that being overweight is neither normal nor healthy for anyone.

Edited by Jon, : No reason given.


Love your enemies!

This message is a reply to:
 Message 166 by Percy, posted 07-19-2015 8:38 AM Percy has responded

Replies to this message:
 Message 168 by Phat, posted 07-19-2015 10:06 AM Jon has responded
 Message 171 by Percy, posted 07-19-2015 1:43 PM Jon has responded

  
Phat
Member
Posts: 11563
From: Denver,Colorado USA
Joined: 12-30-2003
Member Rating: 1.2


Message 168 of 237 (762996)
07-19-2015 10:06 AM
Reply to: Message 167 by Jon
07-19-2015 9:49 AM


Re: Just How Ineffective are Dieting and Exercise
The weight range is a fact, though slow change is possible...perhaps the studies did not take into account the fact that its not an easy process to change ones setpoint....most people will fail...yet success is achievable slowly

Chance as a real force is a myth. It has no basis in reality and no place in scientific inquiry. For science and philosophy to continue to advance in knowledge, chance must be demythologized once and for all. RC Sproul
"A lie can travel half way around the world while the truth is putting on its shoes." Mark Twain

This message is a reply to:
 Message 167 by Jon, posted 07-19-2015 9:49 AM Jon has responded

Replies to this message:
 Message 169 by Jon, posted 07-19-2015 10:29 AM Phat has responded

  
Jon
Inactive Member


Message 169 of 237 (762997)
07-19-2015 10:29 AM
Reply to: Message 168 by Phat
07-19-2015 10:06 AM


Re: Just How Ineffective are Dieting and Exercise
The weight range is a fact...

Well then I trust you have some evidence for this.


Love your enemies!

This message is a reply to:
 Message 168 by Phat, posted 07-19-2015 10:06 AM Phat has responded

Replies to this message:
 Message 170 by Phat, posted 07-19-2015 10:31 AM Jon has acknowledged this reply

  
Phat
Member
Posts: 11563
From: Denver,Colorado USA
Joined: 12-30-2003
Member Rating: 1.2


Message 170 of 237 (762998)
07-19-2015 10:31 AM
Reply to: Message 169 by Jon
07-19-2015 10:29 AM


Re: Just How Ineffective are Dieting and Exercise
perhaps not. I assumed the research had its own evidence....

Chance as a real force is a myth. It has no basis in reality and no place in scientific inquiry. For science and philosophy to continue to advance in knowledge, chance must be demythologized once and for all. RC Sproul
"A lie can travel half way around the world while the truth is putting on its shoes." Mark Twain

This message is a reply to:
 Message 169 by Jon, posted 07-19-2015 10:29 AM Jon has acknowledged this reply

  
Percy
Member
Posts: 17965
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.1


Message 171 of 237 (763011)
07-19-2015 1:43 PM
Reply to: Message 167 by Jon
07-19-2015 9:49 AM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:

If dieting and exercise are such huge failures (see first quote, 1 in 210 for men, 1 in 124 for women, of achieving a normal weight), why do we persist?

Because we know the ill effects obesity has on overall health.

Are you saying we should persist in trying to reduce obesity? If so, sure, everyone agrees with that.

What I was actually asking is why we persist in promoting obesity amelioration strategies that have such extreme and demonstrated records of failure.

Well, just 'cause the doctor doesn't have a treatment up her sleeve doesn't mean she shouldn't tell you there's something wrong.

Are you saying doctors should continue warning patients about the dangers of obesity? If so, sure, probably everyone agrees with that, too. What doctors shouldn't be doing is pretending they have effective solutions.

--Percy


This message is a reply to:
 Message 167 by Jon, posted 07-19-2015 9:49 AM Jon has responded

Replies to this message:
 Message 172 by Jon, posted 07-19-2015 2:16 PM Percy has responded

    
Jon
Inactive Member


Message 172 of 237 (763013)
07-19-2015 2:16 PM
Reply to: Message 171 by Percy
07-19-2015 1:43 PM


Re: Just How Ineffective are Dieting and Exercise
What I was actually asking is why we persist in promoting obesity amelioration strategies that have such extreme and demonstrated records of failure.

What are 'obesity amelioration strategies'?

When you said If dieting and exercise are such huge failures ... , why do we persist?, what exactly did you mean?

Are you saying doctors should continue warning patients about the dangers of obesity? If so, sure, probably everyone agrees with that, too. What doctors shouldn't be doing is pretending they have effective solutions.

If that's the position you want to take now, then I won't disagree, but I will still disagree with the position you took in Message 166 which argued that doctors without solutions at least 50% successful should just keep their mouths shut:

Until doctors can point to effective weight loss strategies, say at least 50% successful, they should abandon the annual shaming that the annual physical has become.

Love your enemies!

This message is a reply to:
 Message 171 by Percy, posted 07-19-2015 1:43 PM Percy has responded

Replies to this message:
 Message 173 by Percy, posted 07-19-2015 4:07 PM Jon has responded

  
Percy
Member
Posts: 17965
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.1


Message 173 of 237 (763022)
07-19-2015 4:07 PM
Reply to: Message 172 by Jon
07-19-2015 2:16 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:

What are 'obesity amelioration strategies'?

Dieting and exercise.

When you said If dieting and exercise are such huge failures ... , why do we persist?, what exactly did you mean?

Rephrasing without the confusing "obesity amelioration strategies" phrase, what I was actually asking is why we persist in promoting dieting and exercise when they have such extreme and demonstrated records of failure.

If that's the position you want to take now,...

I apparently wasn't as clear as I hoped, but if in clarifying my meaning I'm to be accused of changing my position then you'll soon be talking to yourself.

..., but I will still disagree with the position you took in Message 166 which argued that doctors without solutions at least 50% successful should just keep their mouths shut:
Until doctors can point to effective weight loss strategies, say at least 50% successful, they should abandon the annual shaming that the annual physical has become.

I didn't say they should keep their mouths shut. I said they shouldn't engage in shaming, i.e., blaming the victim for the problem.

--Percy


This message is a reply to:
 Message 172 by Jon, posted 07-19-2015 2:16 PM Jon has responded

Replies to this message:
 Message 174 by Jon, posted 07-19-2015 5:09 PM Percy has acknowledged this reply

    
Jon
Inactive Member


Message 174 of 237 (763025)
07-19-2015 5:09 PM
Reply to: Message 173 by Percy
07-19-2015 4:07 PM


Re: Just How Ineffective are Dieting and Exercise
Rephrasing without the confusing "obesity amelioration strategies" phrase, what I was actually asking is why we persist in promoting dieting and exercise when they have such extreme and demonstrated records of failure.

What alternatives do you suggest?

I said they shouldn't engage in shaming, i.e., blaming the victim for the problem.

Well, the doctor didn't eat too much and exercise too little to make the patient obese.

The patient did.

Some medical conditions are entirely the result of the patient's actions. Obesity is one such problem. Lung damage from smoking another. As is a broken skull from bashing one's head against the wall.

What else would you have the doctor do? Lie?


Love your enemies!

This message is a reply to:
 Message 173 by Percy, posted 07-19-2015 4:07 PM Percy has acknowledged this reply

Replies to this message:
 Message 175 by Percy, posted 07-19-2015 5:44 PM Jon has responded
 Message 178 by Phat, posted 07-20-2015 10:18 AM Jon has not yet responded

  
Percy
Member
Posts: 17965
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.1


Message 175 of 237 (763027)
07-19-2015 5:44 PM
Reply to: Message 174 by Jon
07-19-2015 5:09 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:

Rephrasing without the confusing "obesity amelioration strategies" phrase, what I was actually asking is why we persist in promoting dieting and exercise when they have such extreme and demonstrated records of failure.

What alternatives do you suggest?

I'm not suggesting alternatives. I'm suggesting that the health and medical establishments not promote alternatives with a demonstrated record of abject failure. If they don't have any effective answers then they should say so.

Some medical conditions are entirely the result of the patient's actions. Obesity is one such problem.

You'd make a great GP, shaming your patients and sending them on their way with solutions that don't work so that next year they can return in the same overweight state and you can shame them again. Bravo.

--Percy

Edited by Percy, : Change author.


Testing my signature.

This message is a reply to:
 Message 174 by Jon, posted 07-19-2015 5:09 PM Jon has responded

Replies to this message:
 Message 176 by Jon, posted 07-19-2015 7:36 PM Percy has responded

    
Jon
Inactive Member


Message 176 of 237 (763035)
07-19-2015 7:36 PM
Reply to: Message 175 by Percy
07-19-2015 5:44 PM


Re: Just How Ineffective are Dieting and Exercise
I'm suggesting that the health and medical establishments not promote alternatives with a demonstrated record of abject failure. If they don't have any effective answers then they should say so.

What alternatives? They're promoting diet and exercise.

Maybe the diet and exercise approach fails most of the time, but if it's all there is then it's all there is.

You'd make a great GP, shaming your patients and sending them on their way with solutions that don't work so that next year they can return in the same overweight state and you can shame them again. Bravo.

What else should they do, Percy?

The best approach is for the patient to not gain the weight in the first place, but that's obviously no longer an option by the time they show up at the clinic already obese. So the doctors give them the best advice they can. Sure they don't throw in the disclaimer about probabilities, but how much harder do you think it would be to get people to take action if they doctor told them they were likely to fail no matter what?

If the doctors did things the way you'd like, the success rate for diets would be 0 in 210 instead of 1 in 210.

I'm not suggesting alternatives.

Then unless you're arguing that the current approach does more harm than good (and can prove it), then I really don't know what the big deal is.

A solution unlikely to succeed is better than no solution at all.


Love your enemies!

This message is a reply to:
 Message 175 by Percy, posted 07-19-2015 5:44 PM Percy has responded

Replies to this message:
 Message 177 by Percy, posted 07-20-2015 6:17 AM Jon has not yet responded

  
Percy
Member
Posts: 17965
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.1


Message 177 of 237 (763053)
07-20-2015 6:17 AM
Reply to: Message 176 by Jon
07-19-2015 7:36 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:

A solution unlikely to succeed is better than no solution at all.

Except that the diet and exercise solution may actually be worse than no solution, since there is gathering evidence that weight cycling (the usual result for most people who try dieting and exercise) is bad for one's health (see, for example, Weight Cycling, Weight Gain, and Risk of Hypertension in Women).

--Percy


This message is a reply to:
 Message 176 by Jon, posted 07-19-2015 7:36 PM Jon has not yet responded

    
Phat
Member
Posts: 11563
From: Denver,Colorado USA
Joined: 12-30-2003
Member Rating: 1.2


Message 178 of 237 (763065)
07-20-2015 10:18 AM
Reply to: Message 174 by Jon
07-19-2015 5:09 PM


Re: Just How Ineffective are Dieting and Exercise
Jon writes:

What else would you have the doctor do?

I recall reading that its not so much the weight that is the problem so much as it is the lack of exercise. Of course extreme obesity is bad for any animal(or human) but the whole stress related effects of forced dieting may themselves cause more harm than good.

A good GP will tell his patients the whole truth. Realistically the typical patient may not necessarily see wight loss per se, but if they are encouraged to exercise and make better food choices in regards to --as an example---good fats over bad fats, their overall health shall improve regardless whether the scake stays the same or not.


Chance as a real force is a myth. It has no basis in reality and no place in scientific inquiry. For science and philosophy to continue to advance in knowledge, chance must be demythologized once and for all. RC Sproul
"A lie can travel half way around the world while the truth is putting on its shoes." Mark Twain

This message is a reply to:
 Message 174 by Jon, posted 07-19-2015 5:09 PM Jon has not yet responded

  
Percy
Member
Posts: 17965
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.1


(1)
Message 179 of 237 (766236)
08-15-2015 10:01 AM


Low-fat Diets Fight Back
A recently published study in Cell Metabolism indicates that low-fat diets are more effective for losing weight than low-carbohydrate diets. The study was by the National Institutes of Health (Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity). Here's a couple popular press articles about the study:

If this holds up (the study was small, only 19 subjects) then we're beginning to see a more complete but complex picture:

  • For weight loss, caloric reduction through decreased fat intake is more effective than through decreased carbohydrate intake.

  • This would imply that replacing fat in the diet with carbohydrates would be a good weight reduction strategy, but most people's experience says this isn't true. I propose that this is because most people end up replacing fat in the diet with *refined* carbohydrates, which are very difficult to avoid in the grocery store these past few decades.

  • Dietary advice from many sources, but primarily the diet industry and the USDA guidelines, has pushed people away from fat and toward carbohydrates. The intention wasn't to push people toward refined carbohydrates (and in fact they advise minimizing them), but that has been the result, particularly because they highlighted the dangers of fats but not carbohydrates.

  • The origin of the advice against fat was because of its supposed negative health benefits (heart disease and stroke), but research is now telling us that the dangers of fat are not just exaggerated but in some cases even 180° wrong. Trans fat, an invention of the food industry, *is* bad for you, but natural fats, particularly saturated fats, are not.

--Percy

Edited by Percy, : Grammar.


Replies to this message:
 Message 180 by nwr, posted 08-15-2015 8:43 PM Percy has acknowledged this reply

    
nwr
Member
Posts: 5584
From: Geneva, Illinois
Joined: 08-08-2005


Message 180 of 237 (766258)
08-15-2015 8:43 PM
Reply to: Message 179 by Percy
08-15-2015 10:01 AM


Re: Low-fat Diets Fight Back
This would imply that replacing fat in the diet with carbohydrates would be a good weight reduction strategy, but most people's experience says this isn't true. I propose that this is because most people end up replacing fat in the diet with *refined* carbohydrates, which are very difficult to avoid in the grocery store these past few decades.

That sounds about right. Fat has more calories per ounce, so cutting them should help cut calories.

Yes, it is hard to get unrefined carbohydrates, though I try. If you look hard you can find some, though it might be a mixture of refined and unrefined. Keeping the balance toward the unrefined is not too difficult. But you do have to look at labels.

I also avoid artificial sweeteners. My suspicion is that they pique the appetite which can stimulate over-eating. Learning to tolerate feeling a little bit hungry also helps with weight control.

I never worried too much about there being some fat. I mainly look at food labels to avoid added sugars and excessive sodium.


Fundamentalism - the anti-American, anti-Christian branch of American Christianity

This message is a reply to:
 Message 179 by Percy, posted 08-15-2015 10:01 AM Percy has acknowledged this reply

  
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