> Masters pointed out that a lifetime carrying excess weight can lead to illnesses that, paradoxically, lead to rapid weight loss. If BMI data is captured during this time, it can skew study results.
“I would argue that we have been artificially inflating the mortality risk in the low-BMI category by including those who had been high BMI and had just lost weight recently,” he said.
It's like the teetotaling bias — a chunk of people who teetotal do so because they have an illness that makes drinking very unwise (or would conflict with medication).
> He discovered that a full 20% of the sample characterized as “healthy” weight had been in the overweight or obese category in the decade prior. When set apart, this group had a substantially worse health profile than those in the category whose weight had been stable.
There are a few odd things about this approach.
First, 20% of people in a healthy weight being previously overweight/obese? This seems high? Could there be reporting bias or other things here? I'm still trying to understand the full study, but it is odd that more people lost weight than gained weight, according to the numbers I'm seeing in it. Although that may be partially explained by the fact that it was limited to people 45 - 85 years old.
Second, the methodology of taking anyone who was previously overweight/obese and is now healthy (weight-wise) into their own group and then attributing increases in mortality purely to weight seem suspect? There are a lot of things that can cause you to lose weight and lead to increased mortality that aren't related to weight, and those would be captured in here.
The conclusions definitely make sense and "feel" right, at least directionally, I'm just a little confused about some of the methodology to get there.
The topic of obesity somewhat reminds me of a joke I once heard from a stand-up comedian whom I cannot remember the name of, but it went something along the lines of, "People always ask you why you quit drinking, but you know... People never ask you why you drank in the first place."
I do not believe that there is a significant portion of the human population that wakes up each day and decides to actively diminish their long-term health by overeating sheerly because he or she lacks the willpower/motivation to improve themselves. I feel that the minor, medium, and major stressors in life are what subconsciously steer one down this path. It's not like people who abuse substances[1] are completely oblivious or ignorant to the negative consequences of the substance.
I think most people understand living an active lifestyle and eating a healthy diet is beneficial, but it's just not plausible for many. Be it time, money, or energy -- I do not think the average person has enough of all three at the end of any given day.
Educating people on how to better take care of themselves is not enough. Obesity is a symptom not a disease in my eyes. I am starting to believe onus of responsibility is less on the individual than we might think for when many of the rats in this rat race are dropping like flies, then perhaps the issue the with the race and not the rats?
[1] I consider food, especially junk food, to be a substance which can be abused.
Or Big Sugar not actively lobbying and promoting their propaganda would help greatly — it really is unbelievable that due to having loads of corn, the US decided to slowly kill their populace by forcing them onto an over-sweetened diet, purely for profit. For foreigners, plenty of food is simply not edible they are so sweet, like who puts sugar into bread?! And it being the way people grew up with, it is exceedingly hard to change. And it does show up very well on statistics between different first world countries.
This seems to try and give people a way out which is the exact opposite of what is needed to deal with this. There has to be a commitment and a no-way-out approach. It quite literally can be life or death. If individuals are not responsible for their own health then who is? How hard is it to eat chicken/tofu + veggies for one meal a day and cut out pizza/pasta/rice/wheat?
True, but don't feel like you have to run for 30 minutes. Walking for that long will go a long way for a lot of folks. Really, walking should probably be looked at far more closely for many folks.
Studies don't really support that. They show that rapid weight loss is more effective, but slightly worse for body composition. And slower weight loss is of course the opposite.
> Cutting out the daily donut for two weeks is about a pound of fat.
For many people, no it's not. Becuse their metabolism just decreases by the exact same amount they cut calories. They cut out the daily donut, and they find themselves fidgeting less and wearing a sweater because they're suddenly a little chilly a lot of the day. And the scale doesn't budge.
For many people, losing weight is a whole lot more complex than reducing by x calories per day. Getting your body to burn fat rather than slow its metabolism can be maddeningly difficult.
"Cutting out the daily donut for two weeks is about a pound of fat."
While I'm completely behind your post in general, unfortunately it's much more complicated. It comes down to calories in vs energy consumption. If you oversupply your buddy with calories however most science I read states 7.000 calories of surplus to be one kilo in fat in the average human. Highly recommend the Huberman episode about nutrition.
That's what I always felt like why keto helped me. Instead of just eating, I was now looking into everything. Almost 10 years ago, I went from 115kg to 86, and I had no issues keeping the weight.
What's unique about food is that unlike smoking, drugs or booze, a human will always have to go back to eating, it's essential for day-to-day life unlike Jameson, Marlboro and meth.
If you have a healthy relationship with food then you're fine, otherwise every day you're faced with willpower checks that you might struggle to consistently pass.
For me, carbohydrate consumption and appetite are massively correlated.
When I reduce carbs below 30g/day, my appetite is naturally suppressed (or avoids over-stimulation). Food feels much less addictive. It's easier not to snack in the face of stress. Keto probably added 10+ years on to my life expectancy.
Yeah for sure. I kicked a 3 cig a day habit overnight. I was still eating junk food even into into a diet. Never really stopped, but I lost a lot of weight through aggressive portion control.
There was an article[1] about two gene mutations which cause (a) lose fat, lose muscle, and (b) lose fat, gain muscule.
If you could build a selector between these three modes (normal human, (a), (b)), you could solve HALF OF HUMANITY PROBLEMS. For real.
That's not a joke. I see a lot of people around whose lifes are crippled by the fact they're not in the body mass which would be most productive/healthy for them. People are losing a decade of life and another decade of productivity due to this. A lot of interpersonal problems are also due to this, more than you can imagine. Half of world's perceived social injustice go away once you fix BMI.
We do not even realize the amount of self-humiliation humanity suffers by not being able to control something so fundamental.
Disclaimer: My own body weight is normal, though I would perhaps accept additional muscle; but it pains me seeing people who suffer from this every day, people who are better than me in most other respects.
I believe 80 percent of all health issues faced by US citizens are caused by or at least exacerbated by dietary choices. I also believe that cutting carb intake to 30-35g daily would be a night/day change for national health.
Previously believed by whom? Pretty sure we've been aware that obesity is a huge problem for a generation now. I mean we literally talk about an obesity epidemic.
Next, science is going to find out that water is wet.
The previous data/methodology. The whole point of the study was to look at three untracked externalities[0] in BMI-outcome research. They used historical NHANES data combined 2015 data on mortality data.
> (1) confounding bias from heterogeneity in body shape; (2) positive survival bias in high-BMI samples due to recent weight gain; and (3) negative survival bias in low-BMI samples due to recent weight loss.
I don't believe this myself, but I do know a lot of people who believe being overweight is unfairly demonized and not as harmful as TPTB would have us believe. Many point to BMI as an inaccurate gauge of healthiness (there's a fair point there about eating disorders and ethnic predispositions towards higher BMIs) and unhealthy obsessions with thinness (as opposed to fitness). Look up "Fat Acceptance" if you'd like to know more.
Personally, I don't think we should view fatness as a moral failing; some people do naturally tend towards higher weights, especially as they get older. But I also feel that fatness is really dangerous and unhealthy and the "Fat Acceptance" movement makes me a bit uncomfortable because, much like smoking cigarettes, some people need a bit of a push to kick bad habits like overeating. Obesity is very expensive, both in money and lives, so if we can reduce it, we should.
The "science" has been saying for a long time now that there's might even be a health benefit from being a bit overweight, and that --as this article carefully explained (which means I guess you didn't read it)-- there is a "U-shaped" distribution of outcomes; in contrast, this study claims all that prior work is wrong, and that there is a "straight upward line".
https://asdah.org/health-at-every-size-haes-approach/ - and similar efforts have sprouted like wildfire these last several years in the name of inclusivity. Claiming or hinting that obesity is bad for one's health is considered highly gauche in polite company.
The health effects of obesity are well advertised yet people continue to eat a lot. You see it on social media: people dining out with friends at restaurants with large plates of food, huge Superbowl parties, etc. evidently these people are not concerned. There are three ways of looking at this: these people are obvious to the risk, do not care, or the risks of obesity or being overweight are overblown. If the NYTs cares about stopping obesity, they should get rid of their food section, as food is the main contributor to obesity.
This seems useful. However, some people, both inside and outside medicine, believe that negative consequences' education can be a solution to the overweight/obesity issue, even though after 40 years we've seen near no positive correlation. We've seen some positive outcomes from interventions (e.g. mental health treatments, actionable plans, etc.) but the funding/resources for those continue to be scarce. So the trend keeps falling back to education in the professional setting or bullying in the social one as a "solution" because it is free, ignoring the lack of efficacy.
I actually think our "personal moral failing" thinking is a large impediment to actionable solutions for society, because instead of looking at WHY even 18-year-olds have gone from below 20 BMI in 1879 to over 26 BMI in 2022[0] we just go around and around in circles about how it is a personal responsibility issue not a systemic one, while the data continues to show that it is across all of society. We continue to subsidize sugar substitutes (corn turned into HFCS) at the production side but sugar taxes to offset the subsidies are seen as "attacks on freedom." The US's overproduction of HFCS has even lowered the international price of sugar indirectly.
Because sugar is so cheap, and so addicting, in our capitalist system the manufacturer willing to exchange other ingredients (e.g. fats, proteins, etc) for sugars may be both cheaper AND taste better, even if ultimately it isn't satiating. So we have a bunch of foods which are high in sugar relative to historical norms or that simply never existed because they exist to act as a "sugar delivery system" (e.g. soda).
After the UK introduced a soda tax (SDIL), we can see that due to both manufacturers reformulating their drinks AND changes in consumer behavior it resulted in lower calorie intakes that they did NOT make up by buying alternative sources of sugar (e.g., candy)[1]
[+] [-] gnicholas|3 years ago|reply
“I would argue that we have been artificially inflating the mortality risk in the low-BMI category by including those who had been high BMI and had just lost weight recently,” he said.
It's like the teetotaling bias — a chunk of people who teetotal do so because they have an illness that makes drinking very unwise (or would conflict with medication).
[+] [-] cscurmudgeon|3 years ago|reply
https://healthjournalism.org/blog/2019/02/breakthrough-resea...
[+] [-] suresk|3 years ago|reply
There are a few odd things about this approach.
First, 20% of people in a healthy weight being previously overweight/obese? This seems high? Could there be reporting bias or other things here? I'm still trying to understand the full study, but it is odd that more people lost weight than gained weight, according to the numbers I'm seeing in it. Although that may be partially explained by the fact that it was limited to people 45 - 85 years old.
Second, the methodology of taking anyone who was previously overweight/obese and is now healthy (weight-wise) into their own group and then attributing increases in mortality purely to weight seem suspect? There are a lot of things that can cause you to lose weight and lead to increased mortality that aren't related to weight, and those would be captured in here.
The conclusions definitely make sense and "feel" right, at least directionally, I'm just a little confused about some of the methodology to get there.
[+] [-] hirvi74|3 years ago|reply
I do not believe that there is a significant portion of the human population that wakes up each day and decides to actively diminish their long-term health by overeating sheerly because he or she lacks the willpower/motivation to improve themselves. I feel that the minor, medium, and major stressors in life are what subconsciously steer one down this path. It's not like people who abuse substances[1] are completely oblivious or ignorant to the negative consequences of the substance.
I think most people understand living an active lifestyle and eating a healthy diet is beneficial, but it's just not plausible for many. Be it time, money, or energy -- I do not think the average person has enough of all three at the end of any given day.
Educating people on how to better take care of themselves is not enough. Obesity is a symptom not a disease in my eyes. I am starting to believe onus of responsibility is less on the individual than we might think for when many of the rats in this rat race are dropping like flies, then perhaps the issue the with the race and not the rats?
[1] I consider food, especially junk food, to be a substance which can be abused.
[+] [-] kaba0|3 years ago|reply
[+] [-] uptownfunk|3 years ago|reply
[+] [-] uptownfunk|3 years ago|reply
Much easier to say no to a 300 cal donut than to run 30 minutes.
Cutting out the daily donut for two weeks is about a pound of fat.
Maybe we need a “just say no” to junk food campaign like we had in the 90s.
Lean meat, tofu, tempeh, seitan, veggies, low calorie sauces, limited fruits, protein smoothies (watching the sugar/fat)
Do a few pushups, a light run, increase slowly.
Make it sustainable, not a flash crash.
[+] [-] taeric|3 years ago|reply
[+] [-] JamesBarney|3 years ago|reply
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702468/
[+] [-] crazygringo|3 years ago|reply
For many people, no it's not. Becuse their metabolism just decreases by the exact same amount they cut calories. They cut out the daily donut, and they find themselves fidgeting less and wearing a sweater because they're suddenly a little chilly a lot of the day. And the scale doesn't budge.
For many people, losing weight is a whole lot more complex than reducing by x calories per day. Getting your body to burn fat rather than slow its metabolism can be maddeningly difficult.
[+] [-] thorio|3 years ago|reply
While I'm completely behind your post in general, unfortunately it's much more complicated. It comes down to calories in vs energy consumption. If you oversupply your buddy with calories however most science I read states 7.000 calories of surplus to be one kilo in fat in the average human. Highly recommend the Huberman episode about nutrition.
[+] [-] Semaphor|3 years ago|reply
[+] [-] ehPReth|3 years ago|reply
[+] [-] 8f2ab37a-ed6c|3 years ago|reply
If you have a healthy relationship with food then you're fine, otherwise every day you're faced with willpower checks that you might struggle to consistently pass.
[+] [-] nugget|3 years ago|reply
When I reduce carbs below 30g/day, my appetite is naturally suppressed (or avoids over-stimulation). Food feels much less addictive. It's easier not to snack in the face of stress. Keto probably added 10+ years on to my life expectancy.
YMMV.
[+] [-] paulpauper|3 years ago|reply
[+] [-] outside1234|3 years ago|reply
[+] [-] readonthegoapp|3 years ago|reply
[+] [-] thriftwy|3 years ago|reply
If you could build a selector between these three modes (normal human, (a), (b)), you could solve HALF OF HUMANITY PROBLEMS. For real.
That's not a joke. I see a lot of people around whose lifes are crippled by the fact they're not in the body mass which would be most productive/healthy for them. People are losing a decade of life and another decade of productivity due to this. A lot of interpersonal problems are also due to this, more than you can imagine. Half of world's perceived social injustice go away once you fix BMI.
We do not even realize the amount of self-humiliation humanity suffers by not being able to control something so fundamental.
Disclaimer: My own body weight is normal, though I would perhaps accept additional muscle; but it pains me seeing people who suffer from this every day, people who are better than me in most other respects.
1. https://davidepstein.substack.com/p/the-diy-scientist-and-th...
[+] [-] rtev|3 years ago|reply
[+] [-] rdl|3 years ago|reply
[+] [-] exfatloss|3 years ago|reply
https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...
[+] [-] smm11|3 years ago|reply
[+] [-] exfatloss|3 years ago|reply
Next, science is going to find out that water is wet.
[+] [-] Someone1234|3 years ago|reply
The previous data/methodology. The whole point of the study was to look at three untracked externalities[0] in BMI-outcome research. They used historical NHANES data combined 2015 data on mortality data.
> (1) confounding bias from heterogeneity in body shape; (2) positive survival bias in high-BMI samples due to recent weight gain; and (3) negative survival bias in low-BMI samples due to recent weight loss.
https://www.tandfonline.com/doi/abs/10.1080/00324728.2023.21...
[+] [-] vanilla_nut|3 years ago|reply
Personally, I don't think we should view fatness as a moral failing; some people do naturally tend towards higher weights, especially as they get older. But I also feel that fatness is really dangerous and unhealthy and the "Fat Acceptance" movement makes me a bit uncomfortable because, much like smoking cigarettes, some people need a bit of a push to kick bad habits like overeating. Obesity is very expensive, both in money and lives, so if we can reduce it, we should.
[+] [-] saurik|3 years ago|reply
[+] [-] netrus|3 years ago|reply
[+] [-] 8f2ab37a-ed6c|3 years ago|reply
[+] [-] paulpauper|3 years ago|reply
[+] [-] britch|3 years ago|reply
Indulging in a Superbowl party or birthday dinner will not make you obese.
Overeating or eating poorly over a long period of time will.
Cooking can be a great way to have healthy tasty food affordably
[+] [-] exfatloss|3 years ago|reply
[+] [-] tomcam|3 years ago|reply
Well I mastered the first part
[+] [-] Someone1234|3 years ago|reply
I actually think our "personal moral failing" thinking is a large impediment to actionable solutions for society, because instead of looking at WHY even 18-year-olds have gone from below 20 BMI in 1879 to over 26 BMI in 2022[0] we just go around and around in circles about how it is a personal responsibility issue not a systemic one, while the data continues to show that it is across all of society. We continue to subsidize sugar substitutes (corn turned into HFCS) at the production side but sugar taxes to offset the subsidies are seen as "attacks on freedom." The US's overproduction of HFCS has even lowered the international price of sugar indirectly.
Because sugar is so cheap, and so addicting, in our capitalist system the manufacturer willing to exchange other ingredients (e.g. fats, proteins, etc) for sugars may be both cheaper AND taste better, even if ultimately it isn't satiating. So we have a bunch of foods which are high in sugar relative to historical norms or that simply never existed because they exist to act as a "sugar delivery system" (e.g. soda).
After the UK introduced a soda tax (SDIL), we can see that due to both manufacturers reformulating their drinks AND changes in consumer behavior it resulted in lower calorie intakes that they did NOT make up by buying alternative sources of sugar (e.g., candy)[1]
[0] https://www.calciumhealth.com/the-american-obesity-epidemic-...
[1] https://www.instituteforgovernment.org.uk/article/explainer/...
[+] [-] exfatloss|3 years ago|reply
100%. We have no clue how to fix it, so we "do something" to feel in control as a society.
[+] [-] JamesBarney|3 years ago|reply
[+] [-] newaccount2021|3 years ago|reply
[deleted]
[+] [-] nostromo123|3 years ago|reply
[deleted]
[+] [-] WalterBright|3 years ago|reply
A strange statistic, as the actual risk of death is 100% for all of us.
[+] [-] tshaddox|3 years ago|reply
[+] [-] inglor_cz|3 years ago|reply
[+] [-] exfatloss|3 years ago|reply
[+] [-] paulpauper|3 years ago|reply