[kwhitefoot]

I'm still wondering why so many people are so much heavier now than they were fifty years ago and why instead of attempting to medicate our way out of the problem we don't try to attack the actual cause.

[kiba]

We're going to need to medicate our way of the problem while waiting for a public healthy policy that actually works.

It's not like we didn't try, but what we tried didn't work and never really iterated toward something that works.

[tourmalinetaco]

The reason nothing has worked is because food companies, who pay out massively to regulators, rewire our basic desires to make us buy more of their sugary slop. And now, we have medical companies, who also pay out heavily, trying to cash in even more. I highly suggest reading “ Salt Sugar Fat: How the Food Giants Hooked Us“ by Michael Moss, and “The End of Overeating: Taking Control of the Insatiable American Appetite” by David A. Kessler, former head of the FDA.

[tomcar288]

It works for me. The secret is simple: Eat food, real food. the trick is to know what real food is (6 main food groups: Beans, whole grains, veg, fruits, nuts/seeds, tubers)

[aantix]

There’s been no shortage of proposed solutions and education.

Weight loss is apparently a 90 billion dollar industry.

It’s just that the long term weight loss outcomes are still abysmal.

New approaches are gladly welcomed.

[yurishimo]

Because we’re genetically engineered to crave stuff that is awful for our bodies in high amounts. Finding sugar in the wild meant foraging for berries for hours or fighting bees for honey. Now you can buy it at the supermarket cheaper than a head of lettuce.

[teaearlgraycold]

Eating healthy, in the appropriate amounts, and exercising daily is the solution - obviously. Moving the mountains necessary to change America's average diet and lifestyle is much harder than giving out a drug. I agree that the drug isn't the "right" solution. But I'll take a half measure over what we've been getting.

[thefz]

> why instead of attempting to medicate our way out of the problem we don't try to attack the actual cause

Have you noticed that every time this discussion comes up in this forum, simple personal intervention is glossed over as a solution? Causes for obesity, for HN users, are:

- The Environment - The Lack of Walkable Cities - The Policymakers™ - Too Many Cars - The Government Lobbied By Food Corps et cetera.

While none of the above has directly put calories into a person's mouth, and the only responsibility is on the mouth owner, we sometimes forget that the simple solution to the obesity crisis is: caloric restriction. This solution however has a major drawback: it requires being slightly uncomfortable for a tiny amount of time, which is unacceptable to most. So, enter the Magic Pill: No effort is required whatsoever, and we can keep on blaming external factors for what enters our mouth.

[belZaah]

Oh were it that easy. While, absolutely, you could not gain weight with a calorie deficit, a targeted calorie deficit alone is not a direct path to loosing weight. If what you eat goes straight to fat (sugar, highly processed foods etc), you’ll still be lacking immediately available sugars to fuel your day. Cue your body slowing down the metabolism while resisting using the fat reserves. What you say is true (and, per personal experience, even the discomfort might not be there) only if the food eaten is of high quality and varied.

[OptionOfT]

Our food is no longer made by people. It is made by companies who make money taking the cheapest ingredients, reconstituting and selling it as 'food'.

I recommend reading this book https://www.amazon.com/Ultra-Processed-People-Science-Behind... (or the audiobook) to learn what makes our 'food' so much worse than 50 years ago.

If you want something more moving, this is good documentary by the same the doctor: https://www.youtube.com/watch?v=5QOTBreQaIk

[Aaronstotle]

I am going to guess that its a combination of the prevalence of ultra-processed foods coupled with a steep decline in physical activity.

[groby_b]

Because we don't know why. We have many suspects, but no concrete evidence for any of those, and in many cases, not even clear mitigations. (Let's pretend for a moment it's e.g. all about PFAS, what do you actually do about them? And what do you do once there's the inevitable political outcry that it's just spoilsports from the other side trying to ruin your life?)

And so we medicate, because that's the only thing where people can say "my neighbor did it, and look, it worked for them, I'll do it too".

[logicchains]

We know exactly why; the average American dietary caloric intake has increased to three thousand and something, which is more than the average person burns, especially if the person is as sedentary as the average American. More calories eaten + less exercise = more weight gained.

[tomcar288]

Yes, Most people don't know why. But nutritional researchers like Micheal Gregor (he and his team have read over 20,000 research papers! just for one book - how not to die) know why. The problem is all the people who get the most views on youtube, TV and social media are the people who are best at operating businesses and SEO. they often don't know all the research (and even give bad advice sometimes) and hence we get all this back and forth that we see all over the place. Meanwhile, the real researchers who know what they're talking about and are very knowledgable about nutrition and health don't have time for SEO and running a successful media empire. they're content doesn't get viewed very much.

[rrr_oh_man]

> Because we don't know why.

Really?

It’s Calories In - Calories Out.

[tomcar288]

what i find fascinating is, you'll see soooo many advertisements about various medications for so many illnesses, all of which are under the umbrella of metabolic syndrome. and then in the background, you'll see people consuming ice cream and pizza, etc. these ads aren't randomly constructed. every short scene is designed to communicate a certain message.

[RobRivera]

You'd be surprise how much dietary choices and options impact this in America.

Go to Europe and eat home cooked meals there. Your health will improve

[yurishimo]

As someone who moved to Europe and also lost quite a bit of weight, the bigger factor was eating out is hella more expensive here. Junk food is also more expensive though still relatively cheap, at least in the Netherlands.

But yea, the EU does a lot better job policing what goes into food and it shows. Fruits and vegetables and meat that I buy here spoil within 2-4 days (and 4 is pushing it)! I had to adjust my purchasing habits because it would go bad before I could eat it all.

The public transportation and push to cycle and walk definitely helps, but at least where I live in the south, most families still own at least one car. The difference is that they only use it to drive to work and for trips. Any errands are done on foot or on a bicycle.

[dboreham]

Go to Europe where there's public transportation.

[toomuchtodo]

Corn subsidies, and what ag subsidies incentivize in general. There is no lobby for a healthy diet, or providing subsidies for it.

[ProfessorLayton]

People may be heavier than 50y ago, but people are also taller than they were half a century ago.

"...the average height of a man aged 20-74 years increased from just over 5-8 in 1960 to 5-9 ½ in 2002" [1].

Despite the higher weight, life expectancy has increased too [2]. I'm not trying to handwave obesity rates, but pointing out that it's a mixed narrative.

[1] https://www.cdc.gov/nchs/pressroom/04news/americans.htm

[2] https://www.census.gov/content/dam/Census/library/publicatio...

[QuercusMax]

My parents had 4 boys, two of them in the early 70s and two in the early 80s.

Our heights are, in order, from oldest to youngest:

* 5' 7", same as our father

* 5' 9"

* 5' 11"

* 6'

Now obviously the sample size is quite small, but we've always wondered if nutrition had something to do with it.

[jackcosgrove]

There are many causes, one of which that hasn't been mentioned already is the decline in smoking.

I'm not saying we start smoking to lose weight, but it does suppress appetite. Now we have FDA approved medications that can do that.

[tuatoru]

My step-grandson has taken up boxing at the age of 15. He has lost five percent of his body mass simply by ceasing to drink soft drinks ("pop", in some parts of the USA).

Drink water or black tea or coffee.

[adonese]

You are not alone in this.

https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-p...

This series of blog posts goes through various theories (and myths) regarding obesity.

[gruez]

A rebuttal to that piece:

https://www.lesswrong.com/posts/7iAABhWpcGeP5e6SB/it-s-proba...

Their thesis doesn't hinge entirely on lithium, but their sloppy work and responses to the rebuttal mean people should take their work with a huge grain of salt.

[andrewla]

I believe Yudkowsky has put forth a theory that somewhere in our environment there is a "GLP Supercharger" that's causing the opposite effect of the GLP-1 agonists.

If a lizard bite can make you thinner, maybe there's a metaphorical lizard bite that's making us fatter.

[paulpauper]

Some people get fat just looking at food, and this may get worse with age. Slow metabolisms, bad genes can play a role. This does not necessarily explain rising rates of obesity over time, but it can explain how some people become obese so easily despite not eating that much or why obesity is so hard to treat or the high failure rates of dieting.

[iskander]

>we don't try to attack the actual cause

It's cars and large houses peripherally connected to amenities by car-only infrastructure.

People love this lifestyle and will fight you very energetically if you try to do anything to nudge city layouts towards the previous level of walkability.

[mysterydip]

> fight you very energetically

Until they run out of breath, anyway.

[tonetegeatinst]

While the biking/walkable city is a nice concept, it ignores how it is incompatible with certain lifestyles and hobbies.

Anyone into machining, high powered rocketry, or shooting or hunting.

YMMV but I doubt you could have a magazine and pass inspection from the BATFE or your state inspection for fireworks or explosives. And dense living near a gun range is impossible unless you got money to build a long range that can catch any stray rounds, when done in a rural area this is done using natural land and hills or building dirt mounds, which a walkable city would not have.

[cma]

Fifty years ago there were like 3-5 TV channels in rural America, no smartphones, and a good bit less automation in rural work. That may have made it more physically involved, and there was a higher proportion of people living rurally vs cities than now too.

[ams92]

People aren’t eating the right foods and not exercising enough. The cause is very simple, the solution is not. It’s hard to get millions of people to make lifestyle changes and that’s even assuming they have access to healthier food in the first place.

[keybored]

So are you wondering? Or you do know the "actual cause"?

[kwhitefoot]

The proximate cause is obvious: more calories consumed than are necessary to maintain weight.

I do understand that the causes of over eating are not necessarily so simple.

What I wonder about is that essentially no government has an explicit policy to combat this despite its obvious negative consequences.

[Jtsummers]

Our diets have gotten worse and we've become even more sedentary.

Why don't we attack that? Because 30+ years of evening news clips showing obese people walking or sitting and handwringing about the obesity crisis have done nothing, and that seems to be the extent of our ability to act.

[mensetmanusman]

Activity levels have collapsed.

You can save yourself years of extra health-span standing in any way more than sitting.

Turns out knowledge work is just as dangerous as physical work, you just die in a different way and the coffin is larger.

[klingoff]

This is true and contributes to poor health, but I don't think it is the primary factor for weight. It is very hard to excersize yourself out of a high calorie diet.

It's really pretty shocking how much added sugar there is in anything with more than 1 ingredient, and getting more sweetness in is basically a race with every other element of someone's diet. The 1980s had it junk food, but there was still other food.

[tuatoru]

Talking about "activity" is like identifying an organism as "a plant". There is huge diversity.

Walk uphill 400 metres altitude gain every day, and you will lose weight, yes. Run uphill 400m every day and you will lose even more. Carry a backpack, and ... you will put on muscle.

Walking or running on the flat, not so much.

[naveen99]

But life expectancy is higher now with knowledge work and lower activity levels.

[teekert]

Apparently it's not exercise! [0]

Yes exercise is very healthy, that has been proven, but loosing weight is mostly a matter of eating less, at least according to this (reputable) meta source. Apparently, over eating but not getting fat (which holds true for me), leads to other problems (also true for me, I have an autoimmune disorder).

Eat less to lose weight. Exercise more to be healthy.

(nice, got my first downvotes in less time it takes to watch 1/10th of my source ;))

[0] https://www.youtube.com/watch?v=vSSkDos2hzo

[otabdeveloper4]

The human body doesn't have a power-saving mode.

You burn roughly as many calories walking as you do sleeping.

[amriksohata]

Nonsense this is what the food industry tried to tell us when we know it's sugar

[bendigedig]

Neoliberalism is allergic to addressing most root causes.