[maketheman]

Science disagrees.

On an individual level, yes, "try harder" is all we personally can do (well, until GLP-1 agonists, LOL). So, sure, it's "good advice" in that it's all there is.

On a policy level? As far as medical intervention efficacy? It's entirely useless. Even crazy-expensive interventions involving several hours of professionals' time per week, for months on end, are wildly less effective than one might think.

What does work? Changing environment! Just ("just", lol) move to a skinnier country. You'll probably lose weight. Conversely, if people from there move to the US, they'll probably get fatter. That is, willpower and accountability and all that are not why certain populations are skinnier than others. Environment, which likely encompasses tons of factors that'd be incredibly expensive and take decades to change, seems to be it.

> Your claim that "trying harder" is "akin to insanity" is such an overreaction that it's misleading exaggeration, not worthy of further dissection.

"Akin to insanity" in the sense that nobody who's aware of research on the topic thinks it can work over a population... I mean, yes, very much so.

[tuesdaynight]

It's hard to wrap your head around that when you got fit working out. They will firmly believe that obesity will be solved by people working out and having a stricter diet. I took me years to understand that it's doesn't work for an entire population. Honestly, even if that happened (everybody started working out), people would have a lot of problems with body image, as we can see in teenagers boys nowadays.

[maketheman]

Dieting and working out definitely does work, the problem is that the median person attempting it will badly yo-yo over the years while feeling terrible about themselves and probably not really getting that much healthier over the long term. So it does work, but it also doesn't, practically at all, for the overwhelming majority of people who attempt it. That's why a lot of these posts end up having people talking (well, writing) past each other: diet and exercise does work. It works great. It's also a miserable failure that's nearly useless.

Again, even those with extensive and expensive outside support see depressingly poor outcomes on average, though of course that does improve things somewhat. Those are still a ton worse than GLP-1 agonists, as far as efficacy. And that's the very best effort we've got for "diet and exercise" interventions, short of live-in dietitians and chefs and personal trainers or putting people in total institutions.

Meanwhile, people move from a skinnier country to a fatter one and usually get fatter. Willpower wasn't what was keeping them skinnier. It makes no sense to expect willpower to be what'll make the fatter country skinnier when that doesn't seem to be why skinnier countries are skinnier.

[okwhateverdude]

It's difficult to do but demonstrably possible. That's why it is hard to consider any non-willpower solution. And why it is very easy to be consumed by ego if you've done it. I used to be in the militant-willpower camp because I pulled myself up by the bootstraps, so to speak. I had to study... me, in order to make it work. I had to be smarter than default mode network me and anticipate my behavior.

To change my lifestyle meant somehow incorporating all the good behaviors I wanted to do but within the limitations of being me. It took a lot of work. I carefully measured my caloric intake (gram scale all the things) and expenditure (fitness watch with optical HR, fancy schmancy scale that does body fat estimation) plus doing things like: always taking the stairs, combine my morning run/cycle with my commute (shower at the office), taking the longer way, etc. Dropped 40kg. Went from couch to running half-marathons and cycling centuries. I had to completely change my relationship with food and study all of the nutrition stuff that was never taught to me. I had to unlearn habits instilled by my parents (emotional eating, boredom eating) which meant finding different ways to deal with stress and relieve boredom. ADHD is a bitch. And weed is awesome. Learning how to accommodate munchies without putting on weight also requires forethought.

No. It really isn't all that realistic for everyone to do what I did much less have the same privileges and opportunities. I had to treat my body like a biologist studying a critter. I was incredibly lucky to be at the right spot in my life where I hit a glass ceiling at work and had so much fuck you energy pent up from feeling out of control of my life. I chose to exert maximum control over my body in order to cope and prove something.

It was a monumental amount of effort over a two year period. It is extremely unrealistic to ask people to use a gram scale for their food consistently. Or to log/track their food intake for every bite. Or to always monitor their heart rate to estimate/track your caloric output. Hyper monitoring your body is a weird hobby.

I really do think instead we should be legislating and regulating food more strictly. Labeling isn't really enough. Food science is being weaponized, much like psychology has been with advertising. We shouldn't allow that kind of manipulation for profit.

[j_w]

On a micro level you can change your environment easily - stop buying foods that are bad for you at the store. Don't go down the chip and candy aisle. If you are not the one who shops for food in your household, inform the one who is that for your health they need to not purchase snacks.

In my anecdotal experience, fat people grossly underestimate how much they eat or lack the understand of how calorically dense the foods they consume are.

[dgfitz]

Taking a picture of everything you consume in a week that isn’t water, and reviewing it at the end of the week is fucking mind blowing if you’re honest about it.

[nradov]

Science is a process, not an agent that can agree or disagree.

On a personal level we can do a lot more than just try harder. We can make permanent lifestyle changes in which healthier options become the default rather than something that we have to actively choose. This can be done in (almost) any environment.