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> In the obese, however, it can sometimes mean their bodies will literally stop doing essential shit before it will concede and begin burning fat. It will then do everything it can to refill those fat cells.

I’m sure there’s some people that this might apply to, but I suspect it’s a much (much) smaller subset than people that are actually obese. For the rest, just decrease your intake until you lose weight. Not much else.

> You can model a human thermodynamically. But to my knowledge, this isn't used in medicine because it isn't practical. (I'm saying this, by the way, as someone who can eat anything and laze around and not gain weight because my metabolism is tuned the other way.)

Exactly what variables are missing then? We can agree that exercise, although certainly burns some calories, is not really the lever you want to pull if you actually want to lose weight by itself. What other variable besides changing how much food you eat would you suggest?

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unshavedyak 4 days ago | parent [-]

That's the point of the discussion, imo. It seems to be an area of research. There's a lot of questions in my view. Why are people so addicted to food? Why do some models of caloric restriction not work as well as they should? How do we embed behavioral change, or do some of these people just have to be in misery for the rest of their lives?

It's not a profound statement to say if you starve in a desert you'll lose weight. The question is how we can apply this to real, normal people. Or if it's even possible in a food-weaponized world.

My view is that we're in the realm of addiction more so than simply answering "how" they mechanically lose weight. This is a public health crisis, one we need to be open to exploring.

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Kirby64 3 days ago | parent [-]

Again, food addiction and satiety is a different question than if CICO works. If you can't stop eating and cram too many calories because you eat too many... burgers and potato chips or whatever, that has nothing to do with if CICO works. I have yet to see evidence that shows that caloric restriction if properly, truly controlled, does not result in weight loss for the vast, vast majority of obese individuals. People are notoriously bad at estimating calories and knowing how much they eat, so any study that is self-reported is inherently going to be problematic.

Should we do more research to find if anything anything specific that may be causing overeating or food non-satiety? Sure. Is the answer likely to be something that is essentially 'tastier food is easier to overeat, and tastier food is much more available than it used to be'? I suspect that is the likely conclusion.

I think GLP1 agonists are a great tool to be used to create that so-called 'willpower' to stop overeating (or, an easy way to reduce food noise, whatever you want to call it). The next step is figuring out how, as a society, we make it easier for folks to make that lifestyle change without a constant stream of 'willpower drugs' for the rest of their life.

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unshavedyak 3 days ago | parent [-]

> Again, food addiction and satiety is a different question than if CICO works.

Yes, and again - as i said previously. No one is questioning if CICO works. That's like if questioning if physics works. No one is doing that. The laws of the universe are still intact. Talking about humans is the constructive conversion most people are having.

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Kirby64 3 days ago | parent [-]

> No one is questioning if CICO works. That's like if questioning if physics works. No one is doing that. The laws of the universe are still intact.

Other people are, in fact, questioning CICO. Look at the other commenter talking about base metabolism changes.

To put an analogy to this: Gambling addicts often lose lots of money at casinos. The behaviors that lead to them being addicted to gambling are in many ways likely equivalent to overeating problems. Nobody asks 'why are gambling addicts losing money?' because we know the reason (casinos have the house edge... you always lose on aggregate). And yet, with food, people consistently ask the question 'why are people so obese?' as if the answer isn't very obvious: they're eating too much food. It's purely as simple as that. The behaviors that lead to eating too much aren't nearly as focused on, in my opinion. Much time is spent on 'the kinds of foods eaten' and how specific things are bad for you, which is essentially like arguing that people should play more blackjack and less roulette or something.

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unshavedyak 2 days ago | parent [-]

> Other people are, in fact, questioning CICO. Look at the other commenter talking about base metabolism changes.

I disagree. CICO is fundamental physics. Just because metabolism changes does not mean you can produce more energy than you take in. CICO always applies, and it's so 'duh' that it's nearly pointless to discuss in my mind.

Their points about metabolism changes is that the details matter. Finding a way to break the cycle will yield more gains with the population than telling people to starve in a desert.

	▲	Kirby64 2 days ago \| parent [-]
		Metabolism changes are metabolism changes. What does the food you eat have anything to do with that, in practice? As far as I can tell, the mix of carbs/fat/protein has little to do with how much your body “compensates” from a surplus/deficit. If you don’t meaningfully have control over that, the only other real lever is how many calories you eat. Finding a way to lower calories without satiety problems or food noise issues ultimately is the solution. Some people do it via lots of low caloric foods (veg, mainly) that still have high satiety. Some people do it with Ozempic. Some people just aren’t bothered nearly as much by a caloric deficit no matter what they eat.