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> "Fat people just need to eat less, and the issue basically comes down to compliance.: On oversimplification, but the crux of the issue. The astronomical failure rate is because of compliance. The prescription you seem to be suggest is "comply more! comply better!" but the biology of this is exactly why it fails so often. The type of food you eat is what sets you up for sustainable long-term success or its opposite. What you wave away with a wash of the hand--compliance--is the reason people fail and more willpower is not the issue and not a solution. It's a dysfunction of the hormones brought on by high insulin resistance brought on by excessive sugar and flour, which becomes a hunger trap, unless you add fat to your diet, which is exactly what people are told not to do. So, I do think hunger tends to differ when you suffer from fatty liver disease and insulin resistance. People can endure calorie restriction and lose weight for a while doing low-fat but they do not stay on it. Saying that people should just comply more is like telling someone with sleep apnea to sleep better. They need a different intervention. edit--A failure rate of 80-90% is not an anomaly, it's a colossal failure. It's not something to be overcome, it's an indication of wrongness. By asking for more compliance you are asking people to fight their biology and they will lose this fight. Instead the intervention should be to employ their biology as their ally, and lose weight more easily and without much hunger and that's possible. It's just not helpful to tell people to eat less. We've been telling them that for forty years. (Side note. The 4% bodyfat in the UofM study you mention is an assumption of yours, and not the starting weight of the people in the study. I think you're unfairly dismissing the study and presenting it as if it's a binary condition between starving/not starving, and that may be a thing, but it's not certain that it is. I'm merely cautiously using it as evidence that calorie restriction is difficult (actually more than difficult) to maintain, which anyway we all know from experience. It would be good to explore other studies on the topic). Intermittent fasting, for example, is vastly easier than consistent calorie restriction, and you're consuming the same number of calories as calorie restriction (if you design it right). That's not a matter of willpower, that's a different intervention). Unfortunately I don't have time to continue the conversation, but take the time to explore some of the links I posted (there are tons more)--they go into way, way more detail and make the argument better than I have. |
You've offered introducing fats as a way to stave off hunger (aka increasing satiety) but introducing fats are far from the only way to increase satiety. Introducing fiber, for instance, is another way.
You also seem to be in favor of a ketogenic diet. Let me say that I totally believe that a keto diet is a great way to eat healthily and boost compliance for some people. Others have a really hard time tolerating large amounts of fat, and so we still need to find alternative solutions for them.
I agree that simply telling people to have more willpower is not the solution, but I think it's important to recognize that the diet is not causing physiological damage to the vast majority of people (it's not the insulin spike in and of itself that causes damage, it's what happens after that, ie: more food intake). So maybe we can attack this from the pure will power front and leave the diet alone (or maybe not, but let's be deliberate about what we are doing).
Regardless, the UofM study is heavily discredited and I still maintain that it is not relevant to what you are arguing either way: the study is designed to study extreme starvation and famine. Brink of death type stuff. Obese people who feel hungry are not that. We know this because if you don't feed them they don't die.
FWIW I actually have read/watched all the links you've posted (I had before this conversation as they are all relatively well known), and I still hold by all my points.