[soft_serve]

Oh we know why! It's just not acceptable to talk about it:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311490/

Asking people to take responsibility for this one simple thing is taboo.

(I have a Colonoscopy just last week as part of a routine exam at my age. The procedure really isn't that bad. A couple hours on the toilet during the prep, and that's about the worst of it).

[Mz]

Obesity is merely one factor. I have read a number of articles on this and even written at least one (I get paid to ghost write health articles). My understanding is, no, they don't really know why.

Furthermore, how to not be obese is not really a solved problem. Suggesting that fat people are merely irresponsible is pretty lousy. Most fat people have tried to lose the weight. Some have tried incredibly hard and done rather crazy-sounding things, to no avail. We don't really understand that problem space either. Some people are able to lose the weight and keep it off. Others fail and fail and fail while trying like hell.

[arkh]

"Furthermore, how to not be obese is not really a solved problem."

Make your body absorb less calories than it uses. The simplest (not easiest) way is then to eat less. Most people who have "tried to lose weight" but did not manage it just tried lightly. They tried every new miracle weight loss program thinking 50lb could be lost fast before summer.

The thing is there are no miracle cure: you have to learn what has plenty of calories and eat or drink less of it. You have to learn to say no to food. You have to learn that throwing excess food is ok once you're done eating (which is the main problem for people coming from low income environment I think). For people who eat as a way to curb their depression, you also have to work on this illness if you want them to lose weight. You may also have to cut contact with family or friend who will sabotage you (crab in a bucket mentality).

[jodrellblank]

Most fat people have tried to lose the weight. Some have tried incredibly hard and done rather crazy-sounding things, to no avail.

I half wish we didn't have these kinds of comments about weight loss; it comes from the Puritan-work-ethic-suffering-is-laudable style of thinking, and implicitly carries messages like: a) weight loss must include suffering, b) it must include hard work or you aren't earning it, c) 'quantity of trying' is something in and of itself which is praiseworthy, regardless of what is tried or how effective it was, d) crazyness is a proxy for trying hard by implication of exhausting all less-crazy options, regardless of whether that's actually true, e) defending 'why someone didn't lose weight' and whether they endured enough suffering to be allowed to live without criticism is more important than understanding, empathising, fixing, almost anything.

To quote from a blog about going the other way - muscling up:

Just because we’re tired doesn’t mean we had a good muscle-building workout, just that we had a tiring one. Depending on what you’re doing, there’s a good chance there’s a workout that’s less tiring but does a better job of stimulating muscle growth.

Similarly, being full doesn’t mean we ate enough calories, just that we ate a filling meal. Maybe there’s a less filling meal that provides more calories and nutrients.

And in the same idea, just because someone tried hard and suffered to lose weight, doesn't mean they did the most effective things to lose weight. Just because they felt starving doesn't mean they were sustaining long term calorie deficit, just because they tried for years doesn't mean they found a good way and it didn't work, but that they spent years doing things which didn't work. Just because they suffered while exercising doesn't mean it was an optimal calorie burning workout, just that it was unpleasant..

The two (effort/suffering and fat loss) aren't necessarily directly connected at all, yet we discuss as if one is a proxy for the other. It might well be that fat loss implies effort, but effort does not imply fat loss. Or it might be that effective fat loss doesn't necessarily imply effort although that's one way for it. I anecdotally note P.J. Eby's comment once that he'd tried an awful lot of weight loss attempts, but it wasn't until he found Vitamin K supplements that he started to see progress. Vitamin K supplements aren't hard work or major suffering (and undoubtedly they aren't a panacea for all obese people).

The wider context of the quote is:

we’re going to slip, we’re going to “fail”. That’s part of the process. A setback is just an opportunity for us to figure out what went wrong, what needs adjusting, and how to move forward more effectively. A setback shouldn’t be seen as a failure, and it certainly has nothing to do with our ability to build muscle. The moment we stop thinking about change as binary—either as success or failure—but rather as a process that’ll evolve, the more likely we are to actually reach our goals.

So when looking at our routines and our efforts, we need to look at them objectively. If our routine was failing, which part is holding us back? What piece is missing?

If our routine is working but is tough to maintain, what part was enjoyable and sustainable? What is wearing us down? What’s the part that’s actually responsible for our results? What’s useless filler that just wears us down?

This is how we gradually develop lifestyles that work for us—making things more effective, more enjoyable, easier. This is how we get to consciously decide who we want to become. Then eventually those habits become what we do automatically—unconsciously.

In that context, of a life and a way to live, what benefit of talking about "I tried hard", in the past tense, at all?

It's almost tautological to say people who tried hard and are still fat, weren't trying the right things - and yet actually saying that is liable to bring about a reply describing in detail how much effort and suffering and time was involved, as if the sentence was "you didn't try hard enough". Which it isn't.

Empathizing with disease, with medications, with psychological problems, with car-park focused urban sprawl, with disability, with thyroid problems and metabolic disorders and absorption disorders and poor education and stressful busy lives and constraints on money and food availability and susceptibility to peer pressure - these are all things that can usefully and helpfully be discussed. Praise of "they tried something and suffered for it, so if anything was going to work, suffering was going to work, and it didn't work", should fade from the world. It's unproductive, unhelpful, and focuses on all the wrong things.

( - quote source: http://bonytobeastly.com/why-skinny-guys-fail-build-muscle-w... )

[Mz]

My point was only that it is not a solved problem. That's it.

(In my first draft) I originally included the detail that I was quite heavy for some time and didn't manage to slim down any until I got the right diagnosis. I deleted that (before hitting "post") in part because I get a lot of flak for talking about myself for reasons I cannot really fathom. It seems I am damned if I do and damned if I don't.

For context: My medical condition predisposes me to retain fluids. I have lost multiple dress sizes and I still don't have the flat stomach I wish I had, though I walk more than 2 hours a day every day and I eat very carefully in accordance with what I have found works to not aggravate my underlying medical condition. Counting calories is contraindicated for my condition. My specialist never once suggested I should try to lose weight when I was 245 pounds and about a size 24-26, because the vast majority of people with my condition are horrifyingly underweight and the condition is quite deadly.

If just working your ass off was going to make you thin, I should be thin. I am not.

So, sorry to have hit some nerve for you, but my one and only point was that this is simply not a solved problem. There are people who simply cannot lose the weight, no matter how much they try, research it, etc ad nauseum.

[mariushn]

Jod, would you please add your email in profile? Would like to followup with a question. Thanks!

[flunhat]

That's what I thought, too, but then I read this [1]:

> “The honest truth is nobody knows 100 percent why there is an increase,” said Dr. Mohamed E. Salem, an assistant professor at Lombardi Comprehensive Cancer Center at Georgetown University. He said that he is older than about 60 percent of his patients — and he is 42. “It’s hard to blame it on obesity alone. We suspect there is also something else going on.”

The weird thing is that the sharpest increase is among young whites, and it doesn't seem to be entirely correlated with obesity.

[1] https://www.nytimes.com/2017/02/28/well/live/colon-and-recta...

[2] http://www.webmd.com/news/20170808/colorectal-cancer-death-r...

[toomuchtodo]

Diets high in sugars? I wonder if we can plot the consumption of sugar and corn syrup on a trend of colon cancer incidents over the last 4-5 decades.

https://www.ncbi.nlm.nih.gov/m/pubmed/9298574/

[flunhat]

You could argue that high sugar diets are just a proxy for obesity, so if obesity has been ruled out as a cause for this new increase then high sugar diets can be ruled out as well. Plus, no real reason it would be confined to young white people only.

But I still avoid the stuff, because it seems so unlikely that the quantity of sugar we consume is just harmless.

[bnjms]

I dont think you can make that assimption at all. A lot of is have conditions or habits that result in modifying our eating habits and movement habits enough to always be thin even with high carb diets.

[Bjorkbat]

To a certain extent.

Truth be told, anytime I read that someone is a marathon runner I associate that with a red flag just as much as I do obesity.

http://www.mayoclinic.org/diseases-conditions/ischemic-colit...

Ischemic Colitis. Also called Runner's Colitis. Basically endurance running can cause the colon to become inflamed to the point of bloody stools, among other symptoms. If there's blood in your stool your colon is clearly in a great deal of distress and you should probably put a halt to whatever's causing it. Indeed, given the known factors that increase colon cancer, you can boil all of them down to one root cause: inflammation.

Oh, I'm not giving our modern diet or lack of exercise a pass mind you. I mostly eat plants nowadays because the research is pretty clear that eating meat all the time elevates your risk and I avoid sugars save for a twice-a-week pastry because sugar is probably even worse. That being said, I'm troubled by the fact that in modern society millions of people feel compelled to take up a sporting event inspired by the heroic feats of an ancient Greek messenger who promptly collapsed and died after running what would become known as the very first marathon. Perhaps it helps them feel better than average, perhaps it's a way to overcompensate for how unhealthy our lives are. In the latter case we're probably only making things worse.

[rdiddly]

I wouldn't overlook or absolve the thousands of chemicals that have been recklessly deployed into the biosphere and rather haphazardly regulated. But if the corporate class gets its way (and it usually does), that is also not acceptable to talk about.

[cylinder]

Exactly, you can't even mention this online without getting flamed either. Look at the compounds banned overseas and not in the US. Look at agricultural practices. Look what is in our meat.

Someone comes alongs and says "show me a study!!" No, we don't have studies for every single possibility.

[Angostura]

Did you have any anaesthetic during the procedure itself? I didn’t. But rather wish I had.