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by emodendroket 3044 days ago
Well, here's a source I was remembering the claim from (I was just a little off): http://www.slate.com/articles/health_and_science/medical_exa...

> In reality, 97 percent of dieters regain everything they lost and then some within three years. Obesity research fails to reflect this truth because it rarely follows people for more than 18 months. This makes most weight-loss studies disingenuous at best and downright deceptive at worst.

I also think this article is interesting because it includes some personal testimony from a successful long-term dieter that I think illustrates why most people are not successful:

> Debra Sapp-Yarwood, a fiftysomething from Kansas City, Missouri, who’s studying to be a hospital chaplain, is one of the three percenters, the select few who have lost a chunk of weight and kept it off. She dropped 55 pounds 11 years ago, and maintains her new weight with a diet and exercise routine most people would find unsustainable: She eats 1,800 calories a day—no more than 200 in carbs—and has learned to put up with what she describes as “intrusive thoughts and food preoccupations.” She used to run for an hour a day, but after foot surgery she switched to her current routine: a 50-minute exercise video performed at twice the speed of the instructor, while wearing ankle weights and a weighted vest that add between 25 or 30 pounds to her small frame.

> “Maintaining weight loss is not a lifestyle,” she says. “It’s a job.” It’s a job that requires not just time, self-discipline, and energy—it also takes up a lot of mental real estate. People who maintain weight loss over the long term typically make it their top priority in life.

1 comments

Here is a metastudy that finds 97% kept some weight off after 4-5 years, and 35% maintained or increased their percentage loss: https://academic.oup.com/ajcn/article/74/5/579/4737391

Still bad but not as bad.

It's also important to point out a strong self selection bias in such studies: we mostly deal with those who were overweight and needed to start a diet, so they probably had low impulse control to begin with. An important part of population with better control and similar cravings might have started their willpower exercise after gaining the first few pounds, it's disingenuous to discourage everybody using statistics applied to those who have a trackrecord of failure. If you gained weight by simply not caring about your weight (depression, cultural norms etc.) then you might stand a much better chance of success when you start to care.

The testimonial sounds like a clasic case of artificially lowered basal metabolic rate by crash dieting and associated loss of lean body mass. Such people need high resistance, mass building exercises, not catabolism-inducing aerobic. She might live a very long life tho.

> It's also important to point out a strong self selection bias in such studies: we mostly deal with those who were overweight and needed to start a diet, so they probably had low impulse control to begin with.

By this metric some three-quarters of Americans have poor impulse control (cf. https://en.wikipedia.org/wiki/Obesity_in_the_United_States#/...), so I think it is actually the other group that is exceptional.

That's why I mentioned cultural norms, I really don't know how many of those Americans really want to lose weight, but it's clearly not a reflection of typical human capacity for self control.

There are many other nations that reached comparable prosperity and food abundance at similar times, yet don't have even comparable obesity rates. An extreme case is Japan, at 3.5% obesity rate maintained largely though willpower and cultural norms, by literally firing those that are too fat, or in any case applying strong social pressure and mandatory counseling.

Well, I have a few objections to that:

1. There are other differences in Japan -- most obviously a very different diet

2. Obesity rates in other countries are catching up to the United States.

3. The first two points call into question your claim that Americans are uniquely lacking in willpower.

4. I don't want to live in a society where people are fired or ostracized for being fat because it is cruel and inhumane.

5. The US has a $66 billion weight loss market, suggesting many Americans do want to lose weight (cf., https://www.prnewswire.com/news-releases/us-weight-loss-mark...), but I'll leave it to the oracles to decipher what you mean by "really" want.