[rubicon33]

> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.

Where does this line of thinking stop?

Is everything pre-determined by genetics?

Is everyone who is smarter than me, just actually lucky that their dopamine system works correctly, and mine doesn't, and hasn't since I was a very young kid?

I'm sure this response will get down voted but its an honest question. This line of thinking that everything is genetically pre-determined seems both accurate and somewhat depressing.

It means that if I'm skinny and can't gain weight, I need to take steroids and lift. Or if I'm fat, I should take a GLP-1 agonist. If I'm underperforming in my career or school, I should take adderal or similar pharma solutions.

What role does good old fashioned hard work and discipline have in this day and age?

[telchior]

Instead of thinking in terms of "everything", "everyone", etc, it may help to think in terms of bell curves and outliers on that curve.

Would you be willing to believe that, out of 7+ billions people in the world, there is at least one person whose brain is set up to constantly hammer them with feelings of hunger? (I'm not sure how a basic proposition like this could be rejected, since the chemicals and processes that govern hunger are something that science actually has some understanding of, and we also know that basically anything can go haywire.)

Next: if you can believe that one person is such an outlier, can you believe that hundreds are? Thousands? Millions? Whatever size that group is, it seems like a possible answer to your worry of when these lines of thinking stop. Perhaps some outlying group of people do actually need something more than "good old fashioned hard work and discipline", especially considering that thousands of years of people repeating such sentiments hasn't solved quite a lot of problems (beyond just obesity).

[BoxOfRain]

> there is at least one person whose brain is set up to constantly hammer them with feelings of hunger

Not only was there a fascinating example of this the unfortunate man was documented by a doctor of the era.

https://en.wikipedia.org/wiki/Tarrare

[naasking]

> Next: if you can believe that one person is such an outlier, can you believe that hundreds are? Thousands? Millions?

Yes, those people exist as outliers. But a population-level outlier theory doesn't explain why obesity is growing in the population.

[scrollaway]

ADHD used to be only a tiny amount of outliers and is growing, thanks to the lifestyle we lead.

Obesity is similar. This feeling of hunger is thrown out of whack often not by genetic but by lifestyle. I’m lucky enough that I haven’t felt it all my life, but I have felt it during multiple phases of my life; i know exactly how eating the wrong kinds of food can teach your body to eat more than it needs and to adapt to that new number.

Our environment sucks ass.

[chownie]

> ADHD used to be only a tiny amount of outliers and is growing, thanks to the lifestyle we lead.

I think this might be a misunderstanding. Rates of ADHD may be higher but I think it's more likely we have an environment which now challenges people with ADHD more than in the past.

The advent of electrical lighting did not cause an increase in pattern-reactive epilepsy, it just created conditions in which pattern-reactive epilepsy were more likely to be triggered. I believe now is the same.

[_cenw]

If increased stress and the demand for 8 hours of uninterrupted mentally challenging work exacerbates ADHD, why wouldn't increased food availability - especially high density ones - exacerbate obesity in those with a a satiety loop defect.

If you eat until you are no longer physically capable of eating more it sure matters if you ate vegetables or pastries.

[naijaboiler]

same thing we now have an environment that challenges our starvation signals in ways our ancestors never had to deal with. They never had an ever present source of dense calory food.

[naasking]

> ADHD used to be only a tiny amount of outliers and is growing, thanks to the lifestyle we lead.

That's speculative I believe. Last I checked, I think they chalked this up to better diagnosis.

[CadmiumYellow]

I've had the same experience and I agree. It's deeply ingrained but it's not hardwired so it can be changed, it just requires going against the grain in almost every area of your life in order to avoid being impacted by the modern food environment (in America at least).

[throw_pm23]

You make a sound argument, but it doesn't explain, why in one country 1% of the people are in this situation, and in another country 30%.

[watwut]

Given that those countries have massively different foods available, massively different environments available, require people to spend massively different amount of physical effort during the day, it would not be that shocking.

[borroka]

The statistical/genetic view of obesity and observed weight gain in general, which is useful in its descriptiveness, fails to explain, behaviorally, why people 30-40-50 years ago-I was young in one of those decades-were much less likely to be not only obese but also overweight. And while it is true that much more high-calorie food is available today than back then, a lot of butter was used, pasta and bread were widely consumed, and if one wanted to be fat, one could easily become fat.

If the problem was all in poor impulse control and hunger felt differently by some people genetically predisposed to feel it (but >30 percent in some states in the U.S. feel it that way?), there would have been many more fat people in the 1970s, 1980s, and 1990s, when highly palatable food became available. And, I reiterate, those who wanted to or had no problem getting fat could certainly do so. In fact, there were (some) fat people even then.

One thing that has certainly changed over the decades is the social acceptance of obesity and being fat in general. In my country, which is not the United States, people are still asked what happened when they put on a few visible pounds or promise to start working on it before anyone says anything.

I recently visited Buenos Aires and the difference in weight between women and men compared to what I see in the United States/California was hard to believe. It was quite surprising to see so many women and men young and old in good shape, or at least at a good weight.

But in the United States (and other countries) being fat and terribly out of shape is personally and socially accepted. Let me take an opposing and politically incorrect position for a moment, strange as it may seem: if I had a kid who was overweight, I would firmly tell him or her that he or she must lose weight. Would that work? It's hard to say, but it's something I wouldn't accept lightly.

But it's like the differences we see in the way people dress, even though clothes are not part of a physiological process that is apparently easy to hijack. How is it that people show up dressed in a way that 30-40 years ago would have appeared offensive to others-I'm thinking of going to the supermarket in pajamas. Well, for one thing, that way of dressing and showing up in public has become accepted. People of my parents' generation would have been ashamed to show up in public in pajamas. Ashamed to show up in public in pajamas. But nowadays, whether one considers the loosening of dress codes as good or bad, it is socially accepted and becomes almost a need. In fact, for the younger generation, what was once considered normal (for most people), such as making phone calls or being groomed, is almost physiologically intolerable.

[autoexec]

Lab animals kept on strict diets and routines for decades have been mysteriously gaining weight as well. (https://www.nature.com/articles/news.2010.628)

There's more than just social acceptance of obesity and pajamas in the grocery store at work.

[borroka]

Increased calorie consumption is the offender, there is little doubt about that. By carefully measuring food, one loses and gains weight accordingly (taking into account age, physical activity, etc.).

The social acceptability of being fat leads to psychologically easier consumption of calories. Personally, if it were not for the shame I would feel, I would eat 1 kg of ice cream every night. I have a great appetite, but also a great capacity for restraint.

The "mysterious weight gain" not explained by calories is, at this point, rather speculative.

[autoexec]

> By carefully measuring food, one loses and gains weight accordingly (taking into account age, physical activity, etc.)

That was the problem. The lab animals have had their food careful measured for several decades with essentially the same food/lifestyle, but weight was being gained at a rate higher than other animal populations. Because it's unknown the "why" part is speculative, but they've got some interesting ideas. Changes in animal husbandry standards, endocrine-disrupting chemicals and infectious agents were considered as possible factors.

From the study:

"There are multiple conceivable explanations for these observations. Feral rats could be increasing in weight because of selective predation on smaller animals or because just as human real wealth and food consumption have increased in the United States, rats which presumably largely feed on our refuse, may also be essentially richer. But these factors cannot account for the findings in the laboratory animals that are on highly controlled diets, which have varied minimally over the last several decades." (https://royalsocietypublishing.org/doi/full/10.1098/rspb.201...)

[scarmig]

I didn't say anything about genetics, though I wouldn't be surprised if that plays a part. Might be how you were raised. Might be simply your cumulative life path leaving you in a particular state. Might be toxins in the environment. It doesn't matter; in the existing present, people have wildly different responses to food and diet.

As for your actual question, it depends on the particular thing we're talking about. For obesity, we've tried telling people to do more hard work and discipline, and it's been a spectacular failure. Plenty of people who do work hard and have incredible discipline in other areas of their life fail when it comes to getting to a normal BMI. There are large subjectivities involved, but when I got down to a 22 BMI at one point via the hard work and discipline route, I was constantly overwhelmed with thoughts of food, literally every waking second; this was despite trying and adhering to probably a half dozen different diets. Most people able to maintain a constant 22 BMI don't experience this.

This also is more common in our current society, for whatever reason (likely not genes, since we're close enough to our grandparents), than it was historically. This isn't some natural state of affairs we live in.

So, bring on the drugs! If there are ones that help other things with minimal side effects, bring them on too. Everyone wins, because we end up with a better, happier, more productive society.

[depressedpanda]

> There are large subjectivities involved, but when I got down to a 22 BMI at one point via the hard work and discipline route, I was constantly overwhelmed with thoughts of food, literally every waking second; this was despite trying and adhering to probably a half dozen different diets. Most people able to maintain a constant 22 BMI don't experience this.

Out of curiosity, what kind of food were you obsessing over, specifically? Why were you craving that kind of food, instead of, say, lettuce?

[scarmig]

For me, it was primarily carbs. Not potato chips or anything particularly greasy, but things like tortillas, rice, noodles, bread, potatoes.

As to why, who knows. I'd be "starving" but have zero desire to eat lettuce, but then jump on the first chance I got to eat a couple cups of rice.

[depressedpanda]

Well, simple carbs (which includes sugar) are highly addictive, so I can't say I'm surprised. Your brain was trying to get you your fix by convincing you that you were starving. In contrast, if you were truly starving you'd eat anything -- including lettuce ; )

So, maybe you already tried that, but there's a psychological/addiction angle that's seldom explored when it comes to simple carbs and obesity.

That said, if there's a drug that you can take that'll numb those cravings down to a healthy level, there's nothing wrong with that.

[derefr]

"Hard work and discipline" are multipliers for the output of an otherwise-balanced brain and body chemistry. But they're no substitute for fixing that balance when it is imbalanced.

An analogy: "hard work" is what your car's engine does when you throttle it up. But that "hard work" isn't going to take you very far — or even in the right direction — if the car's wheels aren't aligned and balanced equidistantly on the car's axle. This "imbalance" will mean that any power put into the system, just gets shunted into running you faster and faster in circles, and/or into "spinning your wheels" and "burning out."

Bringing the car into balance is an overriding concern. You won't get anywhere without first doing that, no matter how hard you push the engine. Once you've done that, though, then the amount of power you're pushing through the engine — your "hard work and discipline" – becomes relevant.

[nerdbert]

Let's say there were a drug that made people motivated to study hard and get a lot of work done. Would the successes people reaped from that be less useful to themselves and people around them, than those which other people reaped from being natively predisposed in that direction?

[hypatiadotca]

If your eyes got bad, would you get glasses?

My brain doesn't produce the same amount of dopamine as a non-ADHD human's brain. It's morally neutral to fix that with medication, same as it's morally neutral to wear glasses, imo.

[not_kurt_godel]

Why are you more worried about "good old fashioned hard work and discipline" than taking a scientific and results-oriented approach to improve people's lives? Do you want to see people toil and suffer for its own sake?

[ithkuil]

Funnily enough one could argue that we're also biologically predisposed to apply certain moral judgements to the behaviour of other people and our own. After all, our environment of selection didn't include the ability to alter much of our body chemistry.

[pmarreck]

> Is everything pre-determined by genetics?

Well, much more is, than isn't, it seems. You may trim the sails, but life will provide you your wind direction... And in this case:

"As many as 400 genes have been shown to affect body weight in one way or another."

https://www.genomicseducation.hee.nhs.uk/blog/obesity-is-it-...

[tormeh]

We’re products of our nature and environment. Belief in free will, virtue, etc. are useful beliefs, but they’re also just not true.

[raspberry1337]

Free will is a product of our nature.

[tomp]

There is 0% chance that human genetics changed this much in the last 100 years (3-4 generations). Look at photos from 100 years ago, people were mostly thin.

So no, we’re not genetically predetermined to be hungry.

There’s something in our environment that’s messing with our circuits. Either some toxins (e.g. endocrine disrupters) or hyper palatable food (artificially engineered for max enjoyment and min satiety), or maybe something else.

[BuyMyBitcoins]

But this doesn’t dismiss the idea that some people are genetically predisposed to be far hungrier. While true cheap and abundant calories facilitate obesity, that probably synergizes with people who have naturally voracious appetites. Someone in the pre-industrialized past wouldn’t have been able to binge on so much calorie dense food, but they may very well have felt gnawing hunger more strongly than their peers.

[nunez]

I don't think _everything_ comes down to genetics, but a lot of stuff does, including the attributes you mentioned here.

[concordDance]

Genetics and microbiome are the biggest factors, but training, habits and environment (how accessible is that junk food?) also matters.