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I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now.

I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every time, I've gained the weight back. At the beginning of 2022, I was the heaviest I've ever been.

I've accomplished very hard things in my life, including those that take sustained effort. Sufficient willpower isn't a problem for me in general. I honestly only ever hear "it's easy, just eat less and move more" from people that have never actually been fat. "I did it and I lost 15 pounds, no big deal!" and the like. 15 pounds is easy for me to temporarily lose too. I've done it enough times I should know ;)

I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had.

On this drug, I finally know what people are talking about. I still like food, and I still get hungry. But it doesn't dominate my thoughts. I eat, and don't feel like eating again for hours. I eat something that I'd normally easily eat all of like a big burrito or whatever, and I feel quite full halfway through with no desire to finish. I'm steadily losing weight, with none of the usual preoccupation with hunger, ascetic adherence to a strict calorie plan, etc. But above all, I feel like I must be experiencing what most thin people experience all the time. I'll be perfectly happy to take the drug for the rest of my life, though I do hope affordability improves.

As for side effects: I've had some heartburn, but none of the other commonly reported side effects.



> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had.

I had this exact same experience when I was prescribed a drug that, as a side effect, blocked receptors in parts of the brain responsible for signalling satiety from food.

I went from having trouble eating enough food to maintain a healthy weight, and just not being hungry, to suddenly being unable to feel full at all. It was like I always had room for more, no matter how much I ate. And I was constantly hungry, felt like I was starving 24/7 and would ruminate about food so much that it impacted my ability to sleep or concentrate. My brain was obsessed with preventing me from "starving" and it ultimately dissolved the illusion of willpower that I thought I had.

No longer take that drug, but it was an eye opening experience. I didn't know that was a thing people could experience, as someone who was always skinny. It really drove home that we are products of our biology and made me more empathetic with those who struggle with food.


I know what you mean. My doctor prescribed Naltrexone. The first day I took it I ate half my dinner and felt full for the first time in my life. As a middle-aged man I had never had that feeling before. Previously I assumed what people meant by feeling full is that you felt like you literally can't eat anymore.

Unfortunately that stopped working for me after a few months. Hopefully this one will work better.


If that doesn't work out, I think they make a combination drug of naltrexone/bupropion if the naltrexone worked for you originally. The latter drug activates parts of the brain that are responsible for emesis and it works well with the reward blocking effects of naltrexone.

Good luck either way.


Bupropion also helps increase dopamine and norepinephrine levels within the synaptic cleft. It was somewhat helpful for me when I wanted to reduce smoking. I was able to go from losing my mind if I went 90 minutes without a smoke to losing my mind after 3-4 hours without a smoke. I've heard anecdotal evidence from people I know that it helped with weight loss.

Personally, I can say that while Bupropion didn't help me lose weight that it did at least help me stop gaining weight. I've never taken it with naltrexone though. In fact, I'm long-term opiod agonist therapy for chronic pain developed in my early 20s. This actually has more or less the opposite effect of opiod antagonists such as naltrexone. They've definitely had a negative effect on my ability to lose or maintain my weight, although I seem to have achieved some kind of balance where my body plateaus after a certain weight.


> The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had.

I feel exactly the way you do, and yes, I was fat, lost it in one go and never gained it back. I try to keep my BMI around 18, never went over 20 since losing weight. It's been around 15 years now. I still have the exact same unlimited appetite I have always had. If you put food I like in front of me, I'm going to eat it.

I don't do anything special. I eat the same foods I always have, just less of them. Got really good at counting and never get more food than I need. The trick is to not put yourself in a situation where you have to stop eating in the first place. It's hard to just stop eating something you want to eat. Not that hard to stop yourself from going to the store again or ordering more (especially when other people are around).

I feel like most people never get serious enough about counting, try to eat stuff they don't enjoy, waste effort on exercise or let other people interfere.


> Not that hard to stop yourself from going to the store again or ordering more

Well, actually...

I'm fat. Like BMI 40 fat. Most of my life I have been fat. I was laughed at in school for it, as far back as I can remember. It probably wasn't all that bad when I think back. Certainly not as bad as now. But I was the fat kid in class, and I felt like the fat kid.

Anyway, I have lost a lot of it at a few points. Once by going to a place with more disease than I could handle. Months of intermittent diarrhea helps apparently. And once I reduced intake to about 1200 kcal per day for a year, combined with walking around for 5 hours everyday. I got to BMI 26 or something. Not very obese, but still overweight. It felt amazing to be able to do a lot of things, but it also took a LOT of time and effort.

But then I got a job, and kids. And I started to backslide. Just an hour per day walking during my commute, instead of 5 during the day... And oh, that pastry looks gooood. Slowly at first, with intermittent periods of faster backsliding because life required a bit more from me.

I got it back faster than I lost it.

I have re-lost it a few times after that. Each time the losses are a bit less, and the peaks get a bit higher. I always gain it back faster than I lose it. And annoyingly, initially, gaining it back feels way better than losing ever does. Like finally laying down after a day of strenuous work. Or like the first breaths of fresh air after being cooked up in stale air for a while.

During my losing periods the things you describe help. Keep the food away, and you don't have to expend effort to not eat it. I even enjoy the healthy stuff.

But that's not how it is during my gaining periods, oh no. I get bored with the good food, and start craving the bad. I go to the shops to buy stuff. A small packet of candy at first, or a pastry. But that spirals out of control quickly. Soon I start scheming:

* How can I get the food without my family noticing?

* If I go to multiple shops I can buy twice as much without looking like a greedy fuck.

* Oh, and I won't be able to go tomorrow, so I should make sure I have supplies for the day.

* And eating only candy makes me sick, so I should also buy crisps so I can alternate and keep eating.

I'm in gaining mode now. I ate a box of Pringles, a box of cookies, and a box of candy, just today. In addition to the regular meals with my family. I'm here. I see myself doing this, but I can't seem to stop. Until it runs its course. After a few months or a year or two, I can usually cycle back into a losing mode for a few months.

A doctor might help, but I'm not going. The medical state of the art of dealing with obesity seems to be "just don't". A consult seems pointless and humiliating.

I've learned to take and make fat jokes, and other than that to not think too much about this. My BMI will probably keep oscillating higher and higher, and I guess that means I'll get some obesity disease at some point. Maybe that'll stop it, but I'm not confident it will.

I guess we all have our issues, and this seems to be mine. C'est la vie.


> And eating only candy makes me sick, so I should also buy crisps so I can alternate and keep eating.

This one hit hard. If you swapped "crisps" and "candy" for "MDMA" and "ketamine", people would tell you to go to rehab.

No judgment here, but a lot of your behaviour sounds like addiction underpinned by a coping mechanism. If you replaced <food> with alcohol or drugs people would point out how your relationship with the substance is pathological.

IMO food is the most cruel of addictions as it is fuelled by our most primal of instincts to survive, it is also why I think Big Sugar is the most sinister of institutions...


The problem with food is that you can't cut it completely like drugs or cigarettes, rehab schemes are not going to work because the temptation and use is always there, multiple times a day.


No, but maladaptive coping (eg addictions, including eating your emotions) can be replaced with something healthier. It's also possible they've been emotionally neglected or abused (trauma always makes these things much more messier to address without addressing it first) and that's how maladaptive coping develops (or maybe they never learned them from parents for another reason, or maybe they picked up on a parents unhealthy coping style).

Not even remotely a doctor, so take all this with a grain of salt if you're in a similar spot. Mostly based on my own life experiences and having to work on childhood trauma and what that entailed in my case (food addition being just one amongst many maladaptive coping mechanism).


> A doctor might help, but I'm not going. The medical state of the art of dealing with obesity seems to be "just don't". A consult seems pointless and humiliating.

The point of this article seems to be that that is changing. Doctors actually have something to offer you now.


Thanks for sharing. I didn't really understand it (though I didn't doubt it) until I read your comment. What a hard burden to carry; I completely understand the state of watching myself do something unwanted (though not with food).

One thing that's helped me: I just make a rule to myself, 'go from one healthy thing to another'. I just try to find more and more relatively healthy (or at least harmless) and appealing outlets and tell myself that, whatever I do, I may not do something ideal but I'm going to choose one of them.

(A healthy outlet is one where I feel better after I do it than when I start.)

I don't follow it perfectly, of course, but it has helped result in a major shift.


Can you give an example of this?


An example of a healthy outlet? Enjoyable exercise, studying something I'm interested in, creative outlets like writing a story.


Have you watched the new Brendan Fraser movie "The Whale"? If so, what did you think about it?

In the movie he does some of the things you mention, but I don't think he was vilified in the movie. I saw him as a hero at the end. Some fat people on youtube were very offended by "The Whale", I'm curious if it is universally offensive to large people.


If you're content with where you are then that's fine. I won't claim it's going to be easy to change things. But I do think there are few things you could change that will nearly guarantee success:

- There's no good or bad food. The number is the only thing that matters. Don't feel bad about eating chips and candy everyday. That's pretty much what I do. All you need is to hit the number.

- Always keep track of how much you've eaten. A big binge is not an excuse to stop counting. After a year or so, counting will become second nature and can be done purely with mental math. But initially, you want to write all the numbers down. Date | calories in | morning weight.

- Don't tie the counting efforts to any other effort. You mention walking 5 hours a day. That's some other unrelated thing. Don't ever mentally link this to your weight loss effort. If you want to do it, do it, but it should have nothing to do with losing weight. Counting and keeping records is your primary job.

- Your family should know what you're up to. They're there to help you achieve your goals. If you've already eaten, they shouldn't let you have a family meal with them. If they just let you get away with this, let them know you don't appreciate it. When you mess up, they should care and think it's a bad thing.

- Get this idea of a "cycle" out of your head. There is no cycle, every day is a new day. Your behavior only looks like some cycle caused by external forces post facto. Everybody trying to form a habit has a similar experience. There is nothing weight loss specific going on here. When you break a good streak everything can go out of the window. This is why it's important to keep the required actions as simple as possible. The more you couple different efforts the harder it's going to be. When you mess up you have to take the loss and move on. A good streak helps but don't dwell on breaking it.

- You have to have a sense of urgency and importance. Those around you should too. "I guess that means I'll get some obesity disease at some point" - just think how ridiculous that sounds. You know you can potentially prevent a serious disease (most people never have that opportunity) but you're just gonna sit there and let some cycle run its course. I mean, come on! How can you wake up everyday and not want to stop it today? What about your children? Perhaps they will inherit your eating habits (stats do show high heritablity), perhaps it would be nice to show them how to keep it under control? You owe it to them. Why doesn't your spouse think that's a huge deal?

It's one of the few things in life where you are literally guaranteed to get a good result if you do what you're supposed to do. There's a lot of advice on how to do this or that, get rich or whatever. But you can never prove these things are guaranteed to work so I can understand if people have a hard time motivating themselves. With weight loss you have a 100% guarantee of success. Personally, I don't see it as some random little problem. Pretty much any effort in life looks like this. You want an outcome, you think of the necessary actions and then the entire ballgame is about actually implementing these actions.


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He is actually fairly normal, his experiences are similar to those described by thousands of other people in the same situation, and you're an ass.


Hilarious and sad that he couldn't control his own impulsiveness in typing that comment and yet couldn't make the obvious connection to what he thought he was criticizing in others.


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> But it's always true that if you manage to eat fewer calories than your body needs each day you will lose weight.

No, not necessarily. Several studies have shown that different people can get different amounts of energy out of the same food, depending amongst others on their gut micro biome, though stress also seems to play a role. It’s never going to be that simple.

> the laws of thermodynamics won't fail

Conventional thermodynamics don’t work when you consider a full human, which is a very out-of-equilibrium and not-isolated system. Conservation of energy does not tell you anything about the efficiency of the energy extraction process.


> No, not necessarily. Several studies have shown that different people can get different amounts of energy out of the same food, depending amongst others on their gut micro biome, though stress also seems to play a role. It’s never going to be that simple.

Sure, so they just need to compute their at-rest calorie consumption differently, and from there the rest is the same.

> Conventional thermodynamics don’t work when you consider a full human, which is a very out-of-equilibrium and not-isolated system. Conservation of energy does not tell you anything about the efficiency of the energy extraction process.

This is like saying that even if you don't refuel your car it will never stop, because different cars have different mpg ratings. A human is indeed a closed system when you consider the works it outputs and the calories it ingests, unless I somehow missed a newfound capacity for photosynthesis. The fact that it might be a bit harder to compute calorie requirements than what might be naively done does not allow you to just dismiss everything else.


> Sure, so they just need to compute their at-rest calorie consumption differently, and from there the rest is the same.

Not at all, because different gut biomes are more efficient than others at processing some kinds of foods. Famously, some populations are more effective at processing fish than others. Really, "amount of calories" works on average, but people with food issues tend not to be average, otherwise they would not be outliers.

You cannot take any assumption for granted. If it were so easy, we'd have solved it. It's only very recently that we started to grasp the role of the microbiome, and we are far from having explored it all.

> A human is indeed a closed system when you consider the works it outputs and the calories it ingests, unless I somehow missed a newfound capacity for photosynthesis.

You missed a lot of things. Radiative heating and convective heat exchange, for one. Our body spend a lot of energy to heat up when it's cold, and try really hard not to do anything when it's hot. This works differently for different people; I tend to heat up fairly efficiently and I am very rarely cold; my GF is the other way around. Obviously, this is also environment dependent.

Plus, we eat all the damn time. How can you seriously be arguing that we are a closed system? Again the problem is not that it's slightly harder. The problem is that it is multifactorial, that we don't know all the factors, and that the importance of each factor varies with genetics, history, and the environment.

> The fact that it might be a bit harder to compute calorie requirements than what might be naively done does not allow you to just dismiss everything else.

I am not the one dismissing things...


I can get that some people have different satiety levels or have lower resting energy consumption, but this is just stupid. Unless you're running a nuclear reactor inside of you, there is a limit to how much calories/joules you extract by oxidizing things.


Yes, there is a limit. Efficiency still varies across people and types of food, enough that "you need to eat x calories" might be fantastic for one person and terrible for another one.

Even when running a nuclear reactor, there is still a limit, even though it is much higher than that of our puny built-in chemical reactors.


I don't know about anyone else, but I also feel miserable with low energy when restricting calories heavily. It's like my body would rather partially starve itself over of adding too much body fat to my "energy mix".


It’s probably the composition of your gut biome - it’s probably used to quick starchy foods. Give it a few weeks and it will readjust.


I'm more convinced it's leptin insensitivity.


>>Several studies have shown that different people can get different amounts of energy out of the same food, depending amongst others on their gut micro biome, though stress also seems to play a role. It’s never going to be that simple.

Nope still that simple. Your claim just means those people need less calories in to be in a state of calorie deficiency


I told myself this as well, but as an anecdote: I started to lose weight from counting each and every calorie and never exceeding the exact amount my weight-trainer set for me.

What did I eat? Fries, Pizza, Chocolate, Burger, … still lost weight.


Exactly right! Calorie counting always works


Counting calories correctly is really hard.

I've lost 90 lbs, achieved a healthy body weight, and kept it off for years, but I keep trying to lose just 10 more pounds. I only make progress when I'm religious about calorie counting, including weighing every meal or needing to do precise food prep beforehand.

That's such a pain in the ass that I inevitably fail and keep returning to my body's new average weight.

I think you're right about truly obese people. They're eating so many calories that they would lose weight if they could manage a better diet.

For people who aren't obese, the same principle may apply, but it's now a matter of much tighter margins and much greater precision, and it's remarkably difficult.

Natural bodybuilders seem to manage their weight with precision, so it's not impossible with knowledge and effort. But I suspect very few people are capable of managing that if they tend towards obesity to begin with.


Strange, I've found doing meal prep one day a week that you partition into fixed quantities for each day to be way easier than making a meal every day. I'm surprised you found it such a pain in the ass. It's a pain to setup and do the calculations that first time, but once you do it's fairly easy to maintain the routine.


I have a family. I could do meal prep for only me and eat separately, but I value eating the same meal with everyone. And I'm not doing meal prep for our entire family.

I do this sometimes for lunches, which we eat separately anyway. But that's only 1/3 of my meals.


This indeed makes it harder. If I wok some dish for 4 people and use 1 tbsp of olive oil, did I consume 1/4th tbsp? What if 2 of those 4 were kids, so I ate slightly more than 1/4th?


Over time it will even out. Also if you weight out the whole dish it's easier.

I'm assuming we're talking about e.g. rice dishes or stews, curries, etc. "one pot" dishes. Otherwise if it's like steak and vegetables, you can weigh each steak and the vegetables, do them in different racks of a steamer etc.


Sure, there are other ways. For instance using different dishes than the rest of your family to limit portion size. You can share most of a meal, but have a specific side for yourself, etc.


>Strange, I've found doing meal prep one day a week that you partition into fixed quantities for each day to be way easier than making a meal every day

I can't stand eating the same thing multiple days a week. Are you preparing multiple different meals for each day, one day a week?

Not to mention that it's never going to be as nice as a freshly-cooked meal anyway.


> I can't stand eating the same thing multiple days a week. Are you preparing multiple different meals for each day, one day a week?

There are some things I can eat multiple times, some things I can't. Chicken breast is one of my repeat foods. I'll do a few different dry rubs and bake a bunch at once, then all I have to do is pick which rub I'm feeling on the day, cut and reheat when making a meal.

You could see it as a half-prep plan: pre-cook and prep a bunch of base ingredients in approximately equal quantities, and when ready to eat, create some permutation in a few minutes so you have a half-freshly cooked meal that's semi-unique. My gotos were: eggs, chicken breast, tuna, permuted with quinoa, rice, kale, broccoli all sliced and/or diced in various ways to make one of a stir fry, salad, plate, or wrap, with varying hot sauces or oils to keep it interesting.

One day I'll do a wrap, another day chicken salad, another day I'll eat it as is on some quinoa or something, and I'll cycle through options like that that are easy to mix up on the fly. Making a meal to eat usually takes about 5 mins. Apply your programming mind to this like a permutation/optimization problem!

I liked most of the meals because they were tasty and hit all the macros, and with the work put in the gym I could see the results, so there was a great positive feedback loop.

Every meal doesn't have to be a culinary masterpiece, just like every coding session doesn't have to be a symphony of mathematical elegance. Some coding is just glue, and food is primarily just fuel.


i don't know... we don't deviate much from what we eat so it's really about that initial tracking and seeing the results. after that you can kind of "eye-ball" what you are eating. the hard part is just being brutally honest with what you are actually eating and tracking at the beginning.

tbf it's like any learned skill, it sucks at the beginning but over time it gets easier. when i started getting serious about my fitness i was tracking it meticulously but now i rarely do.


I find when I begin eyeballing things I inevitably start to get them wrong.

For example, apples with peanut butter is my favorite snack. I initially measured out and weighed the peanut butter, then used the same entry for calorie counting and eyeballed it for a while.

I eventually measured again, and I was eating nearly 50% more peanut butter than my initial entry! I imagine I probably added just a little bit more each time, because my brain really loves peanut butter.

I don't think I do this with proteins, but with carbs and anything sweet I definitely do. So I have to be very careful.


I somewhat agree. The issue though, at least for me, is that I can only "eyeball" somewhat reliably when I know what I'm looking at. So, when I eat something "new", meaning that I've never measured, all bets are off.

I'm thinking restaurant / takeout mostly. Because you never know what they put in the food. And the usual suspects of carbs and fat loaded with salt can easily throw you off if you don't pay attention.


This is the insight of the day. I have to save your comment for later reference.


> Counting calories correctly is really hard.

Why? My sugar-free protein bars say exactly how much calories they are. I also eat some zero-calory fiber (psyllium), vitamin and minerals pills, a spoonful of fish oil, feel great and loose weight :-)


It is harder to count calories when you make your food at home from fresh ingredients, or go out to restaurants. Not that you can't, but it is both harder and less accurate.


You only eat protein bars?


Mostly. I believe the other things I eat per month account for the caloric intake an average person takes in a day or two and can this way be ignored.

I used to eat a lot of cookies until November but stopped as soon as I noticed (at the clothes store) I gained some belly fat. I don't want to switch my clothes size. I firmly believe any visible increase in waist size (unless attributed to muscle growth) is a strong sign I must lose some weight (by reasonably healthy means - I would hesitate to take incretin mimetic drugs, they seem risky).


For how long are you doing that? I'm skeptical that could be healthy as you would be missing a lot of essential nutrients like fiber, vitamins, minerals. Also the palm oi in the proteins bar being the only source of fat will imbalance your lipids. Concentrated whey protein powder (without added carbs) are cheaper and better than protein bars though it still is a supplement and not a replacement for real food. But you can mix it with oats, nuts, chia, fruits to improve taste and nutrition.


I was just saying the exact same thing to my wife yesterday. We’re both trying to lose weight, for the millionth time in the 20 years we’ve been together. Exasperated, I just said “I don’t get it. I was an artist who had no technical background, and was able to teach myself computer science and now I’m a highly successful engineer. I did that. And yet I can’t lose 10 pounds to save my life.”

It’s so hard to eat healthy, I honestly cannot fathom how people do it.


> It’s so hard to eat healthy, I honestly cannot fathom how people do it.

When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body needs); now, a slice is more than sufficient and satiety lasts well into the next morning.

GLP-1 agonists makes eating healthy trivial and automatic, instead of a dieting state where you're thinking about food literally constantly throughout the day for months or years on end.

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.


> 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?


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).


> 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


> 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.


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.


> 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.


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.


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.


> 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.


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).


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%.


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.


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.


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.


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.


> 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...)


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.


> 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?


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.


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.


"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.


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?


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.


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?


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.


> 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-...


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


Free will is a product of our nature.


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.


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.


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


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


[flagged]


You're breaking the site guidelines badly with your posts in this thread. Moreover it looks like you've done that more than once in the past as well. Can you please stop? It's not what this site is for, and destroys what it is for.

We want curious conversation, not angry putdowns.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.


> 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.

As someone who's always been thin and doesn't have a strong appetite, I couldn't agree more. I'm just enough outside the norm yo be able to recognize it.

There are times when I simply can't force myself to finish my food and it goes to waste, but the upside is that many people assume that people in my body fat range are somehow virtuous for not "overeating". That's not the case at all - I don't eat particularly healthy, don't have any particular exercise routine beyond walking, and I don't limit myself. I just get full quickly and have a metabolism that burns what I eat.


I applaud that self knowledge.

It's always hard to know others' experiences. I have a friend who genuinely tried to help me lose weight in college with the typical advice and a lot of support: he had the strategy of just eating until he was full and then stopping, and he just couldn't get why that didn't work for me. But when he hit his 30s, he suddenly started ballooning up and suddenly couldn't put his strategy into practice, to his great frustration. Did his willpower dry up overnight? Nope; something else changed to upregulate his appetite.

(I pointed him to semaglutide, and he's already halfway to returning to his college weight.)


I'm in a similar boat as you. COMPLETE opposite experience as other folks, to the point of pathology. I could not overeat to save my life. I cannot lift weights and expect any growth due to lack of caloric intake. When I try to exceed 2k calories in a day, I find myself so full I need to lie down and groan for an hour until things move and digest. Force any more down and I'll vomit. I cannot concentrate with a meal in my stomach, so I wake at 9, eat ~500cal at 1pm, and leave the rest til I'm done work at 8.

Sometimes I lose 15lbs when having a bout of constipation due to goddamn IBS.

Every person in my life, friend or foe or family or partner finds it clever and completely acceptable to tell me I'm "too skinny and need to eat more".

Others without my experience just don't get it. Glad these overweight folks have a tool to help them.


Since May, I have (very deliberately) put on ~16kg of mass, going from a BMI of 17.5 to 22.8. Started at around 2500kcal/day, currently at 3500kcal/day.

> I could not overeat to save my life

You are likely eating the wrong foods. It is _highly individual_ what kind of food can people eat in large caloric quantities. Start calorie tracking and experimenting more, you can figure this out. Some people do well with oatmeal (tastes like soggy sawdust to me), some with various nuts (peanut butter is a fitness industry staple), others make themselves milkshakes etc etc.

Progressive overload is key here, don't just expect to start eating 4000kcal/day, it is not going to happen (and would not be productive anyway).

> I cannot concentrate with a meal in my stomach

Same here. I feel like eating makes me lose about 10 IQ points, not great (though I am at a place in life where I can make this sacrifice). Maybe more sugar would be helpful here.

You may also find the /r/gainit subreddit englightening.


Thanks! Congrats on the 16kg.

I've been trying to eat more since I was 20 (am 34 now). It's been getting more difficult as I get older, especially with the onset of IBS a few years ago - now more foods and what used to be regular quantities cause my stomach to balloon.

All my experimentation has landed me on.. a mostly meat diet. Which I don't love (it's expensive, kills animals, impacts climate) but I can digest it more easily than vegetables or grains.

Oats are my everyday ~500cal first meal. If you find them unpalatable, try my recipe (it's literally my favorite thing to eat):

Combine in a jar night before and leave in fridge: 1/2 cup rolled oats, 1/2-1cup water/alt milk (amount depending on consistency you enjoy), half scoop flavorless protein powder, tbsp peanut butter, raisins, walnuts, pumpkin seeds, chia seeds, maybe 1/2 banana (if you need it to be a little sweeter).

I prepare mason jars with dry ingredients for the week, and add water to one or two every evening and put in fridge. Oat+raisin+pb combo tastes like my fav cliff bar. Banana + walnut are also amazing together.

I also recently got a vitamix and have been making vegetable smoothies midday to try and get more of them in my diet. I still cannot drink more than 500ml, else extreme fullness and bloating, but it's something. I'll add oats + avocado + protein powder to make it a meal with proper macros, but then I get to regular dinner time mostly full :)

Eating when full is a real bane for me. But there's bigger fish to fry in life, so I'll be a skinny guy.


I've known a few women with metabolism like yours. They actually had to work at keeping their body weight up. Their friends envied their slim figures, but it was a genuine health concern for them.


I'm sorry, but I'm a decently in shape person that tried semaglutide for reasons other than losing weight and I disagree.

While I'm sure we all are a bit different satiety wise (and I've found it greatly depends on how much I've been eating overall recently), your experience on the drug is not what the rest of us feel like all the time. It's unfortunately normal for our biology to basically want to shove calories down our mouths all the time. I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more. The only reason I ate that much is because I feel a cold coming on so I relaxed my usual limits.

The kind of "fullness" you get on semaglutide isn't natural. I've never felt like that my entire life. The closest thing would be after something like a Thanksgiving meal, but that's more of a "my stomach hurts" than "I really don't feel like I can put more in my stomach."

My sister in law is the skinniest, most in shape person I know. She's 35, has had 3 kids, and has abs, an ass she clearly worked for, etc. My wife (unfortunately) regularly compares herself to her and in this case also thinks like you, that it just comes naturally. She gave me her old phone so I could test some stuff on it as I don't have an Android phone handy. She didn't wipe it. MyFitnessPal was on there, and she was limiting herself to 1400 calories a day.

Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

And it needs to be said in case my wife ever finds this: she's also ridiculously hot and even though she can't see it has, at times, been skinnier than her sister.


>It's unfortunately normal for our biology to basically want to shove calories down our mouths all the time.

Not for me.

>I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more. The only reason I ate that much is because I feel a cold coming on so I relaxed my usual limits.

This is completely alien to my experience.

I eat until I get full, then I stop eating. I do not have any difficulty whatsoever maintaining a healthy weight. I don't think about calories at all. I have no idea how many calories or nutrients are in anything I eat; I've never paid attention to the that part of the label. It does not enter my mind for even a moment.

Sometimes I exercise regularly, sometimes I slip and get lazy for a while. Sometimes I eat a lot of fast food, sometimes I pull myself together and make better stuff at home. Throughout all this, my weight does not noticeably budge at all. I've been 20-22 BMI for my whole adult life.

>Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

I didn't work for it. It doesn't mean I'm a good and diligent person, it means I got lucky with my biochemistry and genetics. In another life, a different sperm would have met a different egg and I'd end up with different alleles and I'd end up fat.

It isn't fair that I'm living my life on diet easy-mode. If semaglutide can replicate this for people who aren't so genetically lucky, that's a fucking miracle.


I was like this for a long time, then I got older. That said, you seem to be following your body's instincts well, so good for you.


> I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more.

You give some thought to it every day, but do you think about it every minute? You could still eat more, but do you still have the same intrusive hunger to eat that you did before you started the nachos?

> Almost all of us work for it.

Your claim here seems to be that you work for it harder than people who have less success. But do you have any actual evidence of that?

Like, can you truthfully say that to keep your presumably healthy BMI you overcome nearly constant thoughts about how hungry you are? Can you eat an entire pizza and still be hungry except it's physically painful to eat?

People vary in their experiences of satiety. Many people do manage to be thin without constantly feeling hunger; that's what being on semaglutide does.


It's funny hearing people debate this topic on HN where the community skews heavily male. The vast majority of women have experienced both of these states of mind and in fact do so on a monthly basis. Three weeks out of the month I get hungry, I eat, I get full, and I don't feel hungry again or think about food at all for hours. You could put a cupcake in front of my face when I was full and I wouldn't even look at it. It requires zero effort to behave this way. Yet during that fourth week I get a constant gnawing feeling in my stomach that never goes away except in the first few minutes after eating something (usually simple carbs). I think about food nearly every minute of the day. Then one day it's like a switch flips and I'm back to having a perfectly normal appetite and satiety signals. It's an excellent lesson in how we're all at the mercy of our biology to some extent.


I’m a male with hormonal issues and I’ve also taken growth hormone peptides that make you ridiculously hungry. I’m no stranger to how hormones can affect our bodies. All I’m saying is that the type of satiety you get on semaglutide isn’t natural and I’ve never felt it before in my life.


Oh I definitely believe you on that. I haven't taken semaglutide myself but from what I've read it seems to increase satiety by slowing digestion, which is why it has nausea as a side effect, and I can't imagine that that's the same as the normal feeling of satiety you get from eating reasonable amounts. Did it make you less hungry in a sick way rather than a neutral way, maybe?


> Can you eat an entire pizza and still be hungry except it's physically painful to eat?

Same as the other poster, yes, but I can also still eat more without pain if it's a Large Domino's Pepperoni Pizza. If it's the Dominos "Deep Dish" though, that's my maximum. I can regularly put away a large Little Caesars pepperoni without trying, it's just a "normal meal".

The difference between me and people fatter than me is that after a large meal like this, my body stops "demanding" food for 1-2 days. Thats what keeps my weight in a +/- 3 lb range.

I know the difference because every once in a blue moon after I turned 30, my body's hunger signals will make me un-satiable. The experience of suddenly being unable to diet was jarring. I've managed to fix that somehow, thankfully. But it was very, very clear over several weeks that dieting was entirely beyond my control no matter how much willpower I had.


What semaglutide does is make the idea of putting more food in your stomach when it’s full…not nauseating, but something akin to that. It’s hard to describe. It almost feels like theres just no more room and the food will come back up. The main point I’m trying to get across is that (probably, sample size of 1) isn’t how healthy weight people feel.

And yes, I could easily eat more than one pizza. It’s a habit to simply stop at a few pieces, or more if I haven’t eaten much that day.

I’ve also taken growth hormone peptides that make you insatiably hungry. Literally insatiable - far beyond what I assume could be natural. I still usually limited myself. If I needed more I made popcorn or something and then went to bed hungry.


> Can you eat an entire pizza and still be hungry except it's physically painful to eat?

Yes. Except that it’s not physically painful not to eat (that would happen probably at 1 1/2 pizzas, but I almost never go there).

I’ve been feeling this way and limiting my food intake since teenage years (almost half my life). Sometimes more, other times less successfully (six pack to love handles, but never beyond that).


> I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication

If this was well and truly about the money you'd support it, because it's going to be cheaper than paying for long-term medical costs of obesity.


Yeah, and that's a definite bonus. It's the attitude I've read from people taking it that grinds my gears - when I read the semaglutide subreddit it was full of people saying "oh, so this is what skinny people feel like."

No, how you feel on the drug isn't how most of us skinny people feel. I'm probably somewhat uniquely qualified to make that distinction at the moment. The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat. It's one thing if you recognize it, but it's beyond annoying if you don't.


> The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat.

Someone could just as easily say that you've had access to a cheat your entire life and are now bitter other people have access to it. The fact that you have a stronger satiety response does not mean you are morally superior or are more entitled to a healthy life than others.


They could say that but they may very well be wrong. Obviously we can’t switch bodies and say, but I’m a non-diabetic person of a healthy weight that’s taken semaglutide. All I’m saying is the “full” you get when taking that drug was absolutely foreign to me.


> The rest of us have worked hard our entire lives to stay skinny [...]

Disagree.

I am skinny.

I spent almost no time thinking about it.

I eat whatever I want. If I overeat, my body feels bad... it tells me to stop.

After fasting 24 hours, my hunger turns off. I have no cravings. I am not eyeing chips and cookies with lust. I do not dream of roast chicken dinner.

Our human experiences of hunger and satiety differ more than I ever would have imagined.

Now should I look for a moral judgement? On me? On you?

I think I'll find something more positive to do with the rest of my day.


> Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

I don't really think this is a healthy way to look at it.

Yes every day is a struggle for most of us. I've been in the "healthy" BMI for a majority of my adult life, but only just barely. This requires constant effort and work for me. I assume that most "fit" people are similarly fixated on the quest to remain healthy.

But clearly, there's "something" that we have which makes it possible for us to succeed at this, which people who do not succeed lack. I don't begrudge them taking a shortcut, and I don't mind if they never understand my version of the struggle here, because I don't claim to understand theirs.

Fundamentally, we need to understand that our physiology has not evolved in a situation where we are both sedentary and have unlimited, good tasting food at our disposal, and any tools we have to make this situation easier should be embraced.


> she was limiting herself to 1400 calories a day

This is closer to disordered eating than healthy eating.

> The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat

Ah, the student loan forgiveness argument, and the pro-spanking argument: I suffered, so you should as well, because suffering is intrinsically moral and pleasure is bad.


> This is closer to disordered eating than healthy eating.

I believe she was losing what little weight she gained during pregnancy.

It’s not about suffering. Like I said, as long as you’re aware of it I don’t really care past the fact that I’m paying for it with my insurance premiums…but as someone else pointed out, it should be cheaper in the long run.


I'd be very careful with this kind of reasoning. We just do not know the insides of others peoples heads. How can you rule out that there are differences between peoples appetites?

Personally, I eat when I am hungry. My body typically generates hunger signals around the times I routinely eat. At other times I'm usually not hungry. Sometimes, I'll eat just for taste, but that is rare. I've had periods of time where I was trying to gain weight for fitness reasons and it was a real struggle. My natural state is to be skinny and it's quite hard for me to deviate from that. There a plenty of people like me and there are also plenty of people who tend to be overweight unless they actively fight it.

Clearly there are differences. There are extremes and their is a continuum between those extremes. You can exert some amount of willpower to change your position on the continuum, but the closer to the extremes you are, the harder it will be to arrive at a "normal" position.

And this is just inherent feelings of appetite. Some people may additionally be subconsciously eating to fill some kind of emotional hole or trauma. There is a lot going on and I wouldn't want to be too quick to judge.


Right, I’m sure there are extreme outliers on each side, but when half the population is fat it’s clearly not just that. The only point I was really getting at is that semaglutide doesn’t make you “feel like all those skinny people do and look how easy they’ve had it.”

Apart from people like you, perhaps. I also have a friend like that but he has pretty severe untreated ADD so I think that plays a part.


> It’s so hard to eat healthy, I honestly cannot fathom how people do it.

It's honestly just what you're used to.

If you eat tonnes of sugar and fat then that's what you crave.

If you cut sugar out of your diet, after a while the amount of sugar you used to eat will taste wayyy too sweet. Same with fat - eating chips for example will leave a gross fatty taste in your mouth.

99% of food bought out will have a whole lot of oil, fat, and sugar in it.

Eating healthy starts by controlling what goes into your own food. Cook and prepare meals yourself. Once you're in the habit of doing this you simply start to replace bad food for good.

Don't buy junk in the first place, then you won't eat it. Always shop for food when you've already eaten (and thus not hungry). Slowly reduce / eliminate the amount of fatty and sugary food in your meals. Just drink water (seriously, just water, no sweeteners).

Combine that with an exercise routine and you'll be set.


This would be more persuasive if it wasn't more or less the opposite of what current nutrition research suggests about fat and satiety.


Fat and non-satiating carbs in combination (e.g. chips) is bad because you will consume loads of calories without feeling full. Most seed oils (i.e. fat) actually seem to be quite unhealthy. If people avoid that shit when being told to avoid fat in general, I think it's actually a net positive.

Apart from them seemingly equating fat and sugar as equally bad, the comment was spot on.


"Potato chips are bad for you" is a noncontroversial statement. "If you want to lose weight, avoid fats", on the other hand, is deeply controversial and probably wrong.


I think that many people discover a particular diet that works for them psychologically and expect that to be the case for everyone.

I do wish that more people understood the basic research on satiety, though. I suspect more diets would be successful if people were eating ~2g of lean protein per kg of goal weight along with a lot (I'm not sure if people have studied amounts here) of dietary fiber.


This is exactly what helped me get my weight down: Lots of protein (whey / casein powder is pretty cheap nowadays if you search online; the exact formula is irrelevant unless you are doing top-tier bodybuilding; I'd suggest casein since it digests more slowly so it keeps you "full" for a longer time, and for me this seems to work) and lots of dietary fibers (wheat bran; drink a lot of water and eat it piece by piece over time; getting a lump of this stuck in your throat really sucks...)

Other than that your comment seems to contradict itself, I'd fully agree.


> Other than that your comment seems to contradict itself, I'd fully agree.

I'm not sure what you mean by this. Could you elaborate?


I meant that you stated,

> I think that many people discover a particular diet that works for them psychologically and expect that to be the case for everyone.

and then did just that for a high-protein, high-fiber diet. OTOH, that worked for me too, so it is certainly something to try.

Re-reading your comment though, I realized that I probably misunderstood it and that you were referring to independent research that came to the same conclusion.


I see. That makes sense.

Yeah - I probably didn't word that the best.


When I said fat I was thinking of the types of fats you eat when eating out.

Lots of deep fried, Canola oil or vegetable oils, bacon etc.

I agree that "fat" isn't harmful, but I do think people get a taste for the nasty ones.


"Deep fried" is a problem because it almost always saturates carbohydrate-heavy food in fat. There's no debate about whether potato chips are probably just as harmful! But it turns out: the baked potato chips are just as harmful. Vegetable oil on its own is probably not a problem at all. Research on ketogenic diets suggests bacon simply isn't a problem: it's an extremely high-satiety food (it's physically difficult to eat a lot of it!).

Bacon might be a problem for other reasons; for instance, maybe the CVD correlation with saturated fats will pan out. But in terms of basic metabolism, appetite, and hunger, the current trend seems to be away from the idea that people should avoid bacon-like fats.

I'm not here to say "bacon is the answer" so much as to say that your original post, suggesting that there's a simple nutritional answer to this problem, is both glib and not especially well-informed. The truth is: this stuff is very complicated, and there's a lot of uncertainty.


Aren't baked potato chips generally cooked in oil?

I agree that nutrition is complicated, and I am in no way an expert, but I really don't think we need to get so complicated to live a moderately healthy lifestyle.

In general most people know what foods they should be avoiding. I'm not saying stop eating avocados and almonds (although I've heard avocados use a ridiculous amount of water to farm). I am saying maybe don't chow down on potato chips, pizza and then eat a muffin - and then repeat roughly the same diet the next day... when I think of fatty foods, these are the types of food that come to my mind (and I'm assuming that's what comes to mind for the general population as well).

Of course if we go down a technical track or move away from the general population nutrition gets complicated super quickly.

On the subject of vegetable oils, this is why I say to avoid them - https://chriskresser.com/how-industrial-seed-oils-are-making...

Lastly, bacon is delicious.

Here's some more of my non-expert opinion: delicious things should be eaten in moderation.


It's complicated.

People with satiety issues (for instance, with hormonal disregulation, issues with insulin resistance, etc) aren't necessarily as well served by the "everything in moderation" message.

Food cravings aren't purely intellectual any more than needing to urinate is; intellectually, I can hold it until I find an acceptable bathroom, but physically, the severity of the urge and thus the energy required to regulate it varies based on how much liquid I've consumed, how long I've been waiting, and whether anything I drank is diuretic.

Similarly: depending on your hormonal profile, different foods will probably have different impacts both on satiety (the feeling of being full, of additional food being a welcome stimulation) and on "cravings". Some people can eat a "balanced" diet in moderation, across all the macronutrients, and be just fine; some people will consume simple carbohydrates (bread, rice) and immediately have an urge to eat more, as a dose-dependent response to the carbohydrates they've consumed.

For those people, "eat a little of everything, don't overdo it on the bacon" might not be good advice. There is in fact not that much evidence that eating bacon (or other high-fat, high-protein foods) is especially bad for you. But those foods also tend to quickly produce satiety, and they don't seem to generate food cravings directly in response to their consumption. Maybe for them the bacon, cheese, and eggs is a good call, as long as they're steering clear of the carbohydrates. It's a very big open question right now.

(Again: I'm only considering the goal of minimizing caloric consumption --- weight management --- not other food health considerations.)

Different people are different, and one of the things we are probably getting very wrong in dealing with nutrition is trying to come up with a single set of guidelines for everybody.


There's no conclusive single position of "current nutrition research".


Citation?


Every study done on ketogenic diets, for starters.


I don't buy that line of reasoning. I'm personally going between "I don't crave sweets at all" for weeks to "give me everything we have at home and when I go for groceries I will buy more". Maybe there are people who keep certain preferences or bodily functions for years, I am not one of them. My need for sleep is also drastically going up and down in bouts of months (when I need 8h, I need 8h and 9h is better, and when I am fine with 6h I am fine with 6h or if need be 5h, this changes every few months and then stays for a few months, not limited to a certain time of the year).


> It’s so hard to eat healthy, I honestly cannot fathom how people do it.

Learn to cook well so that eating out would result in lower quality meals compared to what you could make yourself.

Once you're controlling what goes into your meals, instead of outsourcing it, that makes it easier to control portion sizes, how much fat/oils go into things (I've found that restaurant dishes have an absurd amount of fat in them even when eating at "good" places), how things are sweetened, what you can use as healthier substitutes and what not.

You can eliminate almost all sugars with low to zero calorie substitutes, you can replace bread/panko/etc with low-carb flours, if you're frying you don't need more than a teaspoon of cooking oil, many sauces you can learn to make yourself instead of buying corn syrup and soybean oil-laden sauces from stores, etc.

Make it a rule to not buy things that come in boxes, buy fresh or flash frozen ingredients and make things from scratch. Stay in the produce, meat and fish sections of the store and ignore everything else outside of things like spices, frozen vegetables and protein.

Give yourself some leeway, too. You don't want to go into an all-or-nothing mindset, because that might lead you to giving up on eating healthily altogether if you break your diet. If you can find a way to treat yourself with something healthy that you like, that would be great. Sometimes I crave pancakes, despite them being nearly 100% carbohydrates. I eventually ended up with a recipe that substitutes wheat flour with almond and coconut flour, and to replace the syrup, a berry sauce reduction sweetened with erythritol. Barely any carbohydrates and the berry sauce is better than maple syrup, IMO, and goes with a lot of different meals.

tldr: reduce the opportunities to eat unhealthily, and increase the opportunities to eat healthily, even if you don't take those opportunities all of the time.


There's a lot of words here so you took some time to write this.

Who is it for?

Why do you think this is a new/novel idea the person you are replying to, and others reading it, has/have not heard before?


Indeed!

> Sometimes I crave pancakes, despite them being nearly 100% carbohydrates. I eventually ended up with a recipe that substitutes wheat flour with almond and coconut flour, and to replace the syrup, a berry sauce reduction sweetened with erythritol. Barely any carbohydrates and the berry sauce is better than maple syrup,

This reads like an elaborate troll, at that!


I'm really just that cringey IRL.


I am sorry that my post bothered you, I will keep your sensibilities in mind the next time I choose to share personal experiences on HN.


I'll take a wild guess and say it's for those who "cannot fathom how people [eat healthy]."


You got it.


“Has a high amount of fat” isn’t the same thing as “unhealthy”. “Has a high amount of calories” isn’t either.

Wanting to lose weight isn’t necessarily about health, and eating a lot of fat is an effective way to lose weight.


Eating a lot of fat is an effective way to lose weight, I agree.

However the fats used in restaurants are often used for frying, and likely have been used repeatedly for many hours. Oils used for frying can quickly produce compounds that are not great to consume, like various aldehydes, VOCs, free radicals etc[1]. If they've been used for hours, the chances of those compounds being in your food are high.

They are often low quality, as well, like soybean oils that can be high in fats that can be unhealthy in excess and might contribute to CVD.

I bring up the fat thing not because I think fats are the reason why people gain weight, I'm well aware of how high fat low carb diets are effective. I bring it up because restaurants often put fats into food you might not put it in at home, and the food can soak a lot of it up, turning what might be a 500 calorie dish into something that's 1200 calories or more. If you're trying to watch what you eat, eating out can make that hard because you don't know exactly how much food you're actually eating, and you can't really rely on nutritional breakdowns you might find online or from the establishments themselves.

The foods the fats are in also seem to be high in carbohydrates, which isn't great for ketosis.

I also bring it up because of Ulillillia's decision to degrease the pizzas that were the only thing he ate. By doing that he was able to lose weight while literally only eating pizza for every meal for years.

[1] https://news.ycombinator.com/item?id=32818910


It will be painful.

That's probably the most important lesson you need to learn before starting.

1. log your weight everyday on a graph

2. eat very small portions, no carbs

3. when hungry force yourself to drink a large glass of water

4. drink hot tea at scheduled intervals

5. eat lots of popcorn, get the raw grains from Safeway and put them in microwave for 4 mins in a large bowl with a cover


Popcorn has loads of carbs, and low satiety. Eat boiled potatoes.


A potato is far more energy dense than popcorn. 2 cups of popcorn looks like a good amount of food, but it's only ~150cal. A good way to trick your brain into thinking it's doing a lot of eating.

Source: worked for me. And is a basically daily staple


why hot tea?


You've trained your gut biome to expect a certain composition of foods, it takes a bit for it to calibrate to something different. After a few weeks you can easily get used to different types of food.


> It’s so hard to eat healthy, I honestly cannot fathom how people do it.

There are some simple tricks you can try if you're currently maintaining a stable weight. The simplest is to get slightly smaller plates. Your brain will naturally try to visually match what your old portions looked like on the old plates, but now the plates are smaller so you're eating a bit less.

No other change in behaviour is needed to see some benefits, but of course going for a half hour walk after dinner and shifting more of the food you put on that plate towards greens also helps.


Ironically, we're just about to buy smaller plates for a completely unrelated reason. We moved into a new apartment and the cupboards are more shallow than our previous place, and our plates don't allow the doors to close all the way. So we're buying a smaller dish set that will fit. I hope that helps!


I was diagnosed with something a few years ago which if I didn't change my diet (no beef, pork, fried foods, no foods with preservatives, low to no salted foods, increase water intake to 3/4 a gallon a day & started eating fresh fruit)that in ten to 20 years id be stuck in bed too tired to do anything/ enjoy life.

For me that forced me to eat healthy daily and it has almost healed my affliction upon religiously following such a diet.


What do “preservatives” have to do with it?

Most nutrition advice is so bad you basically shouldn’t believe anything anyone tells you, including, especially if it’s from an expert.


Just eat only liver, eggs, and ribeye steaks -- you can absolutely stuff yourself and you will lose weight. The problem is that as a society we are sending the wrong message about what healthy food is -- nothing from a plant is really good for humans to eat. A diet of only red meat, however, will not only get you in phenomenal shape, but it will also clear up a dozen other major and minor health issues. It is the perfect human diet and it is a tragedy that this is not understood.


I support anyone experimenting with their diet to see what works for them, but I wouldn't be so confident about extreme diets like carnivore working for everyone.

Nothing from a plant is healthy? That sort of absolute statement flies in the face of history and common sense and I can't imagine it's true for all humanity.


I honestly love the idea of individual experimentation. Like, there has to be a not-quite-scientific-but-almost-scientific approach that people can reasonably handle on their own. I'd love to see a book that outlines how to find the right diet that works for you. Like an operational guidebook showing you how to cut out specific foods, and how to watch for and observe changes to see what the effects are on your body.


Hope you don’t have hemachromatosis.


Next you'll be warning me about scurvy, lol


You just don't want it bad enough. You like food more than you like being thin. That's all.


There’s clearly more to motivation, dependency, and even addiction than just how “bad enough” someone wants something.


What finally got me on right way on controlling hunger was just getting used to eating once a day and dropping a lot of the quick-burning foods that made me go hungry quicker. Not necessarily going super healthy but stuff like eating less bread/pasta and more say baked potatoes so still nice tasty food that doesn't get me into diet sadness mood, just shifting away from carbs

Also figuring out when I'm "brain hungry" (brain is bored and wants to munch on something/get reward for hard day at work) and when I'm "body hungry" (body actually wants some energy and is slowing down, fingers/feet getting colder etc.).


I've done all of these things. I've essentially been on a diet since I was 17. I am not (especially) fat, but the amount of mental and emotional energy I burn on not being fat is huge. It is a daily struggle. Like one of the parent posts, I've achieved a number of other hard things in my life that took sustained effort and willpower.

I can easily eat 7-8,000 calories in a day, and there's no amount of stairmaster can fix that.

I've also previously taken modafinil, and had situations where I've had caffeine having been caffeine-free for a while, and the appetite-suppression properties have me thinking "this is what normal people must feel like". I cannot wait until these drugs become available in the country I mostly live in.


Yeah, I've never struggled with weight the way other comments in this thread have, but I made similar changes when I was younger and they've been one of the best things I've done. I have one largish meal a day, with one smaller or a snack, and focus on low GI foods but in a mild way. When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately.


Yeah when I tried the "eat a bunch of small meals during the day" way I felt like some constantly munching pasture animal and also had to plan for all that. And any social plans threw a wrench in it, as getting used to frequent meals also made me go brain hungry quicker.

Now getting some frozen pizza for dinner coz I'm lazy/don't have time no longer ruins diet pace for this week

> When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately.

Anything with a bunch of milk works well for me for quashing hunger. Weirdly enough I usually feel more hungry in the evening than morning next day (at the very least for first 1-2 hours)


>I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had.

I hear people following a carnivore diet have had success in dealing with this satiety issue. The only things you can eat with this diet are butter (or ghee), beef, and salt.

There is a claim that nutrient difficiency causes the scenario you are describing. Your body is being deprived of what it really needs with your current diet and requires more consumption to continue its search for a particular set of nutrients.

The carnivore diet is not a silver bullet but worth a try. I will also mention it is high protien, high fat, and zero carb which has been shown to result in massive weight loss in relatively short periods of time (counterintuitive, I know).


I've heard people say "I'm only being sated by the extras/side dishes, give me 1kg of meat and I will eat 1kg of meat as the main course" and to a degree I understand, at least for "normal" dishes with meat and carbs. Maybe it actually works if you crank the fat contents up.


You are right.

The high fat requirement is neglected when most first start this diet. People have been trained to fear excess fat so it does take extra directed effort to break out of the mindset.

Many manufacturers also remove fat so nutrition labels are more attractive to misdirected consumers ...this will generally lead followers of this diet away from overly processed foods (added benefit).


A carnivore diet can include many other foods than beef and butter. Being high in protein is also a choice, and not a necessarily a great idea. (I'm getting moderate protein and high fat.)


>Being high in protein is also a choice, and not a necessarily a great idea.

Why is it not a great idea?


> high protien, high fat, and zero carb

Basically a keto diet, of course it works due to ketosis.


I think the problem with Ketosis is that people are too busy trying to eat a lot of fats. You just need healthy fats, protein and vegetables.


You don't need vegetables.


A carnivore diet is not necessarily a ketogenic diet, although it is a zero-carb diet. If you eat enough protein then your body will make glucose from it and keep you out of ketosis. But I agree that a diet of only red meat is absolutely ideal no matter which angle you look at it from.


If you eat enough protein then your body will make glucose from it and keep you out of ketosis

Cite for this, please?


They’re probably talking about gluconeogenesis.

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


Yes, but that's not a cite that says eating lots of protein can take you out of ketosis; it's just a Wikipedia article on gluconeogenesis.


I didn't believe it either... it seems to be mentioned in a bunch of keto literature online, like this one [1]. Some folks say it stimulates insulin, and some say it upregulates gluconeogenesis. I haven't found anything authoritative, so I remain skeptical.

[1] https://www.verywellfit.com/gluconeogenesis-2242007



So, it's just a thing you think might happen, because there is such a thing as gluconeogenesis? I went looking, and the only cite I found was a study suggesting this does not in fact happen.


> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full.

This is what all the common advice doesn’t address.

The only thing that has helped for me in the past was an SNRI (sibutramine) that was later withdrawn from the market. Then all the weight came back.


Common advice does address this. A lot of dieting has been, in my experience, finding ways to make less food make me fuller, or to think less about being full. For example, intermittent fasting is a great way to do both.


I have gerd, and was like, I was wondering if this would make it easier for me to eat small amounts and not have as much heartburn... then I read this:

> As for side effects: I've had some heartburn, but none of the other commonly reported side effects.

And I looked up the less side effects, it is a laundry list of gerd symptoms.

I can confirm, these symptoms will help you lose weight, but I mean that tounge in cheek, I hope this drug helps a lot of people but doesn't have much in the way of side effects.


The heartburn has been quite minor, and only at night. Tums has been plenty for controlling it. (But I don't have GERD.) The heartburn itself is definitely not the cause of the weight loss for me, haha.

But intuitively it does make sense, because one of the primary effects of the drug is slowing down gastric emptying, so it causing heartburn isn't exactly surprising.


I just read through the side effect information.

Gerd was reported in 5% of Wegovy users compared to 3% in the placebo arm. It’s a risk but it’s not a huge risk.

Nausea especially in the first few weeks was more common, but it was only bad enough to cause <2% of people to discontinue the trial.


One of the likely factors in my gerd issues is being about 20 lbs overweight, so I wonder how this balances out.


I was fat/overweight all my life until I was about 24. I had enough of it and I went from ~94kg to about 85kg quite quickly (through calorie deficit), then over 1-2 years I went to a low of about 72kg. I am about 75-76 now, and have been oscillating in the 72-77 range for the past 5 years or so. It still requires me to be mindful of how much I eat, which has become part of my daily life. I'm not very strict about it, I have days when I eat more and then I compensate by eating less.

I think the mistake people make is they think they can go on a diet temporarily, then go back to the old eating habits and not get fat again. That is nonsense of course, which is why dieting doesn't work. Dieting implies something temporary and you need something permanent.


I've heard from many sources that maintaining a weight level is harder than losing weight, and that has been my own experience.


> I still like food, and I still get hungry. But it doesn't dominate my thoughts.

This is how I feel as a default, I am a perpetually skinny person. Thank you for putting this into words from your perspective in such a crisp way. I wish everyone would have the same (non dominating) relationship with food as a normal occurance (and not some immense mountain to continually climb.)


> people that have never actually been fat. "I did it and I lost 15 pounds

Also people who have never had an older metabolism. It's different. I was also skinny despite eating a ton and hardly exercising when I was 25. Everyone I know over about 30 can identify when their metabolism suddenly changed. Diet (and to a lesser extent exercise) advice from those who haven't hit their own wall yet is worthless for those who have. Those people need to stop over-generalizing their (limited) experience as universal truth.


A recent study found basically no change in metabolism from the age of 20-60: https://www.bbc.com/news/health-58186710

People usually just start packing on a few pounds a year (or more) in their 20s and it adds up.


I'm 40 and I can't pinpoint when my metabolism changed. I can pinpoint exactly when I moved in with my girlfriend, who cooks delicious food, instead of me ordering a salad a day as my main meal, but my metabolism itself seems to have hardly changed at all.


Does your appetite not adjust to your intake?

I did a “dirty bulk” while working at Trader Joe’s in my 20s. At the beginning I could barely eat one frozen mac and cheese. A month of heavy eating later and I could easily finish 2 and still feel hungry.

Im older now so I don’t eat like that anymore, but it is still very noticeable to me how easily I get full when I am dieting hard.


> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had.

I have a similar experience.


> I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again.

There's something similar here I've noticed while testing myself in the past: At least for me, it seems like hunger occurs when the stomach empties by a certain percent of its last maximum. No matter if I barely eat anything, or eat until max capacity, hunger starts after my stomach empties a bit further, but it doesn't take until I'm actually empty (tested by the size of the following meal), and the hunger tends to end after reaching the last maximum. To use some made-up numbers to demonstrate, it's like I can bounce back and forth between 60% full and 90% full or 20% and 30% full, and once I've gone a cycle or two on either of those, the low ends of 60% and 20% make me feel equally hungry and the high ends of 90% and 30% equally full, but I've digested more when the baseline is on the higher end.

It can be difficult pushing from the higher range to the lower range though, have to ignore/squelch the hunger long enough to reach it.


> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full.

I’ve had a weirdly similar experience due to wildly different histories.

When I was a kid I was on medication that f’ed with my appetite so I literally never learned what hunger was as a kid. As an adult and long off the medication, I just eat and don’t understand the signals my body produces.

When I was younger, I had a healthy and active body and didn’t notice my diet was bad until first I graduated and took a desk job then it accelerated with Covid when I became sedentary and snacks were constantly available. I put on weight very quickly.


If you don’t mind sharing, we’re you prescribed tirzepatide for type 2 diabetes, or was this an off-label prescription for weight loss?


Just curious in regards to saying you never really feel full ..have you ever counted daily calories you consumed on average?


How much weight did you end up losing on that stuff?


[flagged]


> What people who aren't fat do is intellectually recognize that "I could eat forever" feeling, and don't fall for it. That's where the willpower comes into play.

I don't think that is quite right, at least from personal experience. I have a good weight and I feel it's almost impossible for me to gain weight. And personally, I don't really recognize the "I can eat forever" feeling.

I love food, don't get me wrong, but I eat some sort of meal and then once I feel it's enough so that I no longer feel ravenous, I just stop and go back to doing something else. Sometimes I'm even concentrating so hard on some other activity that I forget about eating.

For me, it's definitely not willpower. In fact, once I tried to gain weight (more muscle mass) by going to the gym and counting calories, eating a minimum amount every day over what I usually ate. What happened was that after a short amount of time, there came a day where I just didn't feel like eating.

In short, although I do believe willpower can help you lose weight, I sincerely doubt a lack of it is the only thing that causes people to be fat. I honestly think that people must have a different metabolism and/or a different desire to eat, because I find it very hard to ingest enough calories myself no matter how hard I try. My body just stops me from eating very soon, even though I know I theoretically could eat more.


I don't know what to tell you other than that I was once skinny and young, but then I got older and fitter and my desire to eat changed. It apparently changes quite a lot as different factors in your life influence you, according to the article you're commenting on. It's a good read, I recommend it (and others)!

What factors do you think are influencing your desire to eat more or less? Do you think those will change at all during your lifetime, or do you believe that those factors are entirely genetic?

Additionally, what do you think of the folks who were fat, who then got healthy, and remain healthy? It sounds like you don't believe they can exist, since "metabolism" is just different for everyone, or that if they do exist, they're doomed to failure, since it's encoded genetically and therefore only a matter of time until they "revert" back to their unhealthy state.

Finally, what should we do to the people who have these genetics that cause them to eat and/or gain weight with little or no control? If we could remove those genetics or alter them pre-birth, should we? As for the living people, they obviously cost more to provide healthcare to, so should we split them out from the non-obese-predisposed pool of people?


"What factors do you think are influencing your desire to eat more or less?"

There is a lipostat or setpoint in the hypothalamus. It acts like a thermostat for fat. Fat levels are controlled by a homeostatic system, just like body temperature. The highest amount of bodyfat you've had will typically be the bodyfat your brain will defend. It not only does this by making you hungry, it also will downregulate your metabolism. So you become less active. Anyone who has been obese, is fighting their own brain to maintain fat loss. Losing fat is easier than maintaining fat loss. Semaglutide disrupts this system.

BTW, the mechanism of the setpoint is Leptin, a hormone secreted by fat almost exclusively. Muscle also releases Leptin, but in small amounts.

So if you cut the fat out, if you use liposuction, or you diet down slowly, or you diet down quickly, it doesn't matter. Your brain still knows how much fat you have, based on the leptin signals it gets. You cannot trick it.

The reason bariatric surgery is effective is that cutting out the stomach reduces the amount of ghrelin released, which is a hunger hormone that the brain sends the body. Again, disrupting the homeostatic system...which is the only effective way out of this mess.

I was expecting more people on hacker news to know about homeostasis of fat by now. Leptin was discovered 27 years ago.


I would love to know how any of this would enable or disable a person whose mouth was sewn shut to continue to gain weight, because it was my understanding that in the vast majority of cases, someone must make a willful decision to lift their hand, pick up food, and insert it into their mouth in order to obtain any nutrition at all.

I was expecting more people on hacker news to know about the existence of how eating works. The mouth was discovered... well, millions of years ago.


You can overcome the starvation response caused by the lipostat with willpower if that's your point. Not many do. In fact, there's a registry of such people http://www.nwcr.ws/ . They report having to be diligent every day. They work out every day. They watch their calories. They can't relax about it. That's why it's so hard to succeed in the long run.

You don't seem persuadable, nor too interested in the science of the lipostat, so I'll just let you have the last word here.


Thanks, I think you’re ignoring the forest fir the trees here. We are not lipostat monitors attached to stomachs, we’re thinking, reasoning creatures who are not slaves to our impulses.

Many, many people, billions of people, overcome their animal instincts every single day in favor of reason. Fat people can do this too.


>”we’re thinking, reasoning creatures who are not slaves to our impulses.”

I’m not so sure about that.

We haven’t evolved past our animal instincts and it seems like our conscious mind is only an additional layer on top of the “reptilian brain” - for lack of a better term. It has not replaced our base urges and our intrinsic motivational systems.

We are only sometimes able to shut down our unconscious urges. Even so, we may only be able to do that temporarily, as people fall off the wagon all the time. In fact going “cold turkey” seems like one of the most counterproductive things someone can do.

I feel like much of our ability to succeed via “mind over matter” has to do with our biochemistry rather than rational thoughts. Our motivational systems are ultimately controlled by neurochemistry. So there seems to be a lot more to this than just conscious mindset.


You can "feel" however you want, the science is firmly against you.


Okay then, present your citations. And don’t just copy paste a bunch of studies saying willpower can be practiced. I’m saying there’s a chemical basis for motivation and willpower, which is also backed up by science.

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


> What factors do you think are influencing your desire to eat more or less?

Well, as you said:

> It apparently changes quite a lot as different factors in your life influence you

As far as

> Additionally, what do you think of the folks who were fat, who then got healthy, and remain healthy? It sounds like you don't believe they can exist

There's no implication that they can't exist; just that it's myopic to assume that what worked for them will also work for other people who are fat, particularly when they've tried the same thing and report that it's failed.

> Finally, what should we do to the people who have these [factors] that cause them to eat and/or gain weight with little or no control?

Accessible GLP-1 agonists are a good start.


If you believe that there are people who succeeded at losing weight and keeping it off, then you must necessarily believe there are people who succeeded at losing weight and failed at keeping it off, just as you must also believe there are people who failed at losing weight in the first place.

Are you proposing the people who succeeded at those two steps have something chemically the others didn't? Or what alternative explanation would you provide that explains the different outcomes?


Figure out a compelling answer for what that explanatory factor is, and you'll be a billionaire.

Chalking it all up to willpower is, however, unconvincing. When I managed to get down to ~22 BMI awhile back using the willpower approach, I spent literally every moment distracted and obsessing over the food I couldn't have, for months on end. That's not something that most people at 22 BMI do (unless you think that they also use their willpower to quash the constant intrusive thoughts). It's not a huge leap that others who struggle with getting to a healthy body weight experience something similar, especially because it's what they report happening. I wouldn't be surprised if the people who fail outright have even stronger cravings than I did.


What about 90% willpower? 80/20? I'm willing to go below 100% on ascribing this to willpower, but probably no lower than 70%, just based on the outcomes for folks who have willpower and for folks who don't.

There's just too much evidence supporting the idea that actively eating less and continuing to do so is a successful strategy for losing weight, combined with the obvious fact of simple human biology that eating involves consciously taking food and putting it into your mouth (sleep-eating notwithstanding).


I hesitate to speculate; for any individual, it could be a different mix.

It would be an interesting test to correlate obesity with other non-food related willpower tasks. If the correlation was high, on a population level I'd lean more toward willpower being the dominating factor; if the correlation was low, more toward the catchall non-willpower factor.


But you already speculated by claiming it's not 100%. So either you have another number in mind or are just being contrarian...

Further, your experimentation has a flaw; no two things carry identical risk factors and "willpower" factors. Food, as anything, is unique, so the idea of comparing it to other willpower exertions isn't relevant.


> Food, as anything, is unique, so the idea of comparing it to other willpower exertions isn't relevant.

So, you're backing away from the idea that people who struggle with weight lack willpower and are shifting to the stance that they lack some hunger-specific willpower that's unrelated to anything else meaningful?

That's completely indistinguishable from the idea that some people feel hunger more than others.


Nope, I’m reasserting that applying willpower to food consumption is completely possible, and to claim that willpower isn’t a skill is to deny decades of research that shows over and over again that it is.


You made some good points. I am under 40 so I might still have some changing to do as well I guess! As for factors changing during my lifetime, I am not sure. I don't think it's entirely genetic since genes almost always have some environment mediation.

I do believe fat people can get healthy and remain healthy, and I only meant to say that "metabolism" and desire are mediating but not wholly determining factors.

As for the people who can't stop eating, I don't propose to "do" anything with them. I don't believe in altering genetics or using advanced technology to solve the problem. I don't think we should split them out in terms of healthcare either because that would be cruel. I might also have some predisposition to some other costly condition like heart disease and then I would be in another "more expensive" group and just not know about it because it's not visible like obesity.


If "fat people can get healthy and remain healthy" then you agree that it is indeed a matter of willpower, right?


Well, I think people have different levels of willpower (which may actually also be genetic) and an interaction with their desire to eat. Some people clearly have much stronger wills than others, and that's probably genetic or at least imprinted early on.


What if you found out that willpower wasn’t genetic, but a learned skill like riding a bike? Would that change your opinion at all?


Well, yes and no. I guess it might change it a little. Plenty of things are learned quite early though, so it might be some learned skill that happens so early that the person themselves are not responsible for it. I mean it's a bit of a complex question isn't it?


It's actually a quite simple question; if you found out that willpower were entirely a learnable skill, a skill that you could improve with deliberate practice, would you change your mind about how much agency someone has over their own weight?

It's in fact a yes/no question.


I think the premise of your question is wrong. My reading of OP's comment is not that people have no agency, or that willpower is not a learnable skill.

My reading of OP's comment is that for some people, it is easy to lose weight. For others it is hard. I agree with this (while still saying that I believe that people have agency over their own weight and that willpower is a learnable skill).

There is no doubt that being fat or not fat is absolutely a function of how much you eat (and to a lesser extent, exercise), and that how much you eat is a function of willpower.

The question is the other parts of the functions. For some people, they can eat as much as they like without getting fat. Others get fat eating less than average.

For some people, it takes a lot of willpower to eat less. For others, it takes less willpower. Someone who's 5'5" will have a harder time becoming a pro-basketball player than someone who's 6'5". Doesn't mean they can't do it with a lot of effort and willpower.

So no changes of mind are needed, the answer to your question is 'no', because I already believe that willpower is learnable (and if I understand correctly, so does OP).


If you believe willpower is a skill, and you believe that deciding to eat or not eat is a conscious choice, then you must therefore believe a person can train their willpower to prevent them from making the choice to eat.

There are no other ways to see this. You don’t subconsciously eat, that’s not really a thing.


I don't agree with that reasoning, even with your premises. Willpower could be a skill, but some people could learn it better than others because of innate ability. Piano is a skill, but some people learn it much better than others.

A person might be able to learn some level of willpower but still lack a sufficient amount to prevent them from eating.


[flagged]


Why assert that everyone is equally capable of learning willpower? There are upper limits to skill acquisition, regardless of how much someone practices.

I’m not convinced willpower is highly trainable either. Your citations don’t claim that.


[flagged]


>”...or are you not here to learn? :)”

There’s no need to be snide. Use your willpower to resist the urge to be provocative and have a discussion in good faith.

If you actually go into those citations you’ll find they aren’t very definitive about the malleability of impulse control, especially over the long term.

“Our findings suggest that self-control is potentially malleable and the practice of inhibiting impulses may help people lose weight, eat healthier and increase their physical activity,"

And I think you’re posting studies that extoll the virtue of discipline, which is nice but it doesn’t disprove willpower has a chemical and genetic basis. Some of these are just about children studying in school and having less willpower when one is tired or stressed. Most of them only provide generic and non profound advice.


Nothing is definitive in science, if you're waiting around for certainty before doing something, you're going to wait for a very long time.

Also, "Doesn't disprove" is not, fundamentally, how any of this works. I'm honestly surprised you think that's a viable argument here...


>”Also, "Doesn't disprove" is not, fundamentally, how any of this works. I'm honestly surprised you think that's a viable argument here...”

In a response to me elsewhere in this topic you said, ”the science is firmly against you” and I’ve yet to see anything in your citations that backs that up, much less “firmly”.

And you still couldn’t resist the temptation to be snide…


I’m going to appear snide to you for the remainder of this conversation because you don’t have good faith in mind. You’re in the “seeing ghosts” phase of this chat, paranoia seems to have you.

That’s demonstrated by your refusal to accept the basic truth that there’s a lot of strong evidence to suggest that willpower is a skill that can be grown and applied to weight loss.


You appear snide through your language choice, not through mere disagreement. You come off as arrogant and condescending.


> then you must therefore believe a person can train their willpower to prevent them from making the choice to eat.

Yes. But for some people, that training will be very easy, and for others, the training will be hard. My point does not contradict yours, it adds to it.


I think you are missing the point. People are not skinny because they "intellectually" know something. Nor are people fat because they are stupid, sometimes sure, but the societal trend towards obesity is not caused by ignorance. Read the article.


People absolutely are skinny because they intellectually know something, but the word “intellectually” doesn’t mean smart/stupid, it means “apply critical thinking to a situation” as opposed to allowing your animal brain to keep control.

To put it another way, system 1 will eat until its full, system 2 knows what a calorie is, and at least vaguely understands how many calories are in what you just ate against what you need to survive.

Skinny people are not smarter, they’ve either never had an impulse to eat more in the first place, or are able to react to the impulse with the part of the brain that reasons.


I think executive function might be a better way to understand obesity, rather than Kahneman's system 1 and system 2 thinking. Inhibitory control in particular seems more relevant[0].

Applying critical thinking (as opposed to applying inhibitory control) is only useful against obesity insofar as you can make changes to your lifestyle and diet. Lots of people know what a calorie is yet still fail to lose weight, because intellectually understanding something doesn't mean you can do it.

[0] https://www.sciencedirect.com/science/article/abs/pii/S01497...


Making changes to your lifestyle and diet is still the best, most reliable way to lose weight; this article’s science is far from conclusive or “production ready”, as engineers would say.


The "most reliable way to lose weight" doesn't work for most obese people. The studies on tirzepatide seem reasonably conclusive, at least as far as weight loss goes. Is your issue with undiscovered long-term side effects, or with lifelong dependence on a drug that causes unpleasant side effects, or something else?

My position at the moment is that different obesity interventions work for different people. Obesity is the result of a huge number of different factors such that no single intervention will work for everyone. An obvious example would be an obese patient with thyroid problems, vs an obese patient with sleep apnea: both sleep and thyroid function can cause weight gain, but they have different treatments. I don't think we should ignore a drug that works well in some stubborn cases, just because other cases can be fixed with lifestyle and diet changes.

(I say this as someone who lost 15kg, went from obese to normal, and has kept it off for years by occasional calorie tracking. Most evidence suggests this doesn't generally work for obese patients.)


> The "most reliable way to lose weight" doesn't work for most obese people.

Except that it does, for literally every single one of them. They simply don't do it.


Let's take 1000 people above 30 BMI and divide them between us. I give them my intervention of semaglutide and lifecycle changes; you give them your intervention of "work harder you lazy fatties."

I guarantee you an arbitrary amount of money my group will be >10% lighter than your group after 6 months.


Heh, and so there it is; you are insulted and feeling defensive.

Would it blow your mind to hear I agree, and never said anything to the contrary? Probably, if you weren’t feeling defensive.


It can't possibly work for literally every single one of them, because there are still obese people. "They simply don't do it" is a restatement of the problem rather than a solution, and about as helpful as telling coalminers to learn to code.


Maybe I reject the notion of lost causes, and don’t think it’s a good thing to count people out.


I think this is a values disagreement, not a factual one. I view obesity as a medical problem to be solved and not as a moral failure, whereas I think you see obesity as a moral struggle and drugs as a crutch or an admission of defeat. To me it's more about balancing the risks and dangers of an injection and making sure people have tried less risky things first, and "lost cause" is not how I'd describe taking a weekly injection to manage an otherwise-intractable medical problem.


Where did morality come from??? That's entirely injected from your own interpretations, and has absolutely nothing to do with what I said.

Honestly it sounds like you think people who are overweight have "failed" in some way, as I don't believe that at all. "Taking injections weekly" is also doing something about their obesity, which is just fine with me, I'm simply explaining how "willpower" is also a viable possibility. There's no need to take injections if you learn more about willpower and strengthen yours over time, and this is supported by a cornucopia of recent and sound science.

A failure of willpower is not a failure of moral character, why do I even have to say that?


How would you explain skinny smokers then? or skinny drug addicts?

This whole "intellectual willpower" thesis is so stupid it's insulting.


Most "skinny" drug users are on drugs that have side effects including weight loss.

What's insulting is to take away the accomplishment of the fat folks who got healthy by claiming it was just their genetics that let them stop being fat, but also somehow their genetics that caused them to get fat in the first place?


I'm a former "fat folk" and I tend to agree this is more about willpower than many people are willing to admit.

I'm not insulted by anyone who discounts the effort I put into getting fit though. Weight and genetics and willpower are all confusing concepts and it's understandable to not be willing to attribute it all to willpower.

I will say that it is almost discouragingly hard to maintain this level of discipline for many years though. My body does seem to fight me in ways other healthy weight people don't seem to deal with. So while it does come down to my willpower to stay the course, I also admit that if I were to have an unexpected life event that caused me to fall out of my routine it might lead to weight gain again.


most of my life it was effortless for me to stay skinny - it actually took effort not to be underweight. then I started a medication. initially my BMI was 22 but it shot up to 28. I developed a terrible sweet tooth and binged on carbs, insatiably.

I quit the medication and promptly went back to 22. no willpower involved.

I'm sorry you have to struggle against your body. your body makes it a fight requiring massive willpower, mine doesn't - it's just down to genes or something.


> I developed a terrible sweet tooth and binged on carbs, insatiably.

This sentence is the problem; you didn’t “develop a sweet tooth” like you grow a tumor, you out sweet things in your mouth by choice. You had agency, you made that decision.

Stop avoiding your role in your weight, stop pretending someone else was in control of your decisions. It was you, you did this to yourself.


I'm not sure if you read my post, but I lost the weight I gained and got back to a BMI of 22 just by going off of the med I was on. The med caused cravings and lack of satiety. Going off the med reversed the cravings. This demonstrates that cravings are biological and not caused by a lack of self-control, because I didn't need self-control before or after, and I didn't have the self-control to avoid gaining weight while taking the medicine.

Craving sweets is a well-documented side effect of mirtazapine, I'm not sure why you're having trouble accepting that.


Craving != acting on craving, is my point. That's what willpower can be used for.


Just out of curiosity, what was the medication?


Mirtazapine.


Seems like I'm late to the party, but I feel the idea of willpower is really underrated and misunderstood and I see it all over this thread.

First, willpower is absolutely a trainable skill. In the late 90s there was scientific support for the idea that willpower was a limited resource. The let people choose weather they wanted to eat a healthy snack (radish or cucumber, I think) or a cookie, then after that had them solve an impossible puzzle. People who ate the cookie kept trying almost twice as long as the healthy-snack group. They took it to mean that willpower was limited and the healthy-snack group had used it up in resisting the cookie. More recently this was disproved and an even stronger conclusion was reached - The reason why the stop exerting willpower is that they _believe_ it is a limited resource. People who don't have that idea, tend to stay in it longe.

Second, it's not exclusively willpower that keeps people healthy - things CAN get easier or harder. People who are already obese, for instance, will have a hard time loosing weight and an even harder time staying lean - because the body is indeed pushing towards that same body-fat content.

It gets easier when you avoid a situation where you need to exert the willpower in the first place. I recall a study where they seated kids in a room with a marshmallow and if they didn't eat it for X minutes, they'd get another one and then they could eat two - The kids who were allowed to leave the room for the X minutes (and did leave) had much higher success rates than the ones who chose (or were forced) to stay in the room.

I also recall some neurochemistry that makes it easier to do hard things (like working out) in the morning that later in the day.

People also tend to operate in absolutes - stay on a strict regiment of calorie counting until that one weak moment when they have a cookie. And now they're completely off because, well, they're streak was broken or because they tell themselves "I failed so I can't do it."

None of that should discount the effects of willpower. But the degree to which people need to apply it varies a lot. Just like it's easier for a non-smoker to not pick a cigarette than it is for a chain-smoker going a-pack-a-day. If someone is in the hard-to-lose weight category, I empathise - you have your work cutout for you. But training your willpower is the only long-term sustainable way to do it.


Thank you. If I could go back and time and steal this comment's content and post it instead of what I did, I would. This is what I was trying to say but I lack the knowledge and writing skills to do so, apparently!


>What people who aren't fat do is intellectually recognize that "I could eat forever" feeling, and don't fall for it. That's where the willpower comes into play.

This isn't how it is for me. Of course I've had the "I could eat forever, so let's not" thoughts before, but only in certain contexts like if I'm at a buffet dinner. Ordinarily I just get full and then stop. No mental pep-talk needed.

I've noticed in these discussions, people think how it is for them is how it is for everyone else. They use the same words to mean different things. Look carefully through all the comments here and you'll see that "full" seems to have very different meanings to different people. "Willpower" is another one.

Nobody can give an objective meaning to these terms, or it doesn't even enter their minds that they might need to, because "obviously" everyone else experiences the world in the same way. It's like the blind men of Indostan.

See also: https://slatestarcodex.com/2014/03/17/what-universal-human-e...


Willpower absolutely has a scientific definition, I’m on mobile but there have been hundreds of studies done on willpower and each and every one of them must define the term before studying it.


Please try eating only liver, eggs, and ribeye steaks and drinking only water. You can absolutely stuff yourself on this diet and you will nevertheless get in shape. It breaks my heart that people have such an upside down idea about what healthy food is -- people think they should avoid red meat and eat fruits and vegetables and "heart healthy grains" when in fact the only thing they should eat is red meat. It is a tragedy almost beyond description -- there are millions of people in your situation who have been thwarted in their weightless journeys at every turn because we've been getting the wrong information about what food is healthy for us to eat. In addition to losing weight, you will also completely eliminate heartburn. Just try it.


I did this and lost 18% of my body weight (BMI 36 to 29) after reading Gary Taubes. It works. The resulting blood chemistry worried my doctor.

Worse, it’s excruciatingly boring. The 60th serving of fatty steak is no longer delicious. I lusted for a crouton. Even onions are a cheat in a glycemic load regime.

When I was single, strategies like having no sugar, alcohol, or refined carbs in the house were practical, but living with a family and especially with young kids, they really aren’t.

I regained it all and more. I’ve made follow-on efforts and had several +/- 30lb swings.

I started tirzepatide three months ago. I echo what others have said above: I never understood satiety before this. Keeping keto takes excruciating willpower in comparison. I now know what it feels like to eat 3/4 of a normal dinner with balanced macros and not think about food till lunchtime the next day.

There’s a big difference between maintaining constant vigilance against desire and having none.


> There’s a big difference between maintaining constant vigilance against desire and having none.

This is exactly the case I make for fasting to those who ask why I like it. Nothing to count. It's super effective, much easier than people assume, and very quick. Also gives you a ton of energy and focus.

Glad you found something that works!


I've been cycling "liver, eggs, & steak" + I add BONEMARROW.

Been doing this for 5 years, and I've lost an average of 1.5 Pounds per month, for a total of 90 pounds.

Pretty sustainable, considering I'm only keeping it up roughly 50% of the time.




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