The only effective treatment in the long run is gastric bypass.
And comparing the volume of people in different countries, usually US or wealthy China vs. France (my country) or Italy or Japan.
The difference is striking. It doesn't come from the fact that Americans or wealthy Chinese have some physiological problem: they just eat TONS of food and drink pure sugar (last one is for the US).
One should not look for fancy explanations when the evidence is there: people are more and more obese because they eat shitty food and drink sugar.
And do not talk me about "the poors who cannot afford anything else". We have poverty in France as well, and these people are not horrifically obese.
Chronic obesity means chronic overeating. Except for the infinitesimal minority wich was obese 100 years ago as well because of the weird gene. When they become obese, they are programmed to be even more obese. Or "big boned".
And like with everything in life, willpower moves you ahead in most cases. There is one genius for every 100 hard working people (with willpower) and 100 slackers (in the same demographics).
I cut by 1/3 to 1/2 what I was eating. I eat the same things, just less. And more fruit, and almost no sugar. Was it hard? Yes, to a point. Was it excruciating? No - I was just salivating while looking at a nice cake and my brain decided to say "no".
I still have a hamburger from time to time (say, every two weeks). It is European size.
My kid made a cake, I had two parts (even if it was awful, way too sugary).
I bike to the office because I love it, and play sports again. Just because I WANT TO.
Your comments are bordering on fat-shaming, which I find completely unacceptable.
First off: "Require" means what your body needs to sustain itself, which I would say is your TDEE. This changes when you gain weight or lose weight, or recomp.
Secondly: You can definitely "reprogram" when you get hungry, it only takes a few weeks.
> Losing weight by willpower in the short term just increases the signals to eat, and may cause weight gain in the long run.
This depends entirely on how you lose weight. As obesity (for the vast majority part, excluding thyroid and other physical problems) is a matter of habit, if you starve yourself from your usual diet for a few weeks in an attempt to reset your weight, of course you are going to relapse.
Temporary dieting can by definition never work. A diet is the habit of what you eat.
If you create the habit of eating like someone who weighs 50 kg less than you, you will start losing weight, fast at first, and then slower until it plateaus. I agree that not everyone is exactly the same, so basal metabolism between two similar people can vary a few hundred or so kcal/day.
Gastric bypass can in rare cases be necessary, but it's definitely a last resort, and unneeded in most cases.
You are a tiny sliver of consciousness on top of a vast, powerful machine. That machine gives you ideas, manages your body, and dictates your desires. Using conscious will power to try to overcome innate points of equilibrium in the system that is you, is extremely difficult in most cases. And in some cases it is impossible.
Neither of my parents worked out a day in their life, and neither did I until my late 20s. So I definitely understand the point of view of never learning good habits, but bad habits and not making choices are also a habit, even if you haven't realized an alternative.
Gastric bypass is not a silver bullet, it's a major surgery with a significant mortality rate and is always a last resort for the most severe cases who have at least made an effort.
The existence of large national trends also, to my mind, points away from individual failings. I find it hard to believe that the willpower of the average person has simply dropped off steeply over a few decades.
That's not at all correct. Success rates of weight loss by dieting are around 20%. That's still low, but you have to ask yourself: is it because people really can't control their diet long term, or is it because the majority of the population prefers the self serving narative of obesity genes and viruses, addiction engineered by the food industry, "the calorie myth", the intractable failure of willpower over body impulse, and so on? Because that sounds a lot like a self fulfilling prophecy.
Mind you, I'm grossly overweight (peak BMI 34, current 30), and I know full well the power of my body for mind control. A skinny person can't even imagine the fight every chubby faces on a daily basis. Yet, due to wining most battles, I've managed to lose some and not turn into the 500 Kg monster by body "demands" - I could easily eat 4-5000 calories on a daily basis, to great satisfaction.
> In reality, 97 percent of dieters regain everything they lost and then some within three years. Obesity research fails to reflect this truth because it rarely follows people for more than 18 months. This makes most weight-loss studies disingenuous at best and downright deceptive at worst.
I also think this article is interesting because it includes some personal testimony from a successful long-term dieter that I think illustrates why most people are not successful:
> Debra Sapp-Yarwood, a fiftysomething from Kansas City, Missouri, who’s studying to be a hospital chaplain, is one of the three percenters, the select few who have lost a chunk of weight and kept it off. She dropped 55 pounds 11 years ago, and maintains her new weight with a diet and exercise routine most people would find unsustainable: She eats 1,800 calories a day—no more than 200 in carbs—and has learned to put up with what she describes as “intrusive thoughts and food preoccupations.” She used to run for an hour a day, but after foot surgery she switched to her current routine: a 50-minute exercise video performed at twice the speed of the instructor, while wearing ankle weights and a weighted vest that add between 25 or 30 pounds to her small frame.
> “Maintaining weight loss is not a lifestyle,” she says. “It’s a job.” It’s a job that requires not just time, self-discipline, and energy—it also takes up a lot of mental real estate. People who maintain weight loss over the long term typically make it their top priority in life.
Still bad but not as bad.
It's also important to point out a strong self selection bias in such studies: we mostly deal with those who were overweight and needed to start a diet, so they probably had low impulse control to begin with. An important part of population with better control and similar cravings might have started their willpower exercise after gaining the first few pounds, it's disingenuous to discourage everybody using statistics applied to those who have a trackrecord of failure. If you gained weight by simply not caring about your weight (depression, cultural norms etc.) then you might stand a much better chance of success when you start to care.
The testimonial sounds like a clasic case of artificially lowered basal metabolic rate by crash dieting and associated loss of lean body mass. Such people need high resistance, mass building exercises, not catabolism-inducing aerobic. She might live a very long life tho.
Yes, the statistics of people in weight loss programs keeping their weight off is really low, but this could have many explanations:
* Are they included because they wanted a one-time solution to a permanent problem?
* Did they initially get coaching that they later lost?
* Did the changes they made temporarily not work for them personally in the long term?
Even if this is statistics of everyone that has ever tried losing weight, does it matter? Humans haven't evolved in the 50-100 years that obesity has exploded. This makes it conclusive that it can't be physiological, does it not?
So it could be culturally behavioral, as a society, or individual, and it's looking like the former, but does it matter?
What is more likely, that we as a culture fixes the obesity problem against any market forces pushing it, or that you die of obesity before that happens, unless you individually go against the grain of what is pushed upon you?
The only way to lose weight is to make changes you can see yourself living with for the rest of your life. This sounds heavy, but none of your reflex habits seem heavy to you, but might to someone else. That's exactly why thin people seem to have it so easy (which they do). They have had a healthy habit of exercise and limited portion sizes their entire life, so they don't even have to think about it.
You don't need exercise to lose weight, but you definitely need it to feel healthy. You need to find something you can either bare to do for the rest of your life, or best case enjoy doing. Soon enough it will be a habit you don't consider anyways.
Same goes for food. There is no trick to it, and not one diet that works for everyone (in terms of psychology). Some can do it by counting everything they put in their mouth. Some can do it by forcing them to sit down everytime they put something in their mouth (so you don't walk around and snack without realizing). Some just cut out any drink that isn't water. Some cut out any snacks that isn't their one absolute favorite. Some just eat once a day without regards to portion size. Etc etc etc. It is harsh, but no one else will do it for you. You don't have to do anything about it if you don't want to, but it's not productive to hide behind lies as to why you can't.
Otherwise it’s pure willpower (well technically being able to delay gratification) combined with healthy food. E.g start a meal with a raw brocoli and it’ll be physically difficult to put other things in your stomach after.
Yes it’s very hard but I did it myself, you always have to think I’m suffering now but I’ll be good looking one day (and yes it takes years)
Edit: though I understand that all people may not have the same capacity to delay gratification
Have them exercise, switch sugary soft drinks on refill with water and not eat the one pizza per day or something "they must have", replace that with filling but low calorie food if needed and see what happens
This excuse sounds like the excuses for why the US has more school shootings than every other country.