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by matheusmoreira·9h ago·view on hn ↗
> I don't believe that's possible.

You believe incorrectly.

> They're fat because they have ignored that advice for a long time.

Ah yes, the medical equivalent of "works on my machine".

You've now shifted from "how effective is this treatment" to "whose fault is it when the treatment doesn't work".

You will be able to help the fatties when you shift back into asking the question that matters.

1 comments
Well, the proposed solution works basically 100%, the problem is, as with most issues, people. Tell folks they should not eat sweet things for rest of their lives and half go catatonic when they realize reality of it. The other half go medicating such induced stress with a bucket of ice cream or similar. This is not problem of underlying solution per se, its the problem of expecting too much out of most people.

But you are right with the fact that at the end, it mostly doesn't work. But those who stick with regime, it works 100% and positive changes in life, quality, happiness etc are massive.

The real solution - treat underlying mental issues. They are always there with obese people, they are massive (no pun intended), and they manifest as obesity, among plethora of other mental issues.

> But those who stick with regime, it works 100%

No. Even nearly a decade of intensive behavioral treatment has highly variable results.

Here's what the numbers tend to look like in practice:

  ~26% weighed more than at baseline
  ~23% lost >0% to <5%
  ~23% lost 5% to <10%
  ~16% lost 10% to <15%
  ~11% lost ≥15%
As you can see, results cannot be guaranteed.

> positive changes in life, quality, happiness etc are massive

This is generally true. Eating better and exercising will improve your life.

But will you lose weight? How much weight? Those are far more difficult questions.

Then they didn't stick to it, simple as that. Eat less than you burn = lose weight. Unless they broke physics, in which case we should put them in a sterile room and study them
> we should put them in a sterile room and study them

We have.

https://news.ycombinator.com/item?id=49319339

> Body adapts significantly over time when subjected to weight loss.

> There are compensatory physiological adaptations that favor weight regain, such as changes in energy expenditure and appetite.

> Even with sustained effort, maintaining the initial weight loss may become progressively more difficult because of those changes.

> This shows up in research as results like mean weight loss of ~9% at year 1 and ~5% at year 8.

Frankly, a "solution" to a human problem that does not work with most humans, does not deserve to be called a solution.

Mental issues is a broad category as well. Are food cravings a "mental issue", or a "physiological/hormonal issue"? No clear difference between those two, and given how GLP-1s quench cravings in general - not just food cravings, plenty of people on those report losing their compulsive behaviors, even such as gambling or shopping - the hormonal variant sounds quite plausible.

Which may be actually good. We are a lot better in treating hormonal issues than mental issues.