Modern Scientific Controversies Part 4: The Obesity Epidemic

Guest Essay by Kip Hansen

 

Prologue:  This is the fourth in a series of  essays that will discuss ongoing scientific controversies, a specific type of which are often referred to in the science press and elsewhere as “Wars” – for instance, The Salt Wars.  This essay covers the Obesity Epidemic, aka The Obesity Wars.  The purpose of the series is to illuminate the similarities and differences involved in each of these wars.   Warning:  This is not a short essay.  Dig in when you have time to read a longer piece.

Trigger Warning:  This essay is about obesity – the condition of being fat or overweight.  It is about being overweight, body size, fatness;  it is about all the problems that accompany that condition.   If reading about these topics will cause you any emotional distress or make you feel unsafe or threatened in any way  – stop reading here.

Stephen Hawking is a very smart guy, a very very smart guy.  But like some smart guys in other fields, he can make very foolish statements based on ideas that are commonly believed but almost entirely inaccurate.

In a video produced by Gen-Pep, a Swedish non-profit organization “that works to spread knowledge and get people involved in promoting the health of children and young people”, Hawking made the following statements:

[Important Note:  Stephen Hawking, as you probably know, is and has been severely physically handicapped, suffering from ALS, and has been wheelchair bound since the late 1960s.  His experiences with diet and exercise are not, by necessity, the same as for you and me.   Neither human physiology nor human medicine are his fields of study.  I do not know why he was called upon to make this promotional video for Gen-Pep.]

Hawking starts off by saying: “At the moment, humanity faces a major challenge and millions of lives are in danger…”

“As a cosmologist I see the world as a whole and I’m here to address one of the most serious public health problems of the 21st century.”

“Today, too many people die from complications related to overweight and obesity.”

“We eat too much and move too little.”

“Fortunately, the solution is simple.”

“More physical activity and change in diet.”

When Hawking says these things he is simply repeating the official opinions of almost every major medical and health organization in the world:

The US Surgeon General:

“… the fundamental reason that our children are overweight is this: Too many children are eating too much and moving too little.

In some cases, solving the problem is as easy as turning off the television and keeping the lid on the cookie jar.”

The UK’s National Health Service:

“Obesity is generally caused by eating too much and moving too little.”

The UN’s World Health Organization:

“The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been:   

an increased intake of energy-dense foods that are high in fat;

and

an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.”

The National Institutes of Health tell us:

“What Causes Overweight and Obesity?

Lack of Energy Balance

Overweight and obesity happen over time when you take in more calories than you use.

An Inactive Lifestyle

People who are inactive are more likely to gain weight because they don’t burn the calories that they take in from food and drinks.” 

Of course, the NIH goes on to list the following as “other causes…”:

“Environment, Genes and Family History, Health Conditions, Medicines,  Emotional Factors,  Smoking,  Age,  Pregnancy and  Lack of Sleep”

Everyone knows that the causes of obesity are eating too much and not exercising enough.  All the major federal agencies, the United Nations,  and the learned societies agree.

So how is this a Modern Scientific Controversy?

Simple:  They are all wrong. Just how wrong are they on this issue?  Just how wrong is Stephen Hawking on this issue?

Almost entirely wrong.

Bruce Y. Lee, associated with the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health, was so concerned by Hawking’s  message that he was prompted to write an article for Forbes magazine titled “Stephen Hawking Is Right But Also Wrong About Obesity”.

Let me be perfectly clear:  The obesity epidemic is a major challenge for medical science and public health because, quite simply, we have almost no idea whatever as to the true cause(s) of the phenomena, or, in another sense, we have too many ideas about the cause(s) of obesity.

In fact, Gina Kolata, in the Health section of the NY Times, says that Dr. Frank Sacks, a professor of nutrition at Harvard,

“…likes to challenge his audience when he gives lectures on obesity.

“If you want to make a great discovery,” he tells them, figure out this: Why do some people lose 50 pounds on a diet while others on the same diet gain a few pounds?

Then he shows them data from a study he did that found exactly that effect.

Dr. Sacks’s challenge is a question at the center of obesity research today. Two people can have the same amount of excess weight, they can be the same age, the same socioeconomic class, the same race, the same gender. And yet a treatment that works for one will do nothing for the other.”

Dr. Lee Kaplan, director of the obesity, metabolism and nutrition institute at Massachusetts General Hospital, is quoted by Kolata as saying:

“It makes as much sense to insist there is one way to prevent all types of obesity — get rid of sugary sodas, clear the stores of junk foods, shun carbohydrates, eat breakfast, get more sleep — as it does to say you can avoid lung cancer by staying out of the sun, a strategy specific to skin cancer.”

But wait, what about our beloved Stephen Hawking’s “Fortunately, the solution is simple.  More physical activity and change in diet.”?  Well, frankly, that is not just wrong, that’s utter nonsense.

Dr. Kaplan and his associates have identified, so far, fifty-nine (59) different types of obesity.

Dr. Stephen O’Rahilly,   head of the department of clinical biochemistry and medicine at Cambridge University, and his group,  have identified 25 genes “with such powerful effects that if one is mutated, a person is pretty much guaranteed to become obese.”

Many of these genetic disorders are on the rare side, but Ruth Loos and her team at the Icahn School of Medicine at Mount Sinai, have other evidence – that any one of 300 different genes may be involved in the tendency to overweight, and that each gene can add to the effect of the others—add to the genetic propensity for overweight and obesity.  “It is more likely that people inherit a collection of genes, each of which predispose them to a small weight gain in the right environment….each may contribute just a few pounds but the effects add up in those who inherit a collection of them.”

There are more than three dozen available therapies (Dr. Kaplan claims to have 40 at his disposal) for overweight and obesity, and 15 different drugs.   Using them is guided by experience and plain old-fashioned trial-and-error.

Bariatric surgery, in which the size of the stomach is physically altered by various means, is a drastic last resort for the profoundly obese.

Only the last mentioned treatment, bariatric surgery, is universally successful at bringing about a major and permanent reduction in the body weight of the obese.

In June of 2013, the American Medical Association announced that it had classified obesity as a disease.  This event was covered by the NY Times – in the business–not science—section:

“The American Medical Association has officially recognized obesity as a disease, a move that could induce physicians to pay more attention to the condition and spur more insurers to pay for treatments.

In making the decision, delegates at the association’s annual meeting in Chicago overrode a recommendation against doing so by a committee that had studied the matter.

“Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” Dr. Patrice Harris, a member of the association’s board, said in a statement. She suggested the new definition would help in the fight against Type 2 diabetes and heart disease, which are linked to obesity.”

 “The vote of the A.M.A. House of Delegates went against the conclusions of the association’s Council on Science and Public Health, which had studied the issue over the last year. The council said that obesity should not be considered a disease mainly because the measure usually used to define obesity, the body mass index, is simplistic and flawed.”

The move by the AMA was hugely controversial within the medical community.  In fact, it prompted an editorial from the editors of the journal of the Australian Medical Association, Lee Stoner and Jon Cornwall,  titled “Did the American Medical Association make the correct decision classifying obesity as a disease?

“The American Medical Association (AMA) recently classified obesity a disease, defining obesity as having a Body Mass Index (BMI) measure above 30. This  decision went against the advice of its own Public Health and Science Committee, and has sparked widespread discontent and discussion amongst medical and healthcare communities. The fact that this classification has been made has potential ramifications for health care around the world, and many factors need to be considered in deciding whether the decision to make obesity a disease is in fact appropriate.”

“Are we classifying obesity correctly?

“Before considering whether obesity should be considered a disease, we must question the suitability of BMI as a rubric. The assumption is that the ratio between height and weight provides an index of body fatness. However, there is an imperfect association between BMI and body fatness, and BMI does not and cannot distinguish adipose type and distribution. While total body fat is important, studies have shown that central adiposity (e.g., visceral fat) poses a higher risk for developing disorders associated with obesity than overall body fatness. There are superior anthropometric indices of central adiposity, including waist-to-hip ratio, yet BMI continues to be the criterion owing to previous widespread and historical use despite its obvious shortcomings. Using the BMI tool, incorrect clinical categorisation of “overweight” or “obese” is common. Therefore, this editorial accepts that the AMA has selected an imperfect tool for classifying obesity, and will hereafter focus on the theoretical notion of obesity.”

“Undeniably, obesity is a risk factor associated with a clustering of complications, including hypertension, hypercholesterolemia, and type 2 diabetes, each of which independently and additively increase cardiovascular disease risk. However, obesity is exactly that—a risk factor. Being obese does not necessarily equate to poor health, despite the hormonal alterations that are associated with high body fat. Strong evidence has emerged suggesting that an adult may be “fat but fit”, and that being fat and fit is actually better than being lean and unfit.”

The Australian Medical Association’s editorial wraps up with this:

“Conclusion

Obesity has reached pandemic proportions, is strongly associated with myriad co-morbid complications, and is leading to a progressive economic and social burden. However, being obese does not necessarily equate to poor health, and evidence suggests individuals may be fat but fit. Perhaps most importantly, labelling obesity a disease may absolve personal responsibility and encourage a hands-off approach to health behaviour. This knowledge raises the question of morality, as individuals must now choose whether they will invest effort into maintaining a healthy lifestyle in order to free society of the healthcare burden associated with obesity. Given the myriad issues surrounding the decision to classify obesity in this way, perhaps a new question should be posed in order for society to continue this discussion: who benefits most from labelling obesity a disease?”

And what about a cure?  Is it possible, short of radical invasive surgery, to help an obese person permanently lose enough weight to become a normal weighted person?

If the learned societies, and Stephen Hawking, are correct  in stating that obesity is as simple as eating too much and exercising too little, then the obvious cure is to take obese people, feed them less and exercise them more.

Let’s go back and look at the results from Dr. Frank Sacks,  professor of nutrition at Harvard, and his study “Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates”.

Results

At 6 months, participants assigned to each diet had lost an average of 6 kg [13 lbs], which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to …[the four diets, ranging from 6 to 9 lbs]…Among the 80% of participants who completed the trial, the average weight loss was 4 kg [ 9 lbs]; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels.

 Digging in a little more, we find that:

“At 2 years, 31 to 37% of the participants had lost at least 5% of their initial body weight, 14 to 15% of the participants in each diet group had lost at least 10% of their initial weight, and 2 to 4% had lost 20 kg [45 lbs] or more (P>0.20 for the comparisons between diets).”

These are serious weight loss diets, closely supervised, with group and individual reinforcement sessions, for 2 years.  Only 2 to 4% of the participants lost truly substantial amounts of weight that would reclassify them as normal weight persons.   The rest of the participants lost those easy first 10-15 pounds in the first six months, but after a year, they began to regain their lost weight, despite staying on the diet and receiving group counseling, to end up with average loss, for 80% of the participants, of 9 pounds [4 kg], after two years of supervised dieting.

Let’s see what these results mean for those suffering from obesity:

bmi_chart

 I’ve added three colored dumbbells, showing just what a permanent 10% reduction in body weight means for three sample obese patients.  Two have managed to move from Morbidly Obese to Obese, and one is still Obese.  We have not considered the more extreme cases, which are not rare – persons weighing > 286 lbs.    You can picture for yourself what the loss of 9 lbs would represent for you or someone you know who is far too heavy.

The real finding is that under a strict diet, most people can generally (but not always) lose 10-15 pounds if they are supported by counseling (professional or family).  With care, these people can keep most of those extra pounds off.  This benefits those whom who (h/t jsuther2013) are classified Overweight, but not generally those that are truly Obese, who remain obese after this weight loss.   Nonetheless, medical bio-markers do improve even with these fairly small weight loses.  Whether this improvement in bio-markers adds up to improved health and longevity is not known.

It is important to note that the above chart is based on the metric BMI which is under serious doubt within the obesity research community.

25 genes guaranteed to make you obese; 300 genes that add to each other to pack on pounds; 56 different types of obesity; 15 drugs; 40 therapies; three or four surgical approaches…definitely not simple, Mr. Hawking.

But that’s not all.

Erin Fothergill’s “Biggest Loser” study found:

“In conclusion, we found that “The Biggest Loser” participants regained a substantial amount of their lost weight in the 6 years since the competition but overall were quite successful at long-term weight loss compared with other lifestyle interventions. Despite substantial weight regain, a large persistent metabolic adaptation was detected. Contrary to expectations, the degree of metabolic adaptation at the end of the competition was not associated with weight regain, but those with greater long-term weight loss also had greater ongoing metabolic slowing. Therefore, long-term weight loss requires vigilant combat against persistent metabolic adaptation that acts to proportionally counter ongoing efforts to reduce body weight.”

What this means is that a person’s body fights back against weight loss and adapts its base metabolic rate to burn fewer calories while resting in an apparent attempt to regain weight lost by dieting and thus maintain a set weight point under conditions of lower caloric intake.  This study was such big news that it is featured in the New York Times’ “Medical and Health News That Stuck With Us in 2016”.

Eleonora Ponterio and Lucio Gnessi, in their study “Adenovirus 36 and Obesity: An Overview” report that:

“…the data indicating a possible link between viral infection and obesity with a particular emphasis to the Adv36 will be reviewed.”

Thus, the Obesity Epidemic might be just that, an infectious epidemic.

In a study titled “Trim28 Haploinsufficiency Triggers Bi-stable Epigenetic Obesity”, Andrew Pospisilik and team found that there are titillating hints that epigentics may play a role in determining who is fat and who is lean, even when they generally share the same genes (closely related individuals) , or in the case of identical twins, exactly the same genes.

No, the obesity epidemic is far from Hawking’s,  “Fortunately, the solution is simple.” And the solution to obesity is orders of magnitude more complicated than  “More physical activity and change in diet.”    In fact, universally reliable solutions to the problem of obesity do not yet exist.

There is nothing clearer from obesity research than that the simplistic policies of the federal health agencies and the learned societies – all of which were summarized by Stephen Hawking —  “Eat Less & Exercise More” are totally inadequate to address the problem and are not based on scientific evidence.  The “Eat Less & Exercise More” policies include the war on sugar and the war on soda – they cannot and will not make a clinically important difference in public health.

Summary:

  1. The kernel of truth in obesity studies is that consuming more calories (food energy) than one expends can lead to weight gain–energy stored as fat.
  2. Reversing this does not lead to a remedy for obesity – eating less and exercising more is not a cure for obesity.
  3. The reality of the problem of obesity is vastly more complex and only vaguely understood at this time.
  4. Current public policy on obesity is almost universally based on #1 above, ignoring #2 and #3. Thus, this public policy – no matter how strenuously enforced through education, indoctrination, regulation of the food industry, punitive taxation, etc will not resolve the Obesity Epidemic.
  5. On a positive note, the recommendation that people “eat less and exercise more” will not hurt anyone [with the rare exception of the profoundly underweight, the  anorexic, etc] but, in general, will actually improve most people’s health even though it may have no effect whatever on their weight status.
  6. The Obesity Wars share the common feature seen in other modern scientific controversies —  public government agencies and scientific [and medical] associations forming a consensus behind a single solution, one known to be ineffective, to a complex problem – uniting in a broad effort to enforce the ineffective solution on the general public through regulations, laws, and mis-education. 

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Author’s Comment Policy: 

I have utilized only a tiny fraction of the information I have collected on this topic in the writing of this essay.  Readers familiar with the literature on the topic will notice this immediately.  This is not due to ignorance or laziness on my part – I have been constrained by the necessity of keeping the essay to a readable length, without unduly stretching the patience of you, my readers.

I realize that many readers here will want to move on immediately to discuss the Climate Wars – one of the distinctive science wars of our day.  I ask that you please try to restrain yourselves

The last essay in the series will be an attempt to lay out a coherent pattern of modern science wars and maybe suggest ways that the different science fields themselves can break these patterns and return their specific area of science back to the standards and practices that should exist in all scientific endeavors.

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419 thoughts on “Modern Scientific Controversies Part 4: The Obesity Epidemic

  1. BMI ignores muscle mass. I’m considered “overweight” at 5’7″ and 175 pounds, but the reality is that I have low body fat and plenty of muscle.

    • In general, the BMI index was created by desk jockeys for desk jockeys. After some time, some realized that BMI don’t apply for children, so there’s one index for them now too. BMI doesn’t include bone density/mass either. (The cAGW crew don’t bother about all important factors either. Only those which suits the propaganda …)

      I have came across some doctors that truly believes in BMI and they have been comfused, when told that there’s a number of people that don’t fit into idea of BMI. This include very short, very tall and athletic people.

      In many cases, it’s better to check for the existens of ‘love handles’.

      • “the body mass index, is simplistic and flawed.”

        Oh what a surprise ! You don’t need a degree in medicine to work that out.

        That’s about as dumb and simplistic as suggesting global mean temperature is determined by one factor like the atmospheric concentration of CO2.

        The trouble is they assume the rest of the population are complete morons and if they present us with more than one explanatory variable we will be confused, go into neurological melt down and end up in a corner sucking out thumbs and rocking back and forth uncontrollably.

      • Could be. In Sweden, it is common in some kind of business (like heavy industry), to buy services from private healthcare companies, to make sure that their employees has good health and find out if the working environment might cause anything. Those healthcare companies I’ve been in contact with, are very keen on using BMI as tool to present the results for their customers. For the company buing the service, it could be considered as an insurance, sort of, albeit deceptive in some cases.

        At the health checkup, when they are starting to talk about BMI, I present my view on the matter. As a result, they don’t bother to do any measures involved, as they know my arguments are true. I think that within the healthcare, they shouldn’t deal with something so inprecise/rough as BMI is.

      • HUH? Insurance is something that pays out when you are in trouble. BMI just says ” you’re fat sucker, your fault”.

        No, BMI is : dumb it down so the morons can follow us.

        CAGW is: we want to destroy capitalism but if we say so it ain’t gonna work, so we’ll say “carbon is bad, think of the children”.

        We have not quite worked out what we want instead but we’ll work on that one later.

      • One rarely-reported FACT not covered in this article is that BMI’s between 27 and 33 actually live LONGER, with lower morbidity and mortality than “normals” and the thin. This is what “the science” ACTUALLY proves, yet no one wants you to know this due to billions of dollars in the diet and gym markets not to mention the vested interests of the fashion industry. In other times, robustness was considered a sign of health and wealth. There are many (odd) social factors today driving the desire to appear emaciated in the midst of plenty. Ref: “The Obesity Myth” by Paul Campos. Bottom line: Medically, “obesity” is a very gentle risk factor until you hit the extremes; it’s actually far worse to be too thin.

      • Goldrider ==> And the Australian Medical Assoc. agrees with you….on this bit “Medically, “obesity” is a very gentle risk factor until you hit the extremes; it’s actually far worse to be too thin.”

    • ken
      Absolutely.
      I was, too.
      Older and plumper [and need to shed s little – a hundredweight, my doctors say – taking me to my weight at 13 – winning Borough Furlong sprint titles, then shot/discus hammer titles].
      That said, the simplistic ‘Eat less, Move more’ will help.
      Some folk. A bit. Much – not all – of the time. a Bit – sometimes.

      Auto

    • ken h
      I would say exactly the same. I’m 6 foot 1-2 and weigh around 100 kg, a little more after Christmas. I was athletic and did rowing in my early years and still run and work out occasionally and have muscle mass a little above average. On the chart I’m borderline overweight and obese, which is nonsense – I feel that I’m only borderline overweight. Or maybe global warming skeptics have heavier brains?

    • It ignores bone density as well. My bones are so dense that I am not a good candidate for chest x-rays for diagnosis of lung conditions, e.g. pneumonia (when I’ve had it). Two people of the same height, weight and gender could be drastically different in body appearance and composition based on their bones as well.

    • Indeed. One of the biggest problems in this “obesity epidemic” meme is the gross and consistent use of BMI as an indicator of obesity. It simply is not.

      BMI was intended for other medical purposes. To use it as an indicator of obesity is the worst kind of statistical abuse: trying to apply population averages to individuals. It is well-known that racial profiling is a bankrupt crime-fighting technique for this same reason. Population averages tell us close to nothing about any given individual.

      According to BMI, most serious bodybuilders are grossly obese; yet in fact they probably have far less body fat than your average person on the street.

    • It is indeed possible to exercise and diet and gain weight as you exchange low density fat for higher density muscle. However, the big problem is that no one addresses the fact that we are not suited for consuming carbohydrates every day. It was never meant to be a regular part of our diet let alone a major portion of out intake.

      We are 95+% carnivore and used to take large and small animals. Vegetables and fruits were only available in late summer and fall, and like bears, we would bulk up on carbos in the fall and put on fat for the winter. We are pre-disposed to produce fat from carbohydrates, which would be anything more than what it takes, in a a given meal, to top off our skin, muscle, and liver glycogen stores; the rest goes directly to fat. That is why carbo-landing the night before a major sports event was so stupid, producing only a mental advantage while the athletes themselves are fatter.

      Until we admit that we are carnivores and cut out the carbohydrates, obesity and heart disease will continue. It is the high glucose concentrations that irritate arterial linings, thus allowing entrance of small lipoproteins (small because they are low on cholesterol) which cause further irritation and atherosclerosis, aka heart disease. With a higher cholesterol intake and low carbohydrate intake, the irritation is avoided because the arterial lining is not irritated and the larger lipoproteins cannot enter. Atherosclerosis, if ti has not reached the scarring stage, is reversible. There is even the possibility that the normal hardening of the arteries that is expected with aging is not even normal but an artifact of our messed up diet. Blood pressure does not have to go up as we age.

      • I forgot to mention that polyunsaturated oils are also a negative as they are oxidation risks and much harder to metabolize. Saturated fats and cholesterol are completely normal and good for us. Males with higher cholesterol tend to live longer. One reason cholesterol rises in many people is the bodies effort to heal itself, Instead, we give people liver toxins to prevent the body from making the cholesterol it so desires. Statin drugs have not decreased heart disease at all but do increase liver failure and liver cancer. So, why are they pushing these drugs? It’s a billion dollar industry, that’s why. They are even making noises that we should put children on statins, basically just to sell more drugs.

      • Human teeth, digestive tract and digestive enzymes are no way made for being 95% a carnivore. Carnivores have short intestines, big canine teeth and their molars aren’t made for doing lots of grinding chewing. Note the diet of the most similar creature to humans, the chimpanzee – they eat mostly fruits and nuts but they are occasionally predators. What humans are not made for is being sedentary.

      • Exactly. The last few years have seen the bio-chemists complete all the chemical reactions of the metabolic cycle literally from end to end. The Governments diet promote low-fat, low protein which means a high-carb diet. The thumbnail process is
        1. eat carbs;
        2. carbs are immediately converted to sugar;
        3. sugars cannot be “eaten” by the cells directly
        4. the body produces insulin to bind with the carbs, also almost immediately
        5. the cells bind with insulin which is the pathway for sugars into the cell
        6. eat more carbs, get more insulin.
        7. the cells can only use so much energy, (insulin resistance)
        8. more insulin is produced (sugars are really bad in the body)
        9. the sugars, not able to be used by the cells, are shoved into the fat cells.
        10. continue overeating carbs and you get profound insulin resistance which produces more fat.
        11. the fat accumulates in the cells around the belly — obesity
        You can walk around Walmart and pick out the folks that have insulin resistance. Most do.
        Insulin resistance (used to be called metabolic syndrome) is the precursor to obesity AND heart disease. Obesity is the precursor to type II diabetes.

        In a nutshell, its all about the diet. Oh, and most fats are just fine. It’s the trans-fats that are really bad. If you want to live without obesity, the solution is changing to diets that are high-fat, low carb. Even with very little exercise you’ll avoid obesity. Eat eggs,dairy products, olive oils, butter and protein and reduce as much as you can the carbs (SUGAR) that you eat. For example, if you eat a “healthy bagel” with a fruit jam you’ve just consumed over 100 grams of sugar (carbs convert directly to sugar). It’s like eating 4 or 5 teaspoons of table sugar.

        Do internet searches on insulin resistance and diet. You can start with chemist Ivor Cummins for example:
        https://www.youtube.com/watch?v=UZoQiDaWnuE start at 5:35
        (longer one https://www.youtube.com/watch?v=fuj6nxCDBZ0 )

        It’s really simple — stop eating sugar (carbs and table sugars) by limiting carbs to less than 100 grams a day. Search the net for high-fat, low carb diet sites (example dietdoctor.com).

      • Excess calories in any form make you fat, and pets get overweight on carb-free diets and get diabetes. It is helpful to read the Wikipedia articles on insulin and Diabetes mellitus type 2 – I consider that more credible than explanations by those saying eating over 100 grams of carbs a day is bad. Look at how much low carb diets are and have been promoted; there’s money behind that. Even grain farmers make more money if you eat more meat and poultry and less grain. I remember one saying that went around, obviously promoted by those who want us to eat more meat/poultry, is: “Carbs are what food eats.”

    • This essay says nothing about the real controversy – about good quality research that challenges the dietary dogma about saturated fats and cholesterol, calories, polyunsaturated oils, “healthy” whole grains etc.

      There are excellent books about this: Gary Taubes’ “Good calories, bad calories”, Nina Teichholz’s “The big fat surprise”, to name just two.

    • I remember one of the members of the Athletic team, having skinfold measurements done as part of physical education. The result of this measurement was the was ‘Obese.’ He was one of the champion athletes. This caused me to research BMI and skinfold measurements, and decide not to worry about them
      too much. Just eat healthy and keep fit, and not worry about them too much.

      At the medical clinic that I have attended, they will weigh people dressed in full winter layers, then come up with the result that they need to loose weight. Funny how you weigh more in the winter, dressed in lots of clothing.

      Does anyone here have any thoughts about the composition of flour in Eastern Europe versus the United States. I notice on my last trip to Ukraine I ate a lot, but did not put on weight, which surprised me. I ate a lot of carbohydrates which I tend to avoid in the United States, as I put on weight when I eat them.

      • Isn’t Roundup (Glyphosate) outlawed in Europe? If it is, and the farmers in Europe aren’t using it as a pre-harvest dessicant on their wheat, then that would be one big difference. Since that chemical is especially harmful to beneficial bacteria, avoiding it can help you maintain a healthier balance in your gut flora. So, avoiding that chemical can help you maintain a healthier weight (and avoid obesity).

        I’d like to know if Europe uses chloramine in their tap water, like the US started doing in 2010 as a result of rule changes dictated by the EPA.

    • Goldrider wrote, ‘Medically, “obesity” is a very gentle risk factor until you hit the extremes; it’s actually far worse to be too thin.’
      But isn’t that because the thin have a high % of individuals who smoke or are already ill. If you remove the smokers and the already ill, the ideal weight group- 10% below normal- has greater longevity than the healthy overweight cohort.

    • “The kernel of truth in obesity studies is that consuming more calories (food energy) than one expends can lead to weight gain–energy stored as fat.”

      This is exactly wrong. Caloric imbalance is not the proper explanation. Obesity is a hormonal disease related to insulin. Without going any further, I’m passing along those links concerning Dr. Jason Fung, a Canadian kidney specialist who, along with other doctors and researchers, is leading a paradigm shift in the understanding of obesity and its corollary, diabetes.

      His web site:

      https://intensivedietarymanagement.com/

      The book he has recently published on the subject : The Obesity Code

      https://www.amazon.com/Obesity-Code-Unlocking-Secrets-Weight/dp/1771641258/ref=sr_1_1?s=books&ie=UTF8&qid=1482197698&sr=1-1&keywords=obesity+code

    • I got a good laugh from my doctor who said my BMI showed I was overweight as well. I’m also 5’7″ and weigh about 165-168 (depending), 57 years old and am an avid surfer, even in NY winters! He calls me one of his most healthful 57 year olds he knows due to other factors; low cholesterol, low blood pressure, low pulse and resting heartbeat. Should I lose the 3-5 lbs to get me into the “normal” range based on some good-two shoes bogus studies and conclusions? I think not…

  2. If alarmists really wanted to reduce CO2 emissions, they would push cycling, which would have the added benefit of giving people exercise and being part of the solution to several problems at once. This is one of the many reasons that I doubt the theory of Catastrophic Anthropogenic Climate Change.

    • a bicycling human emits alot more CO2 than a sedentary human (or in the state preferred by the warmists, dead)

    • Cameron…

      If Global Warming scientists were really smart they would spin this obesity epidemic into 24k gold by making the claim that increasing CO2 levels have in fact created the obesity epidemic.

      It goes like this…

      Increasing global temperatures due to CO2 emissions have decreased the amount of calories needed to keep our bodies warm. We then store those unburnt calories as fat which the graph below proves is causing this epidemic.

      Notice the major obesity increase after the 1970’s cold snap followed by the decrease when “the pause” began around the year 2000? The science is now IN and the debate is OVER. I will not be answering any further questions from any obesity deniers.

      Willing to perform more Global Warming science for $$$. Call me.

    • I cycled for years and wore all the protective kit including padded shorts and the best designed seats that my money could buy. Despite these precautions I ended up with numbness, incontinence and erectile dysfunction.So I hung up my bicycle clips and went back to walking but the damage to my perinium was done! Now I am no good to either myself or any adventurous partner I could ever find!

      • I rode a bike to school every day for twelve years and it did me no harm at all. But Lycra and Spandex hadn’t been invented in those days.

      • The data show US all-age cycling participation fell from 56,308,000 in 1995 to 39,300,000 in 2012, a reduction of 17,008,000 or 30.2%. Most of the reduction was among <17yo although it extended to <30yo. 6-17yo participation dropped from 17,401,000 in 2006 to 12,397,000 in 2012, less and less kids enjoying one of the most regular forms of recreational fun during their bodies' formative years. Bicycle helmet laws/parental/school coercion are the main reasons for the decline. Similar results with all-age national helmet laws in Australia, the world's second-fattest country after the US.

        I agree with half of Hawking's opinion. Reduced exercise isn't just sitting in a car, it's also sitting instead of standing up to change TV channels, pushing a button to dry clothes instead of hanging them on a line, having a petrol mower instead of having to push hard to make the blades turn, microwaving instead of chopping wood, etc, etc. Even using a manual typewriter required more Olympic toil for your fingers and arms than lightly tapping a modern computer keyboard. Thanks to technology, it's the lack of minute by minute necessities of staying alive that have created most of the sedentary lifestyle and resultant obesity. TV and the web are big contributors.

        I don't agree that diet is a big part. The high sugar, high cholesterol, etc, arguments nowadays seem to pretend that in granny's day, everyday ate lettuce with low-fat yoghurt. You couldn't even buy yoghurt when I was a kid, let alone low-fat, and nowadays just about every product is low something or other instead of the olden days product with no choice but full cream, full sugar, full fat everything. Do people believe Coca Cola and burgers in the 1950s were made from water with a colour additive and full grain bread with lean veal cooked on extra virgin olive oil? Or that nobody drank Coke or ate burgers or ate too much?

      • Consider how the size of the Coke bottle has evolved since the 1950s. There was a time when a usual Coke bottle had 8 fluid ounces of Coke. Sometime in the 1960s it was 12. Sometime in the 1970s Pepsi increased the size of their usual single serving bottle from 12 to 16 fluid ounces and Coke did likewise at a similar time. Sometime in the 1990s the usual soda bottle size increased from 16 to 20 fluid ounces. And sometime after 2000 one of the two big cola companies tried to make 24 fluid ounces their usual, but that did not catch on, and 20 fluid ounces is still the current usual size.

        [The mods note (with distein) that the average size of the typical US beer bottle has remained at 12 fl ounces through this entire period of both anecdotal, analog and digital satellite-surveillance record. Worse, in these inflationary times, the typical six-pack remains limited to … six. .mod]

      • There is another war: the war against saturated fats. It must have caused numerous deaths, because now they say that the polyunsaturated fats are bad for you and can cause heart disease. These PUF fats may even lead to obesity, who knows.

      • Many studies on fat saturation and/or animal-vs-vegetable oil and heart disease that were done after partial hydrogenation of vegetable oils became common (for shortenings and margarine) did not distinguish trans fats (from partial hydrogenation) from other unsaturated fats. An unsaturated fatty acid molecule whose double bonds (unsaturations) are all trans-aligned has physical properties like those of a saturated one of the same carbon atom count, but it has higher presence in the bloodstream for a given intake rate because one of the two main fat metabolism mechanisms in the human body chokes on the trans-aligned double bond.

  3. This is the topic that introduced me to the fact that scientists lie or mislead in their studies. The conclusions they write do not represent the actual data in their results, and studies are designed to prove one diet is better than the other – amusingly, even when weighted against its favour, diets not considered acceptable by the establishment (e.g. fasting or low carb) always did better than the recommended low-fat calorie restricted diet. As a result of having my eyes opened, I realised that scientific fraud exists elsewhere, which eventually lead me to here.

  4. Did this really need a “trigger warning ” ?
    Isn’t it about time people locks on their “triggers” ? It would be better for all of us.

    • Logoswrench ==> Provided, as they say, tongue-in-cheek, in case any university students are reading here…wouldn’t want to upset the more sensitive of the little dears.

      • “Provided, as they say, tongue-in-cheek, in case any university students are reading here…wouldn’t want to upset the more sensitive of the little dears.”

        Given your willingness to open your eyes to deceptive memes, I think it’s about time that you and others open your eyes to the reality about safe spaces: they’re largely effected by ADULTS for a relatively small subset of the young people that adults manipulate. Most young people, including college students are every bit as sick and tired of the nonsense as older people are; even moreso, because they have to live with ignorant people pointing fingers at them for being “snowflakes”. Try immersing yourself in young people’s worlds and not the bogus media representations of them. Indeed: while people around here are willing to see that climate panic is really a relatively small group of people who don’t represent the majority, the same holds true for young people.

      • I really enjoyed your remarks.

        It is unfortunate to see any one condemn the Digital Natives for what the Digital Natives are being put through in the educational system, and through extreme online SJW badgering. Or for being institutionalized, drugged and a little overweight.

        It is very difficult. But the Millenials are maybe going to surprise every one! Thank you for your comment, it was well-made and perfect timing.

      • brainfan ==> The state of the student bodies of American universities is one of my interests, which I follow pretty closely, including personal communication with professors at various campuses of SUNY.

        The professors that I know do not share your view that the “safe space”, “trigger warning”, et al can be characterized as “they’re largely effected by ADULTS for a relatively small subset of the young people that adults manipulate.” In their experience, this whole leaning towards wanting to be spared exposure to other viewpoints, contrary opinions, etc is ubiquitous and destructive of the university learning process.

  5. I don’t buy into the “weight loss is way more complicated than Hawking says” stuff.

    Here’s the way one thing we know for sure about weight loss: If your energy intake is less than your energy expenditure, then the energy stores in your body must decrease.

    I grant you, achieving a state of energy deficit can be difficult and complicated for some, and many factors figure into it. But everything ultimately answers to basic thermodynamics, and there’s no getting around that no matter how much people try to obfuscate.

    • It is definitely way more complicated, because the body is loaded with feedback loops. Decreased energy intake for a prolonged period leads to a change in metabolic rate, lowering the draw on energy stores. Different macronutrient profiles affect hormones differently, which in turn affect the whole process.

      When I was experimenting with low-carb diets back in the 90s, at the instigation of someone who claimed they only worked because they naturally decreased calorie intake, I decided to see just how far I could increase calorie intake before weight loss stopped. It took increasing it to around 2200-2300 calories/day before weight loss ceased (I was keeping strict logs and weighing my food, so any inaccuracies would have been “on-the-box errors” or due to “box-to-box” variations in food nutritional content).

      I then decided to test whether a traditional low-fat high-complex-carb diet would flatline at the same calorie intake as long as I kept up a consistent activity level. Not even close. I had to drop to 1600-1700 calories before weight gain stopped. Stepping up the activity level (i.e., increasing both workout time and perceived exertion level) let me increase calories to around 1800-1900/day without gaining,. So – at that point I was eating less (calorie-wise) and exercising more than I was at my low-carb stable point, but my weight was not going down.

      • No, it’s not more complicated.

        The law I stated is true. There are no ifs, ands, ors, buts, or exceptions. It holds. Period. The existence of feedback loops does not override it.

        Feedback loops can be a factor when trying to achieve an energy deficit over a prolonged period, but that in no way negates the fact that what we are trying to do is achieve an energy deficit.

        Every sensible discussion of weight loss should begin by acknowledging this basic fact.

      • Being picky …

        2200-2300 calories are not much at all. I assume you ment 2200-2300 kilo calories. Even some diet ‘experts’ don’t know the difference …

        What kind of exercise matter and how it is performed, if you would like to loose some weight. Plain walking (in the same pace and flat ground) will generate some effect intially but not later, as the body becomes more efficient and adapted to the work load. The key is alternated exercises, then the body (simply put) has to change strategy and prepare ‘for worse’. As a bonus, it becomes more fun, compared to basically doing the same thing over and over again. Exercises with walk and/or jogg in hilly terrain (avoid asphalt and concrete!), cycling and swimming, all with various pace will fix it (Not close to or at max though …)

      • I’ve done fasting ( real, water only fasting ) for ten days, a couple of times and I can guarantee that you lose both fat and muscle mass fairly rapidly: at around a pound day.

        After about 48h the body starts digesting stored fat instead of sugars for energy ( a process called ketosis ) and reabsorbs muscle to fulfil basic protein requirements. Your breath starts to smell of acetone, a by-product of ketosis.

        There is a lot of fairly complex biochemistry involved in fat digestion, stockage and reuse. Many of the processes involved in reuse of stored fat involve a number of B vitamins. Several of these B vitamins are stored in the liver. Older people often suffer from a lack of these “vitamins” : vital amino acids. They are ‘vital’ , although we often forget or are ignorant of the origin of the word vitamin.

        Poor diet has a lot to do with problems of reabsorbing body fat. If you do not have the B’s to make the chemistry work you are going to remain fat and feel hungry.

        Most major world religions include a fasting tradition, though it is often corrupted to the point of being worthless or even counter productive.

        Starving yourself of food and water for 12h in a hot climate and then stuffing yourself after dark is probably one of the worst ways to eat.

        The Christian fast of ‘lent’ has now become a farce that rarely goes beyond eating a few pancakes after buying an extra box of battery farmed eggs at the supermarket and then buying lots of chocolate “easter eggs” available well before Easter.

        One of the most interesting things about fasting is re-evaluating how we think about food: realising the much of the time we “fancy something to eat” more than being driven by real hunger.

        The weirdest thing about fasting is that the hunger, rather than getting progressively more intense, goes away after a couple of days. After 7 days of nothing but water, I was quite happy to sit down with a table to 30 people full of delicious home-made food, wine, deserts without being tempted to break the fast of frustrated by having all that under my nose.

        I could linger while passing a pizza shop and ‘feast’ on the aroma, getting more pleasure than have bought one. Animal instincts are heightened when the body lacks food.

        People in India and Africa probably understand all of this from an early age but in the developed world we think it pretty tough if we eat a couple of hours late. THAT is why we are FAT and die of cancer.

        Bottom line, if you can avoid manual labour for a couple of weeks, try fasting. It is an enlightening experiment.

      • SasjaL – I know it’s technically kilocalories, but I learned it as calories so that’s what I call it. It’s not the only measure that has different meanings in different contexts.

        Killer Marmot – if we’re not trying to achieve an energy deficit, what’s the point of the discussion? It’s great to say:

        Weight reduction (in kCal equivalent) = Energy output (in kCal) – energy intake (in kCal)

        but when the same food intake results in different kCal intakes for different people (or even for the same person at different times in their life) and the same activity similarly can result in different kCal outputs, you have no way to effectively build upon it. The fact that it is true does not mean that it is at all useful for the desired purpose.

    • The physics of energy balance is of course true, but ignores the biology – investigate basal metabolic rate which, as a sort of thermostat, regulates energy spent at rest.

      • Biology does not in any way change the veracity of what I said. Biology might interfere with someone achieving a calorie deficit, but that is a different matter.

      • Killer Marmot, You don’t seem to be accounting for the biological processes involved. Insulin regulates body fat. Type I diabetics (before the discovery of injectable insulin) had extremely high blood sugar and were extremely thin, even if they ate a lot. Insulin regulates blood sugar by shunting it to adipose tissues. In a healthy body, insulin is produced in response to elevated blood glucose levels driven by the consumption of carbohydrates. Extremely high blood glucose levels would result in urine being high in sugar.

        http://www.cailsilorin.com/treatment-for-type-1-diabetes-before-insulin/

        That is just one example. Calories in/calories out is a tremendously oversimplified model for human metabolism.

        I’ve also seen research on Zinc-Alpha 2 glycoprotein, another part of the hormone signaling system. If you have high levels, you are thin. Low levels, you are fat. Inject it in obese mice and they lose 30% of their body fat over a period of weeks.

        http://www.neuromics.com/ittrium/visit/A1x66x1y1x85b0x1x9dy1x799x1y1x6223x1x82y1x6b02x1x7f

        All calories are not created the same (we are not bunsen burners) and bodies vary in how they partition the calories consumed. Some store more than others. Some burn it off.

    • Killer ==> Unfortunately, obesity research has found that, despite the veracity of the Kernel of Truth you provide, “Eat Less, Exercise More” — the logical solution derived from that true fact — does not work for most people — because obesity is far more complex.

      It is true that people can be starved and worked into losing weight — your average gulag or concentration camp is a fine example. However, that kind of weight reduction does not make people healthier.

      The “Biggest Loser” study shows why that kind of weight loss is not reliable as, for most people, a permanent solution.

      There are always exceptions, some 2-4% of obese persons can drastically reduce their weight by radically low calorie diets and lots of exercise.

      An approach that only really benefits 2-4% of the sufferers of a condition cannot be considered a cure–and certainly cannot be considered sensible public health policy.

      • It is not a “kernal of truth”. It is the fundamental law of weight loss. It forms the rock-solid foundation of any successful weight loss scheme.

        As I said, achieving an energy deficit can be difficult and there are many factors that go into that, but we must not be so distracted by that as to lose sight as to what weight loss is fundamentally about.

      • “because obesity is far more complex.”
        As an example, I was of “normal’ weight before about 45 years of age then instead of having a full-to-the-point-of-nausea feeling at about 3/4 of that hamburger, began to lose that sensation and found that, if I wanted, I could enjoy two. Some years and ~30 lbs later I tried a high protein Atkins diet which was very effective @3/4 lb a day and after dropping off took about 6 months to regain the weight, primarily because I (think) that I missed sweets so much. That sensation shift is to the point that I want to “taste” food or a snack at the mere visual of food (TV ads are the worst). Would be great if those smart researchers knew what caused the re-set and how to correct it and perhaps this issue is a major part of those that are naturally obese.

      • Killer Marmot, Thermodynamics applies to actual energy, not weight reduction. We mislead ourselves by saying that we turn fat into energy when exercising. How much energy is represented by 20 pounds of fat? How many cities could be levelled by that much energy?

        It’s about chemical processes, not energy per se, and the numbers aren’t as straight forward as you might think.

      • Killer Marmot is absolutely right, it may be tasteless but true, there was no obese prisoner liberated from concentration camps.

    • I’ve been experimenting with a low carb, high fat diet for the last 6 months for the purpose of energy efficiency for long distance running (as opposed to weight loss) and have been fascinated by the multitude of simultaneous interrelationships between energy storage and energy production depending on food source and activity levels. Even a cursory examination of how energy is stored and produced under different conditions in the body ought to convince someone that there is no “one size fits all” answer to obesity.

      The oversimplified “take in fewer calories than you burn” is a little like saying the only thing you have to do to become a billionaire is take in more money each year than you spend! True in principal but the specifics are just as complicated as the body’s glycogen production and use.

      • “take in fewer calories than you burn” is not oversimplified. If you do this over a long period of time you will lose weight — guaranteed. It is how you achieve weight loss.

        Achieving a calorie deficit can be difficult and call in many factors, but you are allowing this to distract you from the basic simplicity of what you are trying to achieve.

      • There is no “one size fits allow” scheme to achieving an energy deficit. I never said different.

        But every successful weight loss program depends on producing a prolonged energy deficit. This is the common denominator that fits — and reduces — all sizes.

        Hawking went straight to the core of the matter, as he should.

      • If you want to lose weight effectively and feel good have a relentless focus on reducing carbs and sugar as much as possible.
        The “high fat” add-on to low carbs diets is a distraction. Focus on the carb/sugar reduction, eat more vegetables and keep fats to reasonable levels.
        If you are interested, Dr Tim Noakes describes the carb diet issues quite well in scientific terms; https://youtu.be/fL5-9ZxamXc

    • Here’s the way one thing we know for sure about weight loss: If your energy intake is less than your energy expenditure, then the energy stores in your body must decrease.

      Agree, plain and simple physics. I have a number of years of experience as an athletics coach and have seen what exercise can do to children with overweight.

      Looking at the human history, it is easy to see that we are made for moving around and not to sit. This worked fine, when we still were ‘hunters and collectors’. Due to technological development, in many cases, humans has become lazy. It’s about loosing that bad habit …

      The main problem usally isn’t to loose weight. It’s to keep it. With high quality food in decent amount and continues execise, that’s possible.

    • Can’t beat thermodynamics. A pound of fat is 3500 Calories, be it butter or body fat. An hour of serious bicycling is only 500 – 700 Calories. “Nothing tastes as good as fit feels.”

      I just spent three hours, in three one hour increments, shoveling 1500 cubic feet of snow, one foot deep on 1500 square feet of my driveway.

      • Sounds like global warming would cause you to be obese!
        Yeah, yeah! I know, Killer. Energy balance, energy balance!

      • Here’s a related metaphor: neighbors all received lots of snow on their yards, many started shoveling. One also erected tarps shielding the sky, thinking: less snow in – more snow out. Another did nothing, not even shoveling. Along came spring. In the end of course only the tarped yard had any snow.

      • Too simplistic. I’m 5’11” and weigh 250 pounds. Technically, I am “morbidly obese,” but mainly it just looks like I am overweight. My goal (endocrinological treatment and body-building exercise) is to lose 50 pounds, at which point I will look like a killer…but I will still be “obese” by the conventional standard. I have a strong interest in understanding all this, and I am totally convinced that carbohydrates are my most serious enemy. I concentrate on eating proteins, vegetables, and fruit (particularly those high in anti-oxidants). Is that a panacea? No proof, no argument, but I am at least trying to put Satan (carbs) behind me.

        But, energy balance means nothing unless the fat is metabolically available. Carbs go in and the sugars convert to fat. Then what? If there is no hormonal or metabolic means of engaging the body’s mechanisms to burn the fat, then the fat might as well be a lead suit that you have to wear around. All the exercise in the world will do nothing to lighten the lead suit. You just wind up burning your own muscle mass. (The emaciated survivors of concentration camps are not just without fat, they are also without muscle.) So far, with a limited campaign of body-building (60-hour work week is also my enemy), I have lost 5 pounds. A pipsqueak amount, but, hey, I am grateful for whatever I can do to go in the right direction. (Especially since my wife seems to notice and approve of the slight changes.)

        I suspect that the key lies in the metabolic pathways facilitated by the endocrine system. it doesn’t take much for that system to go out of whack, and not every endocrinologist is capable of looking at the facts with clear eyes. Someone in the thread above commented on how the body makes cholesterol in order to help the rest of the body, but conventional medicine looks at that situation and knee-jerks right into a Lipitor prescription. Bad idea. Bad side effects. Poor medical motivation. Huge profit motive (I have read that Lipitor is the largest-selling drug in the world…not merely the largest-selling cholesterol-control drug, but THE LARGEST-SELLING DRUG.) No consideration of the question: Why is your body making all this cholesterol? Is it needed? What are you lacking? As a result, I have been concentrating on anti-inflammatory and anti-oxidant strategies. Inflamed blood vessels + cholesterol = plaque. Conventional medicine says “no cholesterol.” I say “no inflammation, thank you very much.” But do I shoot my cardiologist? Not today.

    • Don’t expect much support here. You won’t find it. I fully agree with you. I have been diabetic nearly 45 years. I can gain or lose weight at will because I understand how food works. While it’s true that too many episodes of low blood can lead to weight gain (I’m brittle), I adjust the insulin and food to allow the loss of that weight.

      Examples here often talk about “testing the latest diet”, but that’s not a good way to find out how to lose weight. If you figure out how much a person eats, teach them about calories, find out their exercise level, etc, you can actually tailor a weight loss plan that will work. Their food tastes and lifestyle have to be kept in mind. You cannot, of course, make them follow it, but it will work if they do. Energy intake versus usage is what determines weight.

    • I agree. Look at school photos from before the 70s. Everybody is thin by today’s standards. After 2000, many if not most are fat. There weren’t 300 genetic changes to people over that time. Something simple happened. Dare I guess, television and video games.

    • One of the problems with those who are “making it more complex” is what other people do with the complexity: use it as an excuse for not being able to lose weight or keep it off instead of even trying. But that doesn’t negate the reality that there ARE biological processes that impact what happens to various nutrients in various people. You’re right that a calorie reduction WILL result in some level of either weight loss or less weight gain. However, your charactization of it being strictly a matter of energy input/output ignores the existence of variations in energy use such as efficiency. For a simple example, you can have two vehicles with the same weights and engines sizes that have different fuel efficiencies based on how they’re designed to make use of the fuel.

      • No, it does not ignore that reality. What you are referring to determines how much gas is required to go from point a to point b. If vehicle 1 takes 15 gallons and you only put in 10, you end up walking. If you put in 20, you have left over. If vehicle 2 takes 10 gallons and you put in 8, you end up walking. If you put in 20, you can make the trip twice. If you put in too little, you walk. Extra, you can drive further. Same with weight. If a person burns 2000 calories a day—irregardless of WHY—and eats 2500, they gain weight. If they eat 1500, they lose weight.

    • Killer Marmot. Sure. But it seems fair to presume other things by the same token:

      Thermodynamics doesn’t address hormesis and other biological processes, because human natural selection is unfavourable to individuals whose metabolism operates like a combustion engine.

      Powers should be exercised as close to the citizen as possible. This topic must be kept far from obfuscating bodies, most notably political round tables.

  6. This is definitely a field with a large number of very confident statements by advocates that have no basis in reality. There is also a great deal of preaching.
    Unreal standards are at least one part of the issue. I have been rather thin as an adult, but by the BMI standards, I have been “overweight” most of the time.
    Another thing is the advocacy of unproven theories, like Ancel Keyes and the low fat is healthy theme, despite a lack of evidence to support them.

      • I had already seen the Kolata article, and the Sachs study seems conclude that there is no magic diet. I lived with a woman who was obese, and she resented that I ate much more than she did, and had no problem maintaining a stable weight. I was fat as a kid, so I can get interested in the why of weight gain. In the past ten years, I have been on a drug that induced a 30 pound weight gain, that took most of a year to overcome partly (I started out underweight, so it was a matter of losing 20 of it).

      • Tom Halla ==> Yes, there are many studies in the obesity field that add up to: “Obese people and normal weight people eat the same diet – same foods, same quantities.”

      • Which agrees with anything I have read that I took seriously (i. e. was not trying to sell a magic diet) and my family and personal experience. My sisters and mother were all about the same height, but never within 20 pounds of each other as adults.

    • Among my friends, the one who was most successful with weight loss did so to avoid a second heart attack. He started exercising more and he reduced his calorie intake, mostly his fat calorie intake. (He never was a soda drinker, so he could not reduce his soda intake.) That worked well because a gram of fat has 9 calories, while a gram of carb (other than fiber) or protein has 4 calories. His cardiologist says that because of this along with a statin, he cut his total cholesterol and his triglycerides almost in half and increased his good cholesterol – a much better blood profile outcome than his cardiologist’s other patients who did not make much change in diet or exercise.

  7. Calorie restriction is the only known way to move anyone from being obese to being overweight and from being overweight to being of normal weight.

    Calorie restriction — reducing calorie intake from the calorie intake needed to maintain current resting body weight is the only known way to go from obesity to normal weight.

    Kip Hansen simply is wrong.

    • I think Kip is a bit of a porker and has been ‘triggered’…got all sarky started firing off his little arrows at people ==>

      • charles nelson ==> and you’d be wrong — perfectly normal weight for my height and age, have been all my life.

    • pjissocal ==> You are entitled to an opinion, but if you wish to make an argument for that viewpoint, you will have to find someway to dispute the vast majority of the scientific obesity literature.

    • Calorie restriction is the only known way to move anyone from being obese to being overweight and from being overweight to being of normal weight.

      Calorie restriction — reducing calorie intake from the calorie intake needed to maintain current resting body weight is the only known way to go from obesity to normal weight.

      You, sir, are wrong. Calorie restriction is one factor, not the only factor. Weight loss is a result of negative net energy balance, i.e. more calories being used up than taken in.

      Think of your bank balance as a reverse analogue (good and bad are reversed). You can decrease your bank balance by spending more than you deposit from your paycheque. A lower -paying job (reduced calorie intake) has the same effect as a higher spending (higher metabolism) rate. I.e. they both act to reduce your bank balance (weight). Similarly weight loss can be induced by any combination of reduced calorie intake, or increased calorie burning.

      As pointed out in mstickles’ comment https://wattsupwiththat.com/2016/12/17/modern-scientific-controversies-part-4-the-obesity-epidemic/#comment-2375261 a low-carb diet can allow some people 2200-2300 calories/day for break-even, while a high-carb diet allows them only 1600-1700 calories/day for break-even.

      Personal experience… I’m seeing a diet doctor in greater Toronto. Between vitamin supplements, and low-carb diet, I lose approximately 5 pounds from supper to breakfast the following morning. *THAT* has been the main weight-loss factor for me. And no, I’m not wasting time and money on a gym membership.

  8. It is very simple:

    1. We used to smoke cigarettes. It kept us thin because of whatever, nicotine, smoke, oral activity, …, and who knows?

    2. They made us quit smoking. I understand that smoking will kill you, and sooner rather than later. So quitting was a good idea.

    3. But, .. once we quit we put on weight.

    4. Non smokers live longer, but older people put on weight as compared to younger people.

    5. Getting old and getting fat, caused us to be depressed.

    6. So, they prescribed anti-depressants.

    7. Anti-depressants cause excessive eating and weight gain.

    8. At the end of trail, we are fat, we are old, but we are not depressed.

    • The “Obesity Epidemic” also correlates with the change in the food pyramid back in the 1970s. Coincidence? Or causation? We don’t know.

    • 3. Food substitutes the nicotine. Carb’s affect the reward system of the brain, like nicotine (alkaloids) do.

      4. Older people exercise/moves less (and sits more) then younger do. Also, older people get easier femoral neck fractures, due to lower bone density as a result of lower physical activity. We will see more of this in the future, as young people prefere to play with their computers and/or smartphones, instead of creating some sweat due to physical activity …

    • Do you notice virtually everyone focuses only on quantity of years, and nothing else? The entire medical establishment seems to think the ultimate goal is to keep everyone living for as many years as possible. That just seems dumb to me. I say they need to factor in quality of life, and realize that living longer is not always better. Quality of life can be both a positive or a negative number. For example, someone going thru chemo, every day would be a negative quality of life. Being depressed would be negative quality of life. The goal should be, to have the highest score of quality and quantity combined. Getting old sucks. I look at my parents who are in their 80’s now. They have long lost the joy of living, because they can no longer physically do the things that used to bring them enjoyment in life. At this point life is a burden, not a joy. For them the highest life score would be to have died a quick, graceful, and painless death 5 or 6 yrs ago. It is a tragedy that our culture so frowns on people being able to quickly, honorably, and painlessly check out of this life when they decide it’s time. It’s painful for my siblings and I having to watch them go thru this, knowing that death is inevitable within the next 10 or 20 years. What’s the point of society insisting they need to go through this? If they could honorably and gracefully check out Kevorkain style, they happily would. Society is wrong in not giving them the option to check out with dignity and grace when they are ready. Our culture needs to change. Similarly, obese people can enjoy life with the things that give them pleasure and then check out when they have had enough. Or they can suffer through a life of denying what gives them pleasure because society tells them they need to, perhaps living longer but not better. What is the point of living if one is not enjoying their life? I ask this seriously. We spend way to much time trying to convince everyone it is their duty to live as long as they can. This is not right at all. People cursed with problematic genes should not be forced to endure a life of misery because society thinks they should. Most morbidly obese people I know of would prefer to check out at a young age. Why force them to live? It’s wrong.

      • average joe
        December 17, 2016 at 2:23 pm

        “Do you notice virtually everyone focuses only on quantity of years, and …”

        I’ll be in my 80th year next year, however, I’m an active consulting engineer in the mining and metallurgical industry that exercises my muscles and my brain, so I’m fit on both counts. My biggest client at this time is opening up a mine, building a concentrator and a hydrometallurgical plant (chemical plant). I laid out the drilling program for measuring and sampling the deposit, and the hydrometallurgical process was invented by me (international patents) that I developed for this project. I speak a couple of languages well and can read also German and Russian; I’ve published a number of technical books and am a published author of short fiction; I’m a folk musician and have taught bluebgrass banjo (I even had a gig on TV);…..

        I memorized the Mendeleev (periodic) table of the elements and their general physico-chemical characteristics about 60 years ago and I recite it every once in a while to check out my memory – apparently a fair number of chemists can’t do that.

        The “quality” is something that you can put into your life. For those retired, there is a lot one can do. Tuition at universities in Canada is free for senior citizens; there are community play troops, art school lessons, choirs, bridge and chess tournaments (I and partner won a turkey at a bridge tourney some years ago and I was thrilled to bits!); I like handicapping horse races….

        The “quality” is something that you can put into your life. For those retired, there is a lot one can do. Tuition at universities in Canada is free for senior citizens, there are community play troops, choirs, bridge and chess tournaments (I and partner won a turkey at a bridge tourney some years ago and I was thrilled to bits!); I like handicapping horse races….Give your parents a gift of something for them to do and enjoy – help them find some stuff to put some quality into their lives. Yours is the most depressing post I’ve seen in a while.

      • Agree with both this post and the response. If you are lucky enough to still be healthy (at whatever age), good for you. But there are so many people that are simply existing, not living.

        Also, I am always troubled, whenever I see these “obesity epidemic” articles. They always come over as “information operations”, aka indoctrination; not serious attempts to improve people’s welfare. It’s always about how we’re better than you are.

      • Gary – turning 80 and life is good – good for you. But you miss my point. Which is, much, if not most, of the reason u r happy at 80 is because of your genetic makeup. Many are not so lucky. Who r u to insist that they must either keep on living, or else be dishonored and disgraced? Who r u to insist that they have no honorable and graceful path to leave this life when they choose? Of course they can always put a gun to their head. Why force this mindset that it is dishonorable to choose an early, painless death? You are wrong on this.

      • Further, Gary, answer me this: You, and everyone else, are going to die eventually. It is highly unlikely you will be here more than another 20 years, and certainly not more than 30. When you get to where you are a burden on those around you, and you will, why carry on? In 50 yrs from now, it will not matter whether you died at 80 or at 105. You are gone. Why insist on everyone clinging to a cruddy life as long as possible? Your answer is likely that you believe it is the will of some greater power. And if that is your belief, you have no evidence of that, and are likely wrong. If that is your belief, u r not much different than climate scientists and their beliefs that CO2 is evil. I cannot find the logic in your thinking.

      • This may not be the most edifying response, but here goes:

        Some say that cancer treatment is the only socially-acceptable method of suicide.

        IMHO, they could take anyone off the street and do cancer scans on them and find something they think might be cancer.

        You don’t really need a Dr. K character around. Just keep getting cancer tests done. They’ll find something eventually. Then you can wear the ribbon of the day and collect accolades on your way out.

        /dark-subject-mode off

      • Average Joe, I don’t buy your argument at all. Been there, done that. I was suffering from pretty close to terminal heart failure one day, having driven myself to the ER to check for heart attack. I was left on a gurney, while the doctor went to check something. My lungs were nearly completely collapsed from pleural edema and I was drawing very shallow, short breaths–with no time delay for exhale. It occurred to me that I might have no time left at all, and that realization came as a kind of unexpected surprise. Not that I thought I was immortal, but, you know, one does not expect a particular scenario to arise.

        Well, they did things to put me out on the street again in 24 hours, but I needed corrective heart surgery pronto and, once I convinced my cardiologist that I needed it, they were like a fire station to make it happen. But it was open-heart surgery (the very best kind!) and my post-op experience was like…did you ever fall from a 6-story building–and bounce? After that recovery, which took 2 months, I arrived at my values clarification realization–there are only two categories in life: B.S. and Everything Else.

        What does this story mean, Joe? It means that you are terminally insensitive to the absolute wonder of being alive. All this brave bluster about “dying with dignity” really amounts to the confession that one has run out of appreciation for life. There are those who are blind, deaf, crippled, deformed, mentally impaired, injured, and maimed–and they find life to be full of beauty, sensation, love, and the opportunity to overcome limitations. I think of Helen Keller and Stephen Hawking and I contemplate the perils of old age. I would be ashamed to think of my old age as being a worse burden than they have experienced. I have read Solzhenitsyn’s books on the GULag Archipelago, and there are worse things than the burden of old age, or even of illness.

        At some point, we always die. God did not put us on Earth merely to die. He put us on Earth to live, hopefully to learn what we need to know in order to live forever. And what is the point of living forever? It is to continue living in that beauty, and sensation, and love given us for eternity.

    • Response to Walter Sobchak comment on 12/17/16 at 11:30am

      Your comment combines humor with wisdom, and is concise.

      And when I stopped laughing I had some serious concerns:

      If every internet comment was that good, people would be online every hour they were awake, and no one would get any work done. Nations would collapse. The world would end as we know it. You, Mr. Sobchak, have inadvertently contributed to the end of the world.

      Your comment is also much better than the original article, which I did not like.

  9. ‘The obesity epidemic is a major challenge for medical science and public health because, quite simply, we have almost no idea whatever as to the true cause(s) of the phenomena, or, in another sense, we have too many ideas about the cause(s) of obesity.’

    Far as I got. The ‘obesity epidemic’ is as fake as Putin helping Trump win.

    We do not know what people weigh in the United States. There is no data. None. Declaring an obesity epidemic without out data if fake news.

    The United States conducts annual phone surveys of about 30,000 people asking how tall they are and how much they weigh. The red flag should be visible now. It is self-reporting, with no verification. IT IS NOT VALID SCIENTIFIC DATA.

    Then it is ‘adjusted’ by government employees whose jobs are in part dependent on the results they report.

    It’s junk science through and through.

      • Anecdata isn’t science.

        Additionally, the weight of people at Walmart is none of my business, nor the government’s. I don’t see a big person at Walmart and think, “We need to get the government involved with that person!”

  10. The bell curve applies. Lets forget the fringes. One can hardly justify applying the term ‘disease’ to the masses in the middle. Richer nations have fatter people. It has changed in relation to generations and time too.

    I am interested in the term ‘metabolic adaptation’. Some research shows that a person who has been very active in youth carries a certain capability throughout their life e.g. an ex athlete finds it much easier to come back to such activities after extended time of blobbing out or getting fat, than one who never has such a history.

    So, the history of diet and activity while we are growing up is critical. The solution? : teach your children well.

  11. Skip, nine lines below the graph. ‘Those whom are classified’ should be ‘those who are….’
    Interesting article. When medicine can treat us individually according to our specific genes, and not based upon population statistics, we will all be better off. Cholesterol is another one of these issues. Some people live well with elevated cholesterol, others don’t,yet we treat everyone the same, with statins whether needed or not. Some smokers die young, others live to 100+ after smoking all of their lives.

    • jsuther2013 ==> Thank you for paying attention to words — I love words and do like to use the right ones. In truth, my editor apologizes, s/he incorrectly corrected that sentence.

      They are finding that genes have a greater role to play in weight gain and obesity than the learned societies readily admit. All of them are pushing a “consensus solution” which the literature shows must fail.

  12. What I didn’t see in the essay, and I did go through rather fast, is the notion that perhaps there really isn’t a problem. People today aren’t any more over weight than they’ve ever been. I argue with liberals on this one all the time. They see a fatty and say, “See!” What’s going on is confirmation bias. They’re told there’s a problem just like that topic we’re not supposed to bring up in this thread and so every time “Fat Albert” waddles by they remember the lesson our modern culture has taught them, and say “Oh dear! We must do something about it.”

    I point out that when I was kid in the ’50s we had fat kids in our class. Everyone did. But today, we’re told the existence of a fat kid in class is a new phenomenon. It’s not. I also point out that we didn’t have exercise gyms with droves of people working out at 6:00 AM or people out jogging and riding bicycles everywhere. When you look around at ALL the people, what we’re being told and the reality don’t match. Again, just like the issue we’re not supposed to bring up here. Yesterday I went to the annual school concert to see my grandchildren sing. About 300 or so 4th, 5th and 6th graders. I had the corner seat in the gym and they walked single file right past me. I took a mental note and I’ll guess it was less than 5% that could be said were overweight.

    If there is a statistic that points to a change, it’s no doubt rooted in demographics. Old people like me and the rest of the baby boomers are heavier than we were 40 years ago. And we constitute an ever growing segment of the population and will continue to do so for some time. Also there are some ethnic groups in the United States that have increased their numbers that tend to be heavy. The flip is some ethnic groups tend to be thin, but they generally live elsewhere on the planet.

    • Steve ==> There are concerns that the lowering of the bar on obesity has spiked/hiked percentages of overweight and obese. What is now obese used to be overweight, and what is now overweight used to be the high end of normal.

      You have the right idea in your “rooted in demographics”….but even to the casual observer, visiting your local WalMart to take an impromptu weight survey will reveal that there is truly a lot more heavy people now than there were in the 1950s. I have often wanted to do a survey of crowd scenes in European classical paintings to check the % of heavy people…

      • there are concerns that the lowering of the bar on obesity has spiked/hiked percentages of overweight and obese. What is now obese used to be overweight, and what is now overweight used to be the high end of normal.
        Thanks for pointing that out.

        You have the right idea in your “rooted in demographics”
        I’m enjoying a very nice retirement and as such have travelled the world. I’ve been to those places where the ethnic groups I speak of originated. Some regions of the world people are mostly thin and other place support a large population segment that is heavy. You didn’t argue that what I said wasn’t so, but I just wanted to say it isn’t just from observation here in the United States.

        but even to the casual observer, visiting your local WalMart to take an impromptu weight survey will reveal that there is truly a lot more heavy people now than there were in the 1950s.
        That really needs to be verified.

        I have often wanted to do a survey of crowd scenes in European classical paintings to check the % of heavy people
        I am thinking of those beautiful Rubenesque women. Not fair? OK but as you pointed out the definition of obese has been inflated and the image of health, at least as far as women is concerned is a lot skinnier than when I was a kid. Marilyn Monroe was a bit chunky by today’s standards.

      • In my area, we can watch the old Lawrence Welk Show in syndication. One of my favorite things to do is watch for the crowd scenes, where they show the studio audience. There are almost no overweight/obese individuals in those shots of plain, everyday people. The show ran from the 1950’s to the 1980’s, so there is a long time period covered. The earlier shows were the ones with the fewest heavy people, and in those days people likely were drinking whole milk, real butter, and fried chicken, etc., etc.

        Another item that comes to mind in discussions like these is this:

        In the Disney movie “Lady and the Tramp”, when we first see Tramp, he has just awoken and is looking for breakfast. When he spies the French bakery, he decides against getting breakfast there, saying, “No…too much ______.”

        Try to guess the missing word before reading further.

        If you guessed “fat”, you’re wrong. The missing word is “starch”.

        It always makes me chuckle, because in the early 1960’s even cartoonists knew that too much starch was detrimental to one’s health!

        Finally, when the USDA came out with the Food Pyramid, I knew I couldn’t control my weight eating that way.

        Apparently, many others are unable to control their weight while eating according to the Food Pyramid.

    • Steve Case, there have always been obese people. But the problem is definitely growing, and that has a direct upward push on medical costs. See data from CDC in my comment below.

      • ristvan – at 12:18 pm
        … there have always been obese people. But the problem is definitely growing, and that has a direct upward push on medical costs. See data from CDC in my comment below.

        I don’t put much stock in data from outfits with a dot gov suffix.

    • My cohort only ever had one fat kid. He was notably ‘the fat kid’. By today’s standards he was very slightly overweight (ignoring the BMI BS). He didn’t even have man boobs. Probably 1 in 2 adolescent males have them now.

    • “I point out that when I was kid in the ’50s we had fat kids in our class. Everyone did. But today, we’re told the existence of a fat kid in class is a new phenomenon. It’s not.”

      I also was in grade school in the 1950’s and 29 out of 30 kids in my class were skinny little things, and we had one kid who was obese. That ratio applied to all my grades throughout school. Mostly skinny kids, and very few fat kids.

      Then, during the late 1980’s (right after the Challenger Disaster) I decided to become a substitute teacher as my personal effort to salvage the space program, and taught astronomy and space science to fourth and fifth graders, and I was really shocked at how fat kids had gotten compared to the time I was a kid 30 years ealier. At least half of the kids were significantly overweight.

      I blame most obesity on the environment. There’s something in our environment now, that wasn’t there when I was a kid, and it is making people fatter. I suppose some of it could be genetics since there are much larger numbers of people around now than then, but I still think the majority of the problem is how and what you eat, and the lack of self-discipline.

      To be obese, you have to take in a certain amount of calories. If you don’t eat too many calories then you won’t be obese. If you are obese and reduce your calory intake, then you will lose weight. It’s mind over matter for most people with normal genes.

      Btw, the Atkins diet worked best for me, when I ate too much ice cream for too long and gained an extra 20 pounds. The Atkins diet took that weight off me in a very short time and I got back to my normal weight.

      There may be something in the fast food people eat today. I have seen pictures of a McDonald’s hamburger and french fries displayed under a glass cover, and the meal looked like it had just been cooked, but was actually over two years old. What kind of preservative can do that? What does it do when inside the human body?

      In the past, lots of skinny kids, and no fast food available. Today, lots of fat kids and lots of fast food available.

      • Most of my relatives who tried the Atkins diet said it worked for about 2 weeks. Meanwhile, a lot of the calories in ice cream are fat calories. And how do you know that your weight loss was not simply from cutting back calories, which is an expected result of cutting back ice cream?
        Have a look above at the graphs posted by SC on December 17, 2016 at 1:24 pm and my response shortly below that with link to a graph of calorie consumption by year and protein/fat/carbohydrate calories. Overweightness/obesity has tracked well with total calorie consumption with a lag of a few years since most people got cars and sedentary jobs.
        However, I agree about fast food being fattening – it has high calorie density due to being low on fiber and veggies. Even fast food salads have a fair amount of calories if you use the dressings that come with them – most of which have almost as many calories per ounce as sugar does, with about 90% of their calories from fat. And many fast food sandwiches have 80-100 calories in mayonnaise alone – which has more calories per ounce than sugar, about 95% of them from fat.

      • “Most of my relatives who tried the Atkins diet said it worked for about 2 weeks. Meanwhile, a lot of the calories in ice cream are fat calories. And how do you know that your weight loss was not simply from cutting back calories, which is an expected result of cutting back ice cream?”

        Donald, in my particular case, I probably ate as many or more calories as I was eating before dieting. I was told I could eat as much as I wanted on the Atkins diet, as long as there was no sugar involved. So that’s what I did, I ate until my hunger was satisfied, without even looking at the amount of calories.

        And it was unbelievable how quickly the weight came off. I was really surprised that you could get on a diet where you could eat the amount you wanted, and still lose weight in a matter of just a few months.

        I’m a firm believer in the Atkins diet. It certainly worked for me and was pretty much painless. There are plenty of good things to eat that don’t contain sugar. You can even buy Atkins prepared meals in the supermarket now, so you don’t even have to plan meals if you don’t want to.

        My meal planning consisted of deciding whether I should stuff myself with hotdogs or cheese, or something similar. :)

      • On second thought, I was probably eating fewer calories, since I wasn’t eating any ice cream, but I was definitely eating enough calories to satisfy my appetite. Which is not all that big to begin with.

      • I went to the Christmas concert at a K-8 school this morning. The class sizes were about 40, so well over 300 kids. I saw one truly obese eighth grade boy and a “husky” sixth grader. The rest of the kids looked good. I didn’t have as good a seat as I did the other day, but I got a pretty good look at all of them.

  13. “…the recommendation that people “eat less and exercise more” will not hurt anyone…” True except their self esteem if they aren’t comfortable with their weight because of other people’s expectations and they do eat less and exercise more. As appropriately pointed out there is more to the issue than “doing the right things”. I think the biggest problem is how we label people for physical appearance.

  14. The three main causes of global warming:

    (1) “Adjustments” to raw temperature data,

    (2) Infilling of missing temperature data, and

    (3) People getting fatter (they feel hotter than they used to when they were slimmer, so they unconsciously make “adjustments” and infilling that cause more warming)

    You could look this up.

    • Håkan ==> That is true — doctors don’;t get much training in nutrition, but the obesity literature reveals that obesity is not a problem of malnutrition and is not resolved though nutritional approaches.

  15. “Obesity is generally caused by eating too much and moving too little.”

    True to a point, but actually your quote is maybe second, the result of number one which is dieting.

    When we diet, we loose weight for a couple of weeks, then it drops off, but we continue to diet hoping for the best. What has happened is that our bodies sees and adjusts to an intake of fewer calories. It adjusts by turning down our metabolism burner. Now we can get along on less.

    There is a way around this, and many body builders know about it. Not only do they eat smaller meals ( sometimes 5 very small meals a day), but besides they know how to prevent the metabolism burner from turning down. About once a week you need to eat more. The few times I dieted in my life, I called it my “pig out” day. If you diet 6 days a week, and then one day return to your previous intake, you still take in less fuel for the week, and the body doesn’t adjust towards the starvation mode. Your metabolism stays the same.

    • And once you lower your metabolism, it is much harder to turn up the resting-state burner than to turn it down. Thus dieting is maybe the biggest reason for obesity in the US.

    • Roy ==> Yo-yo dieting is a known phenomena — the Biggest Loser study (linked in the essay) is the proof of the concept you discuss — the body resets is base metabolism tare rate to get by on fewer calories and maintain/regain weight to a set point. They have not yet discovered how to reset the weight point of a body to a different level intentionally.

      • I believe they did some weight gain and loss studies with conscientious objectors at Ripon College during WWII. That is where they identified the set point theory of body fat. If I recall correctly, they determined that aerobic exercise, nicotine, and amphetamines lowered a person’s set point. In addition, a person’s set point goes up with age.

        You did not mention the various “body types” in relation to body fat. I assume body time is controlled by genes.

      • South River Independent ==> Yes, nicotine (a very powerful and sadly unregulated drug) seems to effect the metabolic rate — and accounts for the number of women smokers, who use it as a weight regulating drug. When they quit to save their lives, they gain weight … and many take smoking back up for that reason.

        As for “person’s set point goes up with age”, I believe (and this is supported at least by epidemiological data) that this effect is the bodies attempt to protect itself, to ready itself for, the dangers of old age — giving itself a bit more of a margin in case of illness or accident. Older Persons who are “overweight” survive better than people who are too thin, and people who are what is now classified as normal weight.

  16. According to the most charts like this, and also the standard BMI crap, Barry Sanders and Emmitt Smith were morbidly obese during their playing years. Imagine what they could have done if either one of them had bothered to get in shape.

  17. I am now 74.3 years of age, and recently I have noticed a pronounced slowdown in my metabolism. I am now somewhat overweight (5’11” and 210 lbs), with much of that weight having accrued during the last four or five years. I’ve gained that weight in spite of cutting back substantially on the amount I eat–not from any weight-loss regimen, but just because my appetite is less. If I go to a restaurant that has one, I order from the Senior Citizen portion of the menu, which typically simply omits one dish from the meal. Just a few years ago, I could easily eat a 10-12-oz. steak plus veggies at a meal. Now, I can’t–4 or 5 oz. is my limit for that. I used routinely to order the 3-pc meal at Col. Chicken; now, at most, I order the 2-pc, and sometimes I take one piece home for lunch the next day. Why, then, have I gone from 180 to 210 pounds? I still get out into the garden for 1-3 hrs a day of fairly strenuous work.

    I’ll tell you why I think I have continued gaining weight in spite of eating a lot less: My metabolism has decided to slow down. (Also, I am taking Coumadin, a blood thinner, so I think my thin blood thinks the rest of me needs to thicken up.) I saw nothing in the article above about age, and yet I would bet that there are many of us who have passed three-score-and-ten who have noticed the same things I have. Do doctors notice that?

    • John M. Ware ==> Hidden in plain sight in the studies mentioned is the fact the older people naturally tend to gain weight in their later years — weight that is protective of their health, a plus not a minus. Public health officials pushing the “Eat Less Exercise More” are doing a dis-service by trying to convince older people to lose weight they should keep on. Few things are more dangerous to people of our age than being too thin!

    • Age usually brings you to wider & shorter. Seems blood pressure is correlated with these things, so you’ve got something else to watch.

    • Mitochondria are the energy transducers of our cells. The evidence is that as they age they become less active and less efficient. The result is less energy, poorer body repair and degraded immune system function. We typically find our appetite reduces commensurately but as we also lose muscle mass, fat tends to accumulate. This is aging and has little to do with obesity up to about 40.

  18. It is true that obesity is a BIG multifaceted US problem. In 1985 no state had an adult (20 and over) obesity prevalence >15%. In 2015, no state had an adult obesity prevalence <20% according to CDC. Diseases directly associated with obesity include type 2 diabetes, hypertension/stroke, cardiovascular disease, and joint disease (knee/hip). In 2009 CDC estimated the annual direct medical costs alone of obesity about equal to those for cancer, ~$150 billion. Yet Obamacare expressly disallowed (via a buried provision in 'community standards') any insurance discrimination on obesity grounds. Affordable Care Act, NOT.
    It is not true, at the most basic level, that obesity is not a problem of more calories in than out. The universal success of bariatric surgery proves that it is. bariatric surgery reduces caloric intake two ways: forced smaller portions, and forced less effective digestion. But it is also true that obesity is much more complicated than simple caloric input/output.
    Race matters, but whether this is genetics or eating habits and social norms or both is unclear. Genetics matters, but the change in adult obesity prevalence suggets it may not matter that much.
    Both the quantity and the quality (type) of calories matter. Sugar is worse than simple carbohydrates (e.g. white bread) than complex carbohydrates (e.g. Whole wheat bread with bran) than fats in meat. So does when and how those calories are ingested, because that affects the sensation of satiety.
    Fitness matters both to obesity and to obese medical problems, directly because staying fit uses more calories, and indirectly because of altered metabolism set points.
    There is emerging evidence that gut flora matters, implying obesity is 'contagious' literally rather than just through social acceptance. See Gordon's elegant series of experiments using obese/lean twins and humanized mice in Science 2013.
    As Judith Curry likes to say, a wicked problem.
    Will be interested to read your wrap up post generalizing 'science wars'.

    • I have an obese relative who is dying because of being fat and diabetic. Unable to lie on any part except the back they have had bed sores/abscesses for ten years and the antibiotics have lost their power. Once the point of not being able to move is reached there is no way to lose enough weight to make any difference.

    • An interesting comment (as always) by ristvan
      His comments suggest that the BMI is useful in population studies overtime but is much less useful for individual cases as others have pointed out because of variations in both muscle mass and bone density.
      As a type 2. Diabetic For 18 years but not using insulin I know the relationship between weight gain and my body’s increasing resistance to its production of insulin
      I therefore watch my diet and exercise regularly and find that maintains a constsnt bidy weight of 77 kilos ( 17lbs)
      and at age 82 can do 20 pushups but
      I am aware that a few more grogs (alcoholic drinks) a day starts to add the kilos
      At this Xmas time with parties every second day in warm weather downunder thats a trap which suggests that if I drank every day I start to hit 80+ kilos very quickly yet others I know remain lean while drinking each day
      So there is much in the argument that what works for one individual wont work for another

      • Thomho, highest regards. Alcohol is a classic empty calorie worse than sugar, hence your experience. Sounds like your are doing very well for your age, and are very ‘up for down under’ on health, diet, and exercise. Anyone doing 20 consecutive pushups (full, no knee cheating) at 82 is by definition fit. Most young Americans cannot do that.

  19. From a pathophysiological standpoint, obesity is certainly a multifactorial condition that includes, among others, the differential expression of several genes including neuroregulatory genes, individual-specific glucose metabolism genes and “glycemia sensitivity” genes and lipid metabolism genes. This complex scenario defines the individual’s propensity to obesity, as descried in this post.
    However I think nobody can really prove Hawking’s statement (More physical activity and change in diet.” ) wrong since, at the end of the day human body must respect thermodynamic laws. Notwithstanding the articulated literature evidence , the Occam’s razor lesson should tell us that if the energy balance is negative (more calories burned than introduced) the body weight can only decrease.
    Did you ever see an obese prisoner at Auschwitz?

    • No the point is two individuals eating the same diet and performing the same amount of exercise almost always produce different results in changing body composition. Many people simply can not maintain a “healthy” body weight

  20. Please don’t confuse body composition with weight.
    Initial “weight” loss efforts through diet and exercise = mostly water = positive feedback to dieter.
    More exercise and diet = more skeletal muscle building perhaps also burning adipose fat (if aerobic exercise) = weight gains as muscle tissue is denser and therefore heavier than fat.
    Even if caloric intake is held as constant as possible (just by calories), body composition changes can gain weight.
    Throw away the bathroom scale.

    • Very true. Simple experiment: a chunk of beef fat floats, a chunk of lean beef sinks. The difference in density is ~1:4. That is why the BMI is a very poor metric. In his playing prime, MJ was obese by the BMI. It is also why overweight people who start to exercise more to lose weight actually gain it. Which is perhaps why overweight comedian Robert Benchly said, “Whenever I get the urge to exercise, I lie down until it goes away.” Funny, but a bad idea.

  21. I believe the governments of the world have the nutrition pyramid upside down…..the carbs should be at the top and fat and protein at the bottom.I can recommend Prof. Lutz book Leben one Brot ..Life without bread….he runs a very successful clinic in Austria…curing obesity and many chronic diseases simply by reducing carbs…..the book is on Amazon I believe

  22. The simple statement that most people are fat because they eat too much and do not exercise enough is probably true.

    You are correct that there are many other factors, but that does not make the simple statement wrong. Leaving aside medical influences to concentrate on solutions within our control, here are some comments.

    Food manufacturers and slimming aid companies get rich by making people obese and keeping them that way. Foods are either full of fat or full of sugar or both, for the simple reason that we love the taste. People cut down on sweets then eat prepared meals with huge sugar contents. Healthy food like a small yoghurt can have 20g of sugar. A simple roll with cheese and ham can have the same. If you want to cut down on sugar, read the small print. Exactly the same goes for fat.

    There is a growing awareness that we evolved as meat and fat eaters. Then we were persuaded to give up dairy products and fats. Pasta was the healthy option. Bread, pasta and many vegetables like potatoes are full of carbohydrates, readily broken down to the sugars from which they are composed.

    The diabetes problem suggests that we are rendering our pancreas ineffective and that suggests that we are consuming too much sugar either directly or indirectly. Just consider the calories in a glass of beer or wine.

    Returning to the complex reasons for obesity, there is no doubt that metabolism to different foods plays a part. I would suggest that ignorance about what we are consuming is a major part. That, together with cheating on our diets because we are basically greedy.

    • Schrodinger’s Cat ==> Most of your expressed views are in line with the learned societies and government agencies — the people and industry must do as we say.

      Unfortunately, the evidence in the obesity literature does not support those views, even though the “facts” are correct — there are added sugars in our food, complex carbs are readily converted to sugar by the body, and on and on. The Sacks study shows that altering those elements in a diet does not change weight substantially — and all the variations have the same results — other studies show that fat and thin people eat essentially the same diet — starving and working people will take off weight but the body will fight to put it back on again.

      That’s why the Obesity Epidemic is a controversy — some insist on the simple facts and simple solutions even when they have been found not to work in practice. Kinda like Climate Science…

      • I went on a very strict diet, 600 calories per day for 8 weeks. I started on 13 stones and went down to 11, improved my blood pressure and reduced my blood sugar to pre-diabetes level. Today, my weight has crept back up and normal dieting just reaches a plateau very quickly.

        I think that we enjoy eating so much that we eat more than we need. As we get older, we reduce the energy output so really our consumption has to go down even further. A light breakfast, light lunch and normal main meal become more than we need but psychologically it it represents barrier that we don’t really want to breach. I should really have no lunch and that may be my next step.

      • Schrodinger’s Cat ==> Since you have a condition (diabetes) related to the body’s handling of its basic fuel — sugar — what applies to you may not apply to the general public.

        I’m glad to hear that you have things under control.

      • There are multiple lines of evidence that obesity has increased in the US since the 1970s (https://www.researchgate.net/publication/303846443_Trends_in_Obesity_Among_Adults_in_the_United_States_2005_to_2014). Any alteration to the gene pool which would have allowed genetics to become the predominant factor since that time would have required a selection pressure that is unimaginable. Epigenetic factors are possible- much of the world is still recovering from the starvation conditions imposed by the Industrial Revolution. However, sometimes the obvious is simply correct. We eat more and do astonishingly less. The increase in sedentary behaviour is well documented (https://www.ncbi.nlm.nih.gov/pubmed/18303006). I liked the previous scientific controversies articles but this one needs a heavy slice from Ockham’s razor.

      • BCBill ==> Arguments of associations do not trump actual clinical results. No one has suggested an evolutionary change over the last 40 years. It is not a question of whether people eat more and exercise less, it is a question of will Eating Less and Exercising More cure obesity?. The clinical evidence is that it does not for most people.

      • Reply to Kip Hanson comment on 12/17/16 at 12:41pm

        YOU WROTE:
        “Unfortunately, the evidence in the obesity literature does not support those views, …”

        MY COMMENT:
        You are ONLY talking about the subset of obesity literature that YOU choose to read and believe.

        You write a lot of articles on a large number of topics.

        No one is an expert in so many topics.

        You are not an expert in nutrition and obesity.

        I read the other articles in this series before making the following comment:

        You have an anti-establishment bias.

        Sometimes the establishment is right.

        And they are on obesity.

        This article is your Waterloo !

  23. Another angle here, and this has nothing to do per se with the mechanics of weight loss or gain, is the fact that the ‘obesity epidemic’ is now big business, with a vested core of interested parties: overweight people, academics, drug companies, dieticians, doctors, and, last but not least, a meddlesome government driven by meddlesome do-gooders. Not a one of these players has any reason to come out and say the problem either doesn’t exist or is being exaggerated. OTOH, I agree the weight gain process is complicated, but I’m with Killer Marmot on the physics and fundamentals.

    • It may be big business, but unlike AGW, in my opinion justified because a big medical problem. On current trends, CDC says the direct medical costs of obesity (really the associated complications) will be ~1.5x greater than the medical costs of treating cancer by 2020 despite an aging population with concommitant increase in cancer incidence. And Obamacare expressly forbade insurance rate discrimination on obesity grounds, compounding the problem. I am a former college athlete who has exercised my whole life, eats healthy, am not overweight, and really resent paying via my medical insurance bills for overweight and obese people who didn’t.

      • “…and really resent paying via my medical insurance bills for overweight and obese people who didn’t”
        With government provided health care (e.g., one payer) that attitude could lead to another big area of government over regulation. Hell, we might eventually wind up like Cuba with the government providing (or at least specifying) what everyone will eat for their one meal a day. You might want to be a bit careful about complaining, my grandfather lived to be 92 and said the only exercise he ever got was being pallbearer at this athletic friends funerals. He might not have enjoyed paying for your medical costs.

    • I don’t disagree with Killer, although Killer may think I do. I’m just pointing out that one has to consider the biological organism – which already has lots of stored calories to use and at least three different metabolic pathways to use them – and is not a straight physics problem. Not unlike climate science. Wicked.

  24. As I have been training and changed my diet (permanently) for the past 2 years and 7 months, I think one of the biggest problems is what we all eat, most ‘normal’ (as in processed) foods contain way too much sugar. I do not believe that all calories are equal, and if people stuck mainly to unprocessed whole foods, it would make quite a difference, even if they did negligible training.

    The first things I cut out completely were bread and sugar, and what a difference that made! Over 90kg in May 2014 down to 72kg in December that same year (But I was/am also weight training..)

    People really need to read the labels, it a product states that it is low in fat, the chances are they have added the sugar, which I think is worse, to compensate for the flavour.

  25. “As a cosmologist I see the world as a whole…”

    That sent the needle of my horseplop detector so far to the right, it wrapped itself around the stop post.

    • Absolutely! As a cosmologist I look out from the world and am only interested and knowledgeable in every other part of the universe, which, by the way, looks pretty fat from here!

  26. Check out the sugar and fat content for yourself. Look at the small print on the prepared food in your food cupboard and fridge. You will be surprised. An obvious example is orange juice. I used to drink it by the pint, believing that it was healthy. The 30 grams of sugar per pint probably contributed to my diabetes.

    Being diabetic made me read the small print on other products. Just look at the sugar content of sausages or a can of baked beans. Trying to get below a few percent is almost impossible when around 10% is common.

    • I don’t think that the scientific medical community really has enough understanding about diabetes to be able to claim that people become diabetic because they ate too much sugar. I think the medicos know less about diabetes than they do about obesity.

      • AR, as someone concerned about health care costs, have looked into this in some technical medical detail. It is complicated, but not too much so. The pancreas’ islets of langerhorn beta cells produce insulin to enzymatically enable all body cells to metabolize simple blood sugars. Too much sugar too often, two things happen. In the first stage of type two diabetes, body cells lose ability to effectively use available insulin. Called insulin insensitivity. In the later stage, pancreas islet cells over produce in response to first stage insensitivity, ‘wear out’, then give up and die. Proof is that insulin dependant type 2 diabetics are indistinguishable from type ones where an immune response destroyed the pancreatic islet betas (usually in childhood). Oversimplified, but generally correct facts.

        I spent 4 years as the senior business guy of a startup that thought we had a solution to this. Whether we did remains unknown, as the startup turned out also to be a medical development screwup that did not have drug analogs in the pipeline, and did not do dosing alternatives. We had a bolus dose of one peptide, with no alternative dosing or peptide analogs in preclinical,development. Yet we still met some (but not all) clinical,endpoints in a phase 2b efficacy trial. A long list of not to do things learned the very hard way.

  27. What medical study was done, that demonstrates what an ideal weight is? And, as part of that study, what demographics would have to be included? A crude measurement, such as BMI, is simply a lazy way of computing a number which has no basis in reality, it is an irrational number. I would suggest that we cannot talk about an obesity epidemic, when we don’t even know what an ideal weight is, as it is not defined clearly enough.

    • Janice The American Elder ==> Like fine art, it may not have a definition but I know it (obesity) when I see it. A >300 lb man or woman standing 5’5″ is obese by any standard.

      BMI is not a valid measure — rubric — for discussing the problem of obesity and its related health considerations. You are absolutely right about that.

      The conclusion of the Australian Medical Association editorial included the concept that it is far more important to be fit than any specific weight.

      • Just like an ideal weight, there is no real-world definition of “being fit”. Dr. Hawking is perhaps fit, considering the group (demographic) he belongs to. There is no obesity, or fitness, problem, unless you can clearly define those terms. We need clear definitions of ideal weight, obesity, fitness and non-fitness, before we can even discuss whether there is a problem. On top of that, there is a massive amount of money being raked in by companies who are convincing people that they are not an ideal weight, or they are not fit. Therefore, any attempt to clearly define these terms could interfere with those companies being able to sell their products. Follow the money, and find obfuscations of terms.

      • Janice, as an entrepreneur who started a health care company in a related space but who has dealt with this up close and personal for now 16 years, I am going to push back rather hard.
        I fully support the right of alcoholics and drug addicts to poison themselves to death slowly. Just not on my nickel. In a similar vein, the obese can overeat and the couch potatoes can nosh on Doritos all they want– again just not on my nickel. BMI is nonsense except for the unfit.
        But there are general rules of thumb that can define overweight and fitness adequately for general health and medical cost purposes. 15% bodyfat in males, 20% in females (adult). Caliper or immersion tests. Resting to exercise heartrate in some time period given defined treadmill pace and incline (a standard ECG cardio exam). At a Colorado senior exec training session some 20 years ago (way above near sea level where I lived at the time) I was the only one of the ~40 class that passed the simple weight rep/treadmill heartrate tests for minimum fitness. Administered by a US Olympic team trainer. The other 39 were an unacceptable health cost risk in my opinion.
        No problem with people doing whatever they chose. Just not on mynhealth care nickel. No different than auto insurance. Good driver discounts, bad driver surcharges. And the medical profession knows how to determine the actuarial cost of the average ‘driver’.

      • ristvan, I have a lot of respect for anyone who can get a company started, and have it be successful. You obviously have much more experience than I will ever have. However, I am not questioning your business abilities. I am questioning where your general rules-of-thumb are coming from. The percent bodyfat, and resting and exercise heartrate are interesting, and may indicate some amount of health. However, who set the numbers? How were they arrived at? Where are the multiple studies that make these numbers relevant to actual health?

        The problem I really have, with your comment, is what you say at the end. That somehow people should be punished (charged more), if they don’t meet these quite random parameters. At what point do we try and control other people? If someone is a skier, should they be charged extra, because of the chance of injury through their voluntary choice to do skiing? Or, if someone rides a bicycle to work, or played football in college, or goes surfing at the beach? Should the healthcare premiums reflect those types of healthcare risks?

        Because of those questions, I believe that insurance should go back to being catastrophic healthcare insurance, with anything else simply paid out-of-pocket. The push to try and force people to be a healthy weight, when we don’t even know what that is, is truly ridiculous. We cannot enforce health, because there are too many variables.

      • @Janice: I totally agree with your comments.

        I would only add that, even though it’s a fool’s errand to try to let the government dictate everyone’s diet and weight, they don’t care about how useless it is because they will have so much fun trying to do it. It’s really just “Big Brother” surveillance on steroids!

  28. This was a fun article.

    1. Trigger warning – LOL
    2. Researchers have discovered a genetic component to obesity. Well DUH! We evolved as hunter gatherers. Until we invented farming (and even then) we were trapped in the cycle of feast or famine. Everyone thrived during feast, during famine the skinny people died.
    3. The myth that weight loss is a combination of exercise and calorie intake continues. Exercise is a vital component of over all health, which in turn will affect weight. But the next time you are on an exercise bike with a computer, take careful note of how long you have to pedal to burn just 100 calories. Congrats, you just mitigated one slice of dry bread. Want to lose just one pound of fat? You’ll have to pedal 35 TIMES that amount!

    • On the other hand, Hoffer-san, as long as the exercise bike isn’t located in the kitchen, that will be 700 minutes spent without eating.

    • Yes, of course there is a huge genetic component to obesity.

      One only has to observe genetic selection in meat producing animals over the last 50 years or so. Especially pigs and chickens.
      Constant selection for a lean, fast growing, feed efficient animal has resulted in huge phenotypic changes.
      The overall growth rates and meat producing capacity of individual animals have increased every single year, and the rate of improvement shows no sign of slowing.

      And yet, any large population of such animals, tested for all the paramaters of such improvement, will still reveal a wide normal-distribution curve for those parameters, The population mean has shifted, but there is still considerable genetic and phenotypic variation. Two animals of apparently similar genetics, fed exactly the same diet, can have very different fat levels.

      And all that is probably compounded by the effects of epigenitics (people/animals raised in a certain environment do pass some effects of that onto their offspring.

      And then there is the huge role of the biome, the details of which we are only now discovering.

  29. You do nice summaries Kip. In this case the history and research do suffer from too much focus on cardio studies and blood pressure. A few years ago I was blind sided with a diagnosis of cirrhosis and being an engineer I had to study that. Amazingly, since there are virtually no treatments for fibrosis medicine looks mostly at treating consequences in other organs. An interesting factoid that might enter your calculation is that fatty liver disease has increased about 20 times in the past two generations.
    https://www.ncbi.nlm.nih.gov/pubmed/20460905
    Fatty liver leading to liver disease is expected to be the leading cause of liver transplants by 2020.

    This tracks well with the increasing obesity of our population so it seems clear to me that we do have a generalized problem with the society getting fat. When you dig into the bio-chemistry you find that the liver is the controlling element in the fat equation so it does come down to what feedstocks you are delivering and in what quantities.

    There are certainly genetic differences but generally people who diet ultimately fail because they don’t permanently change the foods they eat so any losses will tend to be temporary. Your analysis that the current state of play is flawed is correct in my mind but a notion that lifestyle changes, in the nature of what you eat, aren’t substantive is a bridge too far. If your diet changes such that you are no longer driving your liver into storing fat inappropriately you will lose body fat as a normal consequence.

    Your criticism of the research of past 50 years is valid and the political nature of the debate should annoy us all. Much of the early effort was focused on the wrong problem but more recent research is gradually leading us to a better understanding.

    • Wayne ==> Thank you, It is an interesting puzzle.

      I am afraid though that research does not support part of your statement that : “There are certainly genetic differences but generally people who diet ultimately fail because they don’t permanently change the foods they eat so any losses will tend to be temporary.“. What you say is true for the seasonal “gotta lose these extra ten pounds before bikini season” crowd….they are not seriously overweight to begin with, and are not serious about losing weight. However, lots of very good research has been done on this and this is not what they find for serious weight loss programs.

      • Well that is a bit overly broad, as you say. However, I think the research does show that the while the reduce calorie mantra ultimately has problems, when you design a diet richer in fats than is fashionable and stop “binge” eating you can lose weight effectively and keep it off. The critical pathway is the feedback loop between the liver cells processing triglycerides and the abdominal “brown” fat which is its key depot. The fat engine turns on that process and it is fundamentally driven by what you eat and our modern diet isn’t particularly kind to that chemistry.

  30. A: I see too many very young (babies, tots, pre-teens) that are fat. In my neighborhood while growing up, this was not the case. (One young person had a genetic issue and was fat.) Perhaps our lack of obesity had something to do with being poor and not having televisions. Our only screen kept flies out.

    B: A warning – Rapid weight-loss can cause weakness of the abdomen and may lead to hernia. You could do this with a severe diet or something such as Giardia.

    • John F. Hultquist ==> My father was a leading pediatrician in the Los Angeles area for almost 40 years — I literally grew up exposed to thousands of babies — babies are supposed to be fat — a thin baby is not a thriving baby.

      By age two or so, they should be beginning to change that, stretching up, thinning down, but will still look like children — not like thin Hollywood models.

      That said, no school-aged child should look like a blimp either.

  31. About ten years ago, when I was about 60, my doctor diagnosed me with high cholesterol, and I could either control it with statins or by diet. I told him I’d try diet. He told me mainly to limit my fat intake to FDA guidelines, especially the saturated fats. And to watch the sugars. Being someone that follows doctors’ orders, I went to the supermarket and looked at the fat content of foods, and began a diet of low-fat foods that would limit fats to the amount of grams recommended. Well, I am kind of hyperactive, and I am a runner (still am). My cholesterol dropped like a rock. Unfortunately, my weight also dropped like a rock. My friends told me I looked like I was sick, and my wife was about ready to kill me — she said I no longer had a butt. The medical people found that I had less than 10% body fat. I felt great, except I was cold all the time. So they sent me to a nutritionist, who told me I needed to increase my fruit and vegetable intake (yeah, right). So I switched over to taking statins, and eating more fat, and my body is maintaining a better weight.

    • littlepeaks ==> You got the standard Public Health recommendation — instead of the advice you needed for YOU.

      Glad you go it sorted out.

  32. I’ve spent time looking at this issue too. My conclusions so far:

    * The impact of (moderate) dietary fat on obesity is overstated.

    * The impact of sugars (esp. refined sugars) is significantly (possibly dramatically) understated.

    • Mike Smith ==> They have finally come around to your first point, but have not managed to turn up any real evidence for the second — and boy have they tried! Time and more research will tell.

  33. In temperate parts of the world we evolved without central heating. I tend to put on weight in the winter with the central heating on and lose weight in the spring/summer when the central heating is off. When I was young and we didn’t have central heating, weight was never a problem The body is similar to the planet except relatively more heat is produced internally, sourced by food and drink and cooled by perspiration, radiation and with energy content reduced by chemical and physical work. I accept all the myriad genetic, dietary and exercise issues are relevant but for the individual to lose weight ultimately energy output has to be greater than energy input with lots of influencing dimensions, some significant and some minor.

    • son of mulder == What you say is primarily true, but only for those easy to gain easy to lose “extra” ten or fifteen pounds. It does not touch on the real problems involved in the Obesity Epidemic.

      Part of the public health problem with obesity is a failure to recognize and acknowledge this well-proven point — they rather stick to the odd “if this trend continues” idea that those extra pounds will continue to add up until we all weight 400 pounds.

      • As we lose weight so we have less bodymass to keep warm and our surface area reduces so we reduce perspiration and radiative heat loss so need even less food to sustain weight loss or more work has to be done to burn calories. This is the key issue why some sort of constant dietary/ exercise formula won’t work.

  34. The cause of the obesity ‘epidemic’ is the use of synthetic fat which the body can store but not recover easily.

    • charles nelson ==> eGads! Let’s see the study — I think you are in line for a Nobel Prize for discovering the real cause of the Obesity Epidemic. /sarc

      Seriously, where did you get such an idea? I’d like to see whatever evidence that opinion is based on.

      • Seriously?

        From your tone I’m guessing you’re a bit of a fatty…am I right?

        But to answer your question…I got the idea from several sources. There have been scientific studies
        indicates that trans fat may increase weight gain and abdominal fat, despite a similar caloric intake.[89] A 6-year experiment revealed that monkeys fed a trans fat diet gained 7.2% of their body weight, as compared to 1.8% for monkeys on a mono-unsaturated fat diet.[90][91] “under controlled feeding conditions, long-term TFA consumption was an independent factor in weight gain. TFAs enhanced intra-abdominal deposition of fat, even in the absence of caloric excess, and were associated with insulin resistance, with evidence that there is impaired post-insulin receptor binding signal transduction.”[91]

        But more significantly there is simple observation and deductive thinking.

        Sugar and carbohydrates have been freely available and plentiful in the western diet for the last 100 years (war time etc naturally excluded) so back in the 1960s and 70s when I was young people could eat as much sugar and carbs as they liked…yet morbid obesity was so rare that it was commented on.

        What changed? Well…the introduction of synthetic fats into the food chain, hydrogenated vegetable oils, based cooking media, margarine and shortening all replaced the commonly used Lard.

        Now gross obesity is ubiquitous…as is sarcasm.

      • charles ==> That’s your evidence? I’ll have to tell the Nobel committee to hold off for a bit on that prize.

  35. We should be able to eat enough each day and each meal to feel satisfied.

    This is a basic principle that should not be broken because whatever you do, you are going to feel compelled to move toward this basic fact of human nature and, indeed, ALL of nature. We are going to move towards eating enough food to feel satisfied.

    And that amount is basically 1.5 kgs to 2.0 kgs of food. Like a really large plate filled to the brim till it is falling off. That is what our DNA designed us to eat in a day.

    To lose weight, you have to keep the calories of the large-filled-to-the-brim-plate under your basal metabolic rate. To find out yours, go here.

    https://www.verywell.com/how-many-calories-do-i-burn-every-day-3495464

    Generally, just being alive burns the most calories. No matter how active you are, you are going to burn something up to 1500 calories by just being a normal alive person. Exercise adds a little (but not very much actually. Exercise is not really the answer because it takes a lot of exercise in a day to offset that hamburger). Calories burned goes up based on your basic weight to start with (the bigger you are, the more you burn). The taller you are, if you are a man or a woman, as you get older, you burn less.

    I am at 2710 calories.

    All I need to do to lose weight is make sure the food I eat is 2710 calories in those 2,000 grams of food I like to eat in a day to feel satisfied.

    (I always default to basic math because it never lies and it tells you basic “truths” that are correct on their face).

    Food to lose weight: 1.2 calories per 1.0 gram for me.

    It doesn’t matter if it is carbs or soup or booze or steak. I need to stick really close to the 1 calories per 1 gram or 28 calories per 1 ounce (for the non-metric folks)

    And you know, lots of food in that category tastes great. I medium baked potato with fixings on it is 200 calories and 200 grams. I could actually eat about 10 medium-sized baked potatoes in a day (2 for breakfast, 3 for lunch and 5 for supper) and still lose a lot of weight. And actually I would be very full on that diet and even bloated. But I would lose weight while still being more than full.

    Let’s try pasta. Let’s make that 2000 grams of Penne pasta. 7,368 calories and now I am gaining one pound a day until I reach something like 800 pounds and then it would level off.

    The worst foods are pasta, rice, pizza, hamburgers, lasagna and most breads as well. Most of the things labeled “lite” are actually NOT.

    It’s all on the nutrition label. Keep the math at 1 calorie per 1 gram. and you will lose weight and reach an nice equilibrium weight. Here is a good one. 100 grams and only 32 calories.

    • What you are missing on the exercise score is that it boosts metabolism. The gains go way beyond what you actually burn during the exercise itself. Also, if you are building muscle, particularly during say, weight-lifting, then that muscle will by itself raise your metabolism, even while at rest.

      • How much exercise do you need to do to offset a hamburger and fries at lunch instead of soup and a sandwich.

        You would have to do weight training for at least two hours.

        How about a soup and sandwich for lunch and then do weight training for one hour. Now you are dropping pounds and gaining muscle.

        That is the point.

  36. Lets start with salt. Now over the years we have added iodine to our salt as a supplement because it was an easy way to get it to those who did not eat enough of it in their food supply. Take away the salt and now you have iodine deficiency which acts very much like a slow thyroid but does not show up in test. I used to crave salt, ate it by handfuls.. a little iodine supplement and that crave goes away as well the weird lump on the side of my neck and about 30 pounds. Perhaps we should be looking at the quality and nutrient value of the food we are eating and not just quantity vs activity.. just sayin.

  37. In today’s world, being fat is a negative. Appearance and higher health risks are the most obvious reasons. However, this is only a recent dynamic. We are basing it on the overabundance of food TODAY, available anywhere at anytime. This contributes to an over-consumption of calories of course but it negates the benefits of being fat/having a slow metabolism that were endowed to people in the past.

    Humans have been around for thousands of years. During most of the time, food was not always plentiful and at times, there were severe famines that lasted for years.
    Crop failures and such, along with less ability to store food for long periods as we can today were serious issues, often causing numerous deaths from malnutrition and starvation. This still takes place in the undeveloped countries and other places but we will assume that most reading this, do not have to deal with such an environment as was very common not that long ago in human history.

    I am 61 years old and can eat all day but not gain weight or get fat. My wife is the opposite and considers me to be the lucky one. Probably so here in 2016 but in the past, when there was a severe famine, guys like me would probably be the first ones to die of starvation. We certainly would be the first to suffer tremendous loss of energy because our bodies are not as efficient at extracting every calorie out of what we eat as is the case for people like my wife.
    I guess people like me sheet out more calories and maybe some nutrients vs a fat person, with a slow metabolism that holds on to every scrap until the last calorie has been extracted.

    What a great time it is to be a human being in this age of science, technology and comforts………….and overabundance of food!

    I’ll eat to that (-:

  38. So being fat and having a slow metabolism was a genetic advantage in most of our past………when there were often life threatening food shortages.

  39. lbs, feet & inches.
    I look forward to the day United States of America will start using international standard units.

    “the international system of measurement now officially adopted by all but three nations in the world: Myanmar (formerly known as Burma), Liberia — and the United States.”
    America, Liberia, Myanmar: The Anti-Metric System Holdouts

    Honestly, the system is really simple. All other people in the world have learned it.
    Seriously – inches! there are 12 of them´s in a foot! There are 3.28 feet in a meter!
    And we have a Base-10 decimal system – come on!

    See how neat the SI system of units is:
    Velocity: m/s
    Acceleration: m/s^2
    Force: kg*m/s^2
    Work: kg*m^2/s^2
    Effect: kg*m^2/s^3

    Does it really matter? Yes it does:
    “The Mars Climate Orbiter (formerly the Mars Surveyor ’98 Orbiter) was a 338-kilogram (745 lb) robotic space probe launched by NASA on December 11, 1998 to study the Martian climate, Martian atmosphere, and surface changes and to act as the communications relay in the Mars Surveyor ’98 program for Mars Polar Lander. However, on September 23, 1999, communication with the spacecraft was lost as the spacecraft went into orbital insertion, due to ground-based computer software which produced output in non-SI units of pound (force)-seconds (lbf·s) instead of the SI units of newton-seconds (N·s) specified in the contract between NASA and Lockheed. The spacecraft encountered Mars on a trajectory that brought it too close to the planet, causing it to pass through the upper atmosphere and disintegrate.” Wikipedia Mars Climate Orbiter

    We are waiting for United States of America – please stop fooling around.

    • When I got my technical educationen in the first half of the 1980’s, we were told that USA had started to adapt to IS units. The military did, but the rest? Still waiting …

    • Many things in the US use the SI system. Wine has been bottled as such since 1979, I think. Tools and many other things are sold via both systems.
      However, the Public Land Survey System (PLSS) used for much of the US is based on the chain, 66 feet (80 ch to 1 mile), to indicate land distances and in particular in surveying land for legal and commercial purposes. The “chain” was a physical thing that was carried about.
      Use Google Earth and go to Pocahontas, Iowa. Zoom out just a little and look at the squares on the landscape. These are roads, set on the boundaries laid out at 1 mile intervals. Much follows from this. From the simple: miles to the next town; to the complex: property boundaries based on a marker far away.

      To convert all of this based on 1.609344 kilometers is not going to happen.

      • I found pocahontas – which part was I supposed to zoom in on?

        Joke aside – that was an truly amazing landscape – Pochahontas, Iowa I mean.

        What has already been made don´t have to be remade. You just have to start using SI units – eventually you will love it – or die trying.

        Sweden decided in the seventies that they would stop driving on the left hand side of the road and start driving on the right side of the road – it can be done.

        Obviously, it will take a while – probably 50 years to get rid of US customary units – but it will be worth it.

      • At work (metal machining), sometimes we get technical drawings from USA, some old (renovation work), some new. Always extra work with those, due to the conversion to IS units. That’s ok with the old ones, but the new ones … Especially when the product will end up somewhere in Europe.

        We do have one US costumer that uses IS units, but those products are conststructed in the Swedish office and sold in Europe.

      • B I N G O!

        Fly over Illinois sometime. That checkerboard down there consists of square miles. Your house if you live in the United States is built on 16 inch centers and 8 foot ceilings. But, in my humble opinion, manufactured goods could and should be made to conform to the rest of the world.

  40. The goal should be physical fitness. Weight loss, if needed, should only be secondary to that. Physical fitness is a combination of both proper diet, as well as exercise. Exercise needs to be both aeorobic and muscle-building. Muscles are the shangri-la of fitness, and boost our metabolism, both at rest, and active.

  41. Follow the money! Advertising encourages everyone to eat processed foods and drinks. And obesity scientists need the disease tag to get funding. And the disease tag gives a lot of, not all, people an excuse. Eat less and exercise more will solve most, not all, of the obesity problem. And stop eating while you think you are still hungry and wait 20 minutes – you’ll find that most of the time the hunger has vanished after 20 minutes. For me and friends who joined me in our own boot camp weight loss campaigns, losing weight is as simple as switching back to unprocessed food (vegetables, salads, lean meats) and water, and doing more exercise. I hear people saying they are on this or that diet but then I see them cheating by sneaking something sweet or having a 2nd glass of wine or skipping the 1 hour power walk.

    I get the feeling obesity scientists may be heading the way of climate scientists talking up a problem for their own sake, not humanity’s, and not being able to see the forest for the trees.

    Kip, I have no doubt that genes play an individual role but I just don’t buy the line that we have been struck down by fat disease.

    • 4 Eyes ==> I can only report the best evidence to date and point out that the field is still only vaguely understood.

      “Kip, I have no doubt that genes play an individual role but I just don’t buy the line that we have been struck down by fat disease.” The hypothesis that Adenovirus 36 infection may [of one of many] cause human obesity is just that, an interesting hypothesis which is getting some attention and research. The gene research is very solid and very well supported.

  42. In today’s world, we see political slants inserted often. We see people claim gun control will stop homicides. Have we tried blaming silverware? We see obesity and sure enough they use silverware. Paraphernalia.

    My daughter went to college with a goal of gaining 7 pounds. She failed. She couldn’t get half of “The Freshmen 15″ (Heptathathlete Big 12) She ate a lot. She also studied all night many nights. Architectural Engineering. She is skiing today on 10” fresh goreflakes. I am sure she has calculations for calorie burns when she runs ultramarathons now.

    I think building muscle mass offsets fat increase due to aging. She runs 400 miles a month and i ride a mountain bike 400 miles a month. I rode my bike 8 miles this week to see Doc for annual physical. They drew blood and my CO2 level was low. How could it be low? Lot of this science doesn’t make sense.

    • “My daughter went to college with a goal of gaining 7 pounds.”

      Is that the same as losing 7 pounds or was she anorexic ?

      ” They drew blood and my CO2 level was low. ” Low compared to what. FFS.

      I get so tired of quacks telling me that my blood pressure is ‘too low’. Compared to what ?! A population statistic based on a fat, obese norm, who smoke and have a history of heart and arterial disease, dying from brain haemorrhages.

      Hey, I’m glad to be “abnormal”.

      If you do a lot of cycling, your blood oxygenation is probably above “normal” and you have ‘abnormally’ low CO2.

      I would not lose sleep about that.

    • Henry ==> You have experienced some of the complexity of the field. Despite the very simple basic truth of “Eat Less Exercise More” — it does not translate into generally applicable workable advice for free-living humans.

    • There is an excellent YouTube video on a lecture by Dr. Ray Peat on the biological importance of CO2. The ingestion of a teaspoon of baking soda in water reversed the stroke damage of a hemiplegic woman within 15 minutes. Most fascinating. Dr. Peat also talked a lot about low thyroid function, and the dangers of polyunsaturated vegetable oils. He also subscribes to the findings of Dr. Gilbert Ling that the protein in the cells is responsible for the storage of potassium and that the protein structures the water. So no sodium-potassium pumps needed. The structured water on hydrophilic surface was further investigated by Prof. Gerald Pollack. This is extremely interesting stuff. This also explains the cell membrane potential.

      And while we are at discussing interesting stuff about health, here is another one: the Zeta Potential and its key role for cardiovascular health. Read online the book by Thomas M. Riddick about colloidal stability and the Zeta Potential. And see Dr. T. C. McDaniel’s website on his Zeta Aid, he is 102 years old, he must be doing something right. I am taking it daily and my heart arrhythmia is gone. Furthermore, dental health is of upmost importance for cardiovascular health. Root canals are harboring anaeoribic bacteria that can easily get into the blood stream, forming biofilms on heart valves (partially damaged the heart valve of a friend of mine) or inside the blood vessels (my mom had stents set and two months later she had dental surgery because of an infected tooth, the infection spread to her jawbone!). When the Zeta Potential is strengthened then these bio films dissolve, it also dissolves kidney stones.

      Gum disease and/or root canals can also cause arthritis. My mom’s care taker had swollen finger knuckles when I came to visit her in Germany in 2012. I offered her my ‘MMS’ (sodium chlorite activated by citric acid to form chlorine dioxide) she mixed 4 drops of the sodium chlorite solution with one drop of 50% citric acid, the proper stoiciometric ratio, and let it sit for 1/2 minute, then she added water and swished it around her mouth, then swallowed it. After the fifth day she no longer had arthritis! But such results can only be achieved with early onset of arthritis. So it can be ‘all in your head’ or mouth, so to speak. In Germany, I found the MMS with 9% hydrochloric acid. Here the proper stoichiometric ratio is a 1:1 drop ratio. I also studied the MDS sheet on sodium chlorite and chlorine dioxide. At these small amounts it isvery safe to the best of myknowledge. It is less harmful then the RDA of table salt when comparing the LD50s. I think this is some of the most important health info that I ever came across.

      http://raypeat.com

      http://gilbertling.org

      http://tcmcdaniel.com

  43. The older I get the more difficulty i have in pinpointing events in my earlier life on a timeline. It seems to me that it was in the late 70’s or early 80’s that I went to bed an average man and woke up obese. That was the point in our historical timeline when the government officially adopted the BMI as the end all be all to classify and define it’s citizenry and i discovered over my morning coffee via the front page of my morning newspaper.
    Now, it will not come as a surprise if someone corrects my time frame and I discover through this page that this took place in the 60’s or the 90’s nonetheless thanks to my Government I woke up one morning to discover that i was FAT and I dare not argue.

    • “we EAT like CRAP.”

      No, we EAT CRAP.

      Being obese in India is as rare as being rich in India. Despite that, being fat is seen as a sign of “beauty”, because being fat means you are NOT POOR.

  44. We should point out that obesity is a modern problem. 50-100 years ago 1/3 of North Americans were not heavily overweight. That puts pressure on the gene-related theory which I think over-complicates a simple problem. We under-estimate how much we eat, we don’t realize how inactive we are and we EAT like CRAP.

    Television, automobiles, take-out food, heavily-processed food, snacks and candy.

      • Kip…why so prickly?
        I’m guessing you struggle with your weight?
        Try laying off any food that uses synthetic fats.
        Incoming==>the body recognises them as fats and stores them…but is unable to recover and metabolise them<==. If you get my drift.

      • charles nelson ==> Still wrong … making guesses about strangers, especially without any data whatever, is never a good idea.

        If you read the essay, you’ll discover why “Eat Less – Exercise More” is not a solution to obesity — it just isn’t.

      • Kip Hansen Said:

        “If it were only true…..what a wonderful world it would be.”

        It IS true. That people underestimate the amount of calories they intake, and overestimate the amount of calories they burn doesn’t make it untrue. It means that people are the problem, not the concept of expending more calories than you ingest.

        People who exercise enough to burn more energy than what they get from their food ALWAYS loose weight. Every time. Anything else would violate the laws of thermodynamics.

  45. A few points.

    Any athlete knows the BMI is seriously flawed. Most ultra fit, lean, professional athletes, especially those in involved with strength such as contact sports and those who are taller, would classify as obese. These are people involved with what is considered to be doing what everyone needs to do-exercise more. Typical examples of rugby players for example around 6’2 and who are strong, fast runners can weigh around 100-110 kg, which is considered obese. They are not.

    The body adapts to its environment-most non-contact tennis players and surfers for example need to be light and lithe, they can be tall, but they are light so they can move around easier; equivalent height footballers are nearly always heavier, even for the same body physique. The body distributes muscle mass where it knows it needs it, and lessens mass where it knows it doesn’t and can conserve- a tennis player doesn’t need strong thigh muscles, whereas a NFL player does.

    Another point, you haven’t touched on one major factor, industry policies and regulation. It is plain obvious the reason there is so much sugar in virtually everything is because it sells-especially to children- because they are wired to both like it and seek it out. Accountants look at the numbers and realise that if they put extra sugar in breakfast cereal, it sells more, so that is why they do it, and in just about everything. Over the long term, this contributes to obesity.

    Mcdonalds has the same issue with bread and meat ratios versus vegetables in its products; the more bread and meat and the less vegetable ratio in its products the more it sells those products, because vegetables are not the things the body craves, and Mcdonalds just looks at the numbers and adjusts its products accordingly. Over the long term this contributes to obesity, along with many other food market practices.

    Coca cola and other soft drink companys have long known that people who are thirsty will tend to buy a drink regardless if there is no other drink option available, so they have made contracts with food outlets which are only allowed to sell their product. It is a form of monopoly; food outlets should be made to sell a range of products-especially drinks -which gives the buyer more choice.

    You have touched on viruses and epigenetics, but there are many social factors that contribute-it is indeed a complicated issue, but one thing you havent mentioned is various examples of market failure, or market flaws such as monopolies on products etc: the market will supply the drug- such as sugar -and people will become addicted, if there are weak or ineffective regulations.

    • thingodonta ==> This is another case of what you say is true, but it does not work in any practical way.

      Dr. Lee Kaplan, director of the obesity, metabolism and nutrition institute at Massachusetts General Hospital, says:

      “It makes as much sense to insist there is one way to prevent all types of obesity — get rid of sugary sodas, clear the stores of junk foods, shun carbohydrates, eat breakfast, get more sleep — as it does to say you can avoid lung cancer by staying out of the sun, a strategy specific to skin cancer.”

      BTW, soda companies ALL make non-sugared versions of their products and are perfectly happy to have you buy these cheaper-to-produce products — as long as you buy their brand. The big boys in the field are even more thrilled if you buy their brand of water — which contains no other ingredients and it far-and-away the most profitable for them to produce and sell. You are just repeating propaganda on this subject.

      • Kip===> Its a complicated issue that has multiple causes, as you and I have both said. But I do think that more efficient market regulation is a factor.

        And I do wish the BMI was updated somehow, it’s ridiculous to say a professional athlete who also exercises regularly is ‘obese’.

  46. What about us people who are prescribed drugs for certain problems that cause weight gain. I almost stopped eating and still gained weight. The weight gain stopped when we changed meds.

    • hey, if you don’t want holes in your teeth , don’t got to the dentists. If you don’t want pills don’t got to the quack.

      I’m glad you are finding your way out of the maze.

    • I agree that stephana’s experience with prescrption psychotropics is a much more important variable than most people have realized. Thank you so much for sharing your experience, stephana.

      And could we please control for drinkers and non-drinkers?

    • “I almost stopped eating and still gained weight.”

      I don’t think that is possible. The fat has to come from somewhere outside your body. You have to put the fat into your body in order to become fat. You can’t get fat just breathing.

      • stephana says, “I almost stopped eating and still gained weight.”

        TA says: “I don’t think that is possible. The fat has to come from somewhere outside your body.”

        I can offer a little bit of insight if personal anecdotes and a little neurology are permitted…

        I was about to undergo proton beam therapy and the doctor told me a potential side effect was weight gain, no matter how little I ate. –Now this is the probable neurology behind his statement:

        The thalamus and the hypothalamus are secretory parts of the limbic system of the brain and control weight gain and weight loss. He apparently was expecting some wear and tear and his experience was that damage in this inaccessible area would cause weight gain.

        This article by Kip Hanson is both a challenge and good fun. It got me thinking of the exceptions to the rule, “diet and exercise.” Also, goodness, hardly any one here has ever been pregnant and gained 30 extra pounds in 6 mos. (Kip Hansen mentioned this via the NIH.)

      • Interesting stuff Zeke,

        However, “no matter how little I ate” clearly does not include not eating. The hypothalamus can only regulate how the body processes food , it can’t make fat come from nowhere.

      • It is counter intuitive. But here is one study you can look at. I posted it below but maybe stephena would like to see it so I will repost.

        Hypothalamic obesity: causes, consequences, treatment.
        Lustig RH1.
        Author information
        Abstract
        Hypothalamic obesity, or intractable weight gain after hypothalamic damage, is one of the most pernicious and agonizing late effects of CNS insult. Such patients gain weight even in response to caloric restriction, and attempts at lifestyle modification are useless to prevent or treat the obesity. The pathogenesis of this condition involves the inability to transduce afferent hormonal signals of adiposity, in effect mimicing a state of CNS starvation. Efferent sympathetic activity drops, resulting in malaise and reduced energy expenditure, and vagal activity increases, resulting in increased insulin secretion and adipogenesis. Pharmacologic treatment is difficult, consisting of adrenergics to mimick sympathetic activity, or suppression of insulin secretion with octreotide, or both. Recently, bariatric surgery (Roux-en-Y gastric bypass, laparoscopic gastric banding, vagotomy) have also been attempted with variable results. Early and intensive management is required to stave off the obesity and its consequences.

        This is a very deep structure in the brain, well-protected and hard to reach with scientific instruments. It is described sometimes as the orchestra conductor because it seems to be relaying signals from/between other areas. Hope this study gives some hint in the right direction.

    • Stephana, medications often affect the gut microbiome. They can act as antibiotics, and change the diversity and ratios between different types. One area of research is about how the make-up of the gut microbiome affects obesity. They can take feces from fat mice, put them into thin mice and make them fat.
      Here is something on antipsychotics, but it applies to other meds as well.
      http://www.microbiomeinstitute.org/blog/2015/10/29/the-microbiome-plays-a-role-in-antipsychotic-mediated-weight-gain

  47. I am interested in how certain environmental factors may influence weight gain/loss as well as diet and exercise. Someone has already mentioned that many older people grew up without central heating so (in the UK where I live) we were cold a lot of the time in winter. But while living in the USA for some time back in the 1980s we noticed there were very few fat people at 5000 feet in the Rockies, but a lot of obviously overweight people on the West coast, especially in Washington state. Does anyone know if altitude is a significant factor or how the obesity levels vary across the US and what factors might affect this?

    • It may. But Colorado generally has the fittest population of any state because of all the outdoor activity opportunities year round, and its demographics.

      • yeah with all that sea level rise coming out of Colorado , I guess everyone is having to do a lot of climbing. ;)

  48. Nobody has mentioned Ancel Keys yet. He was the fat equivalent of James Hansen. He’s the one who cooked the science and told us not to eat butter and to drink only skim milk. link Some people think he’s the one who started the obesity epidemic.

  49. Look, losing weight is easy. Stop eating and you will be a sack of bones, in 30 days… no matter how much exercise one performs. So the matter is really one of maintaining weight. What seems to work for me is to eat freely when very active and very small and selective whenever I am in couch potato couch mode. I am 6’2 – 180lb and an old man and my activity level varies wildly according to the season. Mid-winter I am a complete couch potato. Spring and fall I am a active demon. Summer more laid back but active. FWIW -GK

  50. About four years ago, there was some “study” that was echoed in the press that claimed atmospheric CO2 was contributing to the obesity epidemic. I found the idea intriguing, but not credible. A great premise for a science fiction story, for sure.

    Here, I find equally intriguing, and far more credible that “eat less, exercise more” is ineffective. Lots to ponder here.

  51. I think obesity has a lot to do with one’s tolerance for being hungry. Some think they have to eat before they feel hungry so they don’t ever feel the discomfort of being hungry. Some eat immediately when they feel the initial hunger pangs. Some can put off eating for a short while, and some can function normally for hours while hungry and it doesn’t bother them.

    Don’t treat being hungry like it’s a crime. Its normal, get used to it. Get away from the house, far far away from the house and do something where you will have no alternative than to be hungry because there will be no food to grab in ten seconds. I’m no nutrition expert but I think you even burn fat when you’re hungry.

    All I know when I haven’t eaten, I am doing something interesting (logging, fishing, hunting trapping, etc) calorie consuming and far from the refrigerator, I rarely notice that I’m hungry. Even when I am cold (shivering really burns the calories by the way). Its when I’m sitting around the house doing nothing is when I notice that I’m hungry.

    • “I think obesity has a lot to do with one’s tolerance for being hungry. ”

      Bingo. And the “tolerance’ is not even real, it is social . Naturally the human animal will go through extended periods with NOTHING to eat and nature has blessed us with a system to deal with that. It’s called FAT. Fat is both an insulator and a reserve. nearly all animals fatten up before the winter.

      Every adult in the modern, western world should elect to go with nothing but water for at least 5 days at least once in their life to understand what hunger is, and what NOT being hungry is.

      That does not mean to suffer hell and never moan again, it means to realise that going without food does not really hurt. It does not get worse and worse.

      Most of the time we eat for the pleasure, for the fun, not because we NEED to eat.

      Until you have gone without food for five days, by necessity or by your own choice, you will not understand that.

      If your reaction to that is OMFG, he’s crazy, then you need to try it. You do not even know what hunger is or how it works.

      • I find myself having some kind of intolerance to being overfed. If I’ve eaten too much during the previous week, I skip meals, hardly even thinking about it. Apparently most people aren’t like that.

  52. Compare the human body to a car. The car needs both fuel and replacement parts to keep running..
    The calories in the food we eat provides the fuel, the vitamins and minerals provide the replacement parts.
    When we eat food with plenty of fuel but few replacement parts, ,we’ve got to make up for the shortage of replacement parts by consuming more of that food.we’ve got problems.

    • Alan McIntire ==> Interesting analogy, but not quite right. The body demands more food when it does not get enough calories — it does not demand vitamins, minerals, etc. Salt is an exception — a body can demand salt. When a body runs short of other building blocks, it cannibalizes itself.

  53. I think the take away from this study is the impact our genes have on our weight gain.

    Over the millenium the human body has adapted to the feast/famine cycle by storing calories when times are good. When we go on diets the human body responds by trying to store more calories. When we come off the diet, our bodies are still in the mode to store calories. In effect, the encoded feast/famine DNA responds by changing our metabolism in response to our diet.

    So here’s a little math for you. Each time I go on a major diet I subsequently gain all the weight back plus an additional 10 pounds. I’m now 50 pounds overweight. How many diets have I gone on?

  54. I read some recents studies showed obesity was linked to a lack of microbial variety in the gut..about 40 specific absentees in the obese. They then found foods to increase the variety of mircobes and the weight came off. This was done wthout changing energy in and/or energy out. I will need to find the reference but I recall it was UK based research. Ie diet alters gut bacteria in those people that are susceptible to obesiy.

    • Thanks for mentioning this Macha. About 10% of our calories come from bacteria that produce small-chain-fatty acids in our guts. Obese people have different microbiome profiles. It seems that their gut bugs extract more energy from their food. They can gain weight on the same diet as a thinner person.

    • Macha ==> There is quite a bit if research being done on gut biomes — and some indication that this may have something to do with nutrition, health, and how the body absorbs what it needs from the food we eat.

      I have seen nothing definitive about it in relation to obesity — though there may be a study or two out there.

  55. Recently, the Food and Drug Administration has been asking drug research companies to demonstrate clinical efficacy; ie, does the drug or procedure improve people’s health and longevity? Drugs were required to being compared to placebo to show a difference in a particular drug or doing nothing. Now what the F&DA is asking, is this change relevant? Do the outcomes warrant the risk?

    Early on, drugs or diet or exercise were shown to lower Cholesterol, decreasing a person’s cholesterol by 11%; ie, from say 200 to 187. Did this decrease mean more people are now living because they decreased their cholesterol 13 mg/dl? The answer of course was: NO.

    Then the issue has become: “good Cholesterol” like HDL (High Density Lipoprotein). Raise your HDL, decrease your LDL (Low Density Lipoprotein) and good things are supposed to happen. Well, to say the jury is still out is an understatement. A drug Niacin, decreases one’s LDL and raises one’s HDL and….heart attacks, overall mortality showed no difference between Niacin and placebo. Stay tuned.

    “Nonetheless, medical bio-markers do improve even with these fairly small weight loses. Whether this improvement in bio-markers adds up to improved health and longevity is not known.”

    It is possible the wrong markers are being followed and reported upon.

    Recently, looking at people who live to be 100 and longer: 1/2 smoke cigarettes most of their lives and continue to smoke at 100; 1/2 are obese; most drink alcohol; 25% don’t nor have they exercised at all in their lives. The most important factor, did they have a close relative who also lived to be 100. Relatives with longevity, obesity, exercise, smoking, alcohol use/abuse probably play some role in some people’s health and longevity at some time, its just that all the admonitions by “experts” are glib references to how much no one knows at this point.

    Loose weight if you like the way you look a few pounds less.

  56. There’s more than a little truth to the “energy balance” concept of weight loss. About 20 years ago, I was prompted to lose weight by my then doctor, due to a number of conditions I had associated with being overweight (I was 5′ 11″ tall, and weighed 257 pounds). So I did two things. I consumed nothing but ice water after 6:00 pm, and restricted my caloric intake to 1,000 calories a day. I lost 75 pounds in a little less than three months, and kept if off for a number of years. It was too much, though. My BMI was “right,” but I looked like a concentration camp survivor. Many of my colleagues across the country thought I had cancer.

    I must admit, thought, that I felt amazingly good.

    • My experience was similar. My kids thought I looked terrible and assured me that I was in the grip of some kind of mad food cult. I got a lot of criticism for not looking fatter so societal pressure is an interesting aspect of how we deal with fat and all of the misguided press coverage.

  57. *Even when they are aware of the problem*, people have a tendency to treat problems as if they have *one* solution, and to stop looking for it when they think they’ve found it.

    In addition, a lot of people treat all their ideas as if they were religious tenets – people here are quite familiar with this concept, like the “97%” nonsense.

    So, basically, people lock themselves into 60 different solutions and then dig in and fight over it.

    And the people suffering from the problem also face the scorn of others for not having personally solved the problem that the great community of experts have *also* not solved.

    Don’t anyone dare wonder why I spend so little time around other people. Y’all’re bonkers.

  58. Obesity is a result of modified food. If you eat healthy food you don’t get fat no matter the quantity.

    • “Obesity is a result of modified food. If you eat healthy food you don’t get fat no matter the quantity.”

      I’ve wondered about that. I’m not overweight so I have the luxury of eating most things, although I do have to watch and not go overboard, so I have never tested your claim, other than noting that when I was young, most meals were prepared and eaten at home, which was the norm for most people of the time, and there were very few fat people in those days.

      I have suggested to people who are overweight and want to lose it, to start fixing home-cooked meals, instead of going out to eat in fast food/mass produced food places. It seemed to make sense to me that that would at least be healthier and might contribute to losing some weight.

      That suggestion has not been very well received. It is easier and faster just to go to the fast food place. If they want to lose weight, they order the salad, although that may not help them much. In other words, they are not too serious about losing weight.

    • My decidedly fat ex thougy that, and was raised in the Seventh Day Adventists, and was mostly vegetarian. It did not work, as she was fat all the time I knew her.

    • Amazing how the Americans (and some other people) grew fat over a few dozen years. You must have a very strange genome, evolving so fast… Never thought about a potential problem with your two-pint “regular” soda glasses (the “small” glass exists, but it is not shown on the menu), your seven-tier burgers, loaded with salt, sugar and low-quality fat (then again, a normal sized portion does exist, but only on special request. The rest of the world is watching, with interest. Ask the Finns or the French : they are not really poor, they eat quite well, and most of them are not obese.

      • It has been evidenced and tested that eating too much of what’s available in the market makes one fat.

        I come from a small remote village where the main food were dairy, meat, starch, vegetables etc. All local produce. Not one single person was obese. After the arrival of “outside” food people started getting fatter and fatter.

        The only explanation for that is modified food.

  59. I can highly recommend Dr Barry Sears “Zone Diet” (drsears.com) for those who want to drop a few pounds. I’ve been on it for around 14 years and never looked back. Feel great, not hungry and at 6’2″ & 185-190 lbs very stable.

    Dr Sears recommends you try it for 2 weeks (I usually give things a month) and if you don’t notice about 1 lb a week drop in weight, not hungry for 5 hours after a meal, sleeping better and not drowsy after a meal then “try something else because the zone isn’t working for you”.

    My blood tests have been excellent as well for the whole time I’ve been on the zone and I’m not on any meds.

    Good luck and great health to all.

  60. Question. When did high fructose corn syrup usage in food become common…..
    And why does the baking industry love it so much ? (And others )
    (Retired Ind. Eng. with close to 40 years in the food industry)
    Because sales increased. People ate larger helpings….
    We referred to it as “high fattening ” corn syrup…

    • Quite agree. Not all sugars are created equal. Ground zero for the obesity epidemic is North America where the staple is corn. Obesity levels are much lower in places where the staple is rice or wheat or potatoes. Corn converts to fructose not glucose as these other things do

  61. The human body is, as far as evolution is concerned, in the Stone Age or earlier. It is designed to accumulate energy (fat) during the good times and to utilise that energy in lean times. The most successful humans (in Stone Age terms) are those who accumulate fat the most efficiently during the times of plenty.
    A search for the San people and their women-folk of Namibia will prove my point.
    Various populations in different parts of the globe adapted to solve the “feast-or-famine” problem in different ways and so the various populations survived in the face of often incredible adversity. The adaptations thus made have, in somewhat more modern times (a couple of thousand years, give or take a few) been widely scattered throughout the global population.
    Is it any wonder that any 21st Century attempt at trying to impose a universal weight-reduction program is, by definition, totally doomed? It’s not just “Energy-in V Energy-out” it’s a matter of how your body is progammed to respond, and that is goverend by each and everyone of your ancestors, going back to the emergence of the first hominids.
    Is it any wonder that different people respond to different diets differently?

  62. I was a fitness instructor for about twenty years, and I have heard every excuse in the book, seen every perversion of discipline, heard every rationalization about following a plan to become more physically fit. I have witnessed both tragic physical demise as well as remarkable transformations in physiques.

    I am suspicious of the latest trend in articles that promote the idea that obesity is a … “complex” … problem.
    I suspect that the complexity involves such things as how truthful people are in reporting what they eat, … how truthful people are in reporting how active they are, how consistent they actually are in practicing physical activity with the necessary focus to garner any noticeable effects.

    Also, the complexity involves social problems that limit access and opportunity, more than problems of willingness and dedication. Infrastructure of society, organizational structures that do not allow or encourage time for activity, lack of priority in our educational system to actually train children to be conscious of their health, and other things are the … complexities.

    You don’t have to blow your heart out, burn your muscles, starve yourself, … lift monster-truck wheels, run marathons, go to a gym, have the latest workout attire, water bottles, digital heart monitors, etc. You just have to practice regular physical consciousness, and this can be quite non-exerting, but, if not consistent — religiously consistent — then no good.

    What is complex is the vast differences in people’s perceptions of how they behave. For example, I have witnessed a person saying that she was fasting for health, but, in the next breath, she was eating potato chips (just a taste of them, she would say), somehow dismissing this as a contradiction, still embracing her perception that she was “fasting”. This is how a “taste” can turn into a binge, followed by starvation until the desire for just a “taste” returns.

    On surveys, therefore, that rely on personal reports of behavior, I have serious doubts about the accuracy of many responses that guide researchers to gather data to make reports about the obesity epidemic.

    Many people are not honest with themselves, so how can they be honest with their health-care providers or with researchers trying to determine what is going on.

    Hence, I tend to agree with what another poster wrote:

    I grant you, achieving a state of energy deficit can be difficult and complicated for some, and many factors figure into it. But everything ultimately answers to basic thermodynamics, and there’s no getting around that no matter how much people try to obfuscate.

    • Robert Kernodle ==> You may agree with the other commenter, but the evidence does not agree with your viewpoint.

      Anyone can lose a few extra annoying pounds through a dedicated diet and exercise program, and it does not matter which one they chose,

      But these diet and exercise programs do not reliably solve obesity for most people….that’s why I have included links to the studies in the essay, so that you can look at real evidence and not rely on opinions.

      • Reply to Kip Hansen comment on December 17, 2016 at 7:02 pm

        YOU WROTE:
        “these diet and exercise programs do not reliably solve obesity for most people”

        MY REPLY:
        Your comment shows a startling lack of knowledge about dieting — I hereby declare you are disqualified from writing about obesity in the future.

        You are correct that people who change their eating and exercising habits can lose weight.

        What you don’t understand, and I think this is shocking, is that AFTER people lose weight they often go back to the eating and exercising habits that caused them to gain weight in the first place.

        In addition, people often gain weight slowly over decades but want to lose weight fast, which the human body resists.

        A strict diet that causes fast weight loss is not one people enjoy being on, or could continue for a lifetime.

        The real problem is what the eating and exercise habits will be AFTER the diet “ends”.

        If you want to lose weight and become more physically fit, you have to change your eating and exercising habits PERMANENTLY from those habits that made you fat and out of shape to begin with!

        For some reason the “establishment” doesn’t seem to mention that much.

      • Richard Greene ==> I see you have a very strong opinion, but the vast majority of obesity research does not support your view — they “don’t seem to mention that much.” because it does not agree with the findings of very good research on the matter.

        It would not hurt if you [re-]read the essay — and if you took a very good look at the Biggest Loser study and the Sacks diet study, I provided links.

        What you propose is what is known as “the lazy cheating fat people” hypothesis — “fat people won’t continue to exercise and cheat on their diets that’s why they don’t stay thin” — which has been proven false over and over in carefully conducted clinical research.

    • Reply to Robert Kernodle on December 17, 2016 at 4:29 pm

      YOU WROTE:
      “On surveys, therefore, that rely on personal reports of behavior, I have serious doubts about the accuracy of many responses that guide researchers to gather data to make reports about the obesity epidemic.

      Many people are not honest with themselves, so how can they be honest with their health-care providers or with researchers trying to determine what is going on.’

      MY REPLY:
      Bingo – great wisdom from someone having experience with exercise and nutrition, rather than a writer spouting an anti-establishment opinion.

      People often eat while doing other things and don’t realize how much they are eating.

      If fat people HONESTLY wrote down the exact weight / size of EVERYTHING they ate during a week, at the end of the week they could read their list and have a good idea why they were fat!

  63. Jasper Carrot: “It’s not a disease. It’s because this hole” [pointing to his mouth] “is bigger than this hole.” [pointing to his arse.]

    • The only way to lose weight is to exhale it as CO2. What comes out your arse is stuff that never got absorbed in the first place.

  64. It is amazing how the Nazis managed to find a complete cure for obesity as far back as 1943. It apparently applied to all people, regardless of genetic makeup – it was universal and involved no surgery at all.

    Here are some of the happy successful beneficiaries of this radical treatment.

    • I remember talking to someone who found himself building a Burmese railroad for the Japanese during WW2. He said he couldn’t understand why the fat ones died first. He thought they would live on their reserves, but apparently this was not the case.

      • The fat ones probably had heart attacks.

        I’m sure I’ll be corrected if I’m wrong on this, but I think I read that every pound of fat you have requires one mile of blood vessels to feed it. So your heart is pumping one extra mile of blood vessels for every extra pound of fat you have. If you have a lot of excess pounds of fat, your heart is pumping extra hard all the time.

    • Leo that was a very disturbing Holocaust picture not necessary for comments on this obesity article.

      According to internet Rule 5A, it is acceptable and expected that an internet argument will eventually end with both participants comparing each other to Hitler. So that’s okay.

      But … we’ll never forget the Nazi Holocaust, so we don’t need graphic pictures to remind us.

  65. Back in the day (60-70’s) we wound down car windows, had manual car steering, mostly used clutches and gears, used more public transport, more people walked greater distances, more people rode bikes, ate less high fat high sugar pre-packaged food – yada yada. Kids spent more time outside climbing trees, playing physical games outside, exploring their environment.

    In my simnple mind all this extra excercise and less fat/sugar intake meant less obesity back then.

    Maybe its my lyin’ eyes but I see mostly obese people loading their food trolleys with stuff like large bottles of coca cola, packets of white bread and pre-packaged high fat/sugar content food.

    I’m in the same corner as Stephen Hawking and “almost every major medical and health organization in the world”.

    • My boy and I and the dog walk to the bus stop a quarter mile away every day, the kid next door gets a ride to and fro. Round trip that’s about 80 miles of walking per year, every year, usually carrying books and trumpets. Guess who’s the fit kid and who’s the chubster. Most places the bus stops right in front of the house. All we might have to do to stop obesity is require kids walk to school or a bus stop.

  66. I used to believe the energy balance, laws of thermodynamics, or calories in Calories out model.
    Then I read Good Calories, Bad Calories by Gary Taubes
    Anyone interested in understanding the obesity epidemic I would suggest this is a good place to start. In this book he details a study around 1940 where the researchers tried to fatten prisoners. At 4000 Kcal per day sure enough some got fat others did not. Then 5000, 6000, 7000, 8000, 9000. That’s right 9000 Kcal per day for 2 remaining subjects that would not get fat. After 30 weeks of 9000 Kcal daily they each gained about 5 lbs. Contrast that with a women I know with a powerful self will determined to loss weight eating no more than 1000 Kcal daily and exercising like a fiend. She was always hungry, tired, and miserable but after 6 months plateaued at a weight loss of 15 lbs. After given up in frustration she gained all the weight back.
    No explain to me energy balance and fat people just eat too much or move to little. .

    Why We Get Fat (2011)
    Why We Get Fat (paperback)
    An eye-opening, paradigm-shattering examination of what makes us fat. In the New York Times best seller Good Calories, Bad Calories, acclaimed science writer Gary Taubes argues that certain kinds of carbohydrates—not fats and not simply excess calories—have led to our current obesity epidemic. Now he brings that message to a wider, nonscientific audience in this …

    Good Calories, Bad Calories (2007)

    [released as The Diet Delusion in the U.K.] In Good Calories, Bad Calories, Taubes tries to bury the idea that a low-fat diet promotes weight loss and better health. Obesity is caused, he argues, not by the quantity of calories you eat but by the quality. Carbohydrates, particularly refined ones like white bread and pasta, raise insulin

    • John H said:

      “I used to believe the energy balance, laws of thermodynamics, or calories in Calories out model.”

      “No explain to me energy balance and fat people just eat too much or move to little. .”

      Any answer that contravenes the laws of thermodynamics, has an error in it somewhere. Simple as that… or bin your physics textbooks.

      • Sorry for not being clear. I did not in anyway want to suggest our bodies break the laws of thermodynamics but rather that the “eat less exercise more” crowd ignores our bodies ability to adjust for calorie intake depending on body type. Those who quote the laws of thermodynamics in weight control fail to consider this.
        Consider: does a fat cell take up or give off fat for no reason as it scopes up what ever fat comes by or is there a signal that causes it to hoard fat or divest fat.
        The major signalling hormone is insulin.
        In my examples the 9000 Kcal per day man who does not gain weight is profoundly insulin sensitive and to my mind blows the calories in calories out model out of the water. The 1000 Kcal per day women who cannot loss weight is profoundly insulin resistant. She has high levels of circulating insulin and the fat cell door is slammed shut. Alternatively the 9000 Lcal per day man requires only a whiff of insulin to clear carbs from his system and thus his fat cell door remains open.
        Can insulin levels be measured to confirm this? Yes and in fact it has been done in the 1970’s by Dr Joseph Kraft. His book Diabetes Epidemic is a tough read but for those who do they will find something quit profound.
        Paraphrasing Dr Kraft” those with heart disease either have diabetes or have yet to be diagnosed” Then asked surely there must be those with heart disease not diabetic (remembering by diabetic he means insulin resistant) his response was again paraphrasing “yes I suppose you are right by I have not found them yet.” He was a pathologist who did 3000 autopsies and tested over 15,000 people for insulin resistance (measure insulin at intervals following a 100 gram load of oral glucose)

        Gary Taubes book Good Calories Bad Calories is a seminal work on this subject and a must read for anyone who wants to understand this

    • Well yes. Fats is no problem r e. Wheat and cereals and any products thereof instant fat and pre-diabetic blood tests

  67. Kip, I agree that there is a lot of variability in individual body responses to diets, but you make one observation that supports the simpler arithmetic version: the fact that surgically reducing the stomach size has a universal effect of dropping a person’s weight significantly. I think we cunning folk have a variety of tricks that allow us to cheat on diets and this has to be a significant factor. I saw similar behavior in an alcoholic in-law. They somehow managed to get their booze when their cash and credit cards were controlled!

    • Gary Pearse ==> True but irrelevant…very carefully controlled diet studies all produce the same general results and do not support the “lazy, cheating fat people” hypothesis,

  68. First, Kip, thank you for doing these articles. By looking at parallel universes we can better understand the climate universe. Great reporting.

    One thing I don’t see here is any discussion of the role of the gut microbiome (bacteria) in modulating health, including obesity. Studies have shown that thin mice with “fat mice” gut bacteria transplanted into them (don’t ask how), become fat. This is only one example of the hundreds, maybe thousands of interactions that we have with the guys who process every ounce of food we swallow. We know, for example, that gut bacteria talk to our brains directly through the vagus nerve. All part of the complexity – and lack of knowledge – that you so eloquently point out.

    However, before the (about) 2011-12 NIH study to sequence a group of complete gut microbiomes, there was essentially zero knowledge about what bacteria were present, in what quantities and even today, we are just getting a clue about what they do. It is equivalent to our knowledge of weather, Arctic ice and such before and after the advent of satellites. A company in San Francisco will sequence your gut bacteria for less than $100 and tell you “who you are.”

    It is my strong feeling all.of the commentary in your article and the comments that follow are looking for answers in the wrong places. 90% of the cells in our body are bacteria and the gut microbiome is one of the most complex ecosystems on earth. They digest everything we ingest, and tell us what they want. Maybe we should ask them how to control weight?

    • markopanama ==> Gut microbiome research is very very young and does not yet produce consistent useful results. There are a lot of tantalizing hints of this or that….but nothing that leads to a solution for the obesity problem, yet at least.

  69. Kip, Thanks for putting this post together. I have an interest in the gut microbiome. It is a piece of the puzzle that hasn’t received as much attention as it should. People who are obese have a very different microbial profile in the gut. They seem to get more calories out of the non-digestible fiber in food than the average person. Normally we get 7-10% of our calories from the small-chain fatty acid production of our gut bacteria. So it isn’t as simple as calculating calories that we can absorb on our own. Frequent antibiotic exposure and some medications can cause shifts in microbe populations that have been associated with weight gain. The same is true of circadian rhythm disruptions. It isn’t as simple as eating less and moving more.

    Research in this area is just beginning.
    Here are a few links that illustrate this line of thinking:
    http://www.the-scientist.com/?articles.view/articleNo/44358/title/A-Complex-Disorder/
    http://www.microbiomeinstitute.org/blog/2015/8/9/gastric-bypass-surgery-alters-microbiome-which-possible-contributes-to-weight-loss
    http://www.microbiomeinstitute.org/blog/2015/10/29/the-microbiome-plays-a-role-in-antipsychotic-mediated-weight-gain
    http://www.the-scientist.com/?articles.view/articleNo/44615/title/Gut-Bugs-to-Brain–You-re-Stuffed/
    http://www.microbiomeinstitute.org/blog/2014/12/7/obesity-and-the-daily-cycle-of-the-microbiome

  70. From May ’15 to May ’16, I went from 262 down to 202. I got a dog (two long walks a day), got a FitBit (averaged 19,000 steps a day for a year), quit ice cream for the first 6 months, and ate baby carrots all the time. Prior to that, I’d never tried a diet. Subsequently, I’ve added ice cream back, am not taking quite as many steps, and 15 pounds have returned. I’m 6’6″, so I still feel pretty good. At least my experience would suggest that the simple equation calories out > calories in = weight loss.

    • jefe ==> You have proven what the studies about obesity have found — one can force the body to give up extra weight by managed diet and exercise, but the body will fight back and attempt to regain the weight to some set-point that it “prefers”.

      Well done on dropping 25 lbs — that’s abit better than most accomplish (averaging 10-15).

  71. Only … bariatric surgery, is universally successful at bringing about a major and permanent reduction in the body weight of the obese.

    Not necessarily permanent. A relative who is a nurse said that some people who’ve had bariatric surgery do gain weight after a while. That might be another example of the body’s adaptation to lower caloric inputs.

    • “Not necessarily permanent. A relative who is a nurse said that some people who’ve had bariatric surgery do gain weight after a while. That might be another example of the body’s adaptation to lower caloric inputs.”

      Or they may just be putting more food in their smaller stomach more often.

  72. Hi Kip, – I know you read all so will give some input regarding our intestinal micro-organisms’ role in the subject. What is relevant is the different short chain fatty acids they produce, the relative concentrations of short chain fatty acids to one another & where along the different sectors of our intestinal tract there is output of specific short chain fatty acids.

    (2015) “Dietary Gut Microbial Metabolites, Short-chain Fatty Acids, and Host Metabolic Regulation” reveals that these (Quote): “… act as signal transduction molecules via G-protein coupled receptors (FFAR2, FFAR3, OLFR78, GPR109A) and as epigenetic regulators of gene expression by the inhibition of histone deacetylase (HDAC) … (&) … can be used for de novo synthesis of lipids and glucose … energy sources ….”

    The short chain fatty acid appears to create better sensitivity to insulin, while acetate creates better glucose tolerance. Propionate instigates colon cells to put out postprandial plasma peptide YY & glucagon-like peptide-1.

    Butyrate up-regulates production of peroxisome proliferator-activated receptor-gamma coactivator-1α; in muscle & liver cell leads to phosphorylation of adenosine-monophosphate-activated kinase. (Quote) ” …Acetate reduces the appetite by changing the expression profiles of appetite regulatory neuropeptides in the hypothalamus through activation of TCA cycle ….”. For free full text link = http://www.mdpi.com/2072-6643/7/4/2839/htm

    (2016) “The Influence of the Gut Microbiota on Host Physiology: In Pursuit of Mechanisms” reveals how short chain fatty acids are absorbed via either (Quote) ” … hydrogen-coupled monocarboxylate transporter 1 (MCT 1), MCT 2 and MCT 4 [73] … (or) by dynamic exchange with bicarbonate … (or) … by non-ionic diffusion of protonated SCFAs (short chain fatty acids) at the apical tips of colonocytes ….” Those ” … absorbed into colon are transported into the hepatic portal vein and liver where they may be further metabolized before entering circulation. By contrast … (those) … absorbed in the rectum can bypass the liver and directly enter systemic circulation … “; apparently fewer than 10% of short chain fatty acids are excreted in the feces.

    Acetate “… reduce serum free fatty acids … a major influence on host metabolism … GPR43 was necessary to mediate a reduction in host lipolytic activity …” in response to acetate & propionate. Short chain fatty acids influence synthesis of a fat metabolism regulator called “… fasting-induced adipose factor … (&) … activate peroxisome proliferator-activated receptor γ ….”

    Liver tissue cells response seems to be that acetate instigates ” … a reduction in fatty acid synthase activity….” Short chain fatty acids influence energy balance of liver cells via activation of signaling by ” … the enzyme 5′ AMP-activated protein kinase … (to) … stimulate an increase in lipid oxidation ….” For free full text link = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045138/

    (2016) “Nutritional Signaling via Free Fatty Acid Receptors” details the priority of reception by GPR43 for “acetate = propionate > butyrate” . Among other features this receptor elicits response by colon PYY-expressing L cells. ((Quote) “…PYY is an anorectic peptide that inhibits upper gastrointestinal tract motility … (&) … GPR43 activation … promotes GLP-1 secretion ….” Authors go on to explain (Quote) ” … GPR43 regulates adipose-insulin signaling …(it) … is also expressed in pancreatic β cells and regulates insulin secretion … (it) … inhibits fat accumulation in adipose tissue ….” For free full text link = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848906/

    For more free full research see (2013) “The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism”; link =
    http://www.jlr.org/content/54/9/2325.long

    Some insight may be gleaned from (2015) “Propionic acid and butyric acid inhibit lipolysis and de novo lipogenesis and increase insulin-stimulated glucose uptake in primary rat adipocytes”; free full text link = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496978/

    Of course there are non-linear influences to consider & some of this is gone into by the authors of (2016) “Regulation of immune cell function by short-chain fatty acids”; free full text link =
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855267/

    • gringojay ==> Still very early days for all that….what they have not yet shown is how this makes a difference in the health and lives of people. They might yet, someday…but not yet.

  73. Sometimes weight gain does not play fair.

    Hypothalamic obesity: causes, consequences, treatment.
    Lustig RH1.
    Author information
    Abstract
    Hypothalamic obesity, or intractable weight gain after hypothalamic damage, is one of the most pernicious and agonizing late effects of CNS insult. Such patients gain weight even in response to caloric restriction, and attempts at lifestyle modification are useless to prevent or treat the obesity. The pathogenesis of this condition involves the inability to transduce afferent hormonal signals of adiposity, in effect mimicing a state of CNS starvation. Efferent sympathetic activity drops, resulting in malaise and reduced energy expenditure, and vagal activity increases, resulting in increased insulin secretion and adipogenesis. Pharmacologic treatment is difficult, consisting of adrenergics to mimick sympathetic activity, or suppression of insulin secretion with octreotide, or both. Recently, bariatric surgery (Roux-en-Y gastric bypass, laparoscopic gastric banding, vagotomy) have also been attempted with variable results. Early and intensive management is required to stave off the obesity and its consequences.

    • Speaking of chemical insults to the brain. The main point of the Kip Hansen article for me is that the AMA has classified obesity as a disease.

      In fact, “overeating” is found as a treatable disease in the DSM.

      Well, go on with all the conjecturing about what has gone wrong in America since the eighties. Good luck. Hope you trip over the truth sometime, and it flips up and hits you on the head like a rake, so you don’t miss it.

    • Forget BMI. Those are not good numbers. Please get a full metabolism workup ( blood chemistries plus an EKG stress test). You are at risk for several really bad chronic medical problems.

      I am 6’0 and have weighted 180-190 since was a 21 yo college double athlete. Only issue is age related muscle atrophy despite exercise at my age of ~0.5%/yr without testosterone supplements. Male menopause is not hot flashes, it is less firewood chopped per day and more pain in the evening. So anerobic weights get ‘heavier’ and aerobic runs get ‘longer’ and weight can decline with muscle mass. And, metabolism slows so food intake has to go down. Ten years ago, my significant other (she is a divorced devout Catholic) and I would eat a chicken in two meals, now it is four, so we rarely buy a whole chicken any more. Life’s a bitch, and then you die anyway.

      • To look at me most would say I do not “look” 240lbs, and I don’t. Maybe it is because I have so much iron in my blood? Chronic medical issues are incurable, that’s what chronic means. I have a chronic blood disorder, you could say “cancer”, but it’s not cancer, but it is chronic.

  74. OK so there isn’t just one or a few general “cures” for obesity. You have to find what works for you, that is if you feel the need to lose weight. And when you find something that works for you, guess what? You have to stick with it. Eventually you will hit a plateau but you have to stick with it in order to maintain what you have lost. And if you need/ want to lose more just tweak what you were doing. Trial and error- perspiration and inspiration.

  75. I’m by nature a skeptic and contrarian but on this scientific debate, I side with the conventional wisdom. True, there are other causes of obesity but I think the majority of cases is just overeating and under exercise. Why? Because obesity in the US has more than doubled since 1960. I don’t think this is due to genetic mutations of the whole US population. The more plausible explanation is changing diet (high-calorie fast foods)

    The research of Dr. Sacks monitored the diets of people but not their physical activities, how much calories they burned each day. This is just as important as diet. I believe in the conventional wisdom because that’s how I lost over 25% of my body mass. I was overweight. I reduced my calorie intake and did 10-km running and weightlifting. I regained my teenage body mass and muscle tone (you wouldn’t believe my age) But this is not possible for obesity caused by genetics.

  76. Before the obesity epidemic, people were heavy smokers and were engaged in what would now be considered manual labor employment. We could go back to that era as a solution, but it would take 10 to 20 years off our lives.

  77. The fact is there is no simple measure of calories actually extractable from food and in practice it varies enormously between individuals. Biochemistry knowledge makes it incredibly complicated instead nutritionist (if they are even involved) do arbitrary maths protein times 4.5 to put a label on food.

  78. It can’t be more simple. If you are putting on weight, you are indeed eating more calories than you are using. If your metabolism slows down, then you need to use more energy in other ways, or increase the amount of exercise you do.

    Failure to loose weight, for whatever reason, does nothing to disprove the laws of thermodynamics.

    Any argument that goes along the lines of “well, I’m expending more calories than I ingest, and I’m not loosing weight” is either underestimating your calorie intake, or overestimating the amount of energy you are using.

    One of my favorite Aussie TV shows:

    Dr Rudi:

    “Eat less. It worked in Changi, it worked for Gandhi, no love handles on that man”

  79. I believe that Weight Watchers is the most effective program for people to lose weight and keep it off. They promote portion control and eating more fruits and vegetables while exercising more. I lost over 40 pounds and have kept it off for almost three years now. I ride an exercise bike an hour a day and do some weight lifting two or three times a week. (I am almost 70.) I eat almost the same foods every day, with minor variations. I was an athlete in my youth (football, wrestling, track – sprints, and competitive Olympic-style weightlifting.) Never had a weight problem until I got older and stopped exercising.

  80. I eat any old rubbish, far too much for my energy needs. My job is mostly sedentary.
    My weight never changes, I’m still tall and slim at age 66.

    My body “dumps” what it doesn’t need, maintaining a set point.
    If I ate too little, my energy level would drop. (If far too little, I guess my weight would drop.)
    I usually eat more than I need. No problem. I’m fit and healthy.

    I think that most people have an optimal genetic set point. It can’t change in a few generations.

    Something in the environment has changed, either chemical or viral, to adjust many people’s set point.

    Science could find the cause, but it’s too busy blaming people for being lazy and greedy.

  81. People ordinarily say now that exercise doesn’t do much, because the calories consumed are so low. However, on a Concept machine its not all that demanding to do 700 calories per hour. Has anyone done a study in which dietary intake is, say, 500 calories below maintenance and in addition 700 calories are consumed in exercise? One would have to do some resistance as well, which probably does not add much to calorie consumption.

    So one might have someone with base rate of 2,000 calories, eating only 1500, and in addition burning 700 on a rowing machine or similar, for a deficit of over 1,000 calories.

    Would not that lead to the loss of around a pound every three days? Or if not, surely it would be a directly falsifying experiment.

    • Intense exercise, or what I feel is intense for me, can burn 1200 calories in an hour. That’s the thing about “more exercise” argument, what some people consider exercise looks like standing around to me. Just like people have different tolerance to the discomfort of being hungry, people have different tolerance to the discomfort of exercise. I wouldn’t be surprised if those who don’t like strenuous exercise also don’t like being hungry. It’s a double whammy.

  82. As far as I know, 77% of your weight is genetically determined. So if that weight is not the weight you like , you have to fight alive long against your body’s demand. But there are some simple rules: Eat only, if you are really hungry and eat only as much until you are full. And very important, eat what you like. Your body knows better, what you need than every expert in the world

    • I tried the high fat Atkin’s diet along with increasing my energy output by cycling everywhere for two years and 12,000Km. I was met with limited success and a return to my starting weight when I stopped the diet. After thinking about it for a while I figured that I have an endomorph body type (long in the abdomen and short in the legs) and as such seem to have a more efficient digestive system and don’t require as much food. So one year ago I started what I call the “high fat/eat less” diet with the emphasis on the eat less section.

      So far in a year I have dropped 120lbs going from 440lbs to 320lbs and I only have an additional 80lbs to go for my ultimate goal. I set this goal because while seeing a specialist for my knees he stated that “There is nothing wrong with your knees that losing 200lbs won’t cure” so I’m going to see if he was right.

      I have come to grips with the fact that I don’t need to eat as much as most people because my system is more efficient. I am now used to the reduced food intake and I no longer crave the large meals I always wanted before and I have no doubt that I will make my goal. By the way losing 120lbs feels fantastic. I can’t wait till next spring to see how climbing hills feels like on my bike when I am 200lbs lighter. :-)

      • Matt Bergin ==> Great success story — glad to see you are doing so well with it. You are apparently one of the lucky 2-4% for whom this really works! (Not to detract from your dedication and effort, without which you’d still be 440 lbs).

  83. Kip, a thought for your summary and conclusions.

    It seems what has happened in the US and to some extent in England is that religious feeling and attitudes have moved from religious doctrine to what are nominally and vaguely scientific policy issues.

    You notice in a couple of cases of the science wars that sometimes we have a public which simply refuses to accept the implications of the scientific and policy consensus. In other cases we have a split among scientists, with public followings for each party.

    However, there is something in common in all the science war cases, and that is a sort of apocalyptic or millenialist view of the situation Doom in one form or another is forecast in language very reminiscent of fundamentalist Baptist preachers in turn drawing on the rhetoric of Revelation. We are in the end times, there will be mass death and destruction, there will be very few to be saved, the names of the wicked (the deniers) will be noted and they will reap their rewards.

    Not only is doom forecast, but also dissenters are denounced in terms which are similar to those in which heretics or unbelievers are denounced. So we find the view that the dissenters, (the deniers) are going to be responsible for the disaster which will overtake the world. They are in some way responsible for it by uttering their views. Again, this goes back to the view that belief is what saves and unbelief damns. So in the world of fundamentalist religion, it is very wicked and very damaging to proclaim one’s unbelief. It is putting at risk the immortal souls of the credulous, who may waver in the belief needed for salvation.

    The result is that argument in policy on social media ceases to be about the nominal subject. It turns into a forum in which the object is for the believers to identify the heretics or unbelievers. The important thing is to know whether one is talking to a denier. So to this end we scrutinize what is said, and when we find some doubts being expressed about any element of the canon, we know that we are dealing with a denier, and neither can nor should take anything he says seriously, for fear of contamination.

    If you point out that this is basically a religious approach to a scientific controversy, the result will be even greater indignation. The whole style of the debate means that you cannot question, just as you could not in the religious world question the basis for the chain of reasoning that banned, for instance, theatrical productions. Meta argument is one of the things that has to be avoided.

    What we are really dealing with in the science wars is, in the phrase, thunder without God. We have lost religion but are using the forms and attitudes of religious controversy in other fields, where it makes arriving at rational and evidence based public policy all but impossible. And involves extraorinary contradictions, which as soon as you start looking at it like this crop up all over the place. Here is one.

    its said, in climate, that we are at a tipping point, that reduction of emissions is absolutely vital. Then when you point out that Paris committed the West to cut back and allows China to increase dramatically, along with the developing world generally, you get a moral argument. The argument from catastrophe due to tons emitted vanishes, and we now get the argument that its only fair, given they have just started to industrialise, given that they are installing wind, given that their per capita emissions are lower (not that they are). But of course, if the argument is from physics, none of this has any bearing. It has only a bearing if we are dealing with some moral assessment of righteousness.

    But this is how we get to the proposition which the faithful seem seriously to be asserting, that continued emissions at current levels will lead to catastrophe, that every little helps and so we have to reduce even if our emissions are low, and also that the developing world can indulge in emissions increases which will more than cancel out our reductions. And this is because it is ‘fair’. Somehow its being fair will mean that 5 billion extra tons from China will have no negative effect, whereas a 2 billion reduction from us will save the planet.

    Its religious approaches to what is nominally a scientific matter. It reminds one of Chesterton, who remarked the problem with disbelief what not that one no longer believed in religion, but that people after losing their faith felt free to believe anything at all.

  84. Firstly, Kip Hansen, let me say thanks for this post. I like non-climate stuff. However;

    … what about our beloved Stephen Hawking’s “Fortunately, the solution is simple. More physical activity and change in diet.”? Well, frankly, that is not just wrong, that’s utter nonsense.

    This statement is NOT utter nonsense.
    Perhaps it is too general or too broad a statement but it is true.
    I’ve recently lost weight through simply reducing my calories and increasing my physical activity.
    (My obesity must be the 60th type)
    I KNOW this statement not nonsense.

    Six Months, 25 lbs and I feel great

    ( I’m no apologist for Hawking. I think he’s an Elitist, Progressive tool.)

    • RobRoy ==> Thank you, glad you like my work. The original motto of WattsUpWithThat.com was “Commentary on puzzling things in life, nature, science, weather, climate change, technology, and recent news by Anthony Watts”. A lot of my essays fall into one or more of those categories. Quite truthfully, Climate Science and the Climate Wars are, to me, boring in their predictable tribal warfare kind of way.

      The context for the Hawking statement is the Obesity Epidemic. In that context, what he says is truly utter nonsense The obesity epidemic not simple at all — it is complicated, complex, and a wicked problem that remains yet to be solved. His statement “Fortunately, the solution is simple. More physical activity and change in diet.”– in that context — is foolish — almost the entirety of the actual science on obesity shows that Eat Less Exercise More is NOT a solution to the obesity epidemic and not a cure at all for the vast majority of the obese.

      The fact that you, and nearly everyone who is a little overweight, can drop 10-15 lbs (in your case, a commendable 25) by eating less and exercising more has almost no bearing on the obesity problem. I myself have had periods in my life where I have gained those 15 lbs and periods where I have lost them, so I know what you are saying.

      But it just isn’t the same problem.

      My wife and I live most the the year on our sailboat — and when we live “on the hook” (at long-term anchorages) we get our electrical power from solar & wind, with a backup diesel generator. This works for us in our context but is not a solution that should attempt to be applied to every suburban home in Los Angeles — wrong context — it won’t really work for them with their all-electric kitchens, air conditioners, chest freezers, etc etc. It just isn’t the same problem.

  85. Food has never been cheaper in all of history. We learned reliance on a sole carbohydrate staple was an invitation to blight and certain famine. All by the age of enlightenment or reason. But now we also have worldwide logistics so famine is always political.

    Back to obesity..at mininum wage, one need only work for less than a half hour to buy the recommended daily allowance of carbohydrates, fatty acids, amino acids, fiber, minerals and vitamins. Of course this is based on staples and not premium selections..and certainly not fast food. For example, a fresh, whole chicken is about $5 in my ville. The store also has the same carcass cooked for double the price.

    History is why we are fat. No one remembers. No one cares. History is bunk. Those ignoring the failures of history are doomed to repeat…

  86. Very few people in the western world need to be reminded to eat.

    We could discourage food adverts, they are not helpful.

  87. Recent studies (notably http://www.nature.com/ismej/journal/v7/n4/full/ismej2012153a.html) have demonstrated unequivocally, using Koch’s Postulates, that the presence of Gram-negative bacteria (specifically Enterobacter cloacae) in the human gut is linked to obesity, that suppression of these bacteria in the gut mitigates obesity, and that introduction of these bacteria into the gut (of mice) directly causes obesity. The mechanism is traced to the lipopolysaccharides in the cell walls of the bacteria which are released into the human body upon the death of these bacteria. The lipopolysaccharides are among the most potent known agents that trigger tissue inflammation, which itself is associated with hypertension, type-2 diabetes, and arthritis, and may be associated with several other chronic disorders.
    Yet no list of ‘risk factors’ for obesity I have ever seen acknowledges the possibility that an infections agent may be involved.
    Obesity remains in the same medical dark age as ‘gastric ulcers’ before the discovery of the role of Helicobacter pylorii.

    • tadchem ==> There are tantalizing reports from a lot of micro-biome studies — the one you mention involved one human subject and multiple dietary treatments.

      It will be interesting to see if this, or other, hypotheses of infectious obesity hold up in the long run.

  88. Sorry if this has been covered in the comments before, but right now I don’t have time to read them all. I wanted to post a comment while this was fresh.

    First, skinny people should not be allowed to publish anything about obesity. (g)

    Aren’t many cases of obesity, or even people being somewhat overweight, due to the hardwiring in our brains? So much of this, IMHO, can be traced to, if not obsessive compulsive disorder, then obsessive compulsive tendencies. Overeating, smoking, alcohol abuse – lots of behavior tendencies. Nature works hard to ensure that diversity gets passed on, as some of it might be valuable in the future. Genes that carry on obsessive compulsive tendencies might be especially valuable – think Bill Gates or Steve Jobs. How much is overeating due to this? Now think about the label – obsessive and compulsive. How much free will do we have if we are governed by obsessive compulsive brains?

    On simple example. Ask any obese person if they would rather not be as fat as they are. Would there be even one that would say no, that they prefer to be obese? So, why are they so obese? Doesn’t it just seem so simple, and doesn’t this point to exactly why this is so difficult?

    As for Stephen Hawking, how can someone so smart be so dumb?

    • Kermit ==> “Aren’t many cases of obesity, or even people being somewhat overweight, due to the hardwiring in our brains? ” If they knew, we could cure all the obese people….but they don’t — that’s one of the take homes messages.

  89. Kip. Excellent and thought provoking as usual. It’s probably worth mentioning that the “US Obesity Epidemic” was exacerbated in 1998 when “they” arbitrarily redefined the Obesity Scale roughly 6 or 7 percent to the thin side. That’s important to know if one wants to evaluate historic data. Want to reduce the “problem”? Why not start by moving the goalposts back to where the started from and then leaving them alone?

    • Don K ==> Thank you. The epidemic is, in part, caused by re-defintion — this is par for the course in many medical/health metrics — and a feature of Science Controversies in general. Moving the Bar is a standard tactic for making the Problem seem greater and more urgent, in order to garner more support ($$$) and agreement.

  90. Put down the pies.

    Some of us are more prone to gain weight so adjust your lifestyle accordingly. It’s a never ending battle if you gain weight easily.

    The truth is most obese people eat too much and eat the wrong food. If you are over 280lbs then you are just eating too much, it is that simple. A big fat body needs calories to sustain it.

    Exercise is not the solution controlling what you eat is

  91. I’ve said before, IMO Hawking can’t communicate anymore — even with his close handlers. So statements supposedly coming from him actually aren’t — they’re coming from his handlers. I guess statements from “Stephen Hawking” get far more attention.

  92. Fascinating article.

    My thoughts:

    Eat less, exercise more completely ignores the fact of what we are eating. What changes have occurred in our food supply from say the late 1970’s till today? Can’t be sugar, because we’ve had sugar in our diets since we discovered it. Can’t be fats, because again, we’ve had that in our diets forever too. What about those breads? Well bread has been around for tens of thousands of years. How about veggies and fruits? Nuts? Same thing. Meats? For tens of thousands of years humans have been eating what we are eating. So why are we fat and they weren’t?

    #1 fallacy: humans were lean and healthy until 1980. Bull. Fashion trends bear witness to that. Someone mentioned Marilyn Monroe up thread. She was a size 14, what would be considered at size 22 today. That is just 1 example, there are many. I used fashion because it has a very long recorded history.

    #2 fallacy: People ate better. Bull. Most of the population ate bread with some kind of watery broth and maybe a piece of salted or cured meat because that was all they could afford. Don’t believe me? Look at the stories, the expressions that linger in our culture. You don’t have a whole lot of prayer including a balanced diet of veggies, fruits and nuts, but you sure as heck have bread.

    #3 fallacy: we know better what makes people fat. Bull. No we don’t. What we do know is that more people are fat when we change the scale. Or more people are thin when we change the scale. We decide who is fat or thin.

    My point?
    We can’t point to the past and say: “See? There were no obese people then!” And blame the obesity “seen” now on technology, advancements in transportation, lack of exercise, sedendary lifestyles..etc.

    What we CAN do however is to start looking at our food supply and how IT has changed from the past…before pointing fingers and changing scales, lets start by looking at our food. How our meats are raised, how our veggies and fruits and nuts are processed, how are grains are processed AND our fats and sugars. Until we stop blaming the fat people for being fat on external factors, lets start by examining the food supply we are ALL eating. And examine in depth the stuff we ADD to our food.

    • It has been very nice to have fresh fruits and vegetables all year, with almost no seasonal fluctuations, with just a few exceptions. However, we don’t know if this is good for us, or bad. If I look up some medical problem, I can almost guarantee that part of the solution will include eating more fruits and vegetables, drinking less coffee and alcohol, and making sure that everything is low-fat. So, one thing that has changed from the past, is how much fruits and vegetables we eat, and the fact that we are not dependent upon local growing conditions. Lots of variables have changed, just in the last few generations.

    • Jenn Runion ==> People have been fat forever — some ethnics groups predictably get fat past middle age — food processing and food additives did not make classical greek women heavy…or Italian mothers….

      I’m not too convinced by the “it must be something in the food” idea.

      But ya never know, we certainly don’t have a real good handle on it.

    • “And examine in depth the stuff we ADD to our food.”

      Also, let’s look at what we (accidentally or indirectly, usually) REMOVE from our food.

      • Oh yes that too. What natural element is removed and then replaced with a man made compound.

        So what we ADD and REMOVE.

  93. No matter how complicated the reasons are for being overweight that fact remains if you are starved you lose weight. I don’t recall any fat survivors from concentration camps.
    What your weight should be is an entirely different question.

    • Adrian Ashfield ==> Yes, I have mentioned that it is easy to starve people and make them thin, but that does not, at the same time improve their health. One can totally prevent breast cancer by cutting off the breasts of all women as well — but it does not afford an acceptable solution.

  94. Adrian Ashfield
    No matter how complicated the reasons are for being overweight that fact remains if you are starved you lose weight. I don’t recall any fat survivors from concentration camps.
    What your weight should be is an entirely different question.

    It is basically the question why some peoble eat more than nescessary, and why others do not.
    That bariatric surgery helps is a sure sign of the above.
    Then you can reserch why some regulate their food intake so that they keep their weight and others have difficulties. A very simple advice, that seems to help, is using smaller tellers. It is so low tech, that few experts use it.

  95. What a load of rubbish.

    In the western world: In the old days poor people were thin. Now they’re fat. Because, nowadays even “poor” people can afford a supersized coke on a daily basis.

    It’s really, really not complicated.

  96. I’ve always thought that the conventional science behind CAGW and obesity/chronic disease were exact parallels – basically science gone wrong. Michael Mann is to CAGW as what Ancel Keys was to nutrition. The government is still the government. The EPA, NOAA and NASA are the USDA & FDA. The NAS is the NIH. I think that the people here completely understand how science has failed us when it comes to CAGW but don’t quite understand that the same thing can occur in a discipline like health and nutrition – it can and has.

    I got a huge kick out of the idea that there are “obesity genes” that are lying in wait to make us fat (I know that sounds condescending, sorry about that). People proposing that evolution would develop a gene that puts us an evolutionary and competitive disadvantage simply should be a non-starter.

    Obviously Hawking is looking at the situation incorrectly. Instead of asking “how” do we get fat (obviously because we take in more energy than we expend), he should be asking “why do we take in more energy than we expend”. That’s the important thing. And the idea that we can simply “eat less and move more” has been refuted by just about every study done trying to prove that it’s as simple as eating less and moving more. This is because it’s too simplistic to think that a calorie is a calorie, you need to consider all the biochemical actions that occur in our bodies. People think that our basal energy expenditure is a constant and this is simply not true. Starvation diets work for a little while but most people gain the weight back and a little extra because they aren’t fixing the real problem which is for most hormonal. There are many hormones that we know cause weight weight gain or suppress appetite, these hormones don’t contain any calories and yet they control our body fat percentage so it’s obviously not a matter of how many calories a person eats or how much they exercise. Fix the hormone issues and you’ll fix your weight problems.

    Insulin is the main driver of fat storage, the more circulating insulin the more fat that is stored… period. The question people should be asking is how to fix a damaged system that is producing too much insulin due to insulin resistance in the cells. We become insulin resistant because over time we eat foods that cause our pancreas to produce insulin. This is a chronic condition, it takes decades for insulin resistance to develop in most people. Foods that a person thrives on for years like wheat, rice and other grains and even sugar are causing a slow drip of damage that ultimately manifests itself in insulin resistance, causing higher fasting levels of insulin in the blood. Essentially people are building up a tolerance to insulin just as an alcoholic does to alcohol, so it takes more insulin to do the job and the result is increased body fat. That is simple biochemistry.

    Fortunately insulin resistance is reversible for most – the first step is to lessen the number of carbs you ingest. But unfortunately this probably isn’t going to fix the problem. Going back to the alcoholic example, you don’t get over an alcohol addiction just by lessening the amount you drink, you need to quit it entirely. It’s the same for carbohydrates and insulin – to reverse the damage as must as possible you need to implement an intermittent fasting protocol. A low carb diet, even if you get down to zero carbs, is still insulinogenic because protein and even fat produce an insulin response from the pancreas. The only way to reduce insulin levels to therapeutic levels is to not eat at all via an intermittent fasting protocol. Throw a 24 hour fast in a couple times a week as well as adopting a low carb diet and you will see your fasting insulin drop like a rock, as well as your body fat. Give it try, what can it hurt?

  97. On a tangent here… the beginning of agriculture several thousand years ago saw the beginning of civilization as we know it. High-carb diets, including stuff like bread, reduce the number of calories that we need per day to maintain weight. Our hunter-gatherer ancestors had to spend all their energy hunting for their next meal. Cereal grains, in addition to providing some calories, greatly reduced the the extra calories we need. This meant that they had spare time to invent writing and other stuff, since they weren’t constantly searching for their next meal.

  98. Major problem I have with this article: if bariatric surgery is the only 100% successful treatment to obesity, and all bariatric surgery does is make you eat less. I disagree with your conclusion based on your own statements. If you are right, and that is the only treatment with 100% success rate, then eating less (with our without surgery) is the only cure for obesity. Other things do play a factor in it, that seems to be obvious. But it seems to me like you said eating less won’t always fix obesity, then said it will 100% of the time. Both cannot be true.

    I did enjoy the article regardless, as there was good information provided outside that.

    • Shawn ==> Shawn, think of it this way: Bariatic surgery is like physically enforced starvation — it makes it impossible for the body to ingest enough calories, enough food, to maintain a big body. There are serious health risks and downsides to this approach, so it is generally only used if it becomes apparent that not losing weight will kill you more quickly. Not quite as radical as cutting off a severely arthritic hand to cure the pain…..but not for those who just want to look pretty.

      • Kip
        While I understand that Bariatric surgery is an extreme and enforced method of consuming less calories, it is still just a way of reducing food/calorie intake. So what I am not understanding is why you say a self reduction of food will not necessarily cure obesity, then you say Bariatric surgery will. People can reduce their own intake to those levels without Bariatric surgery. And in those cases how is it technically different from having the surgery?

      • Shawn ==> It’s not so much that I say it, it is that when they try to cure the severely overweight and obese by the ELEM method (calorie reduction and exercise) it does not work very well for the majority of patients.

        That is what this whole essay is about — and that is why obesity is such a problem — they do not have an effective approach.

        Bariatric surgery is not just a calorie reduction mechanism — it is based on what they discovered in treating wounded soldiers — if you blew away half their stomach with machine gun bullets, even the heavy ones became thin — in fact, could not gain weight. There are a lot of health downsides to the approach, which is why it is generally only advised for those that will die from obesity if they don;t lose weight.

    • I have a problem with these extremely fat peoble that can not move anymore. Someone must give them food, because they can not themselves go and buy it. I just wonder.
      Anyway it is still interresting why some take in more than they need and others take in less than they need, and the most keep it balanced.
      It is a distraction to focus on special food ingredients, more of that and less of that and so on, it is the total amount and why.

  99. I would be interested in your thoughts on new microbiome research. Gut bacteria ecosystems seem to impact how food we eat is processed. I read Epidemic of Absence and many articles by the author, but still don’t have a sense of the research.

    • Gregory ==> In regards to “An Epidemic of Absence”, I’ll quote Abigail Zuger, M.D. who reviewed it for the NY Times “”A romance with anything [other than a living being], be it a pair of shoes or a scientific theory, is only asking for trouble, so seldom will the inanimate beloved live up to your besotted expectations.
      The best scientists struggle with this prohibition daily, knowing that even the most seductive data may well disappoint. But premature enthusiasm is routine among others, patients and their doctors foremost among them, with journalists smelling a scoop not far behind.”

      The field of study is so young that several doctors and medical researchers have fallen in love with the hypothesis — and become so blinded by love that they have lost the necessary disinterestedness required to carry out rational investigation of the subject…they are forever rushing here and there, exclaiming over things not yet explained, drawing hasty inferences and jumping wildly to conclusions not yet in evidence.

      There may be something useful there — in the study of gut biome and other fellow travelers — but as far as I have seen, there is little there there yet.

      Give it another ten years and we may have something to talk about.

  100. Somebody else pointed this out, but I think it is worth repeating:

    The percentage of Americans who are obese has gone from 12% to over 35%, between the 56 years from 1960 to 2916. The seeming now-popular claim that this is not just an energy balance issue seems to imply that something major has occurred in the human body’s structural evolution over the past 56 years, which would be an unprecedented evolutionary alteration in such a short time span, if we are to put major faith in this current claim.

    The problem is NOT complex. The problem is simple. The SOLUTION is complex, because the structure of our modern society has made it so, even more so in the past half century.

  101. Epilogue:

    One of the best aspects of writing a series titled Modern Scientific Controversies is that the topics covered are so very, well….controversial. Just the mention of any one of the topics, and I have covered only four out of the easy dozen I am aware of, brings out heated emotional and intellectual arguments, counter-claims, demands for respect for and in defense of the “law of xxxx” and the broad consensus view about xxxx.

    Not to worry, these aspects are the common and essential parts–the woof and warp–of these types of controversies.

    Here in comments we have seen several readers who insist that the essential little kernel of truth — weight gain is caused by too many calories in and not enough out — absolutely must be the acknowledged as the true cause of the biological phenomena called obesity and the societal problem called the Obesity Epidemic.

    And they are not absolutely totally wrong, just misguided.

    The idea is just not very useful — Eat Less Exercise More — is a fine and helpful public health message — it just will have no effect on the Obesity Epidemic, because eating less and exercising more has been proven, even under very controlled conditions, not to cure the obese of their obesity and helps a very small percentage of the severely overweight.

    The massive public health campaign to fight the obesity epidemic is a policy that health officials know — with a high degree of scientific certainty — to be almost totally ineffective in the fight against obesity.

    Many readers offered various hypotheses about the causes of obesity — most of them with some validity and many of them currently under investigation by researchers. None of them have yet been found to be a smoking-gun cause of the widespread increase in the percentage of the population seriously overweight and obese.

    Some savvy readers will recognize the aspect of public and government agencies deciding to publicly campaign for “a policy that … officials know — with a high degree of scientific certainty — to be almost totally ineffective in the fight against” the problem they claim to be solving.

    That last will be the subject of the next essay in this series.

    • Some savvy readers will recognize the aspect of public and government agencies deciding to publicly campaign for “a policy that … officials know — with a high degree of scientific certainty — to be almost totally ineffective in the fight against” the problem they claim to be solving.

      That last will be the subject of the next essay in this series.

      So you’ll be writing about the FDA’s crusade against vaping, then?

      • Roger ==> Not too familiar with that one…what is their Kernel of Truth? Solving what Problem? with what Solution?

  102. “The kernel of truth in obesity studies is that consuming more calories (food energy) than one expends can lead to weight gain–energy stored as fat.” Kip, that isn’t the kernel of truth. It’s equivalent to the Earth’s energy budget. It’s the important concept. Everything else is an example of the process- how the energy budget works.
    It’s true that individuals metabolisms differ for many different reasons which you show aplenty, but as an aerobic athlete who has coached all ages from children to adults and skill levels from joggers to olympic qualifiers, I think most of the reason for our obesity epidemic is that people are eating more and exercising less. With all the statistics you have accumulated, I assume you have statistics that show that exactly that has happened the past several decades.

    • Doug ==> I know, weird huh? But the facts are the facts —

      “The idea is just not very useful — Eat Less Exercise More — is a fine and helpful public health message — it just will have no effect on the Obesity Epidemic, because eating less and exercising more has been proven, even under very controlled conditions, not to cure the obese of their obesity and helps a very small percentage of the severely overweight. ”

      It is a good thing to get kids and adults to get more exercise, if that’s what they want. In general though, if they are severely overweight or obese, it won’t help them in the long run — it won’t change their weight status.

      Since moderate regular exercise (20-30 minutes most days of the week) seems to improve general well-being for most people, it’s a fine thing to do.

      The public health hope is that the Eat Less Exercise More campaign will somehow prevent our youth from becoming obese later in life….but it is an unproven hypothesis. in the US we had had Presidential Physical Fitness campaigns, get out and play campaigns, etc continuously since the 1950s. ( I got an award in Jr. High for being able to climb to the top of a 20 foot rope hung from the ceiling of our gym — not many could do it.)

      Have you, in your professional life, had success treating obesity or severe overweight with strenuous exercise? It apparently will work for roughly 2-4% of the obese population.

  103. Kip,
    I haven’t had the opportunity to work with the obese although I’ve given the idea some thought, but decided against adding personal trainer to my already overextended interests and responsibilities.
    Let me ask you why there’s been such a significant increase in childhood obesity over past decades or why South Carolina, where I retired, has a significant obesity problem, but Colorado where I lived for 20 years does not. There are statistics about the lifestyles of South Carolinians and Coloradans including diet and exercise, Those statistics show that South Carolinians consume more calories (sweet tea is one big part) and get less exercise.
    I’ve always enjoyed your WUWT guest posts and your many Dot Earth posts, but I think you’ve cherry picked your sources on this one to suggest that a basic energy balance doesn’t apply.

    • Doug ==> Apparently my usual communication skills are failing me or the entrenched idea about obesity is particularly strong,

      I do not, and have not, “suggest[ed] that a basic energy balance doesn’t apply.” I have labeled it the Kernel of Truth in the obesity controversy because it is a basic truth of the field.

      The controversy itself hangs on the facts:

      1. If the Kernel of Truth is accurate, if it is a sufficient cause, then 2. Reversing that will be an effective and near-universal cure.

      Eat Less Exercise More (ELEM) however, in practice, not only for the average Joe or Jane at home, but in carefully controlled and followed clinical trials, does not cure the obese or the severely overweight.

      Why? If we really had the answer, we’d get the Nobel Prize in Medicine. So would anyone that could answer Dr. Sack’s question in the essay: “Why do some people lose 50 pounds on a diet while others on the same diet gain a few pounds?”

      ELEM does work to help Sally Smith prepare for bikini season — she can usually drop those extra 10 – 15 lbs if she really tries — and she can keep them off through dedicated diet control and exercise. The second she is distracted, the pound will return and he body will resume its ‘preferred’ weight.
      This is A DIFFERENT PROBLEM — it is not the same as the obesity problem.

      All I can say is that “They are working on it.”

      As for why Colorado has lower child obesity rates? Don’t know — but I’d like to. I will point out that the statistics on childhood obesity are hinky — CDC stats are far different than the National Conference of State Legislatures (which claims it gets their stats from the CDC).

      Then there is this “data from CDC’s National Health and Nutrition Examination Survey (NHANES) published in the Feb. 25, 2014 issue of the Journal of the American Medical Association do show a decline in obesity prevalence in the 2-to-5-year-old age group from nearly 14 percent in 2003-2004, to just over 12 percent in 2009-2010, to just over 8 percent in 2011-2012.”

  104. I got fat after a period of low activity due to a major injury (which included nerve damage). After the injury abated, I had a hell of a time dropping the weight and exercising. My Doc explained my body was fighting to keep the fat (sort of a famine response). Two things got me past this issue:

    1. Cut carbs and sugars and added more fat to my diet (in particular that “Evil” saturated fat)
    2. Started taking supplements, in particular zinc, magnesium, and pantethine (a form of B-5).

    I got into pretty good shape using free weights and an exercise bike, but was still heavy. I was what you could describe as sort of fit-fat at 37% body fat (per a DXA scan I had done).

    Based on a recommendation from someone I was talking to online, I checked out the ketogenic diet. Been on it for months now. I have painlessly dropped 25 lbs of fat (it took 3 weeks for my body to adjust to the painless point) and the workouts have gotten even easier. Blood work is fine (high HDL with a good HDL to total ratio). I cut out all fruit juice and sodas and try to limit my net carb intake to 50 grams or less (mostly green veggies).

    If any of you are like me and have an issue with weight.. check out the ketogenic diet.

    • Newark –
      I had a similar experience with a ketogenic diet back around 2002 after gaining weight while working for a corporation. Not only did we drop more than 40 pounds (still have the charts), maybe 10 or which came back, but something else changed. For my whole adult life, I would get drowsy if I sat still for more than ten minutes – meetings, driving the car, movies. It sucked and I had developed elaborate coping skills. After the diet, that problem just went away and never came back. Now I can arrive at LAX at 11PM, hop in a rental car and drive to SF for breakfast without a moment of sleepiness. When I want to sleep, of course I can, but now it is my choice. It was literally like being reborn. Suddenly I could do much more and enjoy life more than ever before.

      This was a major puzzle until I started reading about the microbiome research that really took off after 2010. Although Kip is right that it is still early days, what is clear to me is that the diet essentially replaced my old microbiome ecosystem with a new one. We also cut out most of the sugar in our diet, not religiously, but mostly — cakes, pastries, sugar drinks, etc. – 200 years ago the average person consumed about 12 pounds of sugar a year. Now in the US, it is more like 120 pounds. Could be a problem? Ya think?

  105. Poor diet and hunger in one’s childhood, plus genetic pre-disposition for obesity, often result in obesity.

    In 1968 my father, a mathematician, signed a letter of protest against the Soviet occupation of Czechoslovakia. He was the only one of 11 signatories who did not recant afterwards. He was fired from all positions in the instutute and in the university, and, being a polyglot, had to provide for his family by doing translations (middlemen, of course, took their cut).

    Until then I ate well, and was thin as a stick. After 1968 we became very poor, and could not afford any good food (socialism makes all high-quality things inaccessible to the general population without special connections: see current situation in Venezuela for typical reference). My German grandmother, who survived the worst years of hunger in Siberian exile during the WWII, became very worried about me being undernourished, and stuffed me with whatever was available, mostly potatoes and cheap macaroni.

    And I became fat. I’ve been fat ever since — since that childhood occasional hunder and poor diet period, my metabolism stores calories in fat. Mind you, I was very phisically active when I was a young man: I spend days on my bicycle, I walked a lot (no honest working person in the USSR could afford a car) — still, according to the nonsensical American BMI index, I always have been overweight.

    After findeing a political asylum in the USA, at first I didn’t know that much of the food products in supermarkets are full of growth hormones, chemical preservatives, and other additives counter-indicated for people with the pre-desposition for ovesuty. In a few years, I’ve become, according to the same BMI index, “morbidly obese,” though I usually eat no more, or even less, than any oother person (certainly never three meals per day — no more than two, one being very moderate); I bought a threadmill, but no amount of physycal exercise would really help. Cortisone shots administered by medical charlatans to hype up the costs of treatment for my joint inflammation (where a few pills of the simple anti-inflammatory drug did the job later), drove my weight to 372 pounds (my hight is 5’9″).

    Later, alarmed by my weight, and by the quality of the supermarket foods, I started to pay much more attention to what I eat, and quickly lost 50 pounds. Now I am 55 years old, and feel more or less fine, though not athletically fit, of course. Further attempts to reduce my weight resul in weakness, fatigue, sleepiness, and some other emerging problems. I dropped these attempts.

    I always suspected that Stephen Hawking often talks to his computer from his behind. Now I know for sure.

  106. Although it appears at first glance that eat less exercise more should work for all. and does not what are we actually eating these days.

    Firstly,

    If we look at how society has changed and the food industry has followed.
    Before the ‘great expansion’, in general, mothers stayed at home to look after the children which included cooking from basic ingredients. Now we have, in general, two working parents per household, the mother, typically, coming home from work, now chooses to cook pre-prepared meals which contain a variety of ingredients that she would never ever consider adding to the family food intake.

    Secondly, are all calories equal? using a simple b@mb calorimeter to measure the calorific value of a gram of food appears to have no relevance to what a human being would do with that one gram of food. Are we fooling ourselves?

    Thirdly, I understand (please correct me) that there is no natural food where a large amount of fat and sugar is present together. However, we buy ready meals which contain large combinations of fat and sugar and it appears that when we consume fat and sugar combined it defeats the ‘stomach full’ signal.

    Food for thought?

  107. the body uses most energy for maintaining temperature. To loose weight start by turning the temperature down in your home. Loosing weight by physical exercise is much more difficult.

  108. Why We Get Fat: And What to Do About It
    by Gary Taubes

    I was on prednisone for 2.5 years. After gaining 40 lbs in 3 months and becoming border line diabetic I read the book listed above. In one year I lost 40lbs, never exercised and was never hungry. The first 8 chapters are weight loss history while all the rest of the book contain medical facts. I now know that the medical “scientists” of the 20th century are just like climate “scientists” of today. It is not a diet book.

  109. Well, I get messages that say one of three kids is obese, but one in four is starving. So are the fat ones eating the poor ones?

    They’re both a crock. I’ve traveled all over the country and ever since Michelle Obama’s BS statement on the subject, I’ve started counting fat kids, and was in three states before I counted half-a-dozen kids who I would define as obese – two of them following behind a mother who was definitely so, walking them in a city street in the middle of a school day, and one of the kids (seven- or eight, I’m guessing) had a purple Mohawk, so I’m guess that’s a lifestyle thing with that family.

    Of course, if you can’t find enough obesity, changing the definition helps.

  110. Mr Hanson has a huge problem and huge bias that prevented him from writing a good article on obesity.
    And one minor problem with comments on his articles.

    The huge problem: I don’t believe he has ever been obese and tried to lose a large amount of weight.

    The huge bias: Based on reading some of his prior articles, Mr. Hanson is strongly biased against establishment views, something that has been especially popular in 2016, and has always been popular among climate change skeptics.

    The minor problem: Hanson gets too offended by people who disagree, and is quick to tell them they are wrong with little or no supporting data.

    Well, Mr. Hanson, I’ve got news for you:
    – Sometimes the establishment is right, and the anti-establishment guy is wrong.
    This is one of those times.

    The article dismisses a real scientific consensus on obesity (unlike the phony 97% consensus on climate change).

    Mr. Hanson apparently thinks he is smarter than “almost every major medical and health organization in the world” and “they are all wrong”!

    When I stopped laughing, I decided to write this comment.

    My conclusion, based on available evidence, is the obesity consensus is real, and correct.
    Of course I could be wrong — I was wrong once before.**
    ** My wife disputes that number.

    I have no problem with an off-topic article, if it provided useful knowledge.
    This one doesn’t.

    The article tells us the obesity ‘establishment’ is wrong, obesity is very complicated and losing weight is very hard, with surprisingly little data to support those conclusions.

    There are logical fallacies in the article: Primarily repeated appeals to authorities — are we supposed to be in awe of the people mentioned simply because they are from Harvard, Cambridge, Massachusetts General Hospital, etc. ?

    Are we suppose to believe them simply because they are anti-establishment?

    Couldn’t those anti-obesity establishment “authorities” be completely wrong?

    The long article wastes much space with quotes from obesity establishment people and organizations the author later says don’t know what they are talking about.

    The article says there are 59 types of obesity without any explanation of what that means.

    The article says bariatric surgery is the only successful weight loss method, which is completely wrong — any “diet” that keeps calorie input lower than calorie output will lead to weight loss, and that is most “diets”.

    There are three problems with “diets”:
    (1) People cheat on spouses and diets,
    (2) Accurate calorie counting is impossible, and
    (3) People who “diet” think they can stop dieting after they lose weight — when in fact they have to permanently change their eating and drinking habits to keep the weight off.

    I have no problem with an individual like Hanson challenging a scientific consensus.
    That’s how progress is usually made in science.
    But the consensus that ingesting excessive calories in your food and drink causes weight gain is correct.
    The problem with the consensus is even though it is correct, it doesn’t really help people lose weight.

    It is impossible for individuals to accurately count calories for everything they eat, especially restaurant meals, and count calories used for their activities during the day.

    Rough estimates are possible, but even tiny errors could result in gaining a pound or two each year — and after 30 years, a pound or two gained each year adds up to a large weight gain.

    The obesity epidemic is recent — there was no epidemic in the 1960s and early 1970s when I was in high school — only one or two percent of students were fat — my spouse and baby boomer friends had the same experience in another state.

    There is no way genes could have mutated so much in the 50 years since the 1960s to cause an obesity epidemic that seemed to start in about 1980 in the US — so blaming genes is nonsense.

    A few minutes of brainstorming with several fat and semi-fat friends over a HUGE pizza, about changes since 1980 that might have contributed to the sudden rise of obesity in the US, came up with this list:
    (1) The US population is aging — older people tend to be fatter than younger people,

    (2) Fewer jobs require physical exertion or standing,

    (3) Kids get much less physical activity during and after school,

    (4) People eat in restaurants more often, where it is impossible to accurately measure portions and count calories, portions are often large and high in fat and sugar, and usually have more calories than specified on the menu, assuming the menu says anything at all about calories.

    (Examples of growing portion sizes: In the 1960s a standard MacDonalds burger was two ounces, now four ounces is typical. Good restaurants served five or six ounce burgers then, now eight ounces is typical. A large MacDonalds fries today looks triple the size of a typical french fries portion in the 1960s).

    (5) Families less often eat dinner together at one table, where an overeater might be told to “slow down” — people much more often eat alone and/or distracted by doing other things.

    Hanson believes the obesity establishment consensus is wrong but offers very little persuasive, specific data to refute it. There are links to other articles/websites — but why read them if the original article is not convincing? Back to the drawing board Hanson!
    I provided an excessively long comment because it’s easier for me to type than to edit.

    Richard “Heavy R” Greene
    4′ 10″ tall**
    455 pounds
    Not my fault.
    Bad genes.

    ** actually four foot nine and one-half inches without heels.

    • Richard ==> It is expected that you’ll do your share of the work, read the studies, at least their abstracts.

      An essay like this is not meant to be an exhaustive treatise on an issue, but to lay out the basic point of the author (in this case, me) and support the author’s view with the facts.

      I will repeat this one more time in the comments — especially for you, since you seem so concerned — energy imbalance, more calories in than consumed, causes extra energy to be stored by the body as fat. This simple statement is so true, that I have labelled it the Kernel of Truth of obesity.

      The fact that doing the reverse, Eating Less and Exercising More, does not cure the overweight and obese, means something else is also going on — thus ELEM is not going to be an effective public health tool to fight the obesity epidemic.

      The Obesity Consensus is not on the Cause of the obesity epidemic — the consensus is formed around a public health remedy for the epidemic — a remedy that their own literature shows will nearly totally ineffective.

      The research literature lays out the known causes and some of the causes-under-consideration.

      You can accept the evidence of the field or not….your choice certainly — I am sure that in your personal situation you are quite aware that THERE IS NO EASY ANSWER.

      Or you can supply your own list of coincident associations and label them causes.

      And, of course, as someone affected by obesity, you are free to try the public health remedy of Eat Less Exercise More — but I think that you already know that it will not help you.

      I am very empathetic with your situation — I have a relative in a similar condition, with no real hope of recovery. My hope is that the research continues down paths that will lead to useful, applicable findings that will help.

      • Kip Hansen said:

        “I will repeat this one more time in the comments — especially for you, since you seem so concerned — energy imbalance, more calories in than consumed, causes extra energy to be stored by the body as fat. This simple statement is so true, that I have labelled it the Kernel of Truth of obesity.”

        Yep, if your body receives more energy than it burns, thermodynamics dictates that you will gain weight.

        “The fact that doing the reverse, Eating Less and Exercising More, does not cure the overweight and obese, means something else is also going on — thus ELEM is not going to be an effective public health tool to fight the obesity epidemic.”

        Yep, if your body expends more energy than it receives thermodynamics dictates that you will loose wei….. oh, hang on…

        So what went wrong there?

        The only way to not loose weight by expending more energy than you receive, is to not expend more energy than you receive.

        Any other issue you can come up with ultimately comes down to not actually expending more energy than you receive. The “something else” that is going on is people not actually expending more energy than they receive. If they did, thermodynamics dictates that they must loose weight.

        So, any solution must involve finding a way to get people to expend more energy than they receive. If something is stopping a person from doing that, then sure, look at ways to help them, but there is nothing you can do that will work that doesn’t involve actually making them receive less energy than they expend.

      • Hanson says:
        “Richard ==> It is expected that you’ll do your share of the work, read the studies, at least their abstracts.”

        My reply:
        Abstracts are misleading — they are usually not an accurate, unbiased summary of the study.

        It was YOUR job to summarize the studies and present a persuasive case — you failed miserably.

        A person who is an expert in a subject can easily summarize it concisely using simple English that ordinary people will understand.

        To keep it simple, so even you can understand, I will sum up obesity science in three brief sentences:

        (1) People who are overweight and DO NOT CHANGE their caloric intake are very unlikely to lose weight.

        (2) People who are overweight and INCREASE their caloric intake will not lose weight.

        (3) People who are overweight and DECREASE their caloric intake have a chance to lose weight. If they reduce caloric intake enough, they WILL lose weight.

        This is so simple a six year old child could understand it.
        Go find a six year old child to explain it to you

    • Thank you Richard. You said it so much better than I did in previous posts. You don’t know how much I appreciate the many Hansen posts to to Andy Revkin’s NYT “DotEarth”- two very good people and one of them, Revkin, mostly wrong. I feel the same way about Kip’s analysis of the obesity problem as I feel about Revkin’s analysis of global warming.
      Let me give an analogy. I just watched an hour CBS Oprah Winfrey program interviewing Michelle Obama. Michelle and Barack are wonderful people. Barack’s selection of science advisor Holdren was awful; some of Barack Obama’s decisions, based on Holdren’s advice, were awful. And yes, I think Obama went well beyond constitutional authority, again based on bad advice
      I think the takeaway is that good people often give and receive bad advice; good people in power make bad decisions based on the bad advice they receive. I think that was true of George Bush and Colin Powell with regard to to Iraq, and Barack Obama in regard to global warming/climate change.
      I hate the incivility, meanness, and demonizing I find on all the blogs including this one.
      I very much disagree with Kip Hansen’s analysis, but I am very grateful for his expressing a point of view.
      And Richard, Kip asked me if I had worked with the over-weight or obese. Though qualified, I said no, too many other passions like- see web site.
      Bad genes or not, I think it is possible for you to get to a normal, healthy weight. I’m here to help you if I can be of assistance.
      Doug

      • What a wonderful world we live in! So many wonderful good people make so many bad decisions to manipullate so profitably us, deplorable hard-working fools! And they are so benevolent and self-sacrificing as to offer us assistance (for e fee) after robbing us blind! I siply melt in admiration.

      • Doug Allen wrote:
        “I hate the incivility, meanness, and demonizing I find on all the blogs.”

        My reply:
        A close relative viciously character attacked Trump to shreds before the elections in an email to me.
        I didn’t even like Trump much, yet the attack offended me, and I told them so.

        After the election, they began posting flowery lets be nice to each other and sing Kumbaya together posts on Facebook. I wrote back asking why that advice didn’t apply to them before the election!

        Liberals, and you may be one of them, adopted the Alinsky style of ridicule and character attack decades ago. In 2016 they threw everything they had at Trump — he ONLY won because he used Alinsky style character attacks on Hillary.

        If you sit back and try to calmly defend yourself against Alinsky style ridicule, you lose the debate / argument / election.

        The climate “establishment” has used Alinsky-style ridicule to avoid debate for decades — “climate denier” , “the science is settled”, “97% of scientists say — are you smarter than them?”, “science denier”, etc.

        What most people here don’t understand is skeptics have to fight back with Alinsky style ridicule first to get attention and put the warmunists on defense. Only later will our data, facts and logic have any effect. 40 years of grossly inaccurate climate predictions — there’s something easy to ridicule!

    • I think the quote below summarizes the main point author Hanson is trying to make:

      “Everyone knows that the causes of obesity are eating too much and not exercising enough. All the major federal agencies, the United Nations, and the learned societies agree. So how is this a Modern Scientific Controversy? Simple: They are all wrong.”

      More of my comments:
      Hanson is wrong — this time what ‘everyone’ knows is right.

      Hanson has cherry-picked scientists with anti-establishment theories.

      They are wrong.

      In the obesity/dieting science you must present a “new” theory to get attention.

      It doesn’t have to be right, it just has to be new.

      Based on his prior articles here, Hanson is extremely biased toward favoring anti-establishment views.

      That bias might make him popular at this anti (climate) establishment website.

      The climate establishment gets attention by making scary climate forecasts — we have four decades of wrong predictions to prove they can’t forecast the future climate.

      When a scientist gets attention by claiming a new obesity or diet theory, laymen have no way of really knowing if his “study” can be replicated by others (most scientific studies can’t be replicated), really supports the claimed conclusion(s), or was “adjusted” to reach a desired conclusion.

      Anti-establishment sentiment (Brexit / Trump / Bernie) became ‘cool’ in 2016.

      Sometimes the science establishment is wrong (CAGW), and sometimes its right (obesity).

      Reading Hanson’s articles, you’d think the science establishment is ALWAYS wrong.

      The author appears to believe he is an expert on an unusually large number of subjects.

      No one is an expert on so many topics.

      Hanson is not an expert on obesity and dieting.

      He is extremely biased in how he chooses what scientists to believe.

      And he obviously has no personal experience with obesity and large weight losses.

      Based on physics:
      Calorie intake minus calories burned determines if you gain weight, lose weight, or remain the same in the long run. You lose weight by burning more calories than you take in.

      Then it gets complicated.

      It’s very difficult to precisely measure calorie intake and calories burned.

      And people are reluctant to self-report what they actually eat … or weigh … especially if they are fat.

      The right way to test a diet theory would be to use pairs of identical twins.

      The tests would have to be done in a laboratory to strictly control diets, how much energy participants burned, and to keep them double-blind.

      One twin would drink only diet Coke, for example, and the other would drink only sugar-laced real Coke.

      After a few months you might have evidence switching from real Coke to diet Coke promoted weight loss.

      On the other hand, putting people in a laboratory for months might be too stressful to them, or to some of them, and would significantly affect the test results.

      I don’t need no stinkin’ scientists, and their new theories that could be complete BS.

      I’m going to share some personal experiences that may help other obese people lose weight slowly.

      In my tips below, the word “diet” will simply mean all the foods and drinks you consume, and I assume no change in exercise:

      (1) The best way to know if you are overweight is to take off your clothes and stand in front of a mirror. Then turn sideways. You’ll know, and hopefully get motivated to lose weight. If you’re not motivated to lose weight, you might as well stop reading now.

      If the thought of looking at yourself sideways in a mirror scares you, as it does for many obese people: Consider if your waist diameter has repeatedly increased as you aged — if it has, you probably need to reduce your waist size. If you change your diet and your waist is getting smaller, then you are losing weight — you don’t even have to weigh yourself. “Waist loss” also happens to be is medically important for male diabetics (I don’t know if that applies to women too).

      (2) Anyone can lose weight (we know that from prisoners at German concentration camps). To keep the weight off you can not go back to the diet that made you fat — your diet must change PERMANENTLY. It could be worse for your health to repeatedly lose weight, go back to your old diet, and then gain it back. I donated all my fat clothes to the Salvation Army halfway through my “ten-year-diet” after I lost the first 25 pounds (of my 50 pound weight loss goal) and bought all new (cheap) clothes. I hope to donate my current wardrobe in another five years!

      (3) Most people gain weight slowly, but want to lose weight quickly. A mistake. Your body will resist weight loss, especially fast weight loss, by slowing its metabolism rate. Losing weight slowly will be easier. My own easy goal was to lose five pounds a year for ten years in a row. What’s the rush? It took me 30 years at a desk job to gain the weight.

      (4) Exercise is a difficult subject for obese people. I don’t have the answers. You could exercise and give yourself a heart attack. You are at much higher risk for back, knee or ankle damage during weight-bearing exercise compared with a skinny person. You don’t have to exercise at all to lose weight. But if you want to improve your health: Try sitting rather than laying down, standing rather than sitting, and walking rather than standing, whenever you can.

      (5) One easy way to gain weight is to avoid becoming very hungry, perhaps by skipping meals. The best way to avoid great hunger is to eat four to six small meals throughout the day — that will reduce the fluctuations of your blood sugar, especially important for diabetics, which many obese people are, whether they know it or not. (If you wanted to gain weight, wait all day until you are starving, eat one huge meal at the end of the day, then go to sleep for eight hours!)

      Another easy way to gain weight is to eat fast. Fast eaters should try this experiment: Cut your planned meal in half: Eat half ay your usual fast speed, and then stop eating for 20 minutes before you start eating the second half. After 20 minutes there is a good chance that you will not want to eat all the food you saved — what you originally thought was a normal portion was probably more than you needed to satisfy your hunger, had you eaten slowly.

      (6) Don’t automatically believe (or dismiss) “studies” done by scientists! It doesn’t matter if they are establishment scientists or anti-establishment scientists –a majority of “scientific studies” can not be replicated by other scientists.

      Those of us who are climate ‘deniers’ know establishment climate scientist PhD’s often Pile it High and Deep with scary but wrong climate predictions — they are less trustworthy than used car salesmen, who are one step above Congressmen.

      Establishment obesity scientists are likely to have integrity issues too.

      Many current establishment diet theories are likely to be falsified some day.

      But not the basic physics of reducing caloric intake to reduce weight.

      Richard “Heavy R” Greene

      PS to Hanson:
      The 4′ 10″ 455 pound “sign off” in my prior post was intended as a joke to amuse people. We obese people are allowed to make jokes about our condition. Unfortunately, half my jokes are not even recognized as jokes. The “joke” explained for slim people: Among obese people its popular to blame our genes for our obesity while eating eating four scoops of ice cream!

      I know you accept bad genes as an excuse for obesity — I don’t — genes could not possibly be the correct explanation for the SUDDEN acceleration of obesity after 1980.

      The truth is I’m not really 4′ 10″ tall and 455 pounds — I wrote that trying to be funny and I guess it wasn’t funny — I’m actually 3′ 10″ tall and weigh 655 pounds***
      *** anotherbadjokefromHeavyR

  111. Oh dear. The money is behind the carbs. Big sugar and Big food fund the nutrition organisations, and Big Pharma the medical organisations. Check what the Australian establishment has done to Gary Fettke, or the South Africans to Tim Noakes. The similarities with the climate wars are obvious.

    Anyway, my wife & I went low carb/gluten free/high vege/healthy fats etc etc and lost 50kg between us.
    After the last 4 years her progressive Multiple Sclerosis has stalled – i.e. not progressed. MRI from 2012 is the same in 2016 with no decernable changes. She is stronger and can do more – though, as a skeptic I note that lose 30+ kgs and you will find yourself stronger and able to do more regardless of any underlying condition. We may not be able to reverse the MS, but we have at least stopped it in its tracks, and maybe, just maybe, slowly clawing some health back for her.

    Oh, and accidentally, my asthma and hayfever largely disappeared, with no more acid reflux and a number of other painful ailments I’m glad to see gone. There are some who can eat carbs all day & not get fat (I have friends like that) – but most of us wear out our pancreas by middle age & then the pain begins.

    But, as Margaret Mead said “It is easier to change someones religion than their diet”

    A lot of quacks have jumped onto the low carb bandwagon, but many informative sites exist to assist without trying to sell you anything (e.g Dr Peter Attia’s eatingacademy.com)

    But diets never work, you need a permanent lifestyle change, and everyone is different, so find what works for you.

    • “kiwistonewall December 19, 2016 at 7:00 pm

      But, as Margaret Mead said “It is easier to change someones religion than their diet”

      Millions don’t have a choice!

  112. “Thus, this public policy – no matter how strenuously enforced through education, indoctrination, regulation of the food industry, punitive taxation, etc will not resolve the Obesity Epidemic.”

    You’ve made this statement with no evidence to back it up.

    There is no doubt that the aetiology of obesity and overweight are complicated but it is an error to suggest that large scale public policy initiatives based on sound evidence cannot have a positive effect in this area.

  113. Well, women think fat on the hips are directly coming from eating porky fat and meat;

    so openly they digest yogurt with dried rosins / aka sheer sugar – at home in the refrigerator they host packs of fair traded chocolate –

    that’s where fat on the hips come frome.

    Fat in food is burnt to energy immediately

    while

    carbons and sugars are saved as body fats.
    __________________________________________

    german saying

    ‘spare in der Zeit dann hast Du in der Not’

    to body language

    ‘save in time then you have when the body needs’.

    Duh!

  114. that will discuss ongoing scientific controversies, a specific type of which are often referred to in the science press and elsewhere as “Wars” – for instance, The Salt Wars. –

    There’s no need for ‘Salt Wars’ –

    when the mouth is dry You ingest lots of liquids. And carry the saltwater to the locus.

  115. that will discuss ongoing scientific controversies, a specific type of which are often referred to in the science press and elsewhere as “Wars” – for instance, The Salt Wars. –

    There’s no need for ‘Salt Wars’ –

    when the mouth is dry You’ll AUTOMATICALLY ingest lots of liquids. And carry the saltwater to the locus.

  116. The UN’s World Health Organization:

    “The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been:

    an increased intake of energy-dense foods that are high in fat;
    ___________________________________________

    There’s no studies correlating thin people to foods low in fat.

    Equally there’s no studies proving thin people consuming high in fat foods are doing sports.

    And

    there’s no studies / metastudies showing

    – people are thin when doing sports

    OR

    – thin people are sportive

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