When you burn fat you take in oxygen and make quite a lot of carbon dioxide and water, which you then breathe out/piss out. So not needing to drink much water is probably a good sign.
Apparently camels don't actually store water in their humps, they store fat, which they can use to *make* water.
Also, you can use all of the logic in this post to argue that PUFAs are beneficial (or, at least, not harmful) to health because loading up on them doesn't cause immediate deleterious effects (beyond the maxxed-out current level of damage).
Some other reactions: (for some reason this post elicited a lot of reactions from me...)
> But I also did the exact same diet almost the entire year of 2024, and yet I was seemingly plateaued, bouncing around the 220lbs mark.
The Law of Diminishing Returns is brutal!
> There’s just a way that fat-gaining diets make me feel.
I remember you and Mac (a.k.a. "Metabolic Repair") having a similar conversation about how fat-losing diets both have you constantly urinating. I've certainly experienced it, too.
> It would be silly for me to expect a diet to work for me just because it worked for somebody else, especially if that somebody else was never very obese and just went from normal/slightly overweight to shredded.
Indeed, this is the key challenge with "health policy." Clearly, most people are metabolically messed up. But how do we fix them if they are each messed up in unique ways? There ought to be a more efficient way to get them oriented than having every person do a wide array of N=1 experiments. Hopefully companies like Patchwork will figure out systematic ways to solve this problem.
> Reversing (morbid) obesity & getting shredded are very different metabolic states and require radically different solutions.
This is so true: the diet that "worked" for me dropped my BMI from 24 to 21. That "diet" was basically "do what Mark Sisson and Brad Kearns say in their book *Two Meals a Day*." It was basically "eat different, move more."
> Metabolically messed up from a lifetime of whatever causes obesity (PUFA, western diets, cafeterias, ..)
The "cafeterias" was a nice touch 😄
> I’m open to the idea that, after a lifetime of obesity, there just isn’t a way for me to get down to 188lbs, or whatever BMI-normal is for me.
This was crushing for me to read. Godspeed, brother. There are a lot of people rooting for you!
1. Yea, my framework of experimentation (30 day trials) for sure is way too short for something long-acting like PUFA or the vitamin A diet. I've talked to several vA people, and all of them basically agree that doing 30 days of low-vA won't do or prove anything. So I'd have to commit for say 6 months to even make a dent. Similar for any reasonable PUFA trial, if not years.
2. I hope that it's not super unique. As in, we won't need to run 7 billion (or is it 8 now?) series of experiments, but maybe 30. I suspect there are 2-3 diets out there that will fix 85% of people. Then it probably starts turning into a long tail, and the final quy is super unique in every way. But I bet if we run people through the "Low PUFA, pick low-fat or low-carb, if it doesn't work try the other, if that doesn't work restrict protein" gauntlet we'll get 85% of people out of obesityland.
3. Cafeteria diet was always my favorite "scientists aren't serious people" thing. Even the Western Diet thing isn't accurate any more, as the Eastern World has largely adopted Western junk food and is having all of the same health problems now. India and China both have the same or higher diabetes rates as the U.S. now, I think.
4. Thanks. I'm still cautiously optimistic, but life doesn't have to be fair haha.
Yay vinegar, I've always loved vinegar. Chips(steak fries) with salt and vinegar is starting to look like ancient wisdom.
Acetic acid is the shortest possible saturated fat and can be fed straight into the Krebs cycle without needing beta-oxidation. I wonder what that's doing for you?
I've only had a few cases of transient, nonrepeatable diet success in my life (defined as simultaneously working and losing weight; I eat 700cal/day for 1 out of 3 months to counteract the weight gain from eating enough to work, but I don't get much done while starving). In all of those cases, it was immediately obvious what was working because I felt energetic rather than tired and starving. Does it work like that for you? If and only if yes, what's the indicator on vinegar?
One continuous month of that much calorie deficit may be counterproductive. Based on his research, Prof. Valter Longo (Director of the Longevity Institute at USC) recommends five (consecutive) days per month, in particular, in the fasting mimicking diet that he developed.
Earlier this year I wrote about my experience with fasting mimicking:
700kcal is nuts, I got starvation psychosis on day 6 on 1,500 a day :D I'm not surprised you can't get any work done during those phases.
Do you mean "energetic despite huge caloric deficit" or "energetic" in general?
I felt very extra energetic in the beginning of keto, and when I first tried ex150 as well. Now, that just feels "normal" to me since I'm on ex150 by default. I'll say that I didn't feel "tired & starving" on e.g. the rice diet, just mildly bloated at all times, but then again it was ad lib, no forced deficit.
On vinegar, in the beginning, I felt "extra energetic" too. I'd have noticeably decreased appetite for cream, too. I drank way less coffee and barely finished my evening whipped cream in one sitting.
Now the "extra" energetic seems to be gone, just like it was every other time so far, and just turned into "normal" I suppose.
I am just busy but the last two posts have so much I would like to unpack! Best probably in a DM, but for now some quick feedback:
1. Everyone in North America and Europe can make fun of NOVA and the difficulty of defining food types, but it looks increasingly plausible that eating mostly highly processed food, defined as commercially prepared and packaged edible (food-like) stuff containing ingredients and chemicals not found in home kitchens, are messing up with the brain / satiety mechanism, short-circuiting healthy metabolic processes and affecting our gut health.
2. BMI is a poor proxy for anything. If GLP-1 receptors work for 75% of those who take them, BMI works for maybe 70% or less of the population as an indicator of obesity. Maybe Ex-Fat you have arrived at your ideal weight. Body recomp is a different matter, mostly to do with training than eating. I like your taxonomy of diets, and once you found the food(s) that makes you feel full and not generate weight gain, you are done.
3. As a public health intervention, anything that works for 70% or so of patients taking a drug is worth trying. GLP-1 medications may be key to stem the increase in obesity.
4. Trying to find the single issue creating the obesity epidemic (it's see oils! It's fat! It's vitamin A!) is unhelpful. It is multi-factorial and we may never quite fully understand it.
Thank you as always for your thoughtful, well researched, and generous in sharing knowledge posts. Take care.
1. "it looks increasingly plausible that eating mostly highly processed food, defined as commercially prepared and packaged edible (food-like) stuff containing ingredients and chemicals not found in home kitchens, are messing up with the brain / satiety mechanism, short-circuiting healthy metabolic processes and affecting our gut health. "
My issue with this is that it's nearly meaningless. It's both extremely full of false positives (it allows unhealthy things) and false negatives (it cuts out harmless things).
It's sort of like banning all red foods, or all foods starting with the letter "R." Maybe you get lucky and some people's health improves on average, but it doesn't have much to do with your heuristic.
2. I think BMI is fine. I haven't reached my ideal weight, because I also get body fat measured via DEXA and it's still around 30%.
BMI doesn't work if you're Mr Olympia or an NFL lineman. But for almost everyone, the BMI + a mirror is a great indicator, I think.
3. My objection here is that the GLP-1 proponents are so dishonest. We have TONS of interventions that work for lots of people, but the same people who shill GLP-1 and pretend there are no side effects claim these are "unproven" or "just anecdotal." Plus, HOW DID WE ALL GET OBESE IN THE FIRST PLACE? Are we just going to pretend we don't need to understand reality here and live happily ever after? Will we eventually just put GLP-1 in the drinking water because the obesity rate will reach 99.999% otherwise, since we never figured out what caused obesity? This feels like the dumbest possible strategy. Clearly you want to understand what happened, right?
4. I find this mindset extremely unscientific. And almost every nutrition scientist has it. This is why I think nutrition science is a big net evil.
Hey, thanks for taking the time to engage in conversation. A few notes for your consideration:
1. I like epistemology, and my framework is old (Popper), yet I think that it is still a good reference. Falsiability is what we want, every hypothesis should be able to fail. Okay, but until it does, it is our best answer. If the question is: What is causing the spike in obesity, diabetes, stroke, cardiac problems and certain cancers? Then it is hard to argue that many studies and more importantly meta-studies are showing that individuals consuming UPFs at more than half of their daily food intake level do have, empirically, poorer health outcomes. Yes, there are confounding factors, but it does not mean that there isn't a clear hypothesis and field work to refute or reinforce the hypothesis. No different than your push against PUFAs.
And UPFs are definable, as I did in my original comment.
2. BMI. For what? My understanding is that it should be an instrument of public health and a predictor of potential adverse health outcomes. Is it? Hmm, 30% fat is not bad or good or anything, what matters is markers of diabetes, coronary disease, etc. Where the fat is matters. So yeah, BMI is becoming useless for what was intended to do. The obsession with body fat is misplace, we must obsess about disease, I would strongly argue.
3. Of all the interventions before GLP-1, the obesity rate in the USA and other places continued to climb... Until now. I quote from a web search: "A study published in December 2024 in JAMA Health Forum analyzed data from nearly 17 million adults and found that the obesity rate decreased from 46.2% in 2021 to 45.6% in 2023. The most significant declines were observed in the Southern United States, where GLP-1 prescription rates were highest". I am certain is not because we stopped consuming seed oils... If some people are on satin for high cholesterol forever, well, some who tolerate it well may be on Wegovy forever as well.
4. See #1. Science is the ability to formulate an hypothesis, and then test it to try to prove it is false. The practical limitations — confounders, measurement errors, real-life messiness — make the science difficult, but they do not make it unscientific. They simply mean nutritional science must remain cautious, iterative, and self-correcting.
1. And UPFs are definable, as I did in my original comment.
I don't think that's an operational definition. The studies are all mostly worthless if they're based on unclear definitions, and lots of averages. That's why I almost never pay attention to meta studies, averages of averages... there's no signal left.
I also basically falsified it myself: I gained 100lbs eating fresh, home-cooked meal 99% of the time.
If UPF gets something right, it's mostly by accident.
2. Markers for specific diseases are obviously good for those diseases, although people disagree which markers to look at or what they should be (e.g. heart disease). But I think body fat % is also a decent marker. If your body fat is 30% as a man, that's probably not optimal, maybe even unhealthy. At 40% it's almost certainly unhealthy even if you never get diabetic or never get heart disease.
The problem with disease is everybody's an ideologue and the markers & definitions are ideological. For example, I don't believe a word of the Lipid Hypothesis and think all the LDL/ApoB/Cholesterol stuff is made up and clearly falsified.
I also think diabetes markers are way too lenient, anybody with 100mg/dL fasting glucose is not healthy but prediabetic in my mind.
So I'd say almost all the other markers besides BMI are even worse/more partisan.
3. Sure, but shouldn't we try to understand obesity? Pretending like we don't need to and these drugs will work for everyone forever (which we know isn't true) seems stupid. We can't just sweep reality under the rug because it's convenient and profitable.
4. That's one definition of science, and because of the limitations you name, it's practically useless in biology. We're just too complex of a system to easily test stuff in a lab. Most RCTs are way too short and you can't lock people in a lab for 8 years. So I'm extremely skeptical of uppercase-S "Science" because it follows a systemic implicit bias and denies all other types of science that come to different conclusions.
Thanks again and we can go on and on so I will stop here, despite how much I am enjoying this!
I do worry about making everything a partisan issue, especially around medicine and public health. Maybe because I live in a country with a single-payer and universal health care program, the worry is to minimize the cost by shifting focus to prevention. Less cases of diabetes, less heart attacks and strokes, less cancer cases help to keep our costs manageable while continue to guarantee access to health care. And some blood markers do help to futurecast potential negative health events.
About the points we are batting around:
1. You can gain weight eating home-cooked foods, but in theory (which can be refuted, of course) it should not lead to diabetes, calcified arteries or another nasty chronic disease. And as an aggregate, you can see that any country or society where UPFs become the lead source of nutrition, overall population health declines over time.
2. I agree that studies show that body fat %, especially around the waist, is a good predictor of potential development of chronic illnesses. I disagree that BMI can give you that info, though. DEXA is the gold standard for that. The % fat of an individual is less important than where the fat is located.
3. Our goals are not mutually exclusive. I just want my health care system to cost less, with less wait times. I want to push up the lifespan of the population, which has reached a plateau and after COVID has gone backwards.
You want to understand the underlying mechanisms leading to obesity. We can achieve both goals at the same time, and perhaps even use how GLP-1s affect brain and bowels to try to find the core reasons. But again, if I see the obesity curve going down or flattening, I will take that over Weight Watchers Points, CICO or "eat less move more" BS!
And for the record, when I was diagnosed with high cholesterol and fatty liver disease, I asked the doctor to give me time to tackle it without drugs, and I did. I am not a pill pusher, but I cannot deny population-wide impacts.
4. Popper's definition of science is not about lab vs "real life", it is about creating an hypothesis (PUFAs are the main cause of our metabolic malaise), testing that hypothesis in a way that can be replicated multiple times (good study design), and take the view that the goal is to prove the thesis wrong, because that is how you learn and improve your understanding of anything.
As I ask my colleagues at work every time I seek feedback: "Tell me why I am wrong".
That's it from me, it has been truly a pleasure to discuss with you so you can help me learn where and how I am wrong!
1. Again, this does not even address my criticism. This is one issue I have with UPF people (like with CICO people). You can't even discuss their theories with them. It's like we live in separate dimensions and our speech does not interact. From my view, you just stated your view for the 4th time and it still doesn't have anything to with my argument.
I actually find the meta very interesting here, because this happens all the time, everywhere, e.g. in politics.
We have 2 (or more) sides that interpret the same data as proving contradictory opposites. Both eventually end up at "Ok let's stop talking about it this isn't helping" (like you just did) or "Ok the other side is CLEARLY LYING nobody could be stupid enough to believe such nonsense" (politics but also much of nutrition)
2. I think BMI is good enough for many/most people when it comes to obesity. BMI won't tell you how much diabetes you have, but if your BMI is 30 and you're not currently in the NFL or a professional bodybuilder.. let's be honest you know.
3. I want healthcare to cost less, too. I just think this is shortsighted. Not understanding the issue and using untested solutions to paper over symptoms is like burning your furniture in the winter. Yes, it'll create heat, but you'll increase problems and therefore cost further down the road.
Of course burning your couch might mean the difference between freezing to death or not, and then it's a good emergency fuel for fire.
But my point is, we're only at this point because we used this same strategy the last 100 winters and put ourselves in this situation, it's our own fault. We're like a habitual drunk driver blaming the alcohol for his car wreck.
We could possibly understand both points at the time, but we won't, because almost all GLP-1 advocates are actively denying & suppressing that there are even 2 points, just as CICOtards did for the last 100 years.
So when the people who have been racing towards the cliff and ignoring all warnings for 100 years say "We have to keep driving towards the cliff, this is an emergency!" then you can imagine my contempt.
4. The "scientific method" works better for some things than others. Historically, almost no scientific breakthroughs were found using it. Read "Against Method" by Feyerabend.
The real scientific method is this:
- Observe something
- It seems kinda weird
- Go "Huh, weird!" (<-- this is the important bit people miss)
- Try 1000 things, 999 of which fail, until you find one that works or you give up
But the meta is: the idea that discussion will eventually lead to resolution of clashing paradigms seems clearly false. There are mental models that are so incompatible that they cannot be discussed between the 2 sides. They either go in circles (like we're currently doing) and people "agree to disagree" or they lead to religious wars.
This makes me pretty bearish on science, society, civilization, etc. I don't know a way out. Historically, the solutions seem to be either total war until 1 side is destroyed, or declaring large portions of dialogue off-limits, like "no talk about religion & politics at the dinner table."
The problem is that if you declare an entire aspect of science & everyday life like nutrition off-limits, you're not gonna solve any of it.
Happy to continue the discussion, albeit I may get slow due to work / life business. I love this stuff and truly value your perspective.
Let me see if I understand your criticism of the UPF framework:
a) It is too vague to be useful
b) It captures so many food categories, and these vary per study so it really explains nothing
c) Correlation does not mean causation. You cannot pin-point what ingredients are causing the alleged increase in obesity
d) The concept is good for advocacy, but cannot be scientifically defined.
e) Kevin Hall is a drunken sailor who compromised his study with insane food choices (that one you did not mention but I love it in general, lol)
Okay. My counter to those valid arguments is that we are trying to find a plausible, and hopefully falsifiable framework that would work across populations. And say what you want about Kevin Hall or Herman Pontzer, still, after taking the criticism, there is now an increasingly large number of peer-reviewed studies showing that health deteriorates when the majority of the food you take in is UPF. And you can argue around the edges of the definition, because you are no longer tied to nutrient profiles, we are able to look into things like satiety mechanisms and gut bacteria, the latter mostly ignored by any other framework I know.
In Feyerabend's terms (I've read him, I studied epistemology back in the day), UPF is a valuable emerging perspective, it is evolving and not reductionist and places the research in a real environment, therefore UPF can coexist with many other approaches. It cannot be dismissed offhand.
I am particularly interested in how PUFA is trying to solve the Japan / South Korea riddle, since they consume quite a bit of PUFAs yet their obesity rates are not increasing at the same speed. Of all people Noah Smith had a great post on Japan and how society pushes to strict caloric restriction... not something I buy but interesting anyway.
2. BMI... I respect your view, the evidence shows that emerging frameworks once again are providing better answers. Not only for Olympic athletes, but also for Asian individuals and others.
3. There are a lot of priors in your argument, especially that GLP-1s are going to cause more harm. My position is based on reality... to this day people smoke. And now youth vape. Governments are unable, unwilling or uninterested in completely stopping smoking, and I do not think you can. To me, eliminating whatever we think is the root cause of obesity is a pipe dream, so we need to work in the context of real people eating whatever they eat. If I can find a hack that works for half of the population, I will take it. A recent study here in Canada shows that of those defined as obese, close to 80% have comorbidities. I am practical here, not ready to wait until we find the consensus explanation and then try to modify eating habits of half of the world population.
4. I like Feyerabend, and I do not like science to become dogmatic, that is called religion, LOL. I just want to make sure whatever we test is reproducible and we try to shoot it down, not just carry water to our windmill, as we say in Spanish. And that is the criticism I have of Kevin Hall, but also of those who bend the data to prove their point.
As of right now, we have not a hot clue what is causing obesity rates to increase mostly in advanced economies. We have some good leads, and we should pursue them all. But if I am to pick a horse, it will be the Brazilan NOVA stallion, LOL. Something is up with highly processed foods and our gut, and what it signals to our brain. Or maybe not. But we should keep looking into it, I posit.
1. I don't think it's "the easy route." My weight loss was already more successful, faster, with no side effects than the best studied GLP-1s. They also just don't work at all, period, in quite a few people.
2. That's not particularly interesting. I want to solve the mystery of obesity. It's clearly not a lack of GLP-1 that our ancestors were injecting biweekly.
I wonder if the new glp1s will be better. I am taking retatrutide which has a lower appetite suppression and my running times have improved a lot. Something about glucagon increasing your energy levels.
My issue is, nobody seems to actually understand how these work. The side effects of the first 2 generations are terrifying, and the drug makers seem to refuse to do good studies on the weight loss aspect, lean mass loss, etc.
There clearly is an insane amount of lean mass loss in many of the people, and they look like skeletons, very unhealthy. I'd much rather look the way I do now (healthy, if a bit stocky) than that, even if there wasn't reports of various cancers, stomach issues, pancreas issues.. truly horrifying side effects.
In addition, it just misses the point entirely. Are we just going to pretend there is no mysterious obesity epidemic and pour GLP1 drugs into the tap water?! Wtf.
This is such a level of willful ignorance as a society I'm just not willing to put up with it lol.
I think they are worth a good hard look, which it looks like you've done. Most of the side effects are actually the effects of a) obesity, b) diabetes, or c) starving yourself. I.e. not caused by the drug but instead caused by what it treats or people abusing it.
Disagree on the side effects. There are pretty insane, direct side effects of the drugs themselves. Plus, if the method of the drug working is "starve yourself" then you can't really blame the effects on "starving yourself."
When you burn fat you take in oxygen and make quite a lot of carbon dioxide and water, which you then breathe out/piss out. So not needing to drink much water is probably a good sign.
Apparently camels don't actually store water in their humps, they store fat, which they can use to *make* water.
Also, you can use all of the logic in this post to argue that PUFAs are beneficial (or, at least, not harmful) to health because loading up on them doesn't cause immediate deleterious effects (beyond the maxxed-out current level of damage).
Some other reactions: (for some reason this post elicited a lot of reactions from me...)
> But I also did the exact same diet almost the entire year of 2024, and yet I was seemingly plateaued, bouncing around the 220lbs mark.
The Law of Diminishing Returns is brutal!
> There’s just a way that fat-gaining diets make me feel.
I remember you and Mac (a.k.a. "Metabolic Repair") having a similar conversation about how fat-losing diets both have you constantly urinating. I've certainly experienced it, too.
> It would be silly for me to expect a diet to work for me just because it worked for somebody else, especially if that somebody else was never very obese and just went from normal/slightly overweight to shredded.
Indeed, this is the key challenge with "health policy." Clearly, most people are metabolically messed up. But how do we fix them if they are each messed up in unique ways? There ought to be a more efficient way to get them oriented than having every person do a wide array of N=1 experiments. Hopefully companies like Patchwork will figure out systematic ways to solve this problem.
> Reversing (morbid) obesity & getting shredded are very different metabolic states and require radically different solutions.
This is so true: the diet that "worked" for me dropped my BMI from 24 to 21. That "diet" was basically "do what Mark Sisson and Brad Kearns say in their book *Two Meals a Day*." It was basically "eat different, move more."
> Metabolically messed up from a lifetime of whatever causes obesity (PUFA, western diets, cafeterias, ..)
The "cafeterias" was a nice touch 😄
> I’m open to the idea that, after a lifetime of obesity, there just isn’t a way for me to get down to 188lbs, or whatever BMI-normal is for me.
This was crushing for me to read. Godspeed, brother. There are a lot of people rooting for you!
1. Yea, my framework of experimentation (30 day trials) for sure is way too short for something long-acting like PUFA or the vitamin A diet. I've talked to several vA people, and all of them basically agree that doing 30 days of low-vA won't do or prove anything. So I'd have to commit for say 6 months to even make a dent. Similar for any reasonable PUFA trial, if not years.
2. I hope that it's not super unique. As in, we won't need to run 7 billion (or is it 8 now?) series of experiments, but maybe 30. I suspect there are 2-3 diets out there that will fix 85% of people. Then it probably starts turning into a long tail, and the final quy is super unique in every way. But I bet if we run people through the "Low PUFA, pick low-fat or low-carb, if it doesn't work try the other, if that doesn't work restrict protein" gauntlet we'll get 85% of people out of obesityland.
3. Cafeteria diet was always my favorite "scientists aren't serious people" thing. Even the Western Diet thing isn't accurate any more, as the Eastern World has largely adopted Western junk food and is having all of the same health problems now. India and China both have the same or higher diabetes rates as the U.S. now, I think.
4. Thanks. I'm still cautiously optimistic, but life doesn't have to be fair haha.
Agreed on the "85-15 rule" for experimentation. You might be "the final guy," though! (But I hope not.)
Yay vinegar, I've always loved vinegar. Chips(steak fries) with salt and vinegar is starting to look like ancient wisdom.
Acetic acid is the shortest possible saturated fat and can be fed straight into the Krebs cycle without needing beta-oxidation. I wonder what that's doing for you?
It sure feels like an energy boost.
Also it almost seems like people knew what they were doing before we re-invented everything to Make It Better (tm)
I've only had a few cases of transient, nonrepeatable diet success in my life (defined as simultaneously working and losing weight; I eat 700cal/day for 1 out of 3 months to counteract the weight gain from eating enough to work, but I don't get much done while starving). In all of those cases, it was immediately obvious what was working because I felt energetic rather than tired and starving. Does it work like that for you? If and only if yes, what's the indicator on vinegar?
One continuous month of that much calorie deficit may be counterproductive. Based on his research, Prof. Valter Longo (Director of the Longevity Institute at USC) recommends five (consecutive) days per month, in particular, in the fasting mimicking diet that he developed.
Earlier this year I wrote about my experience with fasting mimicking:
https://theotherendofthegalaxy.substack.com/p/improving-body-composition
700kcal is nuts, I got starvation psychosis on day 6 on 1,500 a day :D I'm not surprised you can't get any work done during those phases.
Do you mean "energetic despite huge caloric deficit" or "energetic" in general?
I felt very extra energetic in the beginning of keto, and when I first tried ex150 as well. Now, that just feels "normal" to me since I'm on ex150 by default. I'll say that I didn't feel "tired & starving" on e.g. the rice diet, just mildly bloated at all times, but then again it was ad lib, no forced deficit.
On vinegar, in the beginning, I felt "extra energetic" too. I'd have noticeably decreased appetite for cream, too. I drank way less coffee and barely finished my evening whipped cream in one sitting.
Now the "extra" energetic seems to be gone, just like it was every other time so far, and just turned into "normal" I suppose.
I guess the one word answer is "Energetic."
I came across this:
https://youtu.be/vKwjiT2q8Ms?si=_CNE03eeYJshmZ4B
... which might explain how cream contributes to your satiety.
tl;dr? Can't stand that guy haha
Here are the articles cited in the video on calcium creating satiety and increasing metabolic rate:
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/12FBB9D68EAC436A1716B00759187DF5/S0029665112003060a.pdf/acute_effects_of_calcium_supplementation_on_appetite_and_satiety_in_overweight_women.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC2020446/
https://faseb.onlinelibrary.wiley.com/doi/10.1096/fj.00-0584fje
https://joe.bioscientifica.com/view/journals/joe/210/3/349.xml
https://pubmed.ncbi.nlm.nih.gov/9039155/
Interesting, thanks
I am just busy but the last two posts have so much I would like to unpack! Best probably in a DM, but for now some quick feedback:
1. Everyone in North America and Europe can make fun of NOVA and the difficulty of defining food types, but it looks increasingly plausible that eating mostly highly processed food, defined as commercially prepared and packaged edible (food-like) stuff containing ingredients and chemicals not found in home kitchens, are messing up with the brain / satiety mechanism, short-circuiting healthy metabolic processes and affecting our gut health.
2. BMI is a poor proxy for anything. If GLP-1 receptors work for 75% of those who take them, BMI works for maybe 70% or less of the population as an indicator of obesity. Maybe Ex-Fat you have arrived at your ideal weight. Body recomp is a different matter, mostly to do with training than eating. I like your taxonomy of diets, and once you found the food(s) that makes you feel full and not generate weight gain, you are done.
3. As a public health intervention, anything that works for 70% or so of patients taking a drug is worth trying. GLP-1 medications may be key to stem the increase in obesity.
4. Trying to find the single issue creating the obesity epidemic (it's see oils! It's fat! It's vitamin A!) is unhelpful. It is multi-factorial and we may never quite fully understand it.
Thank you as always for your thoughtful, well researched, and generous in sharing knowledge posts. Take care.
1. "it looks increasingly plausible that eating mostly highly processed food, defined as commercially prepared and packaged edible (food-like) stuff containing ingredients and chemicals not found in home kitchens, are messing up with the brain / satiety mechanism, short-circuiting healthy metabolic processes and affecting our gut health. "
My issue with this is that it's nearly meaningless. It's both extremely full of false positives (it allows unhealthy things) and false negatives (it cuts out harmless things).
It's sort of like banning all red foods, or all foods starting with the letter "R." Maybe you get lucky and some people's health improves on average, but it doesn't have much to do with your heuristic.
2. I think BMI is fine. I haven't reached my ideal weight, because I also get body fat measured via DEXA and it's still around 30%.
BMI doesn't work if you're Mr Olympia or an NFL lineman. But for almost everyone, the BMI + a mirror is a great indicator, I think.
3. My objection here is that the GLP-1 proponents are so dishonest. We have TONS of interventions that work for lots of people, but the same people who shill GLP-1 and pretend there are no side effects claim these are "unproven" or "just anecdotal." Plus, HOW DID WE ALL GET OBESE IN THE FIRST PLACE? Are we just going to pretend we don't need to understand reality here and live happily ever after? Will we eventually just put GLP-1 in the drinking water because the obesity rate will reach 99.999% otherwise, since we never figured out what caused obesity? This feels like the dumbest possible strategy. Clearly you want to understand what happened, right?
4. I find this mindset extremely unscientific. And almost every nutrition scientist has it. This is why I think nutrition science is a big net evil.
Hey, thanks for taking the time to engage in conversation. A few notes for your consideration:
1. I like epistemology, and my framework is old (Popper), yet I think that it is still a good reference. Falsiability is what we want, every hypothesis should be able to fail. Okay, but until it does, it is our best answer. If the question is: What is causing the spike in obesity, diabetes, stroke, cardiac problems and certain cancers? Then it is hard to argue that many studies and more importantly meta-studies are showing that individuals consuming UPFs at more than half of their daily food intake level do have, empirically, poorer health outcomes. Yes, there are confounding factors, but it does not mean that there isn't a clear hypothesis and field work to refute or reinforce the hypothesis. No different than your push against PUFAs.
And UPFs are definable, as I did in my original comment.
2. BMI. For what? My understanding is that it should be an instrument of public health and a predictor of potential adverse health outcomes. Is it? Hmm, 30% fat is not bad or good or anything, what matters is markers of diabetes, coronary disease, etc. Where the fat is matters. So yeah, BMI is becoming useless for what was intended to do. The obsession with body fat is misplace, we must obsess about disease, I would strongly argue.
3. Of all the interventions before GLP-1, the obesity rate in the USA and other places continued to climb... Until now. I quote from a web search: "A study published in December 2024 in JAMA Health Forum analyzed data from nearly 17 million adults and found that the obesity rate decreased from 46.2% in 2021 to 45.6% in 2023. The most significant declines were observed in the Southern United States, where GLP-1 prescription rates were highest". I am certain is not because we stopped consuming seed oils... If some people are on satin for high cholesterol forever, well, some who tolerate it well may be on Wegovy forever as well.
4. See #1. Science is the ability to formulate an hypothesis, and then test it to try to prove it is false. The practical limitations — confounders, measurement errors, real-life messiness — make the science difficult, but they do not make it unscientific. They simply mean nutritional science must remain cautious, iterative, and self-correcting.
In short, we need more people like YOU!!!
Cheers!
JS
1. And UPFs are definable, as I did in my original comment.
I don't think that's an operational definition. The studies are all mostly worthless if they're based on unclear definitions, and lots of averages. That's why I almost never pay attention to meta studies, averages of averages... there's no signal left.
I also basically falsified it myself: I gained 100lbs eating fresh, home-cooked meal 99% of the time.
If UPF gets something right, it's mostly by accident.
2. Markers for specific diseases are obviously good for those diseases, although people disagree which markers to look at or what they should be (e.g. heart disease). But I think body fat % is also a decent marker. If your body fat is 30% as a man, that's probably not optimal, maybe even unhealthy. At 40% it's almost certainly unhealthy even if you never get diabetic or never get heart disease.
The problem with disease is everybody's an ideologue and the markers & definitions are ideological. For example, I don't believe a word of the Lipid Hypothesis and think all the LDL/ApoB/Cholesterol stuff is made up and clearly falsified.
I also think diabetes markers are way too lenient, anybody with 100mg/dL fasting glucose is not healthy but prediabetic in my mind.
So I'd say almost all the other markers besides BMI are even worse/more partisan.
3. Sure, but shouldn't we try to understand obesity? Pretending like we don't need to and these drugs will work for everyone forever (which we know isn't true) seems stupid. We can't just sweep reality under the rug because it's convenient and profitable.
4. That's one definition of science, and because of the limitations you name, it's practically useless in biology. We're just too complex of a system to easily test stuff in a lab. Most RCTs are way too short and you can't lock people in a lab for 8 years. So I'm extremely skeptical of uppercase-S "Science" because it follows a systemic implicit bias and denies all other types of science that come to different conclusions.
Thanks again and we can go on and on so I will stop here, despite how much I am enjoying this!
I do worry about making everything a partisan issue, especially around medicine and public health. Maybe because I live in a country with a single-payer and universal health care program, the worry is to minimize the cost by shifting focus to prevention. Less cases of diabetes, less heart attacks and strokes, less cancer cases help to keep our costs manageable while continue to guarantee access to health care. And some blood markers do help to futurecast potential negative health events.
About the points we are batting around:
1. You can gain weight eating home-cooked foods, but in theory (which can be refuted, of course) it should not lead to diabetes, calcified arteries or another nasty chronic disease. And as an aggregate, you can see that any country or society where UPFs become the lead source of nutrition, overall population health declines over time.
2. I agree that studies show that body fat %, especially around the waist, is a good predictor of potential development of chronic illnesses. I disagree that BMI can give you that info, though. DEXA is the gold standard for that. The % fat of an individual is less important than where the fat is located.
3. Our goals are not mutually exclusive. I just want my health care system to cost less, with less wait times. I want to push up the lifespan of the population, which has reached a plateau and after COVID has gone backwards.
You want to understand the underlying mechanisms leading to obesity. We can achieve both goals at the same time, and perhaps even use how GLP-1s affect brain and bowels to try to find the core reasons. But again, if I see the obesity curve going down or flattening, I will take that over Weight Watchers Points, CICO or "eat less move more" BS!
And for the record, when I was diagnosed with high cholesterol and fatty liver disease, I asked the doctor to give me time to tackle it without drugs, and I did. I am not a pill pusher, but I cannot deny population-wide impacts.
4. Popper's definition of science is not about lab vs "real life", it is about creating an hypothesis (PUFAs are the main cause of our metabolic malaise), testing that hypothesis in a way that can be replicated multiple times (good study design), and take the view that the goal is to prove the thesis wrong, because that is how you learn and improve your understanding of anything.
As I ask my colleagues at work every time I seek feedback: "Tell me why I am wrong".
That's it from me, it has been truly a pleasure to discuss with you so you can help me learn where and how I am wrong!
1. Again, this does not even address my criticism. This is one issue I have with UPF people (like with CICO people). You can't even discuss their theories with them. It's like we live in separate dimensions and our speech does not interact. From my view, you just stated your view for the 4th time and it still doesn't have anything to with my argument.
I actually find the meta very interesting here, because this happens all the time, everywhere, e.g. in politics.
We have 2 (or more) sides that interpret the same data as proving contradictory opposites. Both eventually end up at "Ok let's stop talking about it this isn't helping" (like you just did) or "Ok the other side is CLEARLY LYING nobody could be stupid enough to believe such nonsense" (politics but also much of nutrition)
2. I think BMI is good enough for many/most people when it comes to obesity. BMI won't tell you how much diabetes you have, but if your BMI is 30 and you're not currently in the NFL or a professional bodybuilder.. let's be honest you know.
3. I want healthcare to cost less, too. I just think this is shortsighted. Not understanding the issue and using untested solutions to paper over symptoms is like burning your furniture in the winter. Yes, it'll create heat, but you'll increase problems and therefore cost further down the road.
Of course burning your couch might mean the difference between freezing to death or not, and then it's a good emergency fuel for fire.
But my point is, we're only at this point because we used this same strategy the last 100 winters and put ourselves in this situation, it's our own fault. We're like a habitual drunk driver blaming the alcohol for his car wreck.
We could possibly understand both points at the time, but we won't, because almost all GLP-1 advocates are actively denying & suppressing that there are even 2 points, just as CICOtards did for the last 100 years.
So when the people who have been racing towards the cliff and ignoring all warnings for 100 years say "We have to keep driving towards the cliff, this is an emergency!" then you can imagine my contempt.
4. The "scientific method" works better for some things than others. Historically, almost no scientific breakthroughs were found using it. Read "Against Method" by Feyerabend.
The real scientific method is this:
- Observe something
- It seems kinda weird
- Go "Huh, weird!" (<-- this is the important bit people miss)
- Try 1000 things, 999 of which fail, until you find one that works or you give up
But the meta is: the idea that discussion will eventually lead to resolution of clashing paradigms seems clearly false. There are mental models that are so incompatible that they cannot be discussed between the 2 sides. They either go in circles (like we're currently doing) and people "agree to disagree" or they lead to religious wars.
This makes me pretty bearish on science, society, civilization, etc. I don't know a way out. Historically, the solutions seem to be either total war until 1 side is destroyed, or declaring large portions of dialogue off-limits, like "no talk about religion & politics at the dinner table."
The problem is that if you declare an entire aspect of science & everyday life like nutrition off-limits, you're not gonna solve any of it.
Happy to continue the discussion, albeit I may get slow due to work / life business. I love this stuff and truly value your perspective.
Let me see if I understand your criticism of the UPF framework:
a) It is too vague to be useful
b) It captures so many food categories, and these vary per study so it really explains nothing
c) Correlation does not mean causation. You cannot pin-point what ingredients are causing the alleged increase in obesity
d) The concept is good for advocacy, but cannot be scientifically defined.
e) Kevin Hall is a drunken sailor who compromised his study with insane food choices (that one you did not mention but I love it in general, lol)
Okay. My counter to those valid arguments is that we are trying to find a plausible, and hopefully falsifiable framework that would work across populations. And say what you want about Kevin Hall or Herman Pontzer, still, after taking the criticism, there is now an increasingly large number of peer-reviewed studies showing that health deteriorates when the majority of the food you take in is UPF. And you can argue around the edges of the definition, because you are no longer tied to nutrient profiles, we are able to look into things like satiety mechanisms and gut bacteria, the latter mostly ignored by any other framework I know.
In Feyerabend's terms (I've read him, I studied epistemology back in the day), UPF is a valuable emerging perspective, it is evolving and not reductionist and places the research in a real environment, therefore UPF can coexist with many other approaches. It cannot be dismissed offhand.
I am particularly interested in how PUFA is trying to solve the Japan / South Korea riddle, since they consume quite a bit of PUFAs yet their obesity rates are not increasing at the same speed. Of all people Noah Smith had a great post on Japan and how society pushes to strict caloric restriction... not something I buy but interesting anyway.
2. BMI... I respect your view, the evidence shows that emerging frameworks once again are providing better answers. Not only for Olympic athletes, but also for Asian individuals and others.
3. There are a lot of priors in your argument, especially that GLP-1s are going to cause more harm. My position is based on reality... to this day people smoke. And now youth vape. Governments are unable, unwilling or uninterested in completely stopping smoking, and I do not think you can. To me, eliminating whatever we think is the root cause of obesity is a pipe dream, so we need to work in the context of real people eating whatever they eat. If I can find a hack that works for half of the population, I will take it. A recent study here in Canada shows that of those defined as obese, close to 80% have comorbidities. I am practical here, not ready to wait until we find the consensus explanation and then try to modify eating habits of half of the world population.
4. I like Feyerabend, and I do not like science to become dogmatic, that is called religion, LOL. I just want to make sure whatever we test is reproducible and we try to shoot it down, not just carry water to our windmill, as we say in Spanish. And that is the criticism I have of Kevin Hall, but also of those who bend the data to prove their point.
As of right now, we have not a hot clue what is causing obesity rates to increase mostly in advanced economies. We have some good leads, and we should pursue them all. But if I am to pick a horse, it will be the Brazilan NOVA stallion, LOL. Something is up with highly processed foods and our gut, and what it signals to our brain. Or maybe not. But we should keep looking into it, I posit.
Awesome exchange, I really appreciate it.
Have you considered taking the easy road and getting a GLP1?
Apologies if you have already discussed this, I haven't been following closely recently.
1. I don't think it's "the easy route." My weight loss was already more successful, faster, with no side effects than the best studied GLP-1s. They also just don't work at all, period, in quite a few people.
2. That's not particularly interesting. I want to solve the mystery of obesity. It's clearly not a lack of GLP-1 that our ancestors were injecting biweekly.
I wrote about my thoughts here: https://www.exfatloss.com/p/the-totally-speculative-reason-i
Thanks for the reply.
I wonder if the new glp1s will be better. I am taking retatrutide which has a lower appetite suppression and my running times have improved a lot. Something about glucagon increasing your energy levels.
Then again at some point performance enhancing drugs have always been around
My issue is, nobody seems to actually understand how these work. The side effects of the first 2 generations are terrifying, and the drug makers seem to refuse to do good studies on the weight loss aspect, lean mass loss, etc.
There clearly is an insane amount of lean mass loss in many of the people, and they look like skeletons, very unhealthy. I'd much rather look the way I do now (healthy, if a bit stocky) than that, even if there wasn't reports of various cancers, stomach issues, pancreas issues.. truly horrifying side effects.
In addition, it just misses the point entirely. Are we just going to pretend there is no mysterious obesity epidemic and pour GLP1 drugs into the tap water?! Wtf.
This is such a level of willful ignorance as a society I'm just not willing to put up with it lol.
I think they are worth a good hard look, which it looks like you've done. Most of the side effects are actually the effects of a) obesity, b) diabetes, or c) starving yourself. I.e. not caused by the drug but instead caused by what it treats or people abusing it.
Disagree on the side effects. There are pretty insane, direct side effects of the drugs themselves. Plus, if the method of the drug working is "starve yourself" then you can't really blame the effects on "starving yourself."