The Slightly Complicated Theory of Obesity

Hypothetical #1: Bob Changes Shape

Hypothetical: a man named Bob (pictured left) wants to change his shape, from oval to rectangle. There are various diets out there, all claiming to have The Solution for shape change.

So many diets, so little time. Just kidding, Bob has his entire life to try them all.

Bob researches on the internet, and a lot of people seem to be having success with the Low-derp diet. The secret is to eat a very low amount of derp, as derp causes the body to take on an oval shape. People recommend less than 20g of derp per day for the first few weeks, the so-called “induction phase,” and then stay below 50g of derp per day for the long term. Reviews are positive. People are posting pictures of their shape before and after the diet, and they all look very rectangular.

Bob decides to try the Low-derp diet. He buys a Low-derp cookbook, throws out all the derpy foods in his pantry, and buys a lot of foods containing herp instead.

It’s actually not that bad. His friends and family are very supportive of his shape-changing endeavours. He manages to create very palatable herp-heavy dishes, replacing his former derp-laden meals.

First it looks good. His shape changes a little bit in the first two weeks.

But then, after a month, Bob is still mostly oval shaped. He’s been following the recipes from the book, watching tons of low-derp videos on YouTube, and counted derps, making sure never to go above 50g per day.

He manages to go another month on low-derp before he gives up, quickly rebounding to his exact, oval shape.

Hypothetical #2: The Broken Down Car Analogy

Imagine this. You drive down the road, when suddenly your car starts slowing down. You manage to pull onto the shoulder just as it comes to a stop. Puzzled, you get out and inspect the car. You don’t see anything obviously broken.

Remembering that you have a jerry can of spare gas in the trunk, you grab it and top up your tank. When you get back and try to start the engine, the car still won’t move.

Just then, another motorist stops and gets out.

Motorist: Hey there, looks like your car won’t go.

You: That’s right. I’m at a loss as to why.

Motorist: Pretty sure you need to put more gas into it.

You: I tried that, I already put a lot of gas in. But it still won’t drive!

Motorist: My cousin’s car stopped moving once, and he put gas in it, and then it drove again. I’m pretty sure you just need to put more gas in.

You: But I’ve already tried that, and it didn’t help.

Motorist: Nah, I think you didn’t put in enough gas. Are you SURE you put in gas?

We recognize this as pretty silly. There are plenty of reasons cars break down, and putting gas into the tank only helps for one of them: the car was out of gas. The car could have a flat tire, an electric short, engine damage, it could be overheated, out of coolant, low on oil, or any other reason. Quite obviously, putting gas into the tank won’t fix any of these problems, no matter how much gas you put in.

Yet we don’t seem to realize this with diets. When somebody goes on a diet, and it doesn’t work, the instinct of every proponent of that diet seems to be the same: you didn’t do it hard/pure enough.

Try to X harder!

"If X doesn't make you lose fat, you’re not doing it hard enough!"
- Everybody’s Favorite Excuse

This seems prevalent in pretty much every diet community I’ve ever seen. The first instinct is to find out which tenet of the diet you’ve failed to adhere to. Pretty much doesn’t matter what you say, there will be suggestions to do it harder.

CICO

Are you SURE you counted all the calories you ate? Surely you must’ve missed some. Everybody under counts. And your exercise probably didn’t burn as many calories as you thought. In fact, you probably overestimated your metabolic rate. I found this calculator telling me an adult, 6’8 male, lifting very heavy weights should only eat 87kcal/day! Surely you don’t need to eat more than that?!

Low-carb/keto

Are you SURE you didn’t eat any hidden, sneaky carbs? Did you know that restaurants pour sacks of flour and sugar into the food when you’re not looking? Did you know that fruit is full of sugar? Are you sure you read the labels right?

Did you even test you were in ketosis? Everybody knows those urine strips are worthless. You used a blood test? Everybody knows 0.5mmol/L isn’t real ketosis. You had 3.0mmol/L? Everybody knows you need to have at least 19mmol/L to be in real ketosis!

Vegetarianism/Veganism

You didn’t lose any fat eating a vegetarian diet? Surely you weren’t avoiding ALL meats? Ok you were, but did you eat any fish? Eggs? Dairy?

Try going full vegan. Oh, that didn’t work? Have you tried going raw vegan? Fruitarian?

Everybody knows you’re only supposed to eat the fruits that haven fallen off the tree by themselves!

Fasting

Alternate-day fasting? Of course that doesn’t work! You need to fast harder. Try a 16:8 window. Or 20:4. Why not go full 23:1.

In fact, you should probably do 23.9:0.1 fasting, in which you only eat during the 5 minutes directly following your lunch break.

That doesn’t work either? Well, you could always break out the big guns. Water-fasting for 3 days. 5 days. 7 days. Dry-fasting. Eating only on weekends. Only eating on the first of the month. Only eating while the clock strikes midnight on the 29th of April. Only eating during the leap second.

Carnivore

You didn’t lose weight on carnivore? Clearly you did it wrong. Oh, you had dairy, of course it didn’t work! Chicken and pork, too?! Eggs? Why would you do that? You added spices? You added salt? You didn’t add salt? You drank coffee?

Eat leaner meat! Eat fattier meat! Eat only grass-fed meat! Eat raw meat! Eat honey! Eat raw egg yolks! Eat liver! Eat all the organs!

What if it’s Slightly Complicated

Ok, sorry for the tirade. I’ve been in all of these camps, and I got the exact same response everywhere. Often times, people straight up will not believe you.

And it kind of get it. When you lose 100lbs on keto, you have a hard time believing somebody who’s not losing any weight on it. Until you start gaining it all back yourself.

What I find curiously absent is the idea that, just maybe, this diet doesn’t work for everybody. There are tons of things that don’t work for everybody.

A diet that works for 30% of the people is still a great diet! Especially, if you can identify those 30%.

But somehow, in the diet space, we seem to believe that if a diet worked for us, it must work for everybody.

It might not even be that complicated. It might just be Slightly Complicated.

Slightly complicated problems I call those that don’t have exactly one trivial solution, but they’re not complex sense either. We’re probably not all unique snowflakes. There are probably a few categories. Maybe 4. Maybe 10.

Take the car analogy: cars are complicated, but they’re not impossible to figure out. If you take your car to the shop, it’s very likely that the mechanic will figure out what’s wrong. In all likelihood, even the roadside assistance guy will have the tools necessary to fix it.

It could be you’re out of gas. Or your engine overheated. Or you have a flat tire. Or something went wrong with the electronics. Or you have a coolant leak. Or you’re low on oil and the engine shut off for safety.

There might just be a handful of problems causing most obesity, and there might be a specific solution to each one. But since we insist on throwing all of them into one bucket, we can’t figure this out.

In a sense, nutrition science has maneuvered itself into a corner here. Due to the religious insistence on randomized controlled trials and using a large number of people for studies, it’s pretty much impossible to find any solutions unless they apply to everybody.

If we insisted on the same methods as car mechanics, we would have to declare that there is no solution for cars stranded on the side of the road.

After all, we did a large study: we took a sample of 10,000 cars stranded on the side of the road, and we attempted all popular ways of fixing them. We put gas into them, we pumped up their tires, we topped off the oil, and we checked for any engine errors.

Yet not a single one of these repairs made more than 15% of the cars run again!

Clearly, cars cannot be repaired. That’s just science. Gasoline in, gasoline out!

What if some people do best on a low-fat diet, some a low-carb diet? Some do better on grazing throughout the day, whereas others do well eating one big meal?

It’s not that crazy. Yea, we’re all the same species. But there are tons of documented differences in our dietary abilities.

• Fully 2/3 of humans are unable to digest dairy once they reach adulthood. The rest only developed an adaptation to keep lactase, the enzyme used to digest lactose, around 10,000 years ago, after animals were domesticated.

• Early humans lacked salivary amylase, the enzyme in our saliva that helps digest starch. The agricultural revolution only happened 12,000 years or so ago, and our closest ancestors, chimpanzees and bonobos, typically have only 1 copy of the amylase gene, or none at all. Even modern humans vary quite a bit, with some hunter gatherer tribes typically only possessing 2-3 copies of this gene, whereas more starch-adapted cultures often possess 6 copies.

• In some areas of the world, 1 in 40 people (i.e. 2.5%) have celiac disease.

There are probably a lot of other adaptations that vary between humans.

Why would we insist that a diet that works for us must therefore work for all humans?

For example, I’m currently consuming the vast majority of calories from heavy cream. It would be wild of me to recommend this to everybody, when we know 2/3 of humanity is lactose intolerant.

Pro tip: if you’re lactose intolerant, don’t do a heavy cream diet.

One Diet to Rule Them All?

Now it is possible, of course, that there is One Diet to Rule Them All. I can see two possibilities for this:

1. Obesity really is monocausal, and we simply haven’t found the root cause yet

2. Obesity is slightly complicated, but there is one diet that cuts out all the factors

I’m not sure which one I think is more likely. We’ve tried a bunch of things, but honestly I don’t get the impression that we’re very good at figuring this out. So I could totally see us missing the forest for trees. I bet it’ll be hilarious once we finally figure it out. Obviously you need to wear blue socks for weight loss. I mean, duh!

On the other hand, I have tons of hypotheses of why I lost 50lbs on ex150, and I’m constantly coming up with more, however unlikely they may seem (WHAT IF IT’S JUST ISOLEUCINE?)

But what if it’s not that simple? What if it’s just slightly complicated enough so different people will thrive on different diets, and there isn’t one that works for everybody?

This isn’t even that unlikely. For example, there’s evidence that the people who adapted to dairy over-adapted to the excess levels of calcium in dairy, and became very inefficient at absorbing it. So it’s not too unlikely that, if you tolerate dairy, you HAVE to consume some dairy. This would make dairy a requirement for some people, whereas 2/3 of humanity can’t tolerate it at all. We only need a single one of those conflicts to rule out The One Diet.

An Experimental Framework?

There is of course a fairy tale version of this blog where I get to 188lbs, we try the diet with some readers, it works for literally everybody, and we all live happily ever after, and people say “Wow, Exfatloss, you are the most talented, most interesting, and most extraordinary person in the universe!”

But honestly, that’s probably not going to happen.

So I think the more likely long-term vision is going to be a sort of decision tree framework.

If we can quickly identify who will thrive on what diet, we can have a whole bunch of different diets. The trick is just knowing where to point people.

It would be kind of cool to just take a knowing look at people and go “Aha! You look like you have 5 salivary amylase genes and a functioning lactase gene, so you should do this diet, not that!”

But if that’s not in the cards, I’d settle for a decision tree that has individuals try different 30 day experiments, hopefully leading them to a working fat loss diet within a handful of attempts. (If you thought “binary search,” you gain 1 XP.) Should enough people do it, we should learn from each other, and save each other a lot of effort.

Let’s return to Bob, who is mysteriously thin in this drawing.

Don’t worry, Bob! Everything’s going to be alright. Unless your engine light is on.

Although the tree has a lot of possible problems and solutions, it only takes a few steps to walk from the root (“Car won’t drive”) to any given solution.

Not everybody should have to try all the possible experiments. The trick is “just” in building up the knowledge for the tree. Then, every individual person can hopefully start at the top of the tree, and work his or her way down, eliminating ideas one experiment at a time, until something works.

Here’s an example:

1. Keto → didn’t lose any weight

2. Carnivore → didn’t lose any weight

3. Lean meat carnivore → didn’t lose any weight

4. Low-protein / high fat carnivore → lost a lot of weight!

5. Having established a baseline fat loss diet, experiment with what works individually, and what can be incorporated

This is just a hypothetical, of course. Could end up anywhere. But if each experiment takes about 30 days, the average person should be able to work to a solution within less than half a year.

That wouldn’t be so bad. It certainly has taken me a lot longer than that, and it’s still been totally worth it.