Is Obesity Incurable?

[RenaissanceBiker]

Speaking of exercise, what is this "endorphin rush" that other people keep talking about? I've never had it, to me exercise is just a boring, painful and tedious activity that I do for my health.

In my experience the endorphin rush only came after I had been exercising consistently for a few months and began to see real progress in several areas, such as losing weight, being able to exercise harder and longer. The rush of endorphins comes from a sense of achievement, not the exercise itself.

Me too. I get it quite often. Occasionally I get a good rush during a run. Once I got a good "runner's high" at the end of a 15k race and could barely figure out how to turn in my race card (this was before RFID tags became common for races).

A 180 pound man who lifts weights for a full hour burns around 250 calories. This is less than the number of calories in a single Snickers bar.

Another example: To burn off the calories in the aforementioned bagel with cream cheese, the same 180 pound man must run (briskly) for a full half hour.

Don't eat that kind of crap. No one makes you buy a snickers bar. I exercise for 30 - 45 minutes every day. Some days it's running, some it's swimming, lifting weights, calisthenics, etc. I do something every day, usually in the morning. On running days I am hungry all day. I eat a bowl of cereal for breakfast, snack on nuts and bananas during the day and eat a good dinner.

That said, I've heard as a minimum we need 30 minutes, 3 times a week of significant raising of heartrate/being out of breath. These days I can get that bending over to tie my shoes

I'm 48 years old, 5'11" tall and weigh 195 lb. I can make both fists and touch the ground in front of my toes with my knuckles without bending my knees. 10 years ago I weighed 210 lb. and was on cholesterol meds. When I started eating right and exercising my Dr. was able to take me off of them. If I stopped drinking beer I could probably lose another 15 lb. but I like my home brews too much.

The key to curing obesity is to change your lifestyle. Some people simply can't do that so I guess it is incurable for them. It's not incurable for everyone.

 

[Tatyana]

We evolved as hunter-gatherers. We probably need an immense amount of exercise. I remember hearing (w.r.t. the San in the Kalahari) that man is the ultimate endurance predator. Over miles and miles, no animal can outpace us. This may be untrue but it gives an indication of the amount of work teh human body can absorb.

My maternal grandfather was a coalminer. He worked an 18 inch seam with hand-held tools, 12 hours a day, 5 days a week. The amount of physical work he did each day, every day puts the any attempt I may have to exercise into the shade.

That said, I've heard as a minimum we need 30 minutes, 3 times a week of significant raising of heartrate/being out of breath. These days I can get that bending over to tie my shoes

You might want to catch this on the beeb or iplayer if you can:

http://www.bbc.co.uk/programmes/b013gmh1

She nicely lays out the hypothesis that human beings evolved to be distance runners.

 

[AlBell]

Ha ha ha wow. Cool nostalgia/anecdote, bro.

Yes, the reason this country has an obesity problem is because some parents weren't letting their kids run around at a 4th of July fireworks show. This is only time kids can exercise because youth sports and gym class don't exist. It has nothing to do with how our bodies work or our food intake.

Seriously, that was some Glenn Beck levels of bull.

(Also, I don't what planet you grew up on, but a 500 yard dash was not my idea of fun as a kid.)

Interesting. When and where I grew up 4th celebrations included a greased pole in the rodeo arena for kids to (try to) climb, followed by a greased piglet to try to catch.

 

[Pup]

Originally Posted by Vorticity
A 180 pound man who lifts weights for a full hour burns around 250 calories. This is less than the number of calories in a single Snickers bar.

Another example: To burn off the calories in the aforementioned bagel with cream cheese, the same 180 pound man must run (briskly) for a full half hour.

Don't eat that kind of crap. No one makes you buy a snickers bar. I exercise for 30 - 45 minutes every day. Some days it's running, some it's swimming, lifting weights, calisthenics, etc. I do something every day, usually in the morning. On running days I am hungry all day. I eat a bowl of cereal for breakfast, snack on nuts and bananas during the day and eat a good dinner.

I think you're missing Vorticity's point, or at least the point I took from it.

Doesn't matter whether a person eats a 250 calorie bowl of granola or a 250 calorie Snickers bar, unless he/she is counting calories exactly, it's easy to accidentally eat just a little more, that will completely undo the calorie loss of the exercise. As you noted, after exercising, you're hungry all day.

If a person exercised only, and didn't also consciously curb their appetite, there's a good chance they could increase their eating just enough, unawares, to prevent them from losing weight.

Exercise is of course good for one's health, for a variety of reasons, but I think it's too often promoted as a weight-loss solution, more than it deserves.

 

[Beerina]

First hit on google for <obese lifespan>

"Obesity shaves two to four years off the average lifespan, while being very obese can shorten your lifespan by 8 to 10 years..."

I don't know the line between 'obese' and 'very obese', but 2-4? 8-10? But how does that compare to 'standard deviation', which I guess is um about +/- 6-7?

Hmmm, a couple years vs triple bacon cheeseburger deluxe.... hmmmm..... I'll get back to you with my decision- after lunch.

The same kind of study also showed that "overweight" (not obese) people actually lived longer than normal weight people, calling into question how they confused normal, which probably meant average, with that which maximizes lifespan.

If it weren't for issues like heart disease, i.e. mechanical issues, obese people would probably live longer still. Then there's Type II diabetes, which is related to decades of gumming up things.

 

[ZirconBlue]

My argument was that with enough willpower, losing weight is never impossible.

True, but completely useless, I'm afraid. If you don't have sufficient willpower, there doesn't seem to be any way for (most?) people to get more.

Has that really increased though? I couldn't find any stats. My guess would be that participation in organized sports is slightly lower now than 30 years ago for boys, but probably much higher for girls.

I don't have any stats, but since we're talking personal experience and anecdotes, here's mine: My daughter is 9 and has been enrolled pretty much year-round in the local Parks and Rec soccer programs. Her summer soccer academy is 3 nights a week for 1.5-2 hours. No such programs existed for me when I was her age. And, while I did spend a lot of time outdoors (no AC at our house!), averaged out over the week, I'd say she's getting more exercise than I did.

Exercise is of course good for one's health, for a variety of reasons, but I think it's too often promoted as a weight-loss solution, more than it deserves.

A couple of years ago, I started marching in a drum and bugle corps. It's very intense exercise for a couple of days about every other weekend. I quickly got rid of the extra chin and general pudgy appearance, and improved my overall health. But, I don't actually weigh any less than I did when I started.

 

[marplots]

True, but completely useless, I'm afraid. If you don't have sufficient willpower, there doesn't seem to be any way for (most?) people to get more.

Cognitive behavioral therapy comes to mind. It's not a cure-all for addiction, but it does seem to work better than willpower. Coupled with 90 days (or more) of inpatient/residential treatment, it's the best we can do for now.

This assumes that addiction treatment is a good model for overeating and still doesn't rise (at least for some drugs) to the level of "most."

 

[Delvo]

If you don't have sufficient willpower, there doesn't seem to be any way for (most?) people to get more.

Years ago, when I first started lifting weights at home, I found within a few weeks/months that, shortly before my usual time when I planned to do so, I would actually start to want to be lifting, in a strange way that sort of felt like my muscles were asking my brain for something to do.

I got knocked out of that habit by a relocation for a new job that involved hiking up and down the Ozark highlands all day. More recently, having neither worked that kind of job nor exercised otherwise for a few years, I started working at UPS, loading hundreds of boxes into trailers per hour. After I'd gotten used to the physical intensity and then quit a few months later, I found the same thing happening again the following week: my muscles had gotten used to the activity level and started sending messages to my brain about wanting to keep at it. So now I'm weightlifting at home again after having not done it for a long time.

So it seems that there can be changes in how much willpower an individual has, or it might be better to say in how much willpower an individual needs in order to do something... but it might unfortunately depend on having applied enough willpower in the first place to get to that point.

A couple of years ago, I started marching in a drum and bugle corps. It's very intense exercise for a couple of days about every other weekend. I quickly got rid of the extra chin and general pudgy appearance, and improved my overall health. But, I don't actually weigh any less than I did when I started.

The health value or even just weight-loss value of exercise can't really be assessed by counting calories burned while exercising and comparing it to calories eaten. It also affects resting calorie burn rate and the allocation of resources between building/maintaining fat and building/maintaining muscle.

 

[iknownothing]

Now, parents spend their weekends in mortal terror of letting youngsters out of their sight.

I wonder if part of that is demographics? In the 60s, for example, you had a lot of families with young children moving into the suburbs. A kid growing up in a suburban neighborhood could probably find a lot of playmates on their own block.

We just don't seem to have a lot of young kids nearby. Our neighbors do have a daughter who was in my son's Kindergarten class this year. She plays with my kids sometimes. When she's home. Other than that -- I looked at the school directory to find out where my son's classmates live, and they are scattered here and there. None besides our neighbor are closer than a few blocks away. There is a family with a couple of older gradeschool kids at the end of the block. Otherwise, there are a few middle/high school kids scattered around, and a number of houses with couples whose children are grown.

Also, though, I think a lot of the exercises that adults do seem punitive in nature. Running on a treadmill just isn't any fun. Neither is repetitively lifting forty pounds of cold metal. But...take up dancing lessons or carry an 80lb backpack for a weekend hike has a lot more appeal, and I think is more likely to be something people will enjoy doing well enough to make the extra effort. Sadly, those things are usually seen as "retreats" or "vacations" or "rewards" so they aren't adopted as permanent lifestyle changes.

I agree. I have this vision of a fun gym for adults, that would have adult-sized obstacle course type stuff. And bounce houses that can take the abuse from overweight adults. Treadmills are pretty bleak.

And I'm a bit dubious of going "Weight Watchers doesn't work, ergo weight loss is impossible!" The studies would be more interesting if they said what made the few success different from the rest (e.g. long term diet control vs short term "dieting"), or if there seemed to be nothing at all.

I don't remember where I read this, so I can't back it up. But I read awhile back that those few who do keep it off, do so because they continue to monitor calories very closely for life. They continue keeping food diaries, weighing and measuring serving sizes, etc. It probably takes a certain type of personality to do that.

This makes me wonder: could it be that the key to developing a "cure" to obesity would be to take a neurological approach -- to go after whatever it is in the brain that generates the hunger impulse?

I think so. I don't think any amount of lecturing people is going to help their higher brain functions control those ravenous hunger impulses.

If you are obese at a young age, you may have a poor quality of life for 70 years. Of course there are some people who feel that eating whatever they want is worth being obese, but not many.

And some may feel that obsessing over the minute details of every bite, every day (like the long-term successful dieters I mentioned above), is a poor quality of life in its own right.

 

[wolfgirl]

I don't remember where I read this, so I can't back it up. But I read awhile back that those few who do keep it off, do so because they continue to monitor calories very closely for life. They continue keeping food diaries, weighing and measuring serving sizes, etc. It probably takes a certain type of personality to do that.

I just read this this morning!

http://todayhealth.today.msnbc.msn....want-to-lose-weight-adopt-these-3-habits?lite

Apparently the keys (according to this study) are keeping a journal, not skipping meals, and not eating out (especially lunch). And without knowing it, I've been doing all three of these things.

I don't know if I yet qualify as a long-term success story, but I lost 65 pounds on Weight Watchers 2 1/2 years ago, going from obese to "normal," and have managed to keep it off. And yes, I do pretty much have to keep track of everything I eat. When I do so, I find I'm in control, and when I slack off, I find the weight starting to creep back on. So it does take constant monitoring. Luckily I have a pretty obsessive-compulsive personality, so writing things down and counting points is easy and natural for me.

I never skip a meal. In fact, I eat several small meals every day. Instead of eating my entire lunch at once, I eat the main part (sandwich, Lean Cuisine, whatever) at lunch-time, the fruit in the middle of the afternoon, and the other item (yogurt, granola bar, whatever) right before I head home so I'm not starving when I get there.

And I bring my lunch to work almost every day. That puts me in control of what I'm eating all day.

I don't want to give the impression, though, that I never eat anything "off plan," because that would be totally unrealistic for me. I just try to keep those special treats to a minimum. And thinking of them as "treats" makes me appreciate them more. I might allow myself a small DQ Blizzard on the way home from the dentist, for example. I always have pizza once a week. But to do so, I know I also have to be more aware of what else I eat that day. Which is very much the Weight Watchers model...no forbidden foods, only forbidden portions...balance and moderation are key. And mostly, but not always, staying away from really bad stuff. For example, when someone brings donuts to the office, I never have one. Never. It's just a food I've decided I can live without. I cannot, however, live without ice cream, so I have a bowl of low-fat ice cream or fat-free frozen yogurt every night, and a bowl of full-fat Ben and Jerry's once a week. (No matter how badly I crave it the rest of the week, knowing I can have it on Saturday keeps me from going nuts).

So I believe (or need to believe) that obesity is something that I've gotten past. But is it "cured" in the sense that I can eat whatever I want and not get fat again? Of course not. It's not that kind of thing. The "cure" is in my head. If I went back to eating the way I used to, it only makes sense that I would go back to looking the way I used to. And I do struggle with the cravings. But I keep my "before" picture on the fridge and refer to it often!

 

[not_so_new]

I don't know if I yet qualify as a long-term success story, but I lost 65 pounds on Weight Watchers 2 1/2 years ago, going from obese to "normal," and have managed to keep it off. And yes, I do pretty much have to keep track of everything I eat. When I do so, I find I'm in control, and when I slack off, I find the weight starting to creep back on. So it does take constant monitoring.

Almost exactly my story as well.

I don't want to give the impression, though, that I never eat anything "off plan," because that would be totally unrealistic for me. I just try to keep those special treats to a minimum.

<snip good stuff>

So I believe (or need to believe) that obesity is something that I've gotten past. But is it "cured" in the sense that I can eat whatever I want and not get fat again? Of course not. It's not that kind of thing. The "cure" is in my head. If I went back to eating the way I used to, it only makes sense that I would go back to looking the way I used to. And I do struggle with the cravings. But I keep my "before" picture on the fridge and refer to it often!

Exactly the same here. It's a huge challenge but if I work at it I keep the weight off.

I know people on this thread are saying it's more than force of will and I COMPLETELY agree. I (at least) have to use external tools like Weight Watchers or some other diary method and I weigh myself every day at the same time.... but for me it is about willpower on top of that.

I have to push myself to eat better foods (I am not a junk food junkie at all, I LOVE veggies and fruits but I also LOVE doughnuts) and I do MUCH MUCH better when I take the time to track the foods I eat. It doesn't take a lot of time, about 10 to 15 mins a day which sounds like nothing but it does take some willpower.

Am I often hungry when I am losing weight, you bet. Do I have to work at it every freak'n day, absolutely. Have I been reasonably successful at keeping the weight off? Well, for the last 5 years I have lost around 60 pounds and it hasn't come back yet. I go up and down 5 or so pounds every few weeks but I am not going up to my old weight at all.

So I don't believe obesity is "incurable" but it may actually be so for the people who lack the tools or willpower.

 

[marplots]

... And yes, I do pretty much have to keep track of everything I eat. When I do so, I find I'm in control, and when I slack off, I find the weight starting to creep back on. So it does take constant monitoring. Luckily I have a pretty obsessive-compulsive personality, so writing things down and counting points is easy and natural for me...

This is pretty much what I have to do to keep my spending in check. Without constant attention, I drift into financial trouble. Sounds like a good recipe to control other unwanted behaviors.

 

[Vic Vega]

They studied obese people measuring their metabolism -- with very rare exceptions, there were no "glandular" condition or even "slow metabolism". It was simply too much calories. Their metabolism was no different from normal weight people.

Who is the "they" that you are referring to? Can you point us to some evidence or should we take your word for it?

No "slow metabolism"? Of course some people have "slow metabolisms", just like some people have "fast metabolisms". This isn't a mystery. There is a wide range of normal. Just because a particular person's genetic makeup causes them to store calories more efficiently doesn't mean there is something "wrong" with them, just that they are more predisposed to getting fat than other people. This is indesputable. The amount of daily calories for these people that causes weight gain may not be enough for others, who burn calories more efficiently, to maintain their weight.

This is a note in one of Harriet Hall's articles on Science-Based Medicine.

"There are social and cultural influences and practical considerations; but the basic problem is that because of their genetic makeup, some people’s bodies are more efficient at storing calories. In a famine situation, they would be the survivors; in a world where abundant food is available, they are the obese. Taubes is correct when he says, “Those who get fat do so because of the way their fat is regulated.” But they still couldn’t get fat without eating too many calories for their particular metabolism, and if a way can be found to decrease their calorie intake to a level appropriate for their metabolism, they will lose weight."

This is what people mean when talking about their metaboilism making it harder to lose weight, not some defect.

Harriet Hall is a physician so I'm thinking that what she has to say carries a bit more weight than the mythical "they".

 

[Halfcentaur]

I would guess in hunter gatherer times those with slower metabolisms more prone to putting on fat stores survived the famines and lean months more successfully.

 

[Vic Vega]

I would guess in hunter gatherer times those with slower metabolisms more prone to putting on fat stores survived the famines and lean months more successfully.

Of course. I've known many people who didn't execise and could eat whatever they wanted and not gain weight. It seems to change for a lot of people in their early to mid twenties, but for some, it never does.

If I were a Caveman, I'd be all set! I can store fat like a champ. I used to be significantly overweight, but I'm not anymore. I know that if I want to stay fit, I have to be careful about the quantity and quality of what I eat. I also do cardio 6 - 7 days a week and lift weights 5 days a week and all of these workouts are strenuous.

I'm in good shape, so why do I do this? My metabilism is slow. If I don't want to be fat, I have no choice. If I'm not vigilant, the pounds will begin to creep on and before you know it I'll be shopping at the Big and Tall store.

Well, I don't want to shop at the Big and Tall store. I know my body so I do what I need to do. It's a pain in the ass, but I do it.

 

[Modified]

I would guess in hunter gatherer times those with slower metabolisms more prone to putting on fat stores survived the famines and lean months more successfully.

But they outran bears less successfully.

 

[The Don]

About so called fast and slow metabolisms:

http://www.bbc.co.uk/health/treatments/healthy_living/your_weight/medical_myths.shtml

 

[Vorticity]

About so called fast and slow metabolisms:

http://www.bbc.co.uk/health/treatments/healthy_living/your_weight/medical_myths.shtml

I think people are to a certain talking past each other on this issue in this thread.

The linked article defines 'metabolic rate' as "the energy (calories) you expend over a day just keeping your body functioning." It is in no way surprising to me that this is the same for fat vs thin people (taking into account overall differences in body size). Furthermore, it will always be true - by simple physics - that:

weight change ~ (calories absorbed) - (calories expended).

The point some in this thread are trying to make is that "calories absorbed" is not necessarily the same as "calories swallowed." The relationship between these two quantities will depend on the efficiency of an individual's digestive track. If a person processes food with much greater efficiency, they will have more calories absorbed after eating the very same item of food.

This real question is: Does this efficiency actually vary significantly from person to person? Note that this is a fundamentally different question from the consideration of metabolic rate. Whereas the one concerns calories expended, the other concerns calories absorbed.

I don't know the answer to the above question, and I'm not aware of any research that addresses this issue. If someone knows of any, I'd be happy to see it. All I have are anecdotes, which may or may not be worth the electrons they are transmitted via, but which I present below:

1) (Warning: This might be slightly gross.) I have observed that when I have a bad stomach flu, the resulting poop tends to contain... ah... pieces of mostly-undigested food in it. (This is not the case when I am well.) This is significant because it shows that a given digestive track is capable of varying the efficiency with which it processes food. This, in turn, makes it at least plausible that this efficiency may vary from individual to individual.

2) I have struggled to keep my weight down all of my life. I have an older half brother who must constantly struggle to keep his weight up. And not just by a little bit. He must eat two or three times the amount that a person his size should nominally need, just to keep from looking like a famine victim. I don't exaggerate that: If he eats a merely "normal" amount, within a few weeks his cheeks are sunken, his ribs are showing, and people start asking him if he's OK. He'll eat an entire store-bought birthday cake in one sitting, not because he likes it, but because that kind of concentrated calorie consumption is the only way to get the 5-6,000 calories a day he needs without spending all of his time eating. And no, he doesn't do a lot of exercise. He works a desk job. I actually get a lot more exercise than he does. There's definitely something odd going on there, and if it's not metabolism, it can only be digestive efficiency.

 

[Vic Vega]

About so called fast and slow metabolisms:

http://www.bbc.co.uk/health/treatments/healthy_living/your_weight/medical_myths.shtml

There are quite a few problems with this article. There are no studies cited, which would be very helpful. It's 5 years old, which in the science of weight loss is absolutely ancient. It also has some contradictions and some dubious statements in it.

The title says: "There's a common belief that people who are overweight have a slow metabolism (burn energy slowly), while thin people have a fast metabolism (burn energy quickly). This is a myth."

No kidding! Of course this is a myth. It would assume that all overweight people are one way and all thin people are another. That's just silly.

"Results from these studies have consistently shown that overweight people use more energy to keep their bodies working. This is because they have larger bodies with bigger muscles and internal organs."

A ridiculous generalization. Overweight people have bigger muscles than people who are fit and do a significant amount of resistance training? I think that in very many cases this is patently untrue.

"Basal metabolic rate can be influenced by body composition. Muscle requires more energy to function than fat."

"Similarly, two people of the same age and weight may have different metabolic rates if one is fitter (and has more muscle) than the other."

So, in other words, basal metabolic rate IS different in different people and much of it has to do with how fit they are.

Gee... Thanks. What a revelation...

 

[ZirconBlue]

This real question is: Does this efficiency actually vary significantly from person to person? Note that this is a fundamentally different question from the consideration of metabolic rate. Whereas the one concerns calories expended, the other concerns calories absorbed.

I recall a story on NPR discussing the role of gut bacteria in digestion that might be relevant.

And, here is an interesting follow-up.