Or rather, something “of interest” that found me. Drifted across my FB page via a site devoted to exercise and body composition and whatnot.
Now, subject matter apart (which I think has METAR as well as individual ramifications), I like this sort of article for background interest. A little bit of historical nuance, some fairly robust evidence…and coherent to me without having to resort to looking up a whole slew of acronyms (because this is a fairly well traveled path here and with a bit more nuance for us laypeople)
a year after stopping the drug, patients regained two-thirds of their previous weight loss. This motivates the hunt for alternatives (Table 1).
This is a disaster with horrible outcomes. Yo Yo dieting with chemicals? Cant get much worse a few years out.
By my dad’s five year self imposed guidelines he would not prescribe either one. Right off the bat most people are yo yo dieting but with a wider margin because of a greater weight loss.
Sleep well and cut calories. You heard it here first? Really?
Better yet, don’t get fat in the first place … then you could really afford to be sanctimonious.
See, one of the take home messages from this article with it’s mention of the multiple targets for future therapy, is that overweight/obesity is a pretty complicated state of affairs. Especially once people have actually become fat and a point to remember is that, unlike a good many older fat folk there are a increasing numbers around who didn’t actually become fat by their own efforts. Not necessarily “born fat” (aside from the epigenetics of intra uterine life with an obese mother) but raised in an obesogenic environment so, by the time adolescence comes along, they’re well and truly on a disease path.
To the point of study participants regaining 2/3 of their lost weight, I’d say only 2/3? I bet that sort of track record compares pretty well with the Righteous Way…at least when it comes to health related biomarkers.
Whilst I really can’t fathom why folk just don’t do what I did/do…respond to, say, that first 5lb weight gain…I recognise very well that most don’t/can’t. I’ve mentioned in other threads on this topic the weight loss world is so full of myths and misconceptions that even the notion of energy balance/CalsIn vs Cals Out is hotly disputed (you’d have seen this for yourself if you’d been around in the days of the old TMF) I see a strong potential for these sort of interventions (risks and all) to demonstrate that there is no magic…reducing, as they apparently do, the desire and even the ability to overeat.
This is a very good point. Seems like many diets (or whatever change of habit causes weight loss) only works for some period of time, and that when the person gets back to their previous habits, not only do they gain back all the weight they lost, but they also tack on an additional 5 or 10 pounds. Do this yoyo for 20 years and you often end up 20 or 30 pounds heavier than you were when you started dieting 20 years earlier.
After decades of discussing this, I don’t think belief in the principle of cals in/cals out makes any difference. In the end, what likely makes the most difference is which behaviors, or how/what/when you eat, results in a lower cals in, or at least results in better quality cals in. For me, at least since 1993, the only way I can really control my cals in is by avoiding carbohydrates, especially simple carbohydrates, as much as possible. I’ve experimented on myself for more than 4 decades, and I’ve tried [almost] all the different techniques, and that’s the only one that “works” for me.
I’ve been avoiding Craptaculous Carbs with a vengeance for a good half century. You learn a thing or 17 about what you should/shouldn’t be eating at dental school😉. Before that, really as my mum had pretty strict ideas on what, when, and how much food should be eaten.
I still exercise vigilance and accountability over what I/we eat. There are so many clues and landmarks to restrained eating in daily life that are missing unless take account… I’m thinking plate size etc and what’s considered a portion. Even if a person has reached a level of “unconscious competence” in the stages of learning here, it doesn’t do to become too complacent.
In that case, wait till you hear this!!! My teeth are weird, or my mouth is weird. First off, I’ve never had a cavity (in my adult teeth), and I am not very good with brushing and/or flossing (I floss for a few weeks after a cleaning at the dentist, and then I slack off until I reach zero flossing). But the astounding part is, when I profusely eat carbs, I end up with a lot less plaque than when I am on a strict low-carb regimen. I don’t know why, but I have seen it again and again and again.
I am not zero carb, just low carb. For example earlier today I ate half a mango from my tree. It was absolutely delightful, but very very sweet to me. I also eat berries regularly (blueberries, strawberries, raspberries, blackberries, etc).
That is the entire point. Gets back to their old habits.
The old habits are bull blank. If you need to loose weight do not revert to the old habits.
Sanctimonious? No not at all. I am concerned with people getting the help many of them need and getting it right.
No one should go around recommending a new drug use that more often not will fail badly. The first year was 2/3 that does not include the next few years. If no change in how to eat was achieved then it is all a failure.
As far as the eat less yes that fails just as often.
On the other side when it succeeds and habits have changed it works occasionally.
Can people do it? Usually not. That does not make someone successful sanctimonious. It makes them very concerned for others.
But like an ex smoker, which I am as well two packs a day quit at age 26, I would get a bum rap for caring about smokers.
Well zebra hunting (when you hear hoof beats) tends to keep a gig interesting. However, the zebras and weird stuff really aren’t that common. It’s totally possible to be dealt such a favourable genetic hand that, regardless of any Bad Habits we have, the outcome is still ok.
With regard to caries (as a adult) not so rare. The tooth morphology you inherited and the diet you’ve eaten oftentimes combine to give a caries free/zero caries experience adulthood. No cavities ever usually means no restorations so less potential for material failure etc moving forward. Mercifully few of you around else what would I have done to earn an honest crust!?!
Periodontal disease is a bit different and much longer in the making. Concerning plaque formation and diet, it’s generally accepted (based on decades of research…some not entirely ethical) that a high sucrose diet leads to earlier deposition of the “starter” matrix but, the ultimate biodiversity of the plaque biofilm can be totally influenced by diet. Here’s the thing, though … how much plaque you have on your teeth at any one time after, say, a day or two post hygiene appointment is also dependent on how efficiently you brush. Oftentimes this is totally unconscious effort…you “know” that you had a high carb meal so compensate unwittingly at cleaning time.
It is likely genetic. My dad, about 20 years older than I am, also has never had a cavity. My mom, on the other hand, has had 30 out of 32 teeth worked on at various times.
It’s possible, but I’m not talking about a high carb meal. I don’t think a single meal would make much of a difference. When I eat carbs in copious amounts, it usually lasts for a week to a month, and I gain weight during that period. Usually it begins with a change of habits, most of the time, it begins when we are on a cruise and I start eating different things than usual, including desserts and ice cream.
For example, I had a deep cleaning last year, then as usual I brush and floss fervently for a few weeks, then we went on a cruise and I carb binged for that week and for 2 or 3 weeks after our return. By then I had stopped flossing and brushed less often. But my teeth were still quite good. After 3-4 weeks and 10-12 pounds, I got back on my usual strict low-carb way of eating, lost the weight over the next few weeks, but the plaque built up like mad. I mean, so bad that at the crowded areas of my teeth, I can scrape off pieces of calculus with my fingernail.
I suspect that my mouth chemistry varies somewhat while eating a high-carb diet versus a low-carb diet, and that is the primary determinant of plaque buildup.
Anyway, I’m due for another cleaning right about now.
I’m sure you believe that. One thing to consider, though, in spite of your personal success story, personal experience is, by definition, limited experience. From your own account, you’re something of a late bloomer on the healthy eating scene and, had you been around on just this one forum back in the days of the FFF and low carb boards, you would’ve read similarly enthusiastic accounts of diets that were successful. At least, while they were successful.
See, although you’ve kicked a couple of bad habits, eating and food is a bit different. You’re not old enough to have started smoking and boozing unaware that they were harmful to your health…along with actually being totally unnecessary for healthy living. Heck, there’ve been societal barriers in place to actually make it more difficult for smokers and boozers to kick their habits in the form of laws to prevent smoking and drinking in public places etc. Eating is a bit different. You have to do it to survive (unless you believe the Breatharians) and all around you are temptations that are all perfectly acceptable to give in to.
A few months back I had cause to post a question on this very topic on a study support forum for a training course I was doing…specifically if the were any trainers with experience of clients who were overweight but non diabetic and did training suffer/have to be revised. First couple of days the responses were from gals who obviously didn’t understand the assignment because no, they only preached the sort of abstinence that worked for them yada, yada and I stopped following. Came back to check a week or so later and spattered among those early responses a few worthwhile responses began…including one from a physician (OB/GYN and part time personal trainer) who pointed out that excessive weight gain, although it’s certainly due to ultimately to excessive energy intake, is multifactorial and requires a multifactorial approach to restore energy balance. She, in fact, did have experience in this area …although she herself wasn’t a prescriber as pregnancy wasn’t quite the time to be using these meds…but attested to their value as another tool in the weight management armamentarium. After this, a few more trainers jumped in with tips on training such clients (based on experience…a good many from overseas with more affordable access to the drugs.)
I can’t imagine ever using these drugs myself … but, then again, I can’t imagine allowing so much as an extra 5lb of lard sit unattended on this 5’6", 130lb frame…but if all my best efforts didn’t work (and I can attest that maintaining this body composition takes A LOT of effort…I can almost understand why so few people are successful) I think I would contemplate it to head off the future metabolic consequences that’re almost inevitable.
Not unlike my approach to aggressive lipid lowering/ASCVD mitigation as a future proofing exercise.
Oh I have more experience than you know. Between my following different diets and being in OA for a few years. Along with working out over the years and working with people who wanted to diet in a lot of different ways. The books and magazine articles. The friends who are health nuts etc…Popping pills instead of discipline is a huge mistake for many people. It is unpopular in pop culture to suggest discipline. The response generally is laziness and excuses. I stopped directly suggesting discipline a long time ago.
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