Comment by JumpCrisscross
2 months ago
> What does base metabolic variability have to do with using CICO to modify your weight?
Metabolic syndrom is characterised by the basal metabolic rate reducing in response to reduced calorie intake or increased caloric expenditure. In most of us this is good. It gets the immune system to quit mucking around, for instance. In the obese, however, it can sometimes mean their bodies will literally stop doing essential shit before it will concede and begin burning fat. It will then do everything it can to refill those fat cells.
You can model a human thermodynamically. But to my knowledge, this isn't used in medicine because it isn't practical. (I'm saying this, by the way, as someone who can eat anything and laze around and not gain weight because my metabolism is tuned the other way.)
CICO reminds me of something we do in finance: burying the complexity in a magic variable. For CICO, it's the CO. Because if you decompose it into its active and inactive components. Exercise is the former. But the latter absolutely dominates that term.
> In the obese, however, it can sometimes mean their bodies will literally stop doing essential shit before it will concede and begin burning fat. It will then do everything it can to refill those fat cells.
I’m sure there’s some people that this might apply to, but I suspect it’s a much (much) smaller subset than people that are actually obese. For the rest, just decrease your intake until you lose weight. Not much else.
> You can model a human thermodynamically. But to my knowledge, this isn't used in medicine because it isn't practical. (I'm saying this, by the way, as someone who can eat anything and laze around and not gain weight because my metabolism is tuned the other way.)
Exactly what variables are missing then? We can agree that exercise, although certainly burns some calories, is not really the lever you want to pull if you actually want to lose weight by itself. What other variable besides changing how much food you eat would you suggest?
That's the point of the discussion, imo. It seems to be an area of research. There's a lot of questions in my view. Why are people so addicted to food? Why do some models of caloric restriction not work as well as they should? How do we embed behavioral change, or do some of these people just have to be in misery for the rest of their lives?
It's not a profound statement to say if you starve in a desert you'll lose weight. The question is how we can apply this to real, normal people. Or if it's even possible in a food-weaponized world.
My view is that we're in the realm of addiction more so than simply answering "how" they mechanically lose weight. This is a public health crisis, one we need to be open to exploring.
Again, food addiction and satiety is a different question than if CICO works. If you can't stop eating and cram too many calories because you eat too many... burgers and potato chips or whatever, that has nothing to do with if CICO works. I have yet to see evidence that shows that caloric restriction if properly, truly controlled, does not result in weight loss for the vast, vast majority of obese individuals. People are notoriously bad at estimating calories and knowing how much they eat, so any study that is self-reported is inherently going to be problematic.
Should we do more research to find if anything anything specific that may be causing overeating or food non-satiety? Sure. Is the answer likely to be something that is essentially 'tastier food is easier to overeat, and tastier food is much more available than it used to be'? I suspect that is the likely conclusion.
I think GLP1 agonists are a great tool to be used to create that so-called 'willpower' to stop overeating (or, an easy way to reduce food noise, whatever you want to call it). The next step is figuring out how, as a society, we make it easier for folks to make that lifestyle change without a constant stream of 'willpower drugs' for the rest of their life.
4 replies →