Children or no Children?

[fatlittlepig]

hatton1 wrote:

burritos wrote:

AR wrote:

burritos wrote:

As duped person enamored by his(Dr. Fung’s) strategy, I may have been blind to some of his con like suppositions. I always am willing to learn. Can you please remind or identify for me some of the idiotic claims?

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Well there were two things in the post I responded to.  Specifically,

1. The idea that there is anyone out there that claims 1200 kcal/day is sufficient for a maintenance diet for an adult.  Literally no one is claiming this, yet he just lies and says it’s the dogma.  I’m not sure what the “dogma” is.  But that’s definitely not it.  So he fabricates a claim, represents it as “dogma” and then attacks it.  It’s intellectually dishonest and should be obvious to anyone.

2. He then goes on to claim that he was gaining weight on 1200 kcal a day despite exercising.  Even the most fervent Fung believer has to know that’s clearly impossible. It’s an obviously false claim.  Do you believe it?

 

I can understand being “duped” by him.  I’ve repeatedly said his strategy works.  That’s not the problem.

 

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I never knew he claimed that people were gaining weight on 1200 cal. I don’t think you can gain weight on 1200 cal/day.

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Lots of my patients claim to eat “nothing” and still gain weight.  Unless you measure portions carefully most have no idea how much they consume.  I think the obesity epidemic has little to do with insulin levels and more to do with a lack of self control rampant in our society.

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disagree, the more i learn about obesity the more I realize it is not about self control or lack thereof. There are a whole host of neurohormonal, and biological mechanisms in play which work to promote weight regain after weight loss. to say the obesity epidemic is about a lack of self control is intellectually lazy.

[Tim]

@FLP,
“to say the obesity epidemic is about a lack of self control is intellectually lazy.”

Non medical person question. I realize that medical conditions can have severe impacts. My question is how widespread are the conditions and are they actually increasing?

Anecdotally I have known one person in grade school that had a weight gain, but she had a serious condition with medication.
Anecdotally within a large family, I see differences that I attribute to the family diet and activities.

When I go to the mall, there has been a significant increase in observable obesity. Any day at the grocery store or park or a baseball game the same visual observations. What percentage of obesity is caused by medical conditions? It used to be a few moms and more like and isolated kid.
What you eat and how much combined with activity is the limit of my knowledge. I have a hard time believing the obesity is driven up be increases in medical issues.
There are a whole lot more really overweight people now. At least where I live. No offense intended.
Just observations.

[Lordosis]

I order pizza because I am lazy. I eat half of the pie because I lack will power. I know better. I am not going to blame insulin.
I sometimes blame my busy family life. Not having enough time to prepare good food and such but that is also kidding myself. It is just a matter of priority.

[fatlittlepig]

Ever wonder why obese people can lose weight fairly easily only to regain it? Do you think they all lack will power? Do you think people like being fat?

Let’s say Fatlittlepig weighs 160 lbs
Let’s say obese little pig weighs 260 and manages to lose 100 lbs through caloric restriction. Once obese little pig gets down to 160 lbs there are a whole host of innate neuro hormonal processes which kick in to encourage his body to regain weight, in fact to maintain 160 he has to take in fewer calories and exercise far more than Fatlittlepig although they both are at the same weight. These biochemical processes are extremely powerful, it’s not just willpower at that point.

[CordMcNally]

fatlittlepig wrote:

Do you think they all lack will power?

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A lot do.

fatlittlepig wrote:

Do you think people like being fat?

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Most don't but it's easier than the alternative of eating right and exercising.

fatlittlepig wrote:

disagree, the more i learn about obesity the more I realize it is not about self control or lack thereof. There are a whole host of neurohormonal, and biological mechanisms in play which work to promote weight regain after weight loss. to say the obesity epidemic is about a lack of self control is intellectually lazy.

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Self control is a very important component. Why are Americans so much more obese when compared to many of the other developed countries? I certainly think it's multifactorial but downplaying self control, motivation, etc. is intellectually wrong.

[HikingDO]

FLP, you unfortunately sound like many of my patients who eat “perfectly” and exercise “every day” but can’t seem to lose weight. I ask every one of these patients to make a food and exercise diary for a month, recording every calorie that enters their mouth and anything that they consider exercise. In 20 years, do you know the number of patients who have actually scheduled a follow up appointment with their diary? Zero. Willpower has a TON to do with weight loss. It’s far easier to stop at KFC on the way home from work and chow down on a bucket of fried chicken and mashed potatoes and watch Game of Thrones than to grill your own chicken and vegetables and go for a walk or go to the gym. Excuses are like, er, rectums, everyone has one., and feeding into it by saying it’s not in large part their fault that they’re obese is doing a disservice to the patient. End of rant

[fatlittlepig]

I used to think like you but years of reading on this topic coupled with observations has informed me that the issue is the classic multifactorial problem (and yes self control, education regarding energy density of foods, poor choices do play a role, but there are other factors) In terms of weight “regain” the research is fairy conclusive that the reason that “long term” weight loss is so elusive lies in biology rather than pure self control.

[fatlittlepig]

As physician it is so easy to look down upon obese patients, stereotype them, groan about them, Fatlittlepig will be honest and say that FLP does it too, but there’s more to the story here than eat less, exercise more, stop shoveling cheeseburgers into your mouth.

[HikingDO]

At no point in my post did I say that I look down upon these patients, no more than I do with any patient in my practice who has a preventable and reversible disease. I just choose not to enable them, as I don’t enable any of my patients. I agree, there is more to the story, but discounting the main cause of the obesity in these patients and instead focusing on the minutiae is foolish.

[fatlittlepig]

I’m afraid you are taking an uninformed overly simplistic view of the problem. Yes excess calories are being consumed obviously, however a whole host of hormones are being secreted to promote the intake of these calories and to promote weight retention. Arguably it’s an involuntary process.

https://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html

 

[fatlittlepig]

HikingDO wrote:

At no point in my post did I say that I look down upon these patients, no more than I do with any patient in my practice who has a preventable and reversible disease. I just choose not to enable them, as I don’t enable any of my patients. I agree, there is more to the story, but discounting the main cause of the obesity in these patients and instead focusing on the minutiae is foolish.

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I would have a little bit more compassion for these patients, entertain the possibility that keeping the weight off is not something that may be biologically feasible. It’s not like take your anti hypertensives and maintain your sbp below 135 and call it a day.

[HikingDO]

FLP, please stop with your usual troll act and quit putting words into my mouth, it gets old fast. Unlike what you admitted about yourself in a previous post, I do not “look down upon obese patients.”, and like all patients that I treat, I have compassion for their needs and issues, I just choose not to enable them. Anyways, have a nice mother’s day, I definitely have better things to do than to continue to feed the troll.

[fatlittlepig]

I’ll let your words speak for themselves:

FLP, you unfortunately sound like many of my patients who eat “perfectly” and exercise “every day” but can’t seem to lose weight. I ask every one of these patients to make a food and exercise diary for a month, recording every calorie that enters their mouth and anything that they consider exercise. In 20 years, do you know the number of patients who have actually scheduled a follow up appointment with their diary? Zero. Willpower has a TON to do with weight loss. It’s far easier to stop at KFC on the way home from work and chow down on a bucket of fried chicken and mashed potatoes and watch Game of Thrones than to grill your own chicken and vegetables and go for a walk or go to the gym. Excuses are like, er, rectums, everyone has one., and feeding into it by saying it’s not in large part their fault that they’re obese is doing a disservice to the patient. End of rant

[Lordosis]

It is simple but not easy. It is an every day commitment. I am sure it is in part genetic and there are multiple factors involved but will power and education are the biggest.

[CordMcNally]

fatlittlepig wrote:

I’m afraid you are taking an uninformed overly simplistic view of the problem. Yes excess calories are being consumed obviously, however a whole host of hormones are being secreted to promote the intake of these calories and to promote weight retention. Arguably it’s an involuntary process.

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How come these neurohormonal processes have become such a new thing (and apparently more pronounced) in the last 50 or so years?  Has evolution changed so much in the last century compared with the last hundreds of thousands of years? How come humans are the only mammals that struggle so much with this obesity epidemic?

fatlittlepig wrote:

but there’s more to the story here than eat less, exercise more, stop shoveling cheeseburgers into your mouth.

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You've got to admit, this would be a ************************ of a start for a large majority of people.