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Culture War Roundup for the week of September 23, 2024

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Set point theory is very popular among fat activists, yes.

People's metabolisms do vary (which is why "CICO" is both true and simplistic - the "burn rate" is not the same for every person). But nobody weighs 400 pounds because that's what their "set point" says they should weigh, and I have only ever met two kinds of severely obese people: those who admit they eat too much, and those who make up reasons why somehow normal rules of biology and physics are different for them.

Of course I eat too much; looking at the people around me, I eat approximately 2-3 times what a non-fat person does. Even though almost everything I eat is healthy home-cooked food, I am obviously going to be fat at that rate.

But what can I do? If I don't eat that amount, I just go around feeling hungry all day, unable to enjoy anything or focus on any kind of productive work, until my willpower finally snaps and I scarf down whatever is at hand.

Which is exactly what set point theory predicts. Set point theory doesn't posit some kind of supernatural physical or biological mechanism; it merely argues that your brain will defend a given weight by making you hungry, cold, and lethargic (or, alternatively, full, sweaty, and hyperactive) until you reach that weight.

Why do you think some people are able to lose weight, then?

Eating a lot is a habit. It is probably closer to an addiction. Eating less is very unpleasant and your body will fight you unless you satisfy it. Just like your body will fight you when you try to stop smoking.

I don't think you have a set point that demands you eat 2-3 times what a normal person does. I think you have a habit of eating that much, and if you stopped doing it, yes, you would feel like you are "starving" until either you give in, or your body adjusts to a lower intake.

I am not speaking hypothetically. I am a former fat person.

Why do you think some people are able to lose weight, then?

Independent upper and lower set points?

The more I hear about set point theory the more it sounds like just-so stories to explain why they can lose weight but I can't.

There may be something to it, but it looks as rigorous as most pseudoscientific theories, and I am suspicious of a theory that happens to be embraced mostly by fat acceptance activists.

It may well be embraced by fat acceptance activists, but it is also embraced by most of the field of nutrition science.

CICO, meanwhile, is only popular with laymen (who very often pair it with moral condemnation of fat people).

I don't think it's possible to look at a chart like this and conclude that what's really going on is a linear increase in laziness starting in the mid-C20th for no reason. Pick any profession full of intelligent, hardworking people (medicine, law, programming, high-level business) and you'll see similar proportions of fat people to the general population. While there are entire premodern cultures where nobody is fat at all.

CICO feels better than set-point theory in the same way that complaining about greedy landlords feels better than campaigning for YIMBY zoning reform. Most people will choose righteous outrage over real explanations if given the choice.

Sorry, there's actually nothing in that blog post about independent upper and lower set points. Or even really about set point theory, broadly speaking, at all.

This was the part I was referencing:

But there's a third model, not mentioned by Ludwig or Taubes, which is the one that predominates in my field. It acknowledges the fact that body weight is regulated, but the regulation happens in the brain, in response to signals from the body that indicate its energy status. Chief among these signals is the hormone leptin, but many others play a role (insulin, ghrelin, glucagon, CCK, GLP-1, glucose, amino acids, etc.).

Sure, but that's pretty generic and not really making any claims about set point theory. Just that there are some feedback pathways. You might be interested in my old lengthy comment about the gap between simply observing that there are some feedback pathways somewhere and something that could properly be called "set point theory" with all of the features that many of its proponents would like. There are some significant theoretical and empirical challenges that would need to be overcome in order to close that gap.

I've seen a lot of control theory models for a lot of biological systems in my professional career, and there is a wide range in terms of quality. I would not bin what I've seen of set point theory in the high end of that range.

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