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Wellness Wednesday for May 24, 2023

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

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Is eating 100 calories and walking two miles (supposing that, at my height and weight, one mile walked burns an additional 50 calories above TDEE) chemically the same thing as eating nothing and doing nothing? I'm in the middle of a weight loss campaign and love to walk, but am continually baffled at the futility of "exercising to lose weight."

Assuming your math is correct, then there are two opposing processes at play:

  • like @JhanicManifold said, your body reduces NEAT when it's tired and tries to entice you to eat more calories

  • cardio improves your cardiovascular system and endurance

Assuming you have your food intake under control and thus the number of calories is fixed, walking two miles shouldn't tire you out to affect NEAT in any meaningful way other than replacing NEAT for these 40 minutes. Just don't count it as exercise at all, so no +100 cal.

Reducing NEAT due to systemic fatigue means stuff like doing cardio that you can barely finish when the hour is over. For example, instead of walking two miles you run six miles in an hour. I am not a good runner, so this would tucker me out. The calculator says that's 750 calories, so now I actually need to worry about how many hours it takes for me to recover from it. If my hourly NEAT is 50 calories and I go into full lay-flat mode for the rest of the day (1 hour of cardio + 15 hours of being awake), then I could've burned 800 calories and burned only 750. If it's just for a few hours, then it's a good deal.

If, however, I were a more active person and my normal activity level was constantly buzzing around the apartment and not staring at the screen all day, then doing hard cardio would affect me much more. Let's say my average hourly NEAT was 150 calories. Let's say I crash for a three hours to watch a movie and then spend twelve hours more being slower than usual, consuming only 100 calories. That's 750+10012 = 1950 vs 15016=2400, a clear loss.

You might have noticed that I've been pulling the numbers out of my ass. That's the problem with estimating TDEE and its constituent components, so most people rely on rules of thumb: as long as your cardio is light enough that you don't notice it affecting the rest of your day (or the following day), doing it is a good idea to increase your TDEE without boosting your hunger. Just don't "compensate" for it by eating whatever the calculator tells you.

likely not. the latter will result in more weight loss

but am continually baffled at the futility of "exercising to lose weight."

metabolic adaptation. the Apple meter shows you burned 400 calories with that long walk ,and the number on the scale falls, but that was mostly water weight and your body makes up the 400 later by slowing metabolism a bit and increasing appetite.

Short answer: it depends on how much cardio you're doing already. Cardio contributes to systemic fatigue, and too much of it will reduce your NEAT (Non-Exercise-Activity-Thermogenesis), basically you'll fidget less and be less inclined to take the stairs instead of the elevator, which will have a net-negative effect on caloric balance.

Very relevant video: Does More Cardio Equal More Weight Lost?

(and I'm very surprised by your 100cal per 2 miles walking number, I use this calculator for estimating walking calories, which gives me much higher numbers)

Unsourced, so take this with a grain of salt, but my impression has been that the significant utility of exercise in weight management is either:

  1. Body composition changes

  2. Metabolic disorder maintenance

On (2), a salient example is insulin resistance, which can be modulated through either cardio or strength training.

The reason for this, as far as I understand it, is that exercise increases caloric needs, and typically folks will increase caloric intake to compensate.

I think a reasonable weight loss routine incorporates both dietary changes and exercise to normalize metabolism.

Weird personal eccentricities:

I was just reading a particularly good Cultivation novel when a piece of fan service came about, and I noticed a very weird phenomenon:

Sometimes, when I see something very sexually attractive yet unattainable, I literally feel pangs in my lower teeth! It's a weird phenomenon, sort of but not quite like biting into an ice cube and provoking sensitivity.

I've noticed this since I was just a kid, provoked by some of the hotter MILFs dropping off their kids at school. It's not frequent, but it only happens when it's something outside my reach, I've never had it happen in an actual sexual encounter.

What the hell. I'm not sure what wires got crossed in my brain, but it sure is an unusual sensation. I'd be surprised if there was anyone else alive who shared it!

I get this really metallic taste in my mouth when I'm in an extremely stressful/panic situation (like the kind of thing that only happens once every 5 years, like I'm totally shit out of luck with an authority figure or something)

I also feel physical pain in my chest from loneliness sometimes like my heart is literally aching from the emotion

Feeling chest pains from loneliness is actually quite common, so you're not alone in that regard!

That's very interesting. I don't have pangs in my teeth, but in such situations, I get something like a lump in my throat, or kinda like a rising feeling in my esophagus.

I've never gotten a pang in my lower teeth ever for any reason.

I did know a guy who used to get goosebumps when he saw an otherworldly set of ass or tits and my thought was always, "get a boner like the rest of us!"

I did know a guy who used to get goosebumps when he saw an otherworldly set of ass or tits and my thought was always, "get a boner like the rest of us!"

I guess that anime nosebleed trope actually might have something to it.

Some studies have suggested that some men have been known to salivate more when presented with the prospect of reward. Others that testosterone and cortisol levels in men rise on exposure to certain female smells (whether perceived or not), though typically from ovulating women.

Take these studies with a lick of salt, but they're out there. Whether this is related to your bottom teeth is of course another question.

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I'll keep this short and sweet. I'm very tempted to try and hop on the semaglutide train. It seems like folks here have had decent results. I have a few hesitations:

  • First, morally, I feel like I should be able to lose weight myself. With enough physical activity (playing soccer etc) I at one point was able to have an incredible body with awful eating habits. I've improved my eating habits dramatically but I know for sure that I still have unhealthy tendencies. I should be eating less and differently. I can cycle an imperial century and it's almost trivial, but actual weight loss has remained elusive.

  • Second, I feel like this gold rush will end in tears a la COVID vax. I'm ashamed I hopped on that train so early though I didn't have any side effects and rarely encounter any through medication anyway. What are the chances this all ends up being a huge mistake and I shave 5 years off of my life in exchange for losing a beer belly?

morally, i feel i should be able to lose weight myself

No! Bad! The decision to take a drug is a practical one with no moral implications. Similar statements include "morally, i feel i should be able to drive a bit longer without stopping at a rest area" or "morally, i feel i should be able to walk to the grocery store rather than drive."

give it a try. if it works you will know soon enough

What are the chances this all ends up being a huge mistake and I shave 5 years off of my life in exchange for losing a beer belly?

A beer belly will cost you about 1-3 years anyway going by the stats

I at one point was able to have an incredible body with awful eating habits. I've improved my eating habits dramatically but I know for sure that I still have unhealthy tendencies. I should be eating less and differently. I can cycle an imperial century and it's almost trivial, but actual weight loss has remained elusive.

metabolic mid life slow down. it is why so many people gain weight in middle age even despite not eating more.

I'm also tempted sometimes, but at the same time, if semaglutide only helps you be less hungry, I don't see the point for using it on myself. I'm pretty capable of simply denying my urges (for 6 out of 7 days, anyway) and avoiding eating much that way. Unless semaglutide also helps your metabolism or has effects other than making you less hungry, then I don't think I need it, I can just mostly do it on my own.

I'm pretty capable of simply denying my urges (for 6 out of 7 days, anyway) and avoiding eating much that way.

the idea is it makes it easier than having to force yourself to not eat . you simply lose the desire to want to eat as much

I've had the same "I can do it myself" mentality for years, and I did have intermittent successes before starting semaglutide. I can stick to a diet perfectly for roughly a month at a time and lose 10 lbs, the problem always comes when life gets stressful and suddenly my mental energy assigned to the diet starts to decline, if It's crunch time and I have an important presentation tomorrow, I can't also be really fucking hungry because I'm in a 1000cal/day deficit, I'll just throw the diet out the window for the stressful time period.

Semaglutide takes care of all that, and I don't need to have zero stress in order for me to stick to the diet, that now happens more or less effortlessly. I still need to have enough mental space to prep my diet foods at regular intervals so I don't eat out instead of eating my home-cooked stuff, but that's a much lower bar than tolerating hunger.

Can it be taken intermittently? Like, in your example scenario, can a person just live normally for roughly a month, but then take it for a week when life gets stressful... then cycle back off it?

The recommended dosing has you slowly ramp up the dose over like 2 months until you get to the truly effective amounts. I suspect that you would get very large gastro-intestinal side-effects if you just went from 0 to the effective dose. Semaglutide also has a very long half-life of a week, so if you're injecting 1.0mg/week steadily, to get the same blood concentration with a single injection you'd need 2.0mg. I think it would be a fairly bad idea, there's a good chance that the diarrhea and vomiting you'd get would wipe out any mental benefits from the lack of hunger.

yeah this is it. the drug takes care of the willpower element

Do you consider your current eating habits to be ingrained too deeply for you to change them without medication? My uncle used to be a jolly fat dude for decades until he flipped the switch and became a wiry endurance cyclist.

I think that part of the reason so many of us have difficulty with self-controlled weight loss is the rarity of examples like your uncle; that's an incredible story that can serve as a powerful "carrot" for many who know him. 90% of adulthoods are descents into overfed and underactive lives, so I imagine many people lack the evidence that such a transformation is even possible.

And one of the reasons why such stories are rare is because the whole world is biased against you. Even my aunt wasn't happy with him, because now he would eat different food at different times, would dress as a MAMIL and leave home at 7am on weekends. His career in sales also went through a crisis, as his existing customer relationships were based in no small part on shared love of food and drink, forcing him to rebuild his portfolio.

Exercise generally sucks for weight loss. thin people tend to eat less, that is were the thinness comes from, not the exercise. i remember i did 50 miles of hiking in a week, lost a pound, which was within the noise. i did 16 days of consecutive hiking, minimum of 2-3k elevation day each hike, scant weight loss. getting omicron soon after did it though, lost 7 pounds even though didn't feel that sick.

Yeah, exercise only works if you do lots of it every damn day. Appalachian trail through-hikers can get lean as fuck, but that's not 16 days of hiking, more like 160.

I've improved them gradually over the years. Portions have gotten smaller, I enjoy vegetables (especially grilled) etc.

But I can't quit occasionally having a decadent cheeseburger or getting multiple items at Taco Bell. It's not a stretch to say that 3-4 times a week I have a 1,000 calorie meal. Sometimes I'll counterbalance that with 1-3,000 calorie bike ride but then I'm pretty frickin hungry etc.

I don't eat breakfast or drink soda, but when I've done calorie counting I'm consistently above what I need to be at for true weight loss. I suppose part of it is that eating is second only to sex in terms of sublime pleasures that makes life worth living. If I have to eat salad every day I'd kinda rather just die.

Eating salad every day sounds great. I love carrot-and-radish salad, I don't get to eat it often enough. I get what you mean, though. The place I usually order takeout from makes some great beef quesadilla (I'm sure Mexicans would disagree, but it's head and shoulder above any other quesadillas I've had in Russia), but a single portion is 583 kcal, which means I have to plan around it if I want to have one for dinner while I'm still dieting.

If you're not having breakfast then shouldn't your meals be 1k+ calories each, every day? Or are you a tiny elderly woman?

I'll put it this way, it's the calories in part of the equation. I know that much. 2 big meals and two lattes hits that 2,400 mark. I just have taken all the low hanging fruit people typically think of and still love red meat and cheese, as a rule

Why not just wait? My plan is to wait 5 years and if there are still no side effects then I'll do it. I also have a BMI of 26 so I'm not a prime candidate.

I am pretty vaccine skeptical, but is there any real evidence that the vaccines did harm (except for not working very well after 2021)? It might still be too early, but it seems like all the stronger anti-vax predictions have fallen flat.

I am pretty vaccine skeptical, but is there any real evidence that the vaccines did harm (except for not working very well after 2021)? It might still be too early, but it seems like all the stronger anti-vax predictions have fallen flat.

not really. much of the evidence seems like cherry picking, scouring headlines for people dying who were vaccinated. funny how with Neely and DeSantis in the news, no one is posting about #suddendied anymore.

Yeah, it looks like the apparent increase in athlete deaths was limited to a short period of time after getting vaccinated. I still don't know if we have a definitive answer to what was going on there. Myocarditis caused by the vaccine seems like a likely explanation. The phenomenon could also be entirely fake.

In any case, the number of people affected was small. And since few young athletes are getting jabs any more, I doubt we'll see another bout of athlete deaths. 🤷‍♀️

It was still kinda insane to me how hard people were pushing vaccines for kids in 2022.

is there any real evidence that the vaccines did harm

My impression was that they did (very rarely) do real harm and were largely ineffective. My objection to having got it had much more to do with principle than practicality. I did the two Phizer doses and stopped there since I believe they slowed down folks' ability to generate natural immunity.

I think waiting is smart. Supply will be less restricted, there's better alternatives on the horizon. My BMI is closer to 27.5 and I'm just sort of over it and being impatient.

same here. the media and Biden waaay oversold the efficacy of vaccines at stopping covid.

Do you think the COVID vaccine will literally take 5 years off most people's lives? There have been semaglutide studies going up to like 24 months without adverse effects for weight loss, and weaker stuff in the same GLP-1 class like liraglutide has been used for years. We might find negative effects later on, but In general, stuff that doesn't have massive negative effects in the medium term won't suddenly get massive negative effects in the long term.

And regardless of this, if any negative effects happen in 30 years, I fully expect future AI medicine to make them completely trivial.

Semaglutide works really, really fucking well.

Do you think the COVID vaccine will literally take 5 years off most people's lives?

There have been cases of really long-term side effects like Prion diseases from transfusions and tissue donors. These can take decades to develop but very rare.

Do you think the COVID vaccine will literally take 5 years off most people's lives?

No, I really don't at all. Hyperbole and the worry that Semaglutide is if it's too good to be true....

There's just very few things in this world with unequal costs to their benefits. So yeah it's more superstition than anything else I suppose.

I mean, if you want large costs for the same benefits, there are plenty of effective weight loss drugs with a shit ton of unhealthy side effects, DNP and trenbolone will make you lose weight, they just might also kill you lol, their side effects are not subtle at all. Free lunches are rare in the world, but there's certainly lunches that are more expensive than others.

This guy claims to have cured his acid reflux by kneeling over with his head below his stomach while eating to strengthen his esophageal sphincter. For people who understand anatomy, does that sound plausible?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106553/

Both me and my mother used Iqoro and it worked for us(and supposedly 97% of users), so why couldn't this work as well?

I have never heard of this before! It looks like you can't get it in the US, which is curious.

It's a very new product and it usually takes a while for these things to spread beyond the home market.

It does sound vaguely plausible, though my priors for "I cured myself with this one weird trick" claims are pretty low so I wouldn't put too much stock in it.

My priors for "I cured myself with this one weird trick" are pretty high, in that I think most of those reports are honest, and many are even directly causal. My priors for "I cured myself with this one weird trick and you can also cure yourself with that same trick" are low.

Could a simple dietary supplement cure malaise, gum disease, rough skin, bruising, shortness of breath, and emotional changes? Yes! All that's required is that you're suffering from scurvy and the chosen supplement is Vitamin C. Can a physical therapist instantly and permanently cure your chronic issues? Yes! At least if they are the first one to target the simple problem you have.

You can easily get a massive improvement in wellbeing only if you have a major but simple problem and select the correct treatment. Unfortunately, the underlying conditions are either a different simple problem or else more complex in many cases.

Yes, but you can also get a massive improvement via the placebo effect, or just via coincidence, and there will be a huge reporting bias where "one weird tricks" that seem to work will be overreported. So while the phenomenon you describe is also possible, I think the most common situation is simply a mistake on the part of the person reporting their experiences.

A few months ago I overworked my shoulder, and my PT said I should take some indomethacin. I took some, and woke up because I was wheezing and barely breathing. Okay, maybe that was a bad idea. I also kept having a weird dry cough after doing the warm-up stretches, but the lungs are kinda my weak point, so I didn't worry too much.

A month ago I went to see an ENT doc about my nose. He took a look at it, found some polyps and sent me to an allergologist. The allergologist asked some weird questions that I thought had nothing to do with my nose, mentioned something called biologics, took some tests and sent me to the lab to do some blood tests. I kinda put it on the back burner.

This weekend I had a headache, my wife suggested I take ibuprofen, so I did. Guess what? Wheezing and barely breathing again. After taking some glucocorticoids I had left I went online to find out what that kind of reaction to NSAID means, and everything fell into place.

Those weird questions that I thought had nothing to do with my nose? She was pattern-matching my symptoms to AERD. AERD is a possibly autoimmune disease that is identified by the Samter's triad: asthma, nasal polyps and NSAID intolerance and usually manifests in mid-30's:

  • mid-30's? check

  • no issues with any of these symptoms before? check

  • NSAID intolerance? check

  • polyps? check

  • asthma? remember that weird dry cough I had after doing the stretches? I actually had it after doing the running before the stretches

So now I'm waiting for my blood tests to come back and will be going to the doc to confirm the diagnosis. I hate to be one of these people who self-diagnose themselves after going on the internet, but it really looks like AERD.

The good news: my symptoms are rather mild, as long as I avoid any NSAID medications.

The bad news: AERD can be treated, not cured. If (when) the symptoms get worse, I'll need to stay on glucocorticoids and probably start aspirin desensitization. If they get really bad, I'll need to start taking the aforementioned "biologics" - monoclonal antibodies that are much more effective and expensive immunosuppressants than glucocorticoids. But let's hope it won't get to that, and maybe our new AGI overlords will come up with a cure in the meanwhile.

Any idea what causes this? Just another big question mark in the autoimmune basket?

As far as I have learned, yes.