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Culture War Roundup for the week of September 18, 2023

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Weight Loss (...yes, again...)

I listen to a variety of podcasts, and I generally do what I can to avoid listening to ads along the way, even if that's just manually skipping ahead through them. But occasionally, my hands are busy with something else, and I just have to deal. In any event, last week, I heard an ad for GOLO, a weight-loss program.

I'm not at 'current episode' on all of my podcasts; I'm listening to back catalog for some of them. I didn't think to go check the date on it, and I don't even remember which podcast it was in at this point, so I don't know if it was a few years old or brand new, but at whatever time it was, they were touting it as a "new approach". Forbes' review of GOLO says 2023 on it, so presumably it's pretty recent.

I was curious about what the Kids These Days are doing, and you may have seen me here before talking about weight loss, so I decided to check it out. I was sooooo ready to hate it. After checking it out, though, in some sense, it actually pleases me a fair amount. In another sense, it illustrates quite well a phenomenon I've been seeing in terms of our society's collective psychology about the topic.

What's GOLO about? From their website... insulin resistance! Muscle loss! These are the bad buzzwords. Metabolic efficiency! Immunity Health! Hormone Balance! These are the good buzzwords. Plus, they have a magic supplement! It's easy! Just take one capsule with each meal. It's in a paragraph that starts with "The Science Behind GOLO", in bold and everything. The Science (TM) is right there! They even shit on CICO, helpfully pointing out in all caps:

YOU DON’T NEED TO COUNT CALORIES, COUNT POINTS OR FOLLOW AN APP. THE TRUTH IS, LOW-CALORIE, LOW-FAT APPROACHES DON’T WORK.

Let's dive in, see what's really going on. Obvious first place to start is their supplement; what's in it? 7 plant extracts and 3 minerals, of which, best as I can tell, chromium is the star of their show. Of course, best as science can tell, there is just the barest degree of plausibility, and Examine concludes by pointing out:

Anyone wishing to supplement chromium should be aware that chromium supplementation is not associated with any reliable benefits on markers of glucose metabolism.

Ok, so if their magic suppliment isn't exactly Ozempic, what do they have going on? Gotta dig into 'More Information' on their site.... then be careful! Don't fall into the trap of clicking on any of the distractions, even the one that promises to tell you what their 'GOLO For Life Plan' is. Gotta go to the FAQ. That's where you've gotta dig down into the question about what the GOLO For Life Plan is. It helpfully states:

The GOLO For Life Plan combines the right foods together to help manage and optimize glucose and insulin levels while creating a thermogenic effect. The GOLO For Life Plan improves weight loss in two ways:

  • Minimizing or eliminating muscle loss and maximizing fat loss
  • Providing proper nutrition that includes healthy fats and carbohydrates which eliminates nutritional imbalances and promotes steady weight loss and better health.

On the GOLO For Life Plan, you can eat more food and lose weight without the obstacles you may have faced with other diets. You will be eating between 1300 and 1800 calories each day, and will:

  • Stay full and energized
  • Keep insulin steady throughout the day
  • Give your body proper nutrition
  • Reduce hunger and cravings
  • Learn how to eat to promote weight loss
  • Learn how to maintain your weight when you reach your goals

I tried to be helpful and cross out all the noise that isn't relevant for us at this point. What is the real key to a fancy new diet for weight loss that has all the buzzwords that people use when they say that CICO is garbage? It was CICO all along! There are more telltale signs that this is just a recycling of what we've known for a long time. 1300-1800 is a pretty wide range, so what's going on? Two more items further down in the FAQ, under How is the GOLO For Life Plan Personalized?, we see:

The GOLO For Life Plan is based on your energy needs. We help you determine the right amount of food that you need, to lose on average, 1-2 pounds per week.

That Forbes article fills in some more details:

While everyone has the same food guidelines, your specific caloric intake recommendation is based on your gender, age, current weight and activity level.

The government of Canada has helpfully published basically exactly this sort of thing on their website for years. We've known how to do this for years. Weknowdis. Moreover, the real, actual science has confirmed for decades that to a pretty darn good level of approximation, 500cal/day from your TDEE is right about a 1lb/wk weight loss/gain. Weknowdis.

Forbes says, "Programs range from 30 to 90 days," but I can't find solid details on the GOLO website. Most of the examples are people who did stuff for 6mo-1yr. Best I can tell, they're basically just selling the supplement, and then I guess giving away the meal planning to put you in the right calorie range. So, for a bit, with the Forbes wording, I was wondering if they were actually going to have some trick to try to get you to do it for 1-3mo, then 'cycle off', but try to figure out how to get you to just go back to maintenance caloric intake, then say that you should start another 1-3mo cycle. Maybe that's buried somewhere in the planning tool they're giving away with every purchase of the supplement. Final thing to point out, which I couldn't really find in detail on the GOLO site, Forbes says:

GOLO also provides eating guidelines, encouraging you to eat more whole foods (including fruits, vegetables, meats, eggs and grains) while avoiding sugar and processed foods.

In the end, what have they done here? It actually almost makes me proud of capitalism. They've found a way to package and monetize the bog standard, traditional advice for losing weight. You could just listen to the CICO people, the honest doctors, the fitness people, etc., who tell you the same basic advice. Stop eating total crap like piles of dessert all the time. Stop drinking big gulps of straight sugar calories, no matter whether they're soda, juice, or whatever other trendy beverage is happening right now. Eat at about a 500cal/day deficit to shoot for 1lb/wk of weight loss, eat regular foods, and maybe if you're feeling physical/psychological effects after getting somewhat deep into a cut, go back to maintenance for a bit, and then start again.

But the packaging. Ohhhh the packaging! Insulin resistance! Metabolic efficiency! Immunity Health! Hormone Balance! CICO SUCKS! They do what they can to try to meet people where they are. To try to get them used to the idea that they're shooting for about a pound a week, so it'll be longer than other people promise (though, of course, they say 1-2lb/wk, just to get your brain to think it could be twice as fast). And of course, the cherry on top, a supplement that probably doesn't really do anything is the mechanism by which they monetize. Hell, after people lose the weight, I bet the GOLO For Life thing basically steers them toward how to stay at maintenance for the rest of time... but you probably better keep buying/taking their supplement, just to make sure you don't ruin all your gainz! It's a thing of sheer beauty, designed to bob and weave around all the CICO bashers who are going to scream from the rooftops that CICO doesn't work and trash your weight loss program if it even hints at the idea that CICO is what's going on rather than repeating the buzzwords and bowing at the god of, "It's not your fault, it's... check cue card... insulin resistance!"

In the end, I can't help but love it. Could you have listened to me tell you basically all the same underlying facts? Sure. Could you find a plethora of communities or official government public health documents that outline how you can do all this same stuff, but for free? Yup. But man, we're too dry in the delivery, and we tend to be abrasive to the folks who want to believe that there is some other magic going on in the world. I can't help but think of how Matt Levine might put it. The market wants the bog standard advice that works and that is backed by science, but it also doesn't want it to sound like that. It wants to hear some buzzwords, platitudes, shitting on CICO, and having a magic supplement. That's an arbitrage opportunity, and GOLO seems to have filled it.

EDIT: Sigh, I tried so hard to get the strikethroughs to work inside the bulletpoints. It displays correctly in the comment preview (and still displays correctly in the preview as I'm editing). But it's broken in the actual comment. @ZorbaTHut Help?

I've seen other signs of hope too, like LaCroix seltzers becoming so popular that Coca-Cola and PepsiCo were forced to respond. Just today I read this article from ArsTechnica, and was surprised by its relative frankness: https://arstechnica.com/health/2023/09/what-can-we-do-about-ultraprocessed-foods/

I generally expect Ars to be solidly lefty, and while they pay a bit of lip service to mention "exposure to racism and weight bias" as potential causes of poor health (eye roll) the message is pretty clear: obesity is unhealthy, it's widespread because people are eating too much, and our modern diet of ultra processed foods is the culprit.

In a consumer culture, it's not enough to tell people about weight loss - it has to be sold to them.

I am severely overweight and have been all my life. The only thing that does help (temporarily, so long as I stick to the diet, until I fall off the wagon again) is reducing calories. It doesn't seem to much matter what kind of diet it is, though low-carb ones help most.

The rest of it I have no idea about. The basics - don't eat junk, eat less - are what works. What kind of foods you should eat is a freakin' minefield, because for every "eat green leafy vegetables" there's "EXCEPT IF YOU'RE ON WARFARIN BEWARE VITAMIN K" warnings, and as you get older (and podgier) you rack up more "taking medication" which interacts with everything (e.g. grapefruit. I have never before wanted to eat grapefruit/drink grapefruit juice except now, when one of my medications contra-indicates it).

Exercise? I was one of the "fit fatties" because exercise has never made me lose weight, despite the fact that I walked and cycled everywhere (I can't drive) up to a few years ago. Also, I never got the "but exercise is so fun, it makes me feel good, if I don't exercise I feel terrible" experiences other people seem to get. I'd have to be on one of those "training to ride the Tour de France" regimens to see any shift in weight.

Cholesterol: I think nobody feckin' knows a thing. If you look at my total cholesterol (and this is from always, including my most recent lipids panel), the overall level is perfect. Seriously. LDL - the bad one? Within the limits it should be. HDL - too low, needs to come up. My problem is the triglycerides, which are way too high and which medication and diet hasn't shifted an inch.

"Well, that's because you're fat and eat junk".

Okay, but my sister who has been thin all her life (to the point where she was seriously in danger of anorexia a few years back) also has high cholesterol (though hers is slightly different to mine). So - we don't have a similar diet, we don't have similar exercise regime, she does all the right things (except she used to smoke), I do all the wrong things (except I never smoked) and we both have high (though differing in the details) cholesterol.

Is it genetics? I haven't a clue. So I'm not surprised that gimmick websites like the one above ensnare customers, because nobody knows a damn thing about what you should eat, shouldn't eat, can't or can eat, what is the recommended diet yesterday is the one that will give you cancer today.

The only crude metric we still have is "don't eat so much". Which is tough**! Because diets are hard and are not fun*! You can't eat the things you like any more (and that doesn't mean chocolate cake and candy; I love potatoes but, you know, high carbs bad for your blood sugar no no no, so you can guess why I'm crying about the 'all potato miracle diet the pounds melt off').

*No, "you can eat all the raw, undressed broccoli you like to fill you up!" is not fun or easy.

** If you're one of the "well, I never had any problem cutting back because I don't get hungry and indeed I can fast for days, so I don't get what is so hard about simply not eating" crowd, move closer to the screen so I can punch you in the snoot, Smuggie McSmuggerson.

I hate healthy food, but I’m incredibly vain and so being skinny was never non-negotiable for me, so starting from that principle I started intermittent fasting as soon as my teenage metabolism ceased to allow me to eat whatever I wanted. The good thing about it is that I don’t have to think about calories at all and can order or cook whatever I want, as long as I restrict it to a (movable) 2-hour window every day. Over time, I’ve gotten used to it, I don’t get hungry until around 5pm now, and the 2 or 3 hours thereafter are tolerable until dinner is served.

It takes more exercise than most people think to lose weight. I'm currently about 154lbs, and by the numbers, in order for me to exercise enough to lose a whole pound I have to run a literal marathon. That's more than one 5k per day for a week.

I'm currently about 154lbs, and by the numbers, in order for me to exercise enough to lose a whole pound I have to run a literal marathon.

That actually might not be enough. The usual estimate is 100 calories burned per mile, which means that a marathon should burn 2,600 calories, which is not enough to lose a pound of fat.

I've been recently thinking about how much the obesity epidemic simply reflects that food is tastier than before. This would particularly affect a country like Finland, with stereotypically famously bland food (in this poll it's the second least popular in the world among polled, with only Peruvian cuisine scoring worse).

If I compare the selection in stores and restaurants to what we had in even the 90s, there's been an exposion of choice. I can easily go to a store that's 5 minutes from my home and find the ingredients for, say, this delectable meal of kimchi noodles (I actually have them waiting in my fridge already), whereas decades ago even knowing what "gochujang paste" would have required specialist knowledge.

As such, I have a considerable amount of options for cooking meals that taste actually good and have a great variety of them. Would it then be any wonder that I'd also eat more of it if it was just meat and potatoes with salt and pepper, day in day out? The whole idea behind, say, the potatoes diet was, exactly, less about the specific property of the potatoes and more just that it's so bland and samey-tasting it naturally would mean you would limit your food intake to an acceptable level (I haven't tried the potatoes diet myself and make no claims to its efficacy).

Another factor that comes up surprisingly rarely (it does come up sometimes but seems like an obvious thing to be mentioned even more often) is simply the car culture and the fact that people walk aroud less than usually. I would again, on the basis of my memories from the 90s, say that people currently are more prone to drive distances that they would have walked in the past, say parents driving kids to school for a 500m trip when they'd have walked it in the past, but don't have any real evidence.

It's sometimes very odd to have people simultaneously complaining about obesity making everything and everyone uglier and, at the same time, react very negatively to any idea that cities should be designed in a way to limit the use of the glorified four-seater fat scooter in their garage.

I can easily go to a store that's 5 minutes from my home and find the ingredients for, say, this delectable meal of kimchi noodles (I actually have them waiting in my fridge already), whereas decades ago even knowing what "gochujang paste" would have required specialist knowledge.

If you're researching recipes, cooking dishes that you can't cook from memory, seeking out particular ingredients that aren't the same 20 things you always buy and won't have a purpose in your cupboard if you deviate from your intended meal plan, etc., you've already specced several points into amateur chef.

Sure, cooking TV shows and YouTubers are successful, so there are a lot of people specced into amateur chef, but I don't think the typical person is. The average person flits between packaged breakfast foods, has a small repertoire of sandwiches or buys prepared meals at lunchtime, and rotates through a few different frozen dinners and takeout/delivery restaurants.

But I think you're right that even so the modern diet is way tastier than what was around 50 years ago.

But I think you're right that even so the modern diet is way tastier than what was around 50 years ago.

The size of the average vegetable has become bigger and its cost has gone down, but the taste of the average vegetable has become much worse. If you can make food barely taste like anything (so it doesn't really feel like you're eating anything at all), you now have to fix that problem with stuff that's a lot more calorically dense and/or load the dish up with salt.

Also, 50 years ago, with respect to dinner the average person would have been either cooking it themselves or married to someone who was. Fast food was a lot more expensive, relatively speaking.

I agree that the modern diet is tastier than it was in the fifties, but how much of the fattening is just ‘there’s tons of sugar in everything, even things which don’t seem like they should have sugar, so unless you’re at bake-your-own bread levels of from scratch you take in way more calories than it seems like your meal should have’. Add in that, as you note, fewer people bake their own bread.

The point was not necessarily tastiness as an abstract category but the variety in the diet. One can now easily sample cuisines in the world at the confines of one's home and even a small town (~50,000 people) will have a variety of ethnic restaurants.

a small town (∼50,000 people)

The UN's official definition of "town" (roughly aligning with the common understanding of the word) extends from 10,000 people to 49,999 people. A municipality with "∼50,000 people" is either a large town or a small city, not a small town.

Bread, literally, has just as many calories per ounce if you add sugar or don't. The infamous Wonder Bread has 5g of sugar to 29g of total carbohydrate for a 57g serving.

‘Bake-your-own-bread’ was a descriptor, not a literal designation, to refer to cooking tasks on that level of from-scratch preparedness. Making your own tomato sauce/baked beans might be a better descriptor from a literally mechanistic perspective than baking your own bread but it seems like homemade bread is more recognizable as symbolic of an almost entirely from scratch household kitchen. It’s certainly slightly more concise.

The only truth I’ve ever found to be correct about dieting is that I know nobody who:

(a) consistently eats only one meal a day

and

(b) is fat

This seems to be the universal cheat code. It’s very hard to eat more than 2,200 calories in a meal (especially a home-cooked meal, obviously you can go all-out at Buffalo Wild Wings or Denny’s or whatever). If you don’t drink full-sugar soda, aren’t an alcoholic and don’t snack, you can pretty much eat whatever you want for your one meal a day and stay slim.

I'm a short thin man who drinks a lot of alcohol and also has lots of sugary drinks alongside that. I can't subsist off one meal a day. there is no way anyone else can either. What kind of meals are you eating that you can fit 2,200 calories on one plate?

It’s fairly simple to do by eating large portions of fatty meat.

Of course eating a kilogram+ of brisket in one sitting takes getting used to.

I can't subsist off one meal a day. there is no way anyone else can either.

Hi, I've been doing it my entire adult life too. Well over a decade. That said I don't drink sugary drinks (if I do have soda I have diet) and I don't drink a lot of alcohol. What I had for dinner last night was:

2 pies, one Cajun pork, one chicken and camembert,

Some garlic potatoes (blend garlic, parsley, olive oil and Dijon mustard together then pour the mix over par boiled potato slices, then leave for a few hours so it soaks in.) I ate about two potatoes last night.

Half an iceberg lettuce, half an onion, and a cucumber with a splash of olive oil and apple cider vinegar,

A tub of ice cream (about half a litre, it was Ben and jerry's bikkie something, they were on clearance.)

The night before last I did drink though, so my diet was a little different (I don't trust myself to cook when I'm drunk, and I usually don't do my morning workout when I'm hungover). I had:

1 Sarah Lee strawberry coulis cheesecake,

A tub of ice cream.

I don't have a particularly strenuous morning workout, but I've found if I eat less than last night and do it I feel like passing out come afternoon.

I'm a short thin man who drinks a lot of alcohol and also has lots of sugary drinks alongside that. I can't subsist off one meal a day. there is no way anyone else can either. What kind of meals are you eating that you can fit 2,200 calories on one plate?

I've subsisted on one meal a day plenty of times while not losing weight. I'm average height and average build (5' 9", around 160 lbs most of the time). Eating around 2K Calories in one sitting isn't that tough if you plan for it. It's frighteningly easy to get that many Calories by accident with unhealthy foods like french fries or crisps, but if you're trying to eat healthy, it's probably going to be a heavy, fatty meal that will take some acclimating to, but my experience was that the acclimation was surprisingly quick; just a couple days. The really tough part is going around 23 hours every day in a row without eating. This, too, is a case where the acclimation was surprisingly quick. Normally, I would get hungry 4-6 hours after the previous meal, with the hunger getting worse over time; I found that the hunger stopped increasing pretty quickly and, in fact, went back down over time with just a couple days of experience of that 23 hour fasting cycle.

What kind of meals are you eating that you can fit 2,200 calories on one plate?

I think that's the whole point. If you only eat one full meal a day (and OP says nothing about small meals or snacks) then you're not going to be socking down 2000+ calories, so even if all you do is move around your house, you are not going to put on weight. Unless your "one meal" is McDonalds burger and fries and a shake or the likes, then you can easily consume 2000 calories in a sitting.

It's similar to the 'advice' I got from a cardiologist when arguing over "why aren't you on a diet?" "I am, it's just tough to stick to it!" "Well the hunger strikers managed it".

Eat nothing (literally, starve yourself to the point of death), lose weight, simples!

Agree 1 meal feels on the more extreme side of the spectrum. I’ve always gone with skipping breakfast and not snacking. In addition, supplement with protein shakes as my bigger issue is making sure I get enough protein to match amount of activity.

What kind of meals are you eating that you can fit 2,200 calories on one plate?

  • Double Quarter Pounder® with Cheese: 740 Cal.
  • World Famous Fries® (large): 480 Cal.
  • Creamy Ranch Sauce (2 pkt): 220 Cal.
  • Coca-Cola® (large): 290 Cal.
  • McFlurry® with M&M'S® Candies: 640 Cal.
  • Total: 2370 Cal.

That McFlurry is doing most of the work. As is the ranch. Fries, burger, and a soda barley reaches 1,500. That's not even enough to satiate a normal weight adult.

Fries, burger, and a soda barley reaches 1,500.

If you just get a normal Big Mac combo it's a lot closer to 1000. Something, something, shrinkflation, but military rations have roughly the same caloric content as such a meal for a reason.

(Aside: is the GP's comment actually a typical McDonalds order? I thought everyone just ordered the standard combos, which are half that amount of food; that's like 20 bucks worth of food.)

That's not even enough to satiate a normal weight adult.

If you can deal with the slight time disjunction between finishing your meal and feeling full, it is. Which is not something people really talk about all that much, but once you realize it's happening to you it's relatively easy to deal with... and on second thought, this inherent bug in human hardware (the lag time between "is full" and "feels full") with respect to weight control is probably what semaglutide fixes knowing nothing else about it.

Aside: is the GP's comment actually a typical McDonalds order? I thought everyone just ordered the standard combos, which are half that amount of food; that's like 20 bucks worth of food.

The main driver of McDonald’s profit is actually frappes. It’s unusual for someone to get a combo plus a McFlurry, but that’s because McDonald’s would offer to upgrade the combo to have a McFlurry instead of a coke. A standard combo isn’t that much above a typical meal’s worth of calories, but, well, people get fat. Sometimes cartoonishly. Burger, fries, and a shake isn’t that unusual of a meal for a fat person.

but that’s because McDonald’s would offer to upgrade the combo to have a McFlurry instead of a coke

Wait, their employees actually offer to do that? I've never had a McDonald's employee even offer to upgrade my combo to a large, let alone replace the drink with ice cream- I guess they just don't want my money that badly because I probably would more often if they both advertised that was possible and wasn't going to be adding another 30% of the price of the meal.

And to think I believe the height of cleverness is swapping out the fries for a cheeseburger or the Coke for a coffee; clearly, I've been ordering wrong all my life.

That's not even enough to satiate a normal weight adult.

That's the problem, though; it won't satiate you, but burger/fries/soda can make up a lot of the calories you are supposed to consume. My info may be outdated, but women should eat 2000 calories or less a day, and men should eat 2,500 or less a day (depending on age, activity level and so on).

So if you have 1,500 calories in one meal, for a woman that leaves you with 500 calories for the rest of the day and a man will have 1,000. If you're consuming sugary 'coffee' drinks, sodas, etc. you can hit those limits, and that's without eating anything solid. And you'll be hungry because your calories were liquid/one fast food meal, so you will eat more to feel full. Excess calories consumed = weight gain.

For dinner last night (at home) I had tuna carpaccio I bought from the deli with (buttered) sourdough and some iberico ham I had left in the refrigerator, gazpacho with some extra olive oil and garlic bread, steak and french fries (the latter air fried, but tossed in some Schmalz/goose fat I bought a few weeks ago and had kept, a cheese course with some brillat savarin and some excellent Cornish yarg and crackers and then an espresso and a piece of shortbread.

I’d guess that’s about 2000 calories, plus a glass of wine and a cappuccino in the morning puts me over my own sedentary maintenance (which is maybe ~1800 cals) but I went for a long run and will eat less today. To me, feasting once a day is always preferable to boring healthy food throughout the day.

That's a gorgeous meal, and within the calorie limits, but you know what the dietitians will say: too much fat! too much salt! cheese bad! not enough veggies! 😁

I made a rocket salad and some capers with the carpaccio 😂

Your argument is compelling, and furthermore I am impressed by how strongly someone who is not a guy at all can be such a Type Of Guy.

I cook for a customer with very high standards haha.

How is that one meal? that is two at best. You can't call eating a meal over multiple hours one meal. That is two meals at least.

When it comes to CICO, the problem is that reducing your CI reduces your CO.

When an obese person reduces their caloric intake from 3000->2500 calories a day, their body reacts to this perceived deficit with increasing hunger levels and lower energy. If they burned 3000/day before, now they are only burning 2700/day as their activity levels falls to match the lower energy. Weight loss is minimal, hunger is high, and energy is low.

CICO can still work if you strictly monitor weight loss and caloric intake, but it's not easy, and it will revert as soon as the person goes back to eating naturally.

For myself, I've been doing keto for a few weeks now and I'd rate it as highly effective. I've lost a decent amount of weight and hunger levels are very low. I sometimes feel physically very full even without eating a large amount of food. The biggest downside seems to be moderately lower energy levels, which I've countered with targeted carb consumption (10 grams) before strenuous workouts.

and it will revert as soon as the person goes back to eating naturally.

Amazing. If you go back to the diet that was making you fat, you will get fat again. Will wonders never cease.

Sorry. I should probably hold back on the sarcasm, given that this is the motte, but this is the one 'secret' about dieting that I rarely see people point out - you can't stop.

Dieting isn't an on-off switch - it needs to be a conscious decision to moderate your diet aimed at long-term goals and body improvement. Once you reach a certain age, you can't just shovel crap into your face and expect to walk it off.

Dieting is a permanent change to your life, and the sooner people acknowledge that, the better.

Conversely, if someone wants to enjoy themselves sucking down baconators and Dr Pepper by the bucket, well, I can't stop them. Maybe they'll get more enjoyment out of life doing that then I will, I dunno.

Dieting is a permanent change to your life, and the sooner people acknowledge that, the better.

While I don't disagree too strenuously, there is actually some light at the end of the tunnel so to speak. When you actually reach your goal weight you can bump up the calories slightly, because you actually want to maintain that goal weight rather than turn into a pro-ana skeleton person.

Yep. In order to get permanent weight loss, you need to make a permanent lifestyle change.

And a diet that causes hunger and lethargy can never be sustained in the long term. If your body is fighting to return to a higher set point, then you need to fix that somehow. Otherwise you must either be fat or miserable.

At this point, I'll mention that the best diet is never to become fat in the first place.

never to become fat in the first place.

In a perfect world, yes. Ah, if I only knew growing up what I know now.

Can't say I ever hit the lethargy you're describing when I lost weight, however. Not sure if it was my overall slow path toward weightloss or not. If anything, I ended up with more energy, not less.

As for the hunger, eh. I just sucked up and dealt with it. I doubt that's good advice for other people, though.

And a diet that causes hunger and lethargy can never be sustained in the long term. If your body is fighting to return to a higher set point, then you need to fix that somehow. Otherwise you must either be fat or miserable.

My experience as a formerly obese person was that the surest way to fix that issue of hunger and lethargy caused by a low calorie diet was to continue the low calorie diet and push it even harder. The exact same diet that caused hunger and lethargy on day 1 can be entirely fulfilling on day 10. Of course, days 1-9 might not be pleasant, but day 9 was significantly less unpleasant than day 8 which was significantly less unpleasant than day 7, etc., and it's not like going a couple weeks while suffering from hunger and lethargy is particularly difficult or painful, compared to going even a month of simply living while obese, much less the many years I lived as an obese person before the dieting.

At this point, I'll mention that the best diet is never to become fat in the first place.

This, I agree with. One thing I've personally noticed about having been obese is that I'll never be "un-obese." In the roughly 15 years since I came down from being obese, I've stayed within healthy-to-underweight range while keeping active and even athletic at times. Yet not once have I felt fit or, in fact, as if I was anything other than an obese person, even during the height of my fitness when I was sprinting about on the field with the best of my peers. Being obese an experience that can stay with you forever, no matter how you physiologically modify yourself out of it. It's one of those things that can irreversibly, permanently, change you, and I don't think in a good way.

You are an outlier. Congrats!

The probability of an obese person attaining normal body weight is very small.

I do think there is model where anyone can go from obese to slim within an extreme amount of exercise. If you're training for long-distance ski races or endurance swimming, you will burn so many calories that no amount of eating can overpower it.

You are an outlier. Congrats!

The probability of an obese person attaining normal body weight is very small.

I'm an outlier in terms of an obese person successfully becoming normal body weight, but I don't know that I'm an outlier in terms of an obese person who experienced a loss in appetite due to just reducing caloric intake. That study doesn't - and can't - say anything about that. I don't know how many obese people have really committed to even 10 days straight of strict caloric restrictions to see how their appetite, energy levels, and mood would react and how the experience was like for that subset of obese people who did try that.

When it comes to CICO, the problem is that reducing your CI reduces your CO.

It's a common claim. I don't have any reliable data, but I have two anecdotes and one observation

  • when I dieted, I maintained a small deficit (up to 500 calories) and suffered no adverse effects beyond really looking forward to the next meal
  • the guy that has tried dozens of diets (can't find the link) tried a deficit of 1000 calories and stopped after one week of feeling hungry and lethargic
  • if you reduce CI to 0, CO won't get reduced to 0 until you look like a walking skeleton and die of starvation

I sincerely doubt that CO dips below CI at any point between CI=0 and CI=maintenance. This means CICO works, except you can feel like shit when dieting, for which the usual recommendation is to take it slow and maintain a small deficit. Are there people that are so calorie-sensitive that they can't properly function even on a very moderate deficit of 500 calories? And if there are, why?

  • Is it caused by a high-calorie diet? (eating 4000 calories per day really messes up your homeostat)
  • Is it caused by an addiction to hyperpalatable foods? (it's not the deficit, it's the lack of eight slices of pepperoni pizza that triggers them)
  • Is it caused by lithium/fluoride/microplastic/growth hormones/etc?
  • when I dieted, I maintained a small deficit (up to 500 calories) and suffered no adverse effects beyond really looking forward to the next meal
  • the guy that has tried dozens of diets (can't find the link) tried a deficit of 1000 calories and stopped after one week of feeling hungry and lethargic

At least in my experience (I'm not obese, but I've occasionally tried to lose modest amounts of weight to improve sports performance), my best results have come from trying to always be slightly hungry. Trying to be very hungry (presumably a large deficit) quickly led to poor decisionmaking -- "oh, just a small snack" doesn't stay limited very easily, although I've had some success with snacks I don't like, which starts sounding a lot like the potato diet.

But I have observed that this takes active thought, reminders, and is harder when I'm dealing with more IRL just because I have other things to think about.

if you reduce CI to 0, CO won't get reduced to 0 until you look like a walking skeleton and die of starvation

There are at least a few recorded cases of people doing this: the linked guy lost 276 pounds by fasting for 392 days in the '60s. Not recommending this, but not impossible.

Good point, it’s hard to know where hunger ends and addiction to the pleasure of tasting delicious foods begins.

A few weeks ago I tried keto for a week, during which time I had to do a 26km run as part of my marathon training.

Huge mistake. I was basically hitting the wall from the get-go and it took me just shy of three hours to complete, at least half an hour longer than I'd planned. I felt utterly miserable for the duration of the run and was convinced that signing up for the marathon was a colossal miscalculation

I gave up on keto and went back to my regular carb-heavy diet. That weekend I did a 24km run and breezed through it, nearly an entire minute/km faster than my run the previous weekend, and I felt in fine form for the duration.

I think once I've completed my marathon I'll try to do keto for a bit longer, maybe a few months, as it seems effective at weight loss and doesn't seem to interfere with my gym workouts that much. But based on my personal experience it's completely incompatible with long-distance running.

Carbs are fuel, so yeah if you're running marathons you're burning fuel and not putting them on as stored fat.

The trouble is when people stop doing the exercise and still consume the fuel. Then it's not getting burned, so it will end up as fat stores. If you try the keto without the heavy fuel combustion of long-distance running, it may work better for you - let us know how it goes!

I'll report back in one of the Wellness threads.

I also experience difficulty with completing workouts on keto.

There might be some options. On /r/ketogains they talk about targeted carb consumption around workouts and also cycling in/out of keto. Since I'm only about 4 weeks in, and the weight loss has been great, I'm just going to deal with bad workouts for now until my body fat gets down to where I want it.

I'd also point out that at 1 week, you are in "keto flu" territory. In the first few days, you lose a lot of water weight and need to consume a lot of electrolytes to compensate. Some people say that long distance work is doable on keto, but you need help for "explosive" activities like sprinting and weightlifting.

What's a good source of electrolytes?

I purchased some specifically for Keto on Amazon.

It's complicated. You store around 2000 (IIRC) calories as carbs in your body. People regularly overestimate how much calories running consumes - aka you can't outrun a bad diet saying. So if we take 700 calories per hour running in normal times you have almost enough carbs for a three hour run. Of course your body changes the mix the more run progresses - it tries to stretch them. So the ratio of carbs you burn constantly decreases.

if you are on keto (and you are not used to being on it) - well you don't have your preferred fuel to burn. And fat usually takes time to be activated. On top of that by memory - on keto your endurance barely decreases but the peak performance and max load does.

So I think that your experience is absolutely by what science says on the topic.

People regularly overestimate how much calories running consumes

It's so demoralising when you do a half-marathon in two hours, count the calories and realise that you've only burned about half of a kebab.

It's complicated. You store around 2000 (IIRC) calories as carbs in your body. People regularly overestimate how much calories running consumes - aka you can't outrun a bad diet saying.

I don't know if my diet was bad, but I've outran it several times. The way I gain weight is by ceasing to exercise, not by compensating for burned calories through increased appetite, or by weird metabolic shenanigans my body is supposedly pulling.

I don't have a conclusion here, but all the "exercise doesn't help that much" takes run counter to everything I experienced.

I don't have a conclusion here, but all the "exercise doesn't help that much" takes run counter to everything I experienced.

I think people say this because to the average sedentary person. "Exercising" means jogging for 20 min, 3 times a week. And it's true that just doing that doesn't burn a whole lot of extra calories. An actual long distance runner who's doing 100 miles a week can of course eat a lot and stay slim

I was once a jogger, like you, but then I took an arrow to the knee. Even then 100 miles a week would have sounded whack (wouldn't you have to run a marathon 4 days per week to do that?!), I was doing a bit more than double of your example of an average Joe. OTOH I wouldn't say I was eating "a lot", but I was allowing myself a decent amount of vices like beer and various sweets. "Slim" might also be in the eye of the beholder, I'm happy with "not fat" usually.

I honestly think it's more of that "biology is complicated" problem. The way people exercise today is artificial; nobody was doing much of running marathons or three times a week visits to gyms in the past (except for certain people). You 'exercised' by manual labour and general work in keeping house or running a business, plus walking nearly everywhere. From Chesterton's autobiography:

I can remember my grandfather, when he was nearly eighty and able to afford any number of cabs, standing in the pouring rain while seven or eight crowded omnibuses went by; and afterwards whispering to my father (in a hushed voice lest the blasphemy be heard by the young), "If three more omnibuses had gone by, upon my soul I think I should have taken a cab."

People like that walked where they couldn't take buses, and if you read Jane Austen novels (I know, going much further back) the young ladies think nothing of walking miles to visit friends or go see the sights in a nearby town.

So I do think for most people, yeah - being moderately active is enough. For some people, if they want to lose weight (as distinct from toning muscles or increasing fitness), they need to do a lot of exercise. And for some people, like yourself, weight will drop off once you exercise but pile on when you stop, even if you're not eating more or being extra-lazy. Individual bodies respond individually.

Exercise has one slim benefit that I sometimes see mentioned: if you put on muscle that way, the resting metabolism of muscle is higher than that of fat, so the fat loss doesn't stop the second the exercise does; you also get a "free" hundred calories a day per pound of muscle you can maintain.

But for me the biggest benefit is one I've never seen discussed: for some reason my body doesn't seem to "fight me" against exercising the way it does against dieting. If I burn 500 calories on the treadmill one day then I've burned 500 calories and that's done; even the immediate feeling of tiredness quickly goes away and I feel more rather than less energetic over the long term. But cutting 500 calories of food in one day leaves me somewhere between "ravenous" and "awful lethargy". I can't seem to lose much weight via dietary portions (rather than via the easy choices: no liquid calories, avoid sugar, etc) without using a calorie counter app to try to carefully thread the needle between "not eating less" and "my brain feels like it's starving".

If they burned 3000/day before, now they are only burning 2700/day as their activity levels falls to match the lower energy.

Where are you getting these numbers? Are they coming from a table/calculator based on published scientific data? Did you, like, plug a different activity level into the equations that were in the link I gave to the Canadian government's site? Are you going to some review paper that details this effect? For example, this meta-analysis of the effect of exercise programs on resting metabolic rate says that mayyybe the delta there is like 70-100cal/day. Where are you getting 300cal/day just from diet changes, and what are your assumptions?

The numbers were meant as an illustration, and would vary highly by individuals. For some people, the difference is much more stark.

In the linked article, morbidly obese people who lost a lot of weight were burning 450-800 calories fewer per day than a similar person of their weight, age, and gender.

For example, this meta-analysis of the effect of exercise programs on resting metabolic rate says that mayyybe the delta there is like 70-100cal/day. Where are you getting 300cal/day just from diet changes, and what are your assumptions?

This seems loosely correlated to my claim that reducing CI reduces CO. For one, it is related to exercise programs not dieting. Secondly, it deals with base metabolic rate and which is part of, but not the entire, cause of reduction in calories burned due to diet-based lethargy.

But you are correct. I am unsure of the exact figures. My own experience with CICO-based dieting matches that of the general population. It works, but it is possible only with strict calories counting. Hunger and low energy are one's constant companions, making the effort not worth the cost. In a calorie counting diet, people generally revert back to unhealthy habits as soon as they stop strictly counting calories.

According to this, that Biggest Loser study was an extreme outlier, and numerous other studies have found either no effect or a much smaller effect.

I think a big tripping point is what you're counting as energy expenditure. For instance, the piece you linked cites this meta-analysis and claims it "found no penalty". However, if you look at the actual meta-analysis, one of the inclusion criteria is

To have values of resting EE or resting metabolic rate or basal metabolic rate or sleeping metabolic rate and body weight before and after the intervention

So, it is looking at various measures of resting metabolic expenditure. In other words, it is explicitly excluding studies of non exercise activity thermogenesis (NEET) - that is, it is excluding "the energy expended for everything we do that is not sleeping, eating or sports-like exercise" - this is summarized as "fidgeting"

When I skim the other links the article uses to prove that there is no effect, I see the same issues. The one study they cite without this issue found significant declines in energy expenditure.

Other studies also find large changes in energy expenditure and suggest (1) the degree of change varies significantly from person to person and (2) is largely genetic. For instance, in this study, researchers established a neutral level of calories needed by each member of a collection of identical twins, added 1000 kcal to that, and then fed that to the twins over 100 days while they lived mostly sedentary lives under 24-hour supervision. Before and after, they measured energy expenditure on the neutral diet. Based on a naive CICO model, each of these twins should have gained ~12 pounds. Instead (see Figure 1), they gained between 4 and 13 pounds.

morbidly obese people who lost a lot of weight

Ok, so you're saying that you start CICO, you lose a bunch of weight, and then your caloric expenditure goes down? Yep! Sounds right. Why is this "the problem with CICO"? That doesn't sound like a problem at all with CICO. That sounds like the standard thing that CICO people say. You have less mass, often both fat mass and lean mass. So you use less energy. Uh, duh?

You had made it sound like it was something that just happened when you started eating less. That you just start eating less, then your body magically changes, and you never get around to losing weight. That would be a problem for CICO. But not the case where you start eating less than your maintenance, lose a bunch of weight, and then have a lower maintenance. That's just science.

My position (half of which I agree is unsupported by the linked article) is that maintaining a caloric deficit OR maintaining a low weight will cause lethargy and therefore reduced energy expenditure in people who are disposed to obesity.

The person (from the article) who is burning 800 calories fewer than a similar person their same size is going to find it nearly impossible time to maintain their weight. They are always hungry and tired. You might be happy at 2000 calories/day. How would you fare at 1200?

On a trivial level, CICO is correct. As far as I know, no one is saying that CICO doesn't work if you have full control of a person's eating and activity levels. Where is fails for most people is that dieting causes the body's homeostatis to be thrown out of whack, leading the body to compensate with higher hunger levels and higher lethargy. These signals are quite difficult to ignore for long periods, leading to the failures we see in nearly all dieting programs.

Keep in mind that a surplus of 35 calories per day will lead to an additional 36.5 POUNDS of weight gain per decade. To prevent this, the body maintains homeostatis by controlling hunger and energy levels. Until quite recently, most people maintained this homestatis effortlessly. Now, many people cannot. They naturally gain weight unless they maintain strict diet and exercise programs. Keep in mind just how small of a caloric surplus is necessary to result in obesity. A 200 pound person who eats an extra cookie every day will balloon to 300 pounds within a few years. Fortunately, their body sends the satiety hunger signals to prevent this.

I'm interested if you have any substantive disagreement with any of this.

My position (half of which I agree is unsupported by the linked article) is that maintaining a caloric deficit OR maintaining a low weight will cause lethargy and therefore reduced energy expenditure in people who are disposed to obesity.

Clearly, the latter half is supported by the linked article, and my contention is clearly with the former half. Do you have any evidence to marshal for this proposition? Any estimate of the magnitude of this effect? What assumptions are you using? Like, "An X Age, Y Sex, Zlb individual has a maintenance calorie requirement of A. They plan for a calorie budget of B, meaning an A-B deficit. At the moment that they start eating at that deficit, before they lose any weight, their body suddenly shifts to having a maintenance requirement of C, where, plausibly, C<=B." What numbers are you using, and where are you getting them from?

EDIT: Moreover, does this work in the other direction, too? If they start eating D calories, where D>A, does their body suddenly adjust to using more energy, so that their new caloric requirement is E, where, plausibly, E>=D?

At this point I have to ask, what are your numbers and where are you getting them from? The demands for rigor are all coming from one direction. What is the evidence that CICO diet messaging has any value in the long term? What's the evidence that you can lose weight with CICO and not experience hunger or lethargy?

CICO is the current bog standard advice. The results over the general population are miserable. I also want to know, do you even believe it works?

Let's say that you, as a trusted authority figure, are given the opportunity to design a 1 page infographic. This infographic will be distributed to everyone in your country who has expressed a sincere desire to lose weight. In 10 years, you will be measured by the BMI, mordibity, and diabetes level of your cohort. What do you put on your infographic? Do you really think CICO messaging will have any positive effect?

Please answer my questions rather than trying to change the topic. We're actually getting very close to a crux here. We can move to a different topic afterward, and I promise I'll be responsive, but let's not avoid the first topic.

CICO is the current bog standard advice. The results over the general population are miserable. I also want to know, do you even believe it works?

The physical laws are pretty solid here. The messaging may not work, but none of the messaging works.

What's the evidence that you can lose weight with CICO and not experience hunger or lethargy?

You can't. You can't lose weight at all and not experience hunger or lethargy, except perhaps with amphetamines or some other drug. The subtitle of one of the CICO books is "How to lose weight and hair through stress and poor nutrition", and while it's obviously intended to be humorous, it's largely true.

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I'd like to drop a link this thoroughly researched and footnoted article about metabolic adaptation.

https://www.strongerbyscience.com/metabolic-adaptation/

This doesn't immediately support or refute the 300 calorie a day delta here…but it's within the realm of plausibility that when an obese person loses a lot of weight, their system down-regulates non-exercise activity thermogenesis by somewhere in that range.

Trex is great. Love his podcast; glad he keeps inviting that guest co-host on. I am 100% confident that, were he a Mottizen, he would absolutely be binned as a CICO-guy. Literally everything he's saying in that article is starting from the premise of CICO. He would not start a sentence, as @jeroboam did, with, "When it comes to CICO, the problem is..." Like, no. Full stop. He would say, "CICO is absolutely true. Now, there is a question about metabolic adaptation as you're going through a cut. Let's dive in."

So, let's start from your comment, not the article:

it's within the realm of plausibility that when an obese person loses a lot of weight, their system down-regulates non-exercise activity thermogenesis by somewhere in that range.

Notice that the premise is "when an obese person loses a lot of weight". @jeroboam didn't grant that. To him, it seems like as soon as you start eating less, your body drops its metabolic rate through the floor, and you never ever get around to losing the weight. That's why I asked him to specify the assumptions he was working with. If he was going to sneak back in a qualifier of, "...after you lose a bunch of weight..." then I wanted that to be clear. In fact, Trex gives even huger sounding numbers:

When a person loses 10% or more of their body weight, their total daily energy expenditure drops by around 20-25%.

But notice, that's after someone loses 10% or more of their body weight. I mean, obviously, there's some progression down to it along the way, but you actually do lose the weight! It's not just from the diet change, it's from actually losing weight. This is a standard piece of the standard understanding. If you lose a bunch of weight, your energy expenditure goes down. If you need to lose even more weight after that, then you're going to need to revise your calorie intake further downward. This is pretty straightforward.

It's something that, if you're trying to coach someone through weight loss, you need to understand from both sides, because you're going to have both types. You're going to have the person who is just trying to lose ten pounds, and you set them up with targets, but as they get into it a little bit, they're convinced that metabolic adaptation is super duper huge, and they suddenly need to eat, like 700 fewer calories a day than the target you already set for them. You need to reel them back and be like, "No dawg. It ain't gonna be that big for you. It might be there a little bit. Might push your timeline out a little bit, but just don't even think about it." And you're going to have the other person who legit needs to lose 100lbs, and they're absolutely going to need shifting targets on the way down, but that's going to be over the course of months. You will need to prep them for this at some point. And you'll need to prep them for the idea that they're probably never going back to the maintenance level they had before. That they're going to end up eating less forever, but after they've lost the weight, it will in fact be easier to do so, because it will be their new maintenance.

EDIT: I just want to quote Trex's concluding paragraph from Part 1:

The scientific literature has rigorously and repeatedly shown downregulation of energy expenditure, and the long list of physiological changes that accompany it, in response to weight loss. The controversy comes from how some of this information has been discussed, such as implausible anecdotes of fat gain despite remarkably low caloric intake, or the use of less rigorous terms like starvation mode. Rest assured, there is not a single member of our species that can elude the inescapable grasp of starvation; our caloric needs for weight loss may fluctuate from person to person, but we all have a number. Furthermore, nobody is failing to lose fat because they are eating too few calories. Metabolic adaptation places speed bumps in our path to fat loss, no more and no less. But this raises the next important question: Can we do anything to circumvent these speed bumps?

This is not a man who is going to say, "CICO is a problem," or "CICO doesn't work", or whatever.

Love his podcast; glad he keeps inviting that guest co-host on.

Anon, I...

Just an aside, but I’m on my first diet in ages that seems to be working. The sad principle behind it is “cut out high calorie foods that I overeat and/or am prone to binge on”. For me that means beer, bread, cheese, and a bunch of sweet stuff. So I’ve simply cut out alcohol, wheat, and dairy. I’m still eating eggs, b/c as a vegetarian they’re one of my best protein sources, and they’re pretty benign as far as food goes.

The upside to this diet is that it leaves a lot of carbs that I quite enjoy but just don’t binge on. Eg, potato, rice, and corn. I can get McDonald’s fries or guac and chips as a treat or make myself a baked potato or Thai curry with rice. But I can’t absent-mindedly have four slices of toast for breakfast, a giant brie baguette for lunch, pizza for dinner, and ice cream for dessert.

So far it’s going great; just a little joyless. Unfortunately I think this may be the price I have to pay — I overeat these foods because they taste amazing to me and do good things to my brain. By limiting myself to foods that are just “yeah, that tastes fine”, I won’t have to use willpower to limit portion sizes to anything like the same extent. (All of this is very much Stephan Guyenet inspired of course)

So my longer-term plan once I’m through the first ultra-strict 8 weeks or so is to permanently reorient my diet away from these foods but allow them as treats -once a week for the alcohol, once a week for banned foods, maybe special exemptions for stuff like holidays. I’m hoping in the longer run also that I might lose my cravings for these things a bit as my palate adjusts. Of course, it’s possible I’ll acquire new food vices, in which cases I might need to cycle them out.

Anyway, thanks for coming to my TED talk I guess, just wanted to share.

For me that means beer, bread, cheese, and a bunch of sweet stuff.

Oh man, that is the problem, isn't it? People assume fat people are, as one person above said, "sucking down baconators and Dr Pepper by the bucket" (I have no idea what a "baconator" even is). But it's often things like "I love cheese! I love bread! (not the Chorleywood Process stuff, proper bread), I love pasta and rice and potatoes and butter!"

I was in my twenties before I even got near commercial frozen pizza, never mind the fast food kind. I was eating 'proper' food before then, and still fat.

So you have to wave bye-bye to those in order to lose weight on a diet 😔

Ah, I see you do not live in a location that has a Wendy's fast food restraunt.

It's probably for the best. Better to suffer in ignorance and not know the glories you have deprived yourself of.

But, yes. Back when I was exhaustively cataloguing my weight loss on a week by week basis, eating bread at a holiday meal would mean the difference between not gaining any weight if I didn't, and gaining several pounds if I did.

Which is an absolute shame, given all the recipes I have for various types of bread. So it goes.

Oh man, that moment when I discovered that the tortilla on a Chipotle burrito was 320 calories... Now, it's just bowls for me, and each one almost always makes two meals!

I’m hoping in the longer run also that I might lose my cravings for these things a bit as my palate adjusts.

That has been my experience, particularly with alcohol and ice cream. I don't crave them as much as I did when I would regularly over indulge. And these days, when I do indulge, it's to a much less degree. My body just won't tolerate the quantities I once found enjoyable to consume.

This matches my experience too, and I've heard similar accounts from many people. With sweets, it does seem like people's sensitivity for it is highly malleable, and so reducing or quitting sweets for even a short period of time tends to cause noticeable increase in sensitivity to it. Which means same amount of sweetness for fewer calories. If I abstain from sugar for a week, then a single cookie might be enough to satiate my sweet tooth where in the past I might have needed 3.

Generally, I think part of the difficulty of starting and maintaining dieting is the difficulty people have in imagining themselves to have different preferences in the future. Cutting down or out food quantity or quality (in terms of taste) can be painful at first, but it's the very act of cutting it down or out that modifies you to desire less in the first place, thus allowing you to enjoy that new reduced amount just as much. The transition is the tough part.

When I briefly went paleo, regular French bread tasted like candy when I came off of it. Granted, yeast flavored candy. But it was just that sweet.

Thanks for sharing, and good luck! I'd love to hear about your favorite recipes with what's left for you to eat, maybe in the Wednesday or Friday thread.