Discussion on answer by Anne Daunted: How to talk to a teen daughter about her weight

Morgen

01:31

@Eff It's a slam-dunk, but in the wrong net. 200 years ago the struggle wasn't to keep weight on - it was to not starve. For context, from 1800 to 1850 the average life expectance dropped from 56 to 43 years (en.wikipedia.org/wiki/…), and things were good in the USA. Keeping away from sugar helps an number of health outcomes, but please don't portray 200 years ago as any sort of Health Utopia.

@AgustínLado What I described only boils down to psychological needs if your understanding of weight management is based on a paradigm of "mind over matter" and "overweight as a character flaw". The science doesn't bear out that paradigm.

@AgustínLado For example, calories burned isn't just a factor of how much you exercise, if you've cut calories too much your body adjusts how many calories it burns based on how much you eat (livestrong.com/article/…).

@AgustínLado These adjustments are made to keep you within a certain range of a particular weight, what that weight is varies by person based on genetic factors and life experiences. It took quite a bit of work to get my default weight up to 180 lbs, for most of my teen years I was flirting with being dangerously underweight for my height. That experience is somewhat exceptional, most people have issues making it go the other way and psychological cravings have very little to do with it

@AgustínLado While there are some psychological barriers to overcome, as long as they don't pass the caloric thresholds which trigger metabolic slowdown or worse the starvation response, they're manageable for most people who aren't battling other issues like excessive stress or depression. Once you pass those thresholds, those aren't psychological cravings, they're physical manifestations of hunger and I'd ballpark upwards of 99% of people aren't capable of resisting.

@AgustínLado It's an absurdly powerful behavioral motivator. Please do keep in mind that this is the same physical need which has driven people in survival situations to attempt to eat leather, and in some cases resort to cannibalism. This isn't a "put up or shut up" craving.

@AgustínLado The question of if a particular person can manage to lose weight is less certain. It's plausible that, for some people, the target caloric range between "low enough to lose weight" and "too low, bad stuff happens" is super broad so traditional diets appear to work for them. On the other hand, the target range could be so narrow as to be impossible to stay within without dedicating all of their time and efforts to managing, and is impractical.

@AgustínLado Or their success and failure are actually related to a hidden confounding factor we don't understand yet. All we can really say is that, for most people, "mind over matter" doesn't work, and for many people "eat healthy, but boring, food and listen to when your body says 'stop'" is a successful weight management strategy.

@AgustínLado Side note to avoid confusion: the Livestrong article is giving outdated advice in terms of effective strategies for losing weight, I cited it primarily to show that the metabolic fallout of traditional dieting advice is both well known and has been well known for quite some time (they quote a 2010 review study describing the phenomenon).

@AgustínLado A slightly better example is the advice here (provided you don't focus on the calorie numbers and instead on the very good advice to "Eat just enough so you're not hungry", which is easier to do with somewhat boring food): prevention.com/weight-loss/a20475557/…

@AgustínLado Side note 2: I'm starting to regret using the term "default weight" as a shorthand for the more verbose explanation that "as body metabolism changes, despite fluctuating, average weight tends to go up or down to match". It's my term and it's failing its purpose. In my defense, it does help mitigate character limits in posts, but it's causing confusion more often than being helpful.

Eff

07:02

@Morgen Don't put words into my mouth. I NEVER presented 200 years ago as a health utopia. There is a reason why I wrote "Now, I don't suggest people actually do that in practice." Why did I write that? Because people were malnourished, undernourished. They had stunted growth, were shorter. It was only a demonstration that you can have diets that virtually guarantee to not be overweight. As I said, it is not healthy, and I don't recommend this method.

Eff

07:16

@Morgen If you really want to go into it, though, there are psychological measurements that longitudinally predict being overweight (statistically). One psychological test at age 7 predicts BMI at age 51. You can very easily present a strong case that differences in weight are, in part, due to psychological differences. However, I don't even care to get into this. I simply wanted to challenge your assertion that it's impossible to lose weight with diets.

@Morgen I'm completely onboard with trying to understand methods of losing weight that actually work in practice for ordinary people. I completely accept that some "super diet" is more likely to make things worse for the ordinary person. However, this is different from it being impossible, and you cannot shrug this off as having nothing to do with psychological differences.

Eff

07:40

@Morgen (By the way, one of the ways that genetics influence weight is exactly because genetics influence your brain and your psychology)

Morgen

08:20

@Eff Normally, I don't try to put words in people's mouth, this time it was a deliberate attempt to soften the impact. What you actually said was: "The reason why I brought up 200-year-old peoples is because it's a slam dunk easy way to demonstrate that there is a way to stay non-overweight. Simply eat the diet they had, that's it, you're basically guaranteed to not be overweight."

@Eff Without the added context that you understood that it was the result of chronic malnourishment and working 14 to 18 hours per day, 6 days out of 7 (firstindustrialrevolution.weebly.com/…), it's hopefully easy to understand how I misread "slam dunk easy" as a overly nostalgic view of health conditions 200 years back.

@Eff I agree that psychology can have an influence on weight, similarly to the effect it has on intelligence. Those who do not think it can be changed don't put in the effort to change it, and by definition cannot succeed. What I'm pointing out is that, even if your head is 100% in the right place, there are physical factors that can make it impossible to lose weight using traditional diets.

@Eff What I push back against most strongly is the incorrect assumption that it's primarily psychological, because that is one of the fundamental assumptions behind very damaging rhetoric to the effect that people are overweight because of some character flaw. That rhetoric is responsible for doctors withholding pain medication or ignoring symptoms characteristic of chronic conditions like fibromyalgia or MS because they'd go away if the patient "stopped being so lazy and lost some weight".

@Eff Swinging back to the context of the original question, what started this whole thing is someone asking why the OP couldn't simply mandate their daughter lose weight - which is very symptomatic of the "overweight as character flaw" mindset, and could effect a very real human cost if naively applied - particularly to a teenage girl.

@Eff One of the things that really started to shake my own assumptions and start to learn more about it was seeing someone I cared deeply about trying to lose weight by cutting calories and increasing exercise (on the advice of a doctor) - when I knew that level of physical activity was so painful it regularly took 6 Motrin to get through a workout. If anyone should have been able to "mind over matter" their way to thinness, it was them.

@Eff As far as I know, they never "cheated" on their diet, and only missed exercising when they were physically unable to get out of bed. It was both awe inspiring and heartbreaking. What I was seeing was such a mismatch with what I had been taught about nutrition and diet that I ended up doing a bunch of research to find out what was going on. I ended up finding out that the consensus was coming together that traditional diet and exercise often don't work and can be counterproductive.

Eff

08:44

@Morgen What was "easy" is not that diet. What was "easy" was the demonstration that something was possible. And exactly what did I write in literally the sentence after...? Nevermind. By the way, even though people are more overweight now, I obviously accept that people are way healthier and live longer now (Although that has to do with many things, nutrition, vaccinations etc).

Morgen

That really wasn't clear from the context :(

Eff

@Morgen Nope, I see now that the context of the "easy" word could easily be misinterpreted. That was my mistake. [Not English as mother tongue and I'm bad verbally... And that's a character flaw ;)]

Morgen

No problem, I was also thinking of this guy's work: https://www.youtube.com/channel/UCxr2d4As312LulcajAkKJYw
They ate some really, really, weird things in the 1800s

I wouldn't recommend their diet, even if you could get it in sufficient amounts, because some of it is really gross.

He's pretty entertaining though :)

Besides, I'd be a hypocrite for holding that against you. My Portuguese is barely above "abysmal"

Eff

@Morgen Since genetics of individual differences is one of my main interests, I decided to look up the latest genome-wide association study (GWAS) of BMI. GWA studies attempt to find which gene variants are associated with a particular outcome, in this case BMI. One of the things you then can do, is that you can look at which tissues the genes are most expressed in. This can give you an idea about which path the association goes.

@Morgen Here is the study which looked at *height* and *BMI* of over 700,000 individuals: https://www.biorxiv.org/content/early/2018/03/22/274654
Here is a quote from their tissue analysis:
*"Altogether, we found that height-associated genes are significantly enriched among genes contributing to
skeletal growth, cartilage and connective tissue development; while BMI-associated
genes are mostly enriched among genes involved in neurogenesis and more generally
involved in the development of the central nervous system"*

Morgen

09:08

That checks with both our views, as the CNS is the pathway for both the conscious control of our bodies (both sending the signals and originating them) and the transfer pathway for the physical signals of pain, hunger, thirst, etc.
Regulating metabolism and triggering hunger would be intimately tied into the CNS. Sample sizes look good, though it's not yet peer-reviewed so the results should probably be viewed as tentative.

Eff

@Morgen I always look at the latest preprints if I can. However they state right after "These last results
therefore confirm findings from Wood et al. (2014) and Locke et al. (2015) which
previously implicated the same pathways and highlighted their connections with
height and BMI. " which are earlier GWAS that have been peer-reviewed.

Morgen

Excellent, missed that reference

Eff

@Morgen But the point of GWAS is to study individual differences. In other words, what they're finding is that people with different BMI's, most likely, have differences in their central nervous system (statistically).

Crowley

21:31

@Morgen You don't "need" to eat Peeps because they don't give you the stimulus they give to your wife. Was it taste, was it cugar content, was it some special substance you metabolised in something that stimulated you, have you created anticipating emotion to that stimulus? Something changed in you (and it was for good)

Crowley

21:42

Traditional wrongly so-called healthy diets, you mention, are total rubbish and health risk to follow and immoral to sugest. Reaction to starvation is, surprisingly, building up reserves.

True healthy diet, on the other hand, does not convince the body it is starving but that there is a lot of resources available and tricking it in acknowledgement that it does not need to keep and build up reserves. Extremely simplified: Reduce, not remove, junk food. Slightly increase energy input. Increase energy output sligtly more. There must not be a shock, the change must be surreptitious. I the end …

@Morgen One way to maintain constant profit from the comercialized food is to make people addicted to your products. Some people can be labelled as chocoholics, sugarholics because anything can become object of addiction, if consumed in wrong ammounts. For chocolate it is a couple of bars daily for months, for cocaine it is one "line". Another option is to make your product trendy and create the trends constantly or follow the trends constantly.

BIO products, for example, are boring compared to Peeps, yet render (for me overrated) profit, because they are Trendy.

@Morgen Food boring for someone (McDonalder, for example) is delicious for someone else and vice versa. I like fresh cucumber with a bit of salt. nothing more. My colleague assess many meals tasteless if he cannot spice it with couple of drops of chilli sauce. Those meals are tasteful (whatever the taste is - nic or terrible) to me. Foods are tasteful/boring according to your long-term daily diet, nothing more. I used to hate cod liver, now I pick them from a shelf on my own free decision.

@Morgen In that case I am an exception: I can eat huge ammout of food at once and large ammounts on daily basis without significant weight change. As well I can not eat at all for a day and eat very few on a daily basis without weight significant change. With comparable energy outputs. Even if the starving periods chages to gluttony ones irregularly. On the other hand, if I am stressed I lose weight significantly regardless on the income/workout. I am considered skinny or "walking skeleton".

I have never reached the state, a german language has special word for, when I am so full I can do only two tasks - digest and breath. Once I ate so much pasta that a beer hour after used an esophagus as a buffer. And I rode a bide to the pub for that beer.

@Morgen I can copy on that claim. The key is to listen to your actual needs and understanding the mechanics. I'd rather state is as a willpower to acually listen to your body and learn about the mechanics.

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